Pregnant Possibilities- Special Guest - Dr. Laurie Marbas

Hi, I am Jean Schumacher and I am co-founder of The Pregnancy Advantage and my partner is Deborah Shapiro. She's a board-certified OB-GYN. And together we created the program called The Pregnancy Advantage. And our objective is to help women to get their bodies pregnant ready and provide support if you're experiencing difficulties in conceiving, especially before you go down that in vitro rabbit fertilization hole. Okay. So today on our show, we have an amazing, amazing woman. She's Dr. Laurie Marbas from plantbasedtelehealth.com. And Dr. Marbas is double board certified family medicine and lifestyle medicine. She's been utilizing food as medicine since 2012. And she's also the managing editor of the Plantricians Project International Journal of Disease Reversal and Prevention. She's also the co-founder of the Healthy Human Revolution. If you've not seen this website, oh my gosh. The mission is to provide resources that are gonna empower individuals for their knowledge, tools, and mindset to successfully adapt and sustain a whole food plant-based diet. So Dr. Marbas, thank you so much for taking the time to be with us here today.

Oh, well, thank you for having me. I'm excited to be here.

Thank you, Dr. Marbas. Thank you so much. I have— we could probably have you back a few times because I have a lot of questions. But let's start. Let's start with the first one, which is, you know, I was thinking of, you know, I've also been plant-based for about 8 years, and I think you have as well. And I was wondering what had inspired you to make this switch? Was it— was it much of a switch? I don't know how you were raised. Maybe you were raised more vegetarian. I don't know. But I'd love to hear your story.

