Help Your Heart, Help Your Brain: A Culinary Nutrition Perspective

Welcome to the Living to 100 Club Podcast. Here's our host, Dr. Joseph Casciani.

Well, hello to everyone joining us today on our podcast. You're listening to the Living to 100 Club, and I'm your host, Joe Casciani. If you're looking for inspiration about your future and staying positive when hit with setbacks, you're in the right place. We're here to help you get the best out of all the years we are given, regardless of what obstacles come our way. From my articles and podcasts to the new offering of one-on-one sessions to bounce back from setbacks, now available on our website, I want to invite you to join our community and stay uplifted about aging. And keep a positive mindset in all you do. Our guest today is Bridget McVaw. We'll be talking about how to help your heart and help your brain through a culinary nutrition perspective. Bridget wants to help clients make friends with food and empower them to achieve vibrant health through better nutrition. Just a little background on Bridget: she's held clinical research and education positions, most recently in cardiopulmonary rehabilitation and kidney transplant at a major Houston hospital. Bridget has addressed consumer and health professional groups in several states, participated in on-site health assessments for national firms, and continues to present health programs to Texas audiences. She's a registered and licensed dietitian, a member of the Academy of Nutrition and Dietetics, as well as Food and Culinary Professionals and Dietitians in Integrative and Functional Medicine Dietetic practice groups. Bridget, welcome to our program today.

Thank you very much. I'm so glad to be with you today.

Great, glad to have you with us. I always like to begin by asking our guests to tell us briefly about the journey that took you to where you are today.

Well, I was a foodie a long time before I became a dietitian, but I majored in food and nutrition and in both undergrad and graduate school. And as, as you said, I had positions in teaching and research and clinical positions. And in all those years, I spent a lot of time telling people, teaching them about diets and what to eat. And I found that as I got further and further along, what people wanted to know is, but what do I buy at the store? What do I pick from the menu? How do I cook it in my kitchen? People were very much more interested in the nuts and bolts. And so I kind of got away from that clinical aspect and did some training in integrative and functional medical nutrition therapy and focused a lot more on culinary nutrition, which was kind of what got me into it in the first place. And what you said about, in your introduction, I think one of the setbacks that people often have is a health aspect of having to change their diet. You know, that always throws people for a loop and eating doesn't become a pleasure anymore. It's not something they enjoy. They're afraid of everything they put on their plate. And so I really wanted to make a difference in that. I think eating should still be a joyful part of your life, no matter what your physical condition might be.

Sure. Yeah, I appreciate that. It's, it's really helping with the practical steps. What do I do now? It's, I mean, it breaks down the broad general recommendations to very specific everyday activities. So I think that's a great— it makes a lot of sense to me. So when changes are recommended by doctors to patients because of medical conditions, maybe a heart condition, what are the barriers that patients face when they're trying to make these changes?

I think that the big barrier at first for a lot of people, of course, is that they kind of don't like the idea of change. Most of us don't. And that's harder, especially with food, the way that you've eaten all your life, foods that you grow up with. That's hard to think about making changes. But I really think that what is hard for most people is having to think so much about what they're eating gives them conflicting priorities. You know, I don't have enough time for this. Oh, it's going to cost too much money for me to eat healthfully. It's too much effort. And again and again, studies show, surveys show that people's biggest consideration in choosing their foods is what tastes good. And there's a big perception that, that the things that we feel that we have to cut out to be healthier, like less salt, less fat, less sugar, Oh my gosh, what can I have to eat? Is anything going to taste good anymore? I think that's a big barrier for a lot of folks.

Sure. Yeah. So the taste, of course, the fear of, uh, I don't want to get to a diet that has no taste and flavor. I'm used to whatever in my whole life. Now I have to make these changes. So yeah. And again, changes that are going to take time. I don't have time to learn all of the new diets and new foods. And I can appreciate that. So we know there's a lot of diets out there that are heart-healthy diets, and maybe before we jump into the practical steps, maybe you could just give us an overview of what some of these different diets are.