Well, I was raised in a home without a whole lot of resources. So we grew a lot of our food, we had a lot of beans and potatoes. And, you know, we had some meat and, and definitely had dairy, but it certainly wasn't vegetarian or vegan or anything. We made healthier choices because the healthier choices were cheaper. So and that just carried through, which I was actually, you know, it was been a blessing in disguise. So but the reason I went to a whole food plant-based diet, I had gotten out of the Air Force, and we were living in Western Colorado in a little town called Rifle. So if it's called Rifle, you can imagine the culture of people who live in a western part of Colorado in a town named Rifle. So it's kind of bead eaters, ranchers, hunters, hardworking people, amazing individuals. And I had 3 teenagers at the time and my husband. And so this was early 2012, and I had a patient come in to see me. I worked in a regular, basically a county, you know, a little hospital there that was a 25-bed hospital. I did, you know, called on the ER, did inpatient, outpatient, nursing home, the full gamut of family medicine, which was amazing. And so I had a variety of patients and this one patient came in to see me one day and she's like, Dr. Marbas, meat and dairy really upset my stomach. I said, okay, stop eating meat and dairy. It seems like a logical conclusion and they'll still have food to eat. Come back in 30 days and we'll just start adding things in and seeing kind of what the culprit is. Kind of a simple elimination diet. I mean, that left in my mind— apparently I'm kind of a slow processor, but she said, you know, I knew she'd have foodie, but it didn't like dawn on me that that left plants. You know, it seems logical, but it just didn't. And what happened was she came back in 30 days and I had made a note in her chart that this was what she was going to do. But she also brought her daughter with her to that appointment. The reason she brought her 16-year-old daughter was because something happened over the last 30 days. And she goes, now you tell Dr. Marbas what you did. And she actually pulled her out of school to come to her own mother's appointment for a follow-up on a diet. And it was really intriguing because it really piqued my interest because I was like, what did she do? Pulled her out of school. And she said, well, Dr. Marbas, I really wanted to support my mom. So I did the diet with my mom and I felt so good. I stopped both my ADD meds. In the last 30 days, and she'd been on them for 4 years. And she goes— and the mom is so sweet. I mean, those are the sweetest people. And she's like, Dr. Marbas, why was she able to do that? And not in a sense that she was angry, but frustrated. And why hadn't she been told that all it was was a simple dietary change and her daughter could be off medications that can have some potentially very serious side effects? And I said, I don't know, but that's the coolest thing I ever heard. So I was like, Let's talk. And so we started talking more. I was like, what did you eat? She goes, well, we ate what you said. I was like, no, no, no, really, what did you eat? She goes, oh my goodness, so fruits and vegetables and beans and whole grains. I was like, so you're eating plants? She goes, oh my goodness, yes. So I was like, oh my goodness, this is like plants. And it's like, it was like finally like dimmer switch came on. I'm telling you, I'm very slow. Once I got it, I got it. And so after that, I went on Google, of course, and I Googled plant-based diet ADD. I was like, what is going on here? And the first book that came up was The China Study by Dr. T. Colin Campbell, which we all adore and admire. And I ordered it. And when it arrived, I read it, literally read it in 2 days. And I was engulfed. And I would point out to someone like, look, they're turning off cancer genes with plants. This is freaking me out. Like, why didn't I learn about this? And I, I was like, whoa. And in that process of trying to just wrap my head around this, I understood the potential for my patients, but I also understood that I would have to make that change in my own life to use that with my patients because I'm not going to tell a patient, you know, to do something that I'm not willing to do myself. I just, I can't do that. And so what happened was I was, you know, processing for a little bit and about a week later I had a patient come in to see me who had lupus. And had been a patient for a little bit, a few months, and she was younger than me at the time, and she had been diagnosed a couple of years earlier, and she was on 12 different medications. She was at least 50 pounds overweight, severe migraines daily, and she was telling me all of this, and I was like, oh my goodness. I mean, she was on high-dose prednisone. She was on immune suppressants. I mean, these are some serious drugs with some very serious potential. Side effects. And what happened was she's sitting there and I'm going, I think this is my next one. I need to give this a try. And if she gets better, I'm going to do this. And because I also knew the challenges of bringing it home to 3 teenagers. Granted, I have amazing children, but still. So when I, when I, I listened to her and I said, you know, I don't have— there's no other drugs that we can try right now. And that's the really interesting thing about being primary care in a really rural setting. You are the endocrinologist, you are the rheumatologist, you are, you know, the early stages of cardiologist. I mean, you're having to do so much, and because we don't have access to the specialists that are in larger cities. I mean, if you've ever tried to travel over the Rocky Mountains in the middle of winter and they shut down the highway, you're not going anywhere. You know, if I had to fly out a patient to Denver, To a, you know, a serious— like, there's no pediatric ICUs on the western side of Colorado. And so, I mean, it's a really serious thing. So you better, you better feel comfortable doing a lot of different things. And anyway, that's outside of that. But what I said is like, there really are no medications. Like, this is, this is what we got. But I said, like, let's try this little experiment if you'd be willing. I said, I've got about 2 weeks of knowledge. I was like, would you be willing to go You know, change what's on the end of your fork to see if it'll change how you're feeling. She goes, I'll try anything. I was like, okay. So before you leave, though, let's measure what we call the CRP. It's a C-reactive protein. It's an inflammatory marker in the serum, in your blood. And I said, you know, let's check it now. And I said, you have to come back in 14 days because 30 days is just too long. I'm very excited about this. And I was already— I mean, I'm already plotting how I'm going to do this myself in my own life. But what happened was she came back in 14 days. So her original CRP was 3 times high normal. And she came back in 14 days, 8 pounds lighter, no migraines, and her CRP was just outside normal by 0.1. And she felt amazing. And I was like, oh my goodness. So if you fast forward 5 months, just to get a, you know, a little bit of understanding how she did, she lost 50 pounds. She was off 7 of 12 medications, off both of her lupus medications, and she did amazing. Now, she had other health issues that she would be on long-term medications, but we decreased the burden of her medications and helped her feel better. Just by changing what's literally on the end of her fork. And so I went home the day she followed up and I said— I came home to a 13-year-old, a 15-year-old, and an 18-year-old, and my poor husband. And I said, this is what we're doing, guys. We're going on a plant-based diet. I literally took a garbage bag and I threw everything out that was animal product out. I mean, like, out, threw it in the garbage. And I said, this is what we're doing. And my kids are like, she's lost her mind again. And my husband's like, you're still cooking and buying groceries? And I said, yeah. He goes, okay. And I was like, all right, here we go. And this is why we've been married 28 years, by the way, because he's a very nice person. And interesting thing was I also had a quarter of a grass-fed beef, you know, in my freezer in my garage. Now, that is not something you just throw out in the garbage can. And I was like, what am I going to do with this? Am I going to give it to the shelter? Because I'm not going to give it to a human. So like, now I'm thinking food of a very different way. And we, 2 days later, so that was a Friday, 2 days later on Sunday, we came back from church and I swear, literally the freezer broke. And I don't know if you've ever had the stench of the decaying flesh, but as in the smell and the fluids and— Whoa. I never, ever, ever, ever wanted to eat meat after that day. And my husband's like, if you hadn't been with me, I would have sworn you unplugged this thing. I was like, nope. I said, that is divine intervention, my dear, and you will Listen, this is what we're doing. And he went on to lose 70 pounds. My children are now— my daughter is about to graduate medical school in May. She'll be 27. I have a 24-year-old and 22-year-old who are all plant-based. My 24-year-old does 500 pull-ups a day. My 22-year-old, just when he was 21, did his first half Ironman. And these kids are incredible. My husband did his first full Ironman at 49. I run 30 miles a week. I'm 50, but I feel like I'm in my 20s. I'm waiting for my Like, this is a trick, right? But that is really how it all happened was because a patient was upset with milk and dairy, or meat and dairy upset her stomach, and that's how it all started.