Okay. We have really moved away, I think, in, in the nutrition field from focusing on single nutrients. I think a lot of people listening probably remember when we first started to worry about cholesterol and heart disease, that it was 30% of your calories from fat and, and limiting saturated fat. And we focused on very certain nutrients. And now the idea is much more to look at your overall eating pattern. So you would almost have to be on another planet if you haven't heard about the Mediterranean diet. That's probably one of the most widely recommended today for heart health, for brain health, for general, for, for reducing high blood pressure, for just about anything you can think of. There are benefits to the Mediterranean eating plan. And that is one that, well, really all of them that we talk about are going to emphasize fruits and vegetables. But the Mediterranean diet compared to some of the others that we've heard about in the past is not necessarily a low-fat diet. It focuses on eating fat from good sources, healthful fats that can benefit us. And kind of, I think a lot of the other popular ones are somewhat offshoots of that. The DASH diet, which is also very highly rated, in fact, it's been in in the news just recently for its benefits, and that's Dietary Approaches to Stop Hypertension. Not so very different from a Mediterranean eating plan, just slightly different types of oils recommended. And then there's kind of the other end of the spectrum, and that's diets that are very, very low fat. Or mostly vegetarian or even vegan eating plans. Probably the one most people have heard about is, um, Dr. Dean Ornish's eating plans, and also Dr. Caldwell Esselstyn at, um, in the Cleveland area. Those are very low-fat plans, and all of these have been researched, and you can point to benefits to all of them. You know, I still don't think— I remember learning as a student, oh, we don't know what the perfect diet is, but we think one day we might. Well, I don't think we've gotten there yet. I don't think we've learned what the ideal perfect one is. And that may vary with people, but there are some things they have in common.

Yeah. Yeah. So either low fat, or healthy fats. That's one of the similarities, right, among the choices. Any other parallels? Any other similarities?

I think the biggest similarity among all of them besides— well, emphasis on vegetables and fruits. And if you think about looking at your dinner plate, the recommendation is that about half of that would be covered with vegetables and that's not necessarily the plate we're used to looking at, um, certainly not when we go out to eat. Um, and I very deliberately say vegetables first because a lot of people say, oh, I love vegetables, but they don't really take the time to fix them. They don't make up a very big part of our diet. And the other similarity is plant-based proteins. Using legumes, or your beans and peas and lentils, as a protein source, as well as nuts and seeds. Those are emphasized in almost all the eating plans. And then less reliance on animal proteins. Some of them include it, some of them exclude it completely, but overall there's less reliance on that. And another interesting thing I think that they have in common, they're all aiming at being anti-inflammatory. You know, we kind of think that a lot of chronic disease comes from inflammation, and one of the things that many of these diets emphasize are using herbs and spices for their anti-inflammatory properties. Sure, that's kind of a newer thing.

Sure. Now I've heard a lot about inflammation, of course, but I'm also hearing a little bit more about brain inflammation. Can you explain that and how does that compare to inflammation in the body, or is it one and the same?

Well, and I'm not a physician, so there are certainly aspects of it that I can't talk about, but, you know, one of the things that our whole lifestyle is about these days is almost a chronic state of inflammation. It's kind of the little bits of stress that accumulate for lots of reasons. And in this past year with, with the pandemic, that's certainly been amplified for people. So one of the things that, that we think is that the way we eat can either kind of enhance that inflammation, the pathways in our body that synthesize hormones and other compounds, they can kind of lean toward the pro-inflammatory or the anti. And so our food choices can have some impact on that. And it affects the heart, it affects the brain, really it affects your whole body.

Yeah, so there's not a— this difference, so to speak, between inflammation in the body and inflammation in the brain, it's really one and the same.

I would say for the most part, at least as, as I'm speaking of it.

Sure, okay, yeah, that's helpful. So yeah, the similarities, that's good. I mean, the vegetable-based diets, fruits and vegetables, of course, plant-based protein. Any striking differences among these popular diets? I mean, You mentioned the fats, either low fat or no fat. Any other differences?

Well, I would say that the— probably the no fat, or let's not even say low fat, is the fats are the big difference. Okay. The heart-healthy diets that some people remember being taught about were indeed meant to be low fat. So people might remember the 30% of your calories or less, and, and that was real confusing to people. You know, they looked at nutrition labels and thought, okay, what do I do about this? The Mediterranean plan and similar plans are actually not low fat. They may actually have more than 30% of their calories. And I think most of us don't think in that percent terms anymore. But if, if we were to sit down and analyze it, the Mediterranean plans may actually be a little higher. But the emphasis again is on where the fat comes from. Instead of saturated fat from animal products, it's from vegetable oils, nuts, seeds that are unsaturated fats. And then the other end of that are the very low-fat ones. So they're really a contrast, and that would be similar to Dr. Ornish's plan. They actually recommend no added oils to the diet. You would be using just what's in the foods themselves. So those are really very low-fat plans, a little bit harder for people to follow because they're more limiting in your food choices.

Yeah, yeah, so ideally we would eventually understand which diets are best for certain people, certain constitutions, certain body types, physical functioning. Right now, we— I mean, maybe the experts do have an idea of what's, what's better, which diet is better for certain people, but I guess a lot of the recommendations would come from our, our GPs, right? I mean, the physician will say, look, you need to look at this kind of diet and here's why.

So you're right. They do often come from, from a general practitioner, an internist, because that's the person who maybe catches the high cholesterol level or the blood glucose that's creeping up slightly. And they're in a position to say to us, let's, let's start doing something about this now. And diet is one of the things most often recommended. I think we're just, we're starting to get to the point where we can do some genetic testing that, that may indicate just precisely how to recommend a diet for individuals. They're not, we're not there yet overall, but, but we have the capability And I think for people who have really big health challenges that they're having a hard time meeting, sometimes that's providing the answer. And they can say, okay, these particular fats are going to work for you. But there's another subset of people for whom a really low-fat diet is going to work out the best. So we're getting there. We're really getting there.

Yeah, good, thanks for that. Yeah, for our listeners who may have some history of heart disease, or maybe have had a heart attack, or congestive heart failure, or high blood pressure, how do we go from the medical advice to the practical changes? I mean, that's— I think that's your insight into this approach for clients, for patients. How do we How do we cross that bridge? Or here's, you gotta change your diet and here's what you gotta do. So what do people do practically? How do they start?

Well, probably the first thing that happens is that GP who told them to change their diet hands them a sheet and says, here, go home and do this. Yeah. And, uh, boy, dietitians sure hate to, to hear that that's happened to people. Um, So the sheet is usually going to have one side that says eat this, don't eat this. And in fact, someone actually wrote a book with that title, I think, Eat This, Not That. And there are some okay recommendations in there, really, but that's a starting point. I think a really helpful thing for people to do is at the same time that Dr. Hanson, that sheet is to tell them, you know, what are the goals that they're aiming for? Because a lot of times we get that sheet and we don't know what we're supposed to try to do. So are we aiming to lower blood pressure? What are the goals? And if you want me to cut out a certain amount of sodium, give me some numbers. It helps to have some background. But then I think the next thing is you have to look at Okay, what do I eat now and how can I make that better? There may be a few people out there who just go home and wipe out their pantry and their refrigerator and start from scratch, but I don't know too many people who are successful at doing that. For one thing, we don't like to throw away food. Our parents taught us there are children starving in China, so we don't waste stuff, but look at what you eat in a normal day and then think with those big general guidelines in mind, how can I make this better? And I'll take, say, an example. You know, a lot of people are used to maybe going through a drive-through or whatever for their breakfast, and they just unthinkingly order an Egg McMuffin or get a breakfast taco or whatever. Well, you know, those are going to fuel your morning just fine, but they could be better. You can make that at home with not too much effort, or in some places maybe even custom order it. The typical breakfast taco, for example, if you want to make that at home, you can get a whole grain tortilla. There are loads of them out there now, many different brands. You can take and spread it with vegetarian or non-fat refried beans. You can sprinkle it with a little bit of cheese if you like. You can put veggies on it. A lot of us don't think of trying to incorporate those into breakfast, but you can do that. Then you can put a little bit of salsa. You can put an egg in there if you want, if that's something you're including, and you can have a pretty healthy breakfast taco. So you— what have you done there? You've included whole grains, you've added veggies, you've made the beans perhaps the major portion of the protein and emphasize vegetables more, and you can end up with using healthier fats if you cook your egg on your own.