Amazing. And you didn't even have to take them off of— were they eating organic? Were they having any artificial colors or flavors? Or were they just eating whole plant foods or just no meat or dairy?

I just literally just said, eat a whole food plant-based diet. And I remember in a rural setting, you're not going to have all the fancy restaurants to go to. Like if you went out to eat, it's a steakhouse. They might have a salad and a baked potato that you can order, but they had to buy food from Walmart and City Market, which is our local grocery stores. And that literally is it. And, you know, there's a, there's a large, vast array of food deserts. So when you travel, you go and you buy your food because there's just not a large quantity of restaurants that are going to sustain a healthy diet. And that was to our advantage being in that position. And so But I learned a lot over the next year for sure on how to actually introduce this because, you know, the ACLM board certification wasn't available. I didn't even hear of the ACLM. You know, thank God for Dr. McDougall. He had a few articles for physicians. I was searching everywhere. Dr. Greger had some, some things that I could start, you know, working in my head. And I had some amazing patients that were very patient with me and— Mm-hmm. Literally helped me understand what I need to do better. And so I ended up creating like a 30-page handout I would save for my patients. My poor clinic, they were very supportive of me. I killed some trees, guys, but I saved some lives. Yeah. So, you know, what I would do is I would have, you know, 25 patients coming in. I would look at the, you know, 4 or 5 that I felt really need to hear this message. I highlighted them, I printed off their packet that they were going to get that day and Lo and behold, they walk in and they're going to get that plant-based message and I'm going to give them 3 steps today to start. And that's how it all started. And it was— they were very receptive. We ended up doing a study at my local hospital with 30 employees. A dear friend of mine, Dr.— or not Dr., but Chef Martin Oswald, he's in Aspen and came and worked with our chefs and taught them how to prepare delicious, healthy plant-based foods. And It was phenomenal. We had prediabetics and non-prediabetic people stopping blood pressure meds, loss of 20 pounds in 30 days. I mean, so there are some really incredible opportunities if people just take the moment to think outside the box and see what they can do. Just got to do something.

It's fantastic. And then you did have the community support. You had the hospital support. That's something I didn't really find here when I tried to implement the changes here. There was definitely a lot of pushback from the other doctors, from the— Is it—

Now, I'm not saying— I had some pushback from the local registered dietitian that we had. I had some pushback from some colleagues, but I'm like, listen, you can't argue. Yeah, my evidence is anecdotal, but I'm digging into the research and I'm very stubborn. When there is something that I can offer people, whether they're my patient or not, that can help them, why would you not want me to present that message? Because you have a problem yourself and you can't change your own diet? Well, that's your issue. My issue is not— that's not what I worry about. What I worry about is that these patients have the opportunity to make an informed decision, and that should be every physician's mantra is because if you don't allow them to make the informed decision with every opportunity, I consider that malpractice, and I think that's being harmful. And this is not a patriotic type of setting. This is a partnership between you and your patient, and you should be making those decisions together. Now, you may not agree with what their final decision is, but you have to respect it because it's theirs. However, I will— it won't be because I didn't try. But if you still make the, in my mind, the wrong decision not to go on a plant-based diet, you're going to hear the message again. I mean, you come back to see me, you're going to hear it again because I really truly believe, after, especially after this long and as many patients as I've had, this is the right decision for everybody. And this whole, oh, my body's different. No, it's not. You have a human body. Right. Just like a giraffe. Every giraffe has the same giraffe body. It's a giraffe body. It's not a You know, a special giraffe body. It's like, no, you have a human body. Now, there are some special cases with genetics as far as like mutations or something that we might have to work around, but— Well,

it's lucky that your patients were— that you were open to this, because when I first started down this road, I literally would bring stuff into my doctor and go, you're gonna read this, and I want a report. I want to hear from you like next week, you know, and she wouldn't call me back and be like, I'd call the office, she hasn't done her homework, please have her call me. And I was very adamant. And one of the first things that I saw was my thyroid was healing because she looked at me straight in the eye and said, you're going to be on thyroid medication for the rest of your life. No. So—