Sure. Well, there's a lot of convenience to fast food. We know that it's faster. In some cases, it might be cheaper. But we know it's not good for us. So what's the most harmful parts about fast food?

Okay, well, that sort of depends upon the person. The first answer that comes into my mind is calories, just because a lot of the fast food, the portions— what do we do? We go with the value meal. The soda that's a quart, literally a quart. Somebody had, I think it's 7-Eleven or someone, they have a Big Gulp or whatever. The biggest burgers, the double patties, the double cheese, the double everything. So just a lot of calories, more than most of us use. And the other big thing for a lot of people is sodium. There's just a lot of sodium in fast food. In places that you can't really control it very well. You know, to a little extent you can say, okay, leave off the special sauce or whatever, and that's where some of it will come from. But you, you don't have a lot of control for some of those meals.

Okay. And what about the fat content?

A lot of the items are high fat. Now I think we've come a long way, you know, And it, and it's a good thing because I don't think we'll ever get to the point where fast food is not going to be somebody's fallback option sometimes. And they've done a reasonable job in responding with some better menu choices, but you're not going to know what kind of fat they've used. You can't be sure it's the best oil. And a lot of the items are fried. So you're automatically adding fat that way. So chances are that many, if not most, of the items that are available will be high fat and high saturated fat.

Yeah, okay, so it's the calories, it's the sodium content, and most likely also the fat content that can be unhealthy. Yeah, for the average person. Yeah, yeah, the big three, sure. So that's a good example of how to switch from the store-bought Egg McMuffin— I don't mean to single out any particular chain— but to go from that to making one for oneself at home. That's a good example. Let's, let's talk again about what do I eat for breakfast, what do I eat for lunch, what should I eat for dinner on this new diet. We don't want to make a 180-degree turn from where we were, but how do we gradually shift toward the more healthy diets?

There are a lot of— there's a lot of support out there these days for that. One of my favorites that you actually hear a lot about are Meatless Mondays. You know, we are very accustomed here for the meat or the entree to kind of be the main portion of our meal, and so that's a piece of chicken or a piece of beef or a pork chop or whatever. We don't generally think in terms of meatless meals, but someone— and I have to admit, I don't really even know how this started, the Meatless Monday idea— but there are lots of recipes out there and ways to have a Meatless Monday. I would say for most people, beans are the most— are the simplest and the most versatile option for that. And wow, you can go on the internet and find it. Just put in black beans or whatever and find any number of recipes that'll serve you for a Meatless Monday. Some of them are really super quick. Beans and rice are kind of a staple meal for many cultures, some version of that, and that can be made fairly quickly and made into something that most people will like. I I have a favorite that I make at home, which is a black bean recipe, and it's made with canned beans. So you don't even have an excuse. You don't have to cook the whole pot. You can get salt-free beans now very easily. And you just make a mango salsa, which has 3 ingredients: mangoes, cilantro, and orange juice. And that's it, and you put that on top, and it's a real quick satisfying meal. Easy to find those recipes, and that's one good way. Start by substituting one meal.

Right, small steps get us farther along toward our goals. I also like, by the way, what you said earlier about the measures, that you really need to know what your goal is, and if you're trying to reduce your blood pressure or whatever that whatever that metric is, that's something that we use for feedback, right, as we're making progress. Because it's not going to happen overnight. And as long as we're making tiny steps, tiny incremental steps toward that goal, that's got to build our confidence, right, and increase our motivation. I think that's an important message.

It really, really is. And I, you know, sometimes we don't think about that. I, I remember a patient that I had one time, a cardiac rehab patient, and this gentleman had a lot of weight to lose, and he just felt like he wasn't getting anywhere. He just felt like, I'm working so hard, these changes aren't happening. And, and I could see that he had made progress. It wasn't until I visually did a graph for him that he could see the line coming down from his weight. So some of us, just seeing the numbers on a chart maybe works. For some of us, a visual like a graph, whatever. But, but if, if you don't know where you're headed, and I think sometimes as health professionals we're not always the best at helping people with that. We— it's second nature to us, and we think, oh, they know this is important and they'll do it. You have to see results. You have to know where you're headed.