No. Yeah. Yeah. Well, I've been hypothyroid for 24 years. And at that time, I had been hypothyroid for 15 years, actually, during pregnancy. So my son was actually born hypothyroid. With his initial testing, you know, the little heel prick that they do, and then they repeated it in 2 weeks and he was fine. But he went on to develop severe dyslexia, which was a challenge. And I'm like, that's an incredible story of incredible work ethic. And this young man is one of the phenomenal humans that I know. I'm blessed to have called him mom. I don't know how God was so generous with me, but I got 3 of them. I'm like, wow, this is great. But, you know, what was interesting is at that 15-year mark, I had escalating doses over the years and didn't really think— I mean, this is just what it is, right? I got thyroid issues. And nobody's ever told me that it could get better. Well, I went on that plant-based diet and lo and behold, I started— it's just really interesting how I figured that out was I started having some shoulder issues. Now I've been active. I've done all sorts of like Tough Mudder races and I'm going up on 11-mile hikes, whatever. It doesn't matter. I'm just going to do it. It is what it is. But I was like, you know, I didn't injure myself in any weird way, but it started getting really stiff and it got to the point that I really— someone couldn't even literally lift my arm up. Stuck. I was having to put my— excuse me, but I had to put my bra on in the front and flip it around. And I did that. I was like, what is going on? So I went to a friend of mine who's an orthopedic surgeon, and he's like, you have adhesive capsulitis. I was like, adhesive capsulitis? Like frozen shoulder? I was

like,

what in the world? And he goes, yeah, so if you're over 40— I'm like, well, yeah, okay, I was over 40. Diabetes? Nope, don't have diabetes. But hyperthyroidism? I was like, well, I don't have hyper, I have hypo, but I do take medication because Do you think I could be overdosing? It's like I've never had that happen before. So I checked my TSH and it was zero. And I was like, I'm highly overdosed. I'm in a very hyperthyroid state. I was like, oh my goodness, this is insane. And I just continued to escalate. So I suffered literally, it went from one shoulder to the next. There's like 16% of people will get it in both shoulders for 2 years. I said the, you know, the whole food plant-based diet is supposed to be helpful. Well, it helped me, but then the medication was harmful because I took too much. So I'm very cognizant of And that was 15 years later and I'm still on medication, but it's such a much lower dose. I mean, I had done my job, I guess, of burning out my thyroid well, but I still had to use some, but there was still some functionality left. I was like, whoa, that's incredible.

Oh my God. Did you add iodine to your diet?

No, no. I had still used iodized salt. I don't use it a whole lot, but I do take an iodine supplement now because we do really try, especially as we're getting older. And you know, my real dad had his first heart attack at 38. My mom's dad died at 46. My mother had breast cancer. Her mother, all— I mean, I have genetic badness. So do I. So we understand the choices that, you know, as we get a little older and we was like, all right, we're gonna have to be good. So yeah, no, I was using iodized salt until that point, but I didn't add anything extra. I was just eating a whole food plant-based diet, literally. Nothing organic. I mean, I would buy organic when I could, but I was just really trying to just eat healthy plants. I was trying to stay away from oil, but that's about it.

That's fantastic. Those are amazing stories. And I hope everybody listens and hears what's possible because I think people don't always know what is possible. And it is important to realize sometimes that your physicians need to be educated as well. There are opportunities for them, but sometimes they're just slow on the uptake and they have also some Incentives, financial incentives, possibly not to make you as healthy as possible, which is disappointing, but it's true.

Yeah, but I rather— I really like to think that that's less of an issue versus people just don't understand the science. They think this is too simple of a tool to have such profound effect.

And who's going to change?

Right.

I think that's one of the biggest issues is who's going to do this? It's too much work. My patients aren't going to do this, you know. Right. And when you start to think about this, really? I mean, you're not even given the choice.

So, so exactly. You're exactly right what you said. You have to be given the choice. And like, who are you to decide what they will or will not do? So if you have an opportunity to decrease the burden of a chronic disease for a patient and literally change their life, why wouldn't you give them that opportunity? Right. And if that's— if you don't, then you shouldn't be a physician. Sorry.