Yeah, yeah, that's a good point. It's like saying you're gonna— you gotta lose weight, right? And the person is just kind of wondering what's next. So in terms of the practical steps, if I'm going shopping for groceries, what should I think about for my breakfast, lunch, or dinner? Some general recommendations?

You know, the standard one used to be shop the perimeter of the store and don't go up and down the aisles. I'm not sure that works so well anymore.

That's because the stores have figured that out, right?

I think that maybe they have. The overall guidance I would say is to make as many of your choices as you can be fresh, whole foods. And then the next step down from that— so the example of that would be, and these are often the cheapest choices, the bag of dried beans on the shelf. They're going to cost very little and you get a lot of meals from them. But you say, okay, I have 4 kids and I work and my husband works and, you know, I don't have time to cook big pots of beans. The options now are, are those canned products that are no added salt and that you can easily handle, that, that don't take the time to cook. The same with other vegetables. There are no added salt canned veggies, and frozen veggies are also a good option. So I kind of hate to resort to this guideline, but there is some truth to it. When you look at the immediate— at the ingredient list, you're kind of looking for something with not a whole lot of ingredients when you buy a canned or a frozen item. The frozen veggies that have the sauces and the breadings, you've immediately lost some control. Now that kind of goes against what I said about let's enjoy your food. I'm not saying to people, oh, you should only eat plain, unadorned unsalted, unbuttered, uneverything. But the simpler you start out, the more control you have over it, and you can decide, okay, this is how much I need to add to make it satisfying, and you can work on that.

Sure. Yeah, that makes sense. So fresh whole foods, the less processed, the better. The fewer ingredients, the better in a package of frozen product or canned product. Any other recommendations when I'm shopping grains, breads, seafood?

I like to look at where my seafood comes from. I like to look at where everything comes from. You know, a lot of people prefer to buy organic, and there have been some studies that show I know that there might be benefits, especially among some foods, but given the choice, if I can buy something local, I'll do that. I live in Texas and we have a lot of stores that actually mark Texas products, and I think that's true for most states. If something's local, you can tell perhaps a little bit more. You can make a connection and see how it's grown and where it comes from. So I like to look at local. I like to include a lot of whole grains, and that's one of the other things that many of the diets have in common. And that's one of those internal aisles of the supermarket that's way loaded. I think that I can't think of any store now that you don't go into that there aren't both sides covered with boxes of cereal. Um, most of those are not worth picking. Um, so for grains and for breads, what I like to tell people to look at there on the nutrition label is the fiber content. Most breads that you buy are going to have 1 gram or less. Many kinds of cereal that you buy will have 1 gram or less per serving. And it's always important to look at that serving size so that you know how much you're talking about. So look for products, not just— there's something called the whole grain sticker, and it's a little symbol that shows something has whole grains. That doesn't always mean it's high in fiber. So cross-check things on the label. If you see whole grain and it says multigrain bread, 12 different grains, look and see how much fiber is in it. If you do that, you get a better hint— is, is it really a good choice?

Yeah. Any rule of thumb here for the amount of fiber?

For adults, you're looking to have somewhere between 25 and 35 grams of fiber per day. Now, your fruits and vegetables are where a lot of that comes from, and many of those, if you buy them fresh, you won't have a label on them that tells you that. But trust me, if you're not including lots of fruits and vegetables in your diet every day, you're not going to meet that fiber.

You're not going to get enough fiber.

You won't get there. It's another rule of thumb that I think is a good one to work toward. Is a serving, ideally in a perfect world, one fruit, at least one fruit and one vegetable at every meal. Start there and see if you can't move up because, you know, there are some of us that if we really look at our meals, there are meals and for some folks maybe even days when they don't eat a fruit or vegetable.

Now I'd read somewhere that it's not advisable to eat fruit in between meals. Did you ever hear that?

There have been a lot of books over the years that kind of encourage limiting fruit between meals, or there was one plan that said don't eat any fruit before a certain time of the day. Or, you know, again, there may be people that for specific reasons it's not the best idea, but my personal general rule is never miss an opportunity to eat a vegetable or a fruit.

Good advice.