Right. I've had, I've had a few experiences that would probably Curl your hair. I mean, it's really not sure, very unpleasant. I worked with a vascular surgeon once who I was assisting him in a procedure. I was just in the operating room. And, and so we were doing this FEMPOT bypass, he was pulling out this gunk from this vessel. I'd never seen plaque before, looked like chewed chewing gum. And I said, look, Dr. G, this is why you should tell your patients about a plant-based diet. And he said, yeah, look, this is why I shouldn't.

Oh, wow.

But you know, He later passed away because he developed Crohn's. And I've actually reversed Crohn's in a patient, got them off Humira, but he didn't want to do that because he didn't believe in it. So he went on Humira. He developed lymphoma.

Oh, it's called karma. That is called karma.

There was another cardiologist I had. I had Neal Barnard in for a grand rounds, and I said to this cardiologist, come on in and speak. Come in and meet— this is Dr. Barnard, and he said, oh, Debbie, you know, they call me Debbie when they're diminutive, right? Oh, Debbie, it's too extreme.

Oh, cardiologist.

And he was one of the good guys. So anyway, it's— so I've had this other— but anyway, let's moving on. I know there are some mixtures of vitamins and supplements. One of them is Complement, which I did used to recommend a lot because it has the B12 and the D. It has the It doesn't have cyanocobalamin, right? But now there's a Complement Plus. They add iodine and the zinc and the K2. But I don't know whether we should be supplementing zinc on everybody if we're eating nuts and seeds.

So I measure, right? So I measure patients and I have a lot of— I take Complement myself. I give it to my family. I think it's a very good product.

The Complement Plus.

The Complement Plus. And they've had some manufacturing issues, so there's been some delay for 6 or so months and that's been a little frustrating, but I certainly think measure it. So I measure iodine, I measure zinc, we measure selenium, we measure magnesium, we measure the vitamin D, the B12, the omegas, and we measure all of those things. I measure homocysteine, methylmalonic acid. So I'm looking at my patients. I call it my whole food plant-based panel. So these are my patients who are eating the diet and they want to know, am I planning my meals correctly? Am I eating enough variety? What am I doing? We're going through and we're talking. I'm talking about how are their— how's their energy? What is their— you know, some of them are not eating enough calories. I have some patients who are just losing too much, and I wish I had that problem. I don't. Really?

Really?

I do have them. There is, and there's actually more than I realized because now all of my patients want to do a plant-based diet, which is— that's a whole other amazing— it's just the coolest job ever, and it is just way cool. So I'm sitting here looking at these folks and there are cases, my patients are low on iodine. I've seen a few low in zinc. I've not seen anybody high on zinc that was taking the supplements. I have seen a few, oh, maybe 2%, 3% are a little bit higher on the selenium, but I think they're also eating some high selenium containing foods like the Brazil nuts. So we just talk about that and adjust accordingly and retest. Many of them do fine. I actually most of the time end up adding even more vitamin D3 because I just don't— people, some people really struggle to get that vitamin D up.

I found is if you eat a nut, you know, one of the things I do is like I use my— I make an omega-3, omega-6 nut bowl and, you know, I put one cashew, one pecan, you know, and just putting in chia seeds, hemp seeds. So then I'll use that as a condiment on my salad.

Yeah.

And so that's the time when I take my vitamin D because I've got some of the fat to help get the vitamin D into— it's because it's fat soluble, so it helps to get it into the cells. So if you're doing that, that's one of the tips, you know, tricks I've learned along the way is to help get that fat in. You know, that's when I take my vitamin D supplement.

Yeah. Well, it's important to you to have, you know, you know, some— a little bit of fat in your diet regardless, right? So the fat doesn't have to come from Oils, obviously. So, but yeah, so I use like a quarter, I don't know, anywhere about a quarter of a cup with nuts and seeds throughout the day. And that's what I encourage my patients to do. I'm a big fan of, you know, the soy products, tofu, tempeh, because they are very good for bone health. There's a little bit more fat in those. Gotta be a little bit more careful with my diabetics because, you know, we really monitor that fat intake, especially until, you know, they can reverse some of the insulin resistance. And my type 1s do amazing on a plant-based diet. My patient started at 4 as a type 1 and he's 5 now. He's doing amazing. He's got an incredible mother and she's right on board and it's just been a real joy to work with people like this.

Wonderful. So you were saying that you actually measure zinc, iodine, magnesium, the functional B12, the selenium, and the D3.

Yeah. So B12, homocysteine, methylmalonic acid, D3. your omega-3, and it depends if you do LabCorp or you do Quest what their panels exactly measure, but we measure to see where they're at. And you know what's really, really fascinating? Granted, these are anecdotal. You know I'm a big fan of the science, but I am going to share with you almost a decade now of doing this, and the vitamin D is really, really amazing. When I have people who are super low, and I'm talking about people who are under 20 when they first are measured, And they're fatigued or depressed, really, really struggling. The vitamin D, I usually put them on a high dose for about 12 weeks and then we measure and see if we need to do it again.

50,000 a week like that?

Yep. 50,000 of the D2 weekly. And what's incredible is these people have like life-altering experiences. Not all of them, but many. And, you know, as if you're higher BMI, you're going to need more vitamin D3 because this is a fat-soluble vitamin. The other thing that I've also found with my patients who are over 400 pounds, my morbidly obese patients, is that many times we will check a lipid panel and their cholesterol will actually be low many times, but it's not because they probably don't have arterial disease or anything like that. It's just that the liver just can't keep up with the cholesterol needs of a body that weighs 400 pounds. And so that's been really interesting too. And as people lose weight, they'll see cholesterol shoot up. I'm like, well, they're There are some reasons. We just have to be kind of logical about thinking about it. But yeah, those are the things that I check.

Fantastic. And LabCorp has that?

Yeah, LabCorp and Quest.

Fantastic. One of the most serious complications of pregnancy that I've been seeing more of more recently as I was practicing obstetrics was the hypertensive complications with preeclampsia and seizures and stroke. So I was, you know, in The Pregnancy Advantage, one of the things that we really do focus on is getting people's blood pressures low before they conceive. And then we believe that a plant-based diet is going to keep them steady. And I was just wondering what your experience was in getting people off of their blood pressure medications. And do you have a reliable sort of prescription for this? Yeah. In my experience, we had to get people off of oils in addition to whole plant foods, but really reduce those oils and salt. What do you do?

You're 100%. It's the, you know, get that low-hanging fruit first is remove salt. They're not going to be happy, but you're like, you want a healthy baby? You want to decrease your risk for, you know, all these different potential complications? And so salt is the first one. Oil, I agree. I'm not an oil advocate. If you're young and healthy and not going to be pregnant or having high blood pressure and you're like my 21-year-old, he may eat something with oil in it. That's fine on occasion, but he also understands that it's not something to be cooking or adding to your salads and all that type of stuff. So yes, the salt and oil are big ones, but I also try to increase those really high nitrate-containing foods, right? So these are your dark green leafies, and I don't care how I have to get you in your body, they just need to get in your body. So they could be a salad. Anyone who knows me, I'm not a huge salad eater myself just because I just don't have time to chew. It is like I am busy. I don't have time to chew for an hour. I appreciate those who do and I applaud you, but I can't. But I still get my greens in. So that may be a soup or a smoothie or something else stuck in a veggie burger or whatever it might be, but I'm getting those greens in daily and that really is key. And then the ground flaxseed has some really interesting research and the hibiscus tea at high doses can be helpful. I would have to do more research on pregnancy because there can be some complications with other things with the hibiscus tea. But, you know, those things are very, very helpful. And as you're moving into that plant-based diet, you know, exercise is also going to be very important. You'll have some improvement with blood pressure. And but sometimes that, you know, in your younger population, you could probably push that a little bit faster. I do have, you know, young people to older people, but the majority, I'd say, are my middle-aged or older patients who have had hypertension for many years. And it may take 6, 12, sometimes longer months to get them off all the medication. It takes some time. And I think diabetes certainly reacts a lot faster. And that's a really fun thing to have people stop insulin very quickly and to reverse their diabetes. And my type 1s using half the amount of insulin that they did before, even sometimes even more than that. And it's It's an interesting thing. Also, you have your type 1.5 diabetics. I know we're getting into diabetes a little bit. I've attracted a lot of those because these are the ones who don't necessarily get better on a plant-based diet, or they get a little bit better for a little bit and then they continue to progress. And so, yeah, it's been a really interesting, challenging opportunity. And there's certain medications that some people will do better with than others. And, you know, some you have to wean down slowly. So it's, it's, it's an art to deprescribing. And it's, you know, I'm a big fan of, you know, they talk to you about motivational interviewing. I think those are very helpful techniques. So when a patient comes in and you're meeting them where they're at, you're gauging their agreeableness to change and where their willingness to change. But as the time goes on and we develop a relationship, you're going to hear more and more, and I'm going to push you to think about your boundaries and what are the opportunities you have for your health. Because honestly, I'm not here to You know, let you guide the boat to the destination that you want to go to by the means that you think you know. That's why you came to me, is to help you get there a little bit faster. So I'm going to keep you from going like this and we're going to go like this, right? You know, so I tend to want to push my patients a little bit more than I think they're expecting. You know, I look all nice and sweet, but you just got to watch it. No, I'm just kidding. But, you know, it's really, really important that people understand that You have to, as a physician, especially as a lifestyle medicine physician, it is imperative that we make people open their minds, take off the blinders to the possibilities of health, and to understand normal is not chronic disease. And it doesn't mean that some people don't have chronic disease and they're doing everything right. Yes, that happens. But the majority of this is a choice. And so it really is important. And that may really piss people off, and I'm sorry, but— We are making poor choices every single day, and it really is imperative if you want to live a long, healthy life. This is what we're supposed to do. We're supposed to be born, we live our life to the lifespan of a human being, and then we're supposed to die quickly like every other animal on earth. They live their life to the span, lifespan typically of that type of animal, and then they die quickly. Now it doesn't, you know, I'm being very blunt and very you know, objective about that. But that really is important to understand. Between the birth and the death, there should be healthy years here, right? Yeah. Just because you're 50 doesn't mean you're 50, your last however many years should be worse than your first ones. I mean, I want to be the 100-year-old, you know, pushing the lawnmower out front and running around with my great-great-great-great-grandkids. And, you know, that's what I— and I hope that I'm blessed with that opportunity. If not, well, I've lived my life the best I could. I'm not going to regret those choices. But that is the important thing, is having those tough conversations with patients and listen, there is more for your life than what you're doing. Why do I want that more for you than you? Ask the hard questions and it's okay. But those are the questions that they're going to appreciate and love you for doing because their life can change. And that's— I just fiercely love my patients. And I think that's what we have to understand is that we just got out of I would love them to understand so they can see and have those conversations.