If having a fruit between meals is the way that you avoid eating something that's not so healthy, then that's a better choice.

Sure. Now, what about the dessert aisle? There's some people that do like their desserts. I'm not one of them. Just kidding. There are some people that like desserts, cookies and ice cream and all of that. Are there healthier choices?

There are healthier choices. I think that becomes a much bigger challenge for people. You know, we talked about some of the things that many of the diets have in common. And one of the other things that they all have in common is limiting what we used to call concentrated sweets. Nowadays we talk about that as added sugar. And so I have to say that for the most part, the things you're going to find in the grocery store in that dessert section are not going to be things that you can include daily and get away with it. There are reduced fat and reduced sugar products, and if you watch your portion sizes and be sure that you're, you're meeting other needs first, that you're getting in those veggies and your weight is okay and you don't have to worry about it, then you can not have to look so hard at some of the, of the choices.

Yeah, we know there are new products coming along all the time with great flavor and are healthier, lower fat, lower sugar, so it's probably smart to test those things out, see if they really work. I mean, I think that that's good general advice. If it tastes good and there is a little bit of fat or sugar, use it in moderation, right?

And, and you know what we do a lot of times when we eat out, many people have gotten used to sharing things like that. Sure, that's a good way to kind of limit the, the amount of calories and, and bad stuff that you, that you take in from that, the added sugars. The thing is, when you, when you look at what desserts are, it, it gets difficult to make some of these products without the sugar in them, you know. There are some times that you just have to say, okay, I'm going to eat this high-fat, high-sugar thing. I'm going to have a small portion. I'm going to enjoy it, and I don't have to have it every day.

Yeah, okay. So that's some good recommendations for shopping. How about dining out? I mean, it's always difficult, any type of food, American food, continental, French, Italian, you know, Greek. What are some general recommendations for making those choices off the menu?

One thing that I always tell people is the more frequently that you eat out, the more important those choices become. In other words, if you're someone who travels on business, and none of us have been doing that recently, but as things open up and business travel resumes, For many people, most of their meals are on the road, or if you just are a non-cooking person, you may get many of your meals out. So the more meals that you eat away from home, the more critical your choices become. So if you're one of those folks, look, really get to know the places where you eat and know how things are prepared. Know if they'll make something off the menu for you. Know if you can ask and have a knowledgeable person tell you how was this dish prepared. So that's a good place to start if you're a frequent diner out. The wonderful tool that we have these days, the internet. Mr. Google knows everything. And so you can look up your menus ahead and at least kind of scope out what's available. And what I tell people when they're eating out, look for the choices that you would enjoy most that have the most vegetables included in them. That sounds like kind of a silly thing, but if you look over menu items, appetizers and soups especially are often really meat-oriented. There aren't a lot of vegetable ones, so try to seek those out. It's worth it health-wise if you're a frequent diner out. It's worth it to pay the extra money for the sides that are veggies, for a salad, because otherwise you won't get them in. Not always— I think this is a worthwhile thing for people to know— not always is the fish or chicken option the most helpful. It's not always the best choice in terms of calories, fat, sodium. If you've got, for example, a chicken breast dish that is stuffed with butter and cheese and other meats and rolled up and deep fried, you're better off to choose the plain beef tenderloin.

Mm-hmm.

Okay.

Sure, yeah, the preparation can really make a big difference.

It really can. And vegetarian options, there are almost everywhere now has a good vegetarian option that you can choose. So sometimes it's a mindset thing. We go into places and we know what we like and we order the same thing. Take a few minutes to look at the menu and say, oh, hmm, maybe this would be worth trying.

Sure. Yeah. So what about family members that aren't so keen on making these changes? All right, so our doctor advises XYZ for our new diet, and a spouse or children, adult children or young children, they're not so eager to make those changes. How, how do we deal with that? Any recommendations?