There's way too much suffering in the world. It's completely unnecessary. It's very, very sad. Very

sad.

I agree with you 100%, but it's interesting how many patients are, you know, pretty complacent. You know, oh, I take this pill and it's fine, and maybe if I was younger, and, you know, I hear all these things too. It's interesting, right? But I totally agree with you, and I love that straightforward approach. It's like, we can make it better. Why don't you want this? But, you know, I get really excited

excited. Like, it's really hard to contain my excitement when I look at the potential opportunities for patients, right? The interesting thing is I tell people, like, this is— listen, you and I are gonna have to have an agreement. I'm a big fan of the dopamine hit, and I call it veggie cracks. I'm gonna tell you some vegetables, you're gonna get better, and I'm gonna get my dopamine fix, okay? So let's keep doing that, you know? And so we just really try to make them understand, I, I really And I think we just got to infuse hope into someone, right? So if you infuse hope in someone and you get them excited about, I mean, I can get well, you open their eyes like you can have a different destination. Your destination does not have to be illness and sickness and pain and suffering. Now, it doesn't mean life doesn't throw suffering at you on occasion. That happens. But you can handle it better. You can deal with the stresses every day if you're feeling better. You can live the purpose that you were here put on this earth to do if you don't have to deal with so much of the burden of the chronic disease? So let me help you, but you have to make the decision. This is going to be the key to your winning. And that really is what I do. So—

Knowing your why. Yeah, yeah. Why you're doing this.

For what? The why is one thing, right? So the why is your goal and your destination. But I think we need to understand behavior design. And I really— that's why I started my podcast because I really wanted to understand why some people were very successful and others weren't, right? So if we think about the why, yes, but the motivation waxes and wanes. Like, in 30 seconds it can change. But it's the ability. So when I first met BJ Fogg, he wrote Tiny Habits, and Dr. Jud Brewer, who wrote The Craving Mind, who both have become good friends of mine now because I just keep harassing them. And I'm just like, I need to know more of what's in your brain. And How can I help my patients? It's the ability, right? So if we make something hard to do, we're less likely to do it, even if we have high motivation. But if we make something easy to do, even on those low motivation days, it's going to be easier to do. And there are techniques and ways to do that. And once you describe to a patient that they have control over that, that they can actually start a very tiny habit and build it into something massive, that is like power to them. And then if they can understand mindfulness and understanding The cravings are just this physiologic thing that occur that you can think yourself through them. You can ask these questions, becoming mindful, and it's empowering for them. And that is just the most incredible stories. And to talk to these patients as they progress and evolve over time and just seeing them and they become inspirational to me in my own life. I mean, it's just amazing what these people can do.

Absolutely. I had a client who was almost homebound with Crohn's, horrible Crohn's.

Wow.

A lot of her life she was on Humira and she could barely get off. She was asking her children to bring her a glass of water because she was just so— really couldn't get off the couch and afraid to go out in the afternoon. Anyway, we got her off of her Humira. She was very interested in doing that. We got her off her Humira, which her doctor said she would never be able to do because she would then have some flare and not be able to be treatable or something. And then she went to graduate school. She's already got one master's. She's working on another. Incredible stuff that she had never thought was possible for her. Because of this diet, because she started to eat more plants.

Yeah. And these cases are typical, right? So we don't need the disclosure like all of these, you know, commercials you see, like, these are your typical cases, my friend. You too can have this.

So yeah, amazing.

Well, Dr. Marbas, thank you so much for taking the time to be with us here today. Like, like, we could clearly talk to you forever because we have lots of things to talk about.

And we would learn so much. You're amazing. You're amazing. And you're just— your enthusiasm and also, and just your understanding of the science and just, it's just, you're a well of knowledge. And so thank you. Thank you. Thank you for coming to us.

Well, thank you. And I do this for my patients and I just, I'm diving into the lipid research right now also, because I just think it's so important that if I don't know the answer, at least I got to reach out to someone who does. I at least need to have the beginning of an answer in order to help patients. But it's just, it's so incredible and it's such a joy to see people get well. So thank you for what you're doing and your work with the most precious resource we have, which is our babies and their mamas. And those are just, those are long-term consequences for generations. We have no idea what the work you're doing now and profound generations from now. So thank you for what you're doing.

Well, we hope to get it studied soon. We're going to be meeting, we're, I'm really trying to reach out to researchers who could put this to the test and then maybe we'll get published in your journal.

That'd be awesome.

But also, people want to get in touch with you and they want to work with you.

Yes.

At Plant Based Telehealth, right?

Yes, I am the co-founder with my dear friend Anthony Maciello of Plant Based Telehealth. It's plant-based for lifestyle medicine. It's been an incredible journey. And we have grown exponentially since then. We're 9 months old. And we're already— we have the beloved Dr. Klaper on board with us and my dear friend, Dr. Chris Miller, who has her own lupus recovery story, who's an incredible human. Probably one of the smartest people I know. And we're bringing on 2 additional physicians in the next 30 to 45 days. We are growing like this because of partnerships and really huge support from people like you, Chef AJ, Mastering Diabetes, and just some incredible people who are willing to, you know, have us on there and share with their audience so they know that we exist. And, you know, we hope to continue to tap into our network. And, but yes, you can go to plantbasedtelehealth.com. request a patient portal invitation. It's a HIPAA-compliant EHR. We do our video chats like this. We order medications as needed. We order labs and we can see you. I've seen patients from all over the world, as has Dr. Clapper and Dr. Miller, and it's just been a wonderful opportunity. And then I also have thehealthyhumanrevolution.com, which is the resource that I really wanted to build to teach people how. Right. So that's where the podcast is hosted. But we have courses that really teach people, like, for example, if you have children, what do my kids need at different stages and ages? And I created even a cartoon cookbook. I have Brock the Rock Broccoli. We have 8 different cartoon characters, little cookbooks with them, you know, 58, 57 tips to get your kids to eat more vegetables. And just some incredible— and Nourish is coming out also. That's a great book. And I need to get that book. I haven't read that yet, but the—

Oh, amazing.

Yeah, exactly. And this just walks people through if they have questions about supplements, but also, you know, like, how do you shop on a budget eating healthy? How do I do mindful eating? How do I transition to a plant-based diet? We have a 7-day course that walks you through that. And honestly, if they just did the 7 days, that would be honestly all they need to know. And yeah, we've had some amazing feedback. Working on some other things and super excited. And I run that with my 2 boys, Jonathan and Gabriel. And so yeah, it's just been a blast and to see things grow and we will continue. If we see a need, we'll try to fulfill it.

So thank you. Oh, amazing.

Incredible.

Incredible.

Thank you.

Appreciate it. We'll see.

We'll have to have you back. We'd love to have you back.

Thank you. I'd love to be back.

And we'll see you guys next year. So Deborah and I will be taking some time off for the holidays. So We'll be seeing you next year. Bye-bye.