Well, I think that's an interesting one because In the days when we were much more restrictive about what a medically necessary diet was, and I think we've looked at how to make them a little more family-friendly, I think that the bottom line is what is healthful eating is actually not so different for healthy people as it is for people with conditions. Now, that's not to say they're all going to love it if you want to try to make changes, but one of the things that you can do is when you're planning a meal, try to at least have one item that everybody will like, that, that children know that they don't have to leave the table hungry because there, there's some special things that apply to young children, certainly. But if you're working with, with a house full of adults, then they're freer to make their choices and they can make an alternative. And sometimes that has to be done. But the other thing that's handy is condiments. Sure. You can almost always take plainer foods, and that, that's the whole point of cooking fresh whole foods as much as you can. Without a lot of added ingredients than the kids who want to put ketchup or whatever. But I think part of, you know, where we're trying to go with eating is educate our palates a little bit. We've— there are a lot of reasons that American diets are looked at as not being very good. And I think a lot of it had to do with people working, two working adults in the family and less time to fix food. So we've kind of gotten away from home-cooked meals, but, and that means we limit our choices. So I think part of teaching kids to eat and maybe even adults is exposing them to a lot of different foods. So you want to give everyone a chance to learn to like things that they might not have always tasted. They might not have thought to try it. So sometimes maybe that means the salt shaker or the pepper grinder is there, or some vinegar or some lemon juice or things that can enhance flavor. Heaven's— even sometimes a little sprinkle of sugar. People who don't like cooked carrots, if you put a pinch, like a quarter of a teaspoon, you might bring out the sweetness in some veggies. So little things like that. Those are workarounds that might help people try. And so I'm all for broadening palates and not trying to make short-order meals for every person in the family. Try to have options that everyone can like as much as possible.

Yeah, yeah, you made some good points there. I like the part about the fact that healthy diets apply to everyone, not just the person who needs to change the diet, but to everyone. I mean, a healthy diet is good whether you have a heart condition or you don't have a heart condition, right? I mean, that's, that's just true. Makes a lot of sense, yeah. And then the point about making sure there's at least one item on the table that everyone will like and not expecting everybody to shift overnight to this new approach, but gradually, again, in moderation, having something that's available that everyone, at least one item that everyone would enjoy.

There's a really good book that was written. It's not a new book, but it's called Feeding Healthy Families, and the author is Ellen Satter. She is a dietitian and a social worker, and a lot of her work was done with children. And she talks about the division of responsibility in feeding kids, but her, her Feeding Healthy Families book talked a lot about adults and just kind of the whole idea of eating family meals together and everyone enjoying them. And I really recommend that as kind of a reference. It's, it's an easy reading book and she has a very sensible philosophy about food and, and how it fits into our lives and how to look at it.

Great, great. Feeding Healthy Families, Ellen Satter.

Yes, her— it's E-L-L-Y-N-S-A-T-T-E-R.

Okay, all right, I'll be sure to put that in our program notes at the end. So I'm always curious about resistance. I mean, good advice— stop smoking, lose weight— that's easier said than done for a lot of people, and there are many that are going to say, look, I just can't make these changes, I'm just not able to, I don't have any confidence in, you know, picking up new behaviors. So what do you say to the person that is resistant to these sound medical recommendations?

I think that's all something that— wow, has, has not every health professional faced that at one time or another? And, and it's one of the things that is frustrating when you know changes could make a difference for them. I think One thing that, that's not easy to do, but to see if you can maybe get at the root of why they don't have the confidence, or what are the barriers for them to making the changes. You know, is it fear? Is it real challenges to preparation? You know, sometimes we kind of— some of us like to do ultimatums to patients: do this or else. Or, you know, you've got to do this, or you're— the favorite one is if you have diabetes, you have to do this or we're going to put you on insulin. You know, that scare tactics like that don't usually work very well. But if you can find out what holds them back, sometimes there's a middle ground. Sometimes there's perhaps a smaller change or a lesser change. That can get them started. There may be options. I think that people do have freedom of choice about this. You know, you can always refuse medical treatment, and so you can refuse to make changes. I guess what I always have tried to do is tell people what, what the consequences in their life will be. You know, the easy example I think of, well, is if you eat sugary foods and you don't brush your teeth, you're going to lose your teeth. That's pretty drastic, but you know, if your illness persists, if your heart disease persists, if your arteries are getting harder and your whole body will function less well, these are some of the things that will be limiting for you. Are you— can you live with that, or are you willing to maybe try to make some smaller changes? We're not going to reach everybody. I mean, I think there really will be people for whom diet is the last thing they'll change. You know, that's one place where we have some control in our life.

Yeah, that's right, that's right. And, you know, the idea of educating the person and helping him or her make informed choices. That's, that's really crucial. And I think that's the early stages of motivational interviewing where you can help the person really understand, you know, what are the choices and what are the impacts of those choices. When we talked on the phone earlier, you made a great point about the resistance and people are not— there's a reason for resistance, and I don't remember exactly what it was. Do you remember that line?

I remember that line. I don't remember where it I don't know where it came from, where I did it, but the comment was, people don't resist, they exist the best way they know how. And, you know, I've more recently seen that related to COVID, but it's true for heart disease, it's true for diabetes, it's true for dementias and anything you can think of. Nobody wants to be sick. We would all like to be well, but there are all kinds of things that may hold us back from making changes that we aren't actively resisting. We're just kind of doing what we feel like we need to do to get by.

Yeah, the only way we know, the only, the best way we know how. That's an important insight. Yeah, thanks for that. We're just about out of time, but I'm curious if you could tell us about the online course that you and a colleague prepared on helping with brain health and heart health. Tell us about that.

Yes, my longtime friend and colleague, Dr. Paula Hartman Stein, who was a previous guest of yours, we worked together on a book chapter for preventing cognitive impairment, for slowing down or reducing or perhaps Preventing, and the book was aimed at physicians, health practitioners, but we thought the information would be a great benefit to consumers. And so we put together a 4-part series on enhancing brain and heart health, the things that you can do. It's based on the Lancet Commission's report in 2020. And they identified 12 risk factors that we can modify, that we have a chance to change, that can help in these areas, and so our series focused on learning, sleeping, moving, eating well, and staying calm and connected, so those are all related to those factors, and we did it live, but It's also available online through Paula's website, which is www.centerforhealthyaging.com. That's all one word strung together. And right at the top of her page, there is a place that you can click for more information to access that series. We had a number of people attend live, and, and hope that people will find it interesting enough to, to watch the series online. Good practical techniques for making some of these changes in your life.

Great. Yeah, congratulations. I know Paula and Paula's work, and we've been friends and colleagues for a long time, so I know the quality is at the top of the list, so That's got to be good information. So center— www.centerforhealthyaging.com, that's Paula's website, and people can go there and access this, uh, 4-part series.

Yes, you can.

Great, great. So it looks like we're out of time, uh, Bridget, but before we wrap up, let me remind our listeners about a few items. There's a new offering on our website where individuals can arrange one-on-one calls with Dr. Joe that's me, to discuss bouncing back from setbacks. How can we tap into our resilient self? How can we find ways to make it over those obstacles we face on our different journeys? Take a look at the Work with Dr. Joe tab on our website, www.livingto100.club. Also be sure to subscribe to our email list to receive our newsletter and other announcements. And finally, pick up a copy of my book on Amazon, Living Longer Is the New Normal. I think that whatever age we're at, inspiration and a positive mindset can be put to good use. That's my message in the book, and I think that's a message that our guest today, Bridget McVaw, would agree with. So Bridget, thanks so much for being a guest on our show. For those who might want to contact you, how can they do that?

You are welcome to contact me. I'll give you my email, which is bk Bkmcvrd@gmail.com. And if you look at Paula's website on our series, you can also contact me through her, through that website as well.

Okay, can you repeat the letters again? Bkmcvrd.

@gmail.com.

Great. Okay, well, thank you again for being on our program today. This is very helpful, and I'm sure very helpful for our listeners. So very much appreciated your, your input. Thank you.

Thank you very much.

Great, you're welcome. And thanks to all of our listeners for tuning in. Hope to see you next time.

It's time to rethink, renew, and reimagine retirement. Hey everybody, Jared Sylvester here, host of Retire Repurposed. Now this podcast is about the non-financial parts of retirement, which many times can be even more challenging than the financial. We believe retirement is not the end, rather the beginning of what could be the most impactful, purposeful, and fulfilling season of a person's life. So don't retire, become repurposed. To listen now, search Retire Repurposed on your favorite podcast platform, Senior Resource, or Life Audio.