Speaker 1: 0:03

Welcome to the healthy matters podcast with Dr. David Hilton, primary care physician and acute care hospitalist at Hennepin healthcare in downtown Minneapolis, where we cover the latest in health healthcare, and what matters to you. And now here's your host, Dr. David Hilton.

Speaker 2: 0:20

Hey everybody. And welcome back to the healthy matters podcast. I'm Dr. David Hilton, your host, and this is episode 20, and we're gonna talk about something that I hope is of interest to, well, all of you food, but we're gonna take a different perspective on food. And we're gonna talk about the relationship between food and health in ways that maybe just, maybe you haven't thought about before to help me out with that. I got somebody who knows a great deal about the topic, Dr. Kate Shafto. She is general internal medicine physician here with me at Hennepin healthcare in downtown Minneapolis. Kate, thanks for being

Speaker 3: 0:52

Here. Thank you so much, David. It's a pleasure.

Speaker 2: 0:54

What is the connection or why does it matter what we eat?

Speaker 3: 0:57

I love talking about this, first of all. So thank you for the great question to start this off and the invitation to be here. It's really a delight. So food is something we interact with many, many times a day and every week and every month for every year of our lives. And for that reason, it is one of the things that has the most impact on our health because of the frequency with which we interact with food and food has become really complicated in our world. Today, we have a global economy, a global food system, and we have a lot of layers of that food system that we aren't seeing day to day. And so food has become more complicated because of those different layers that aren't visible when we go to the grocery store and therefore food has had more chances to, uh, impact our health because of the effect of all those different layers on the ultimate food product that we consume different

Speaker 2: 1:55

Layers. Interesting. So, um, here's what I'm envisioning and tell me if I'm off a hundred years ago, the layers were maybe not quite so complex and you and I haven't talked about this. So I'm, I'm, I'm being honest back in the day, a hundred years ago, you had a product that was made and you were lived very close to probably the place where it was produced and there weren't all those layers, is that what you're

Speaker 3: 2:14

Getting at? Exactly. So a hundred years ago is probably a very accurate estimate about when things started changing to a more industrialized food system, but ask your grandmother, if you have the good fortune to have a great grandparent around, they will tell you a very different story about where their food came from. They remember when their food came from the farmer down the street, they remember when the cows all got sick. And so then there wasn't cheese that month or year. And they'll tell you about how they knew the person that raised the chickens and how they didn't have things like maybe coconut, because coconut wasn't exported all over the world like it is now.

Speaker 2: 2:59

And we expect it all year round and avocados all year round and

Speaker 3: 3:03

Everything. Exactly, exactly. And so it's very strange now in the large scope of history that we have avocados all year round in Minnesota, and we have the same array of produce and then also the same array of all the canned goods and packaged goods all year round. And so what happens then is that people eat the same thing all year round, which has never been the case for humans until the last probably 50 or 30 years.

Speaker 2: 3:33

Yeah. And if I wanna mango, I can go get a mango today. And I live in the frozen Tundra of Minnesota. Exactly. And, and I can have that year on. So why, why does that matter for our

Speaker 3: 3:44

Health? So when food has been harvested in Argentina and flown shipped, transported all the way to Minnesota, it has been picked at a point in its life when it wasn't ready to be picked, or it was picked when it was ready to be picked. And then by the time it gets here, it is not in good shape and then it's wasted. And so that contributes to food waste because of all of the transport and all the production issues all over the world. There's a ton of food waste. It's estimated a third of food is wasted. A third of the food produced in the world is wasted. So that contributes to all kinds of things in the environment, which then impacts our health. Other ways that impacts our health is that the cost of transportation is mostly paid for by the people who are the most vulnerable to climate change. And so the cost of transportation costs a ton in the way of fossil fuels and pollution. And so that's an impact to our health. What's more many of these products because people expect these products to be available all year round, not even just produce, but, um, packaged goods and highly processed, ready to eat foods. Um, many of those are made from a very few number of ingredients, rice, corn, wheat, soy, and those crops are grown all over the world, especially soy corn. I'll just focus on soy and corn are grown in monoculture mm-hmm<affirmative>. So that means that there's vast fields of corn or soy. They are genetically modified organisms, which goes by GMO. And they are specifically, that means that those seeds have been modified so that they can resist pesticides, which are sprayed heavily so that everything else dies except for that plant. But the pesticide residue or the traces of pesticides still stays on that food. And then those food, those, um, products, the corn and the soy are packaged and broken down into like lots and lots of different byproducts and parts to be created into these food products that are then on our shelves and in pretty much anything that has a package.

Speaker 2: 5:45

So what, what, I didn't eat any soy today, did I

Speaker 3: 5:48

Maybe, maybe

Speaker 2: 5:48

Not. Well, I mean, I'm being facetious. I mean, there's, I don't, I don't know. There's do, I don't know. Right?

Speaker 3: 5:54

The, the impact of that on our health is that we are consuming these byproducts of corn and soy in many different products and corn on its own. There's no problem eating corn. Mm-hmm,<affirmative> soy on its own. Great. It's a complete protein. The sub, the whole Asian world has eaten that for generations and centuries. And it's a complete protein it's super healthy in its, um, intact form or, or if it's minimally processed forms. But our bodies aren't used to seeing these little like fragments of soy and corn and especially the highly processed ones that have all this pesticide residue sticking to it. And so it can show up in things like maltodextrin and soy protein isolate. It can be soy and corn can show up in salad dressings in a cappuccino in breads, any kind of bar, like a granola bar, that kind of thing. So they're just all over the place because this is how our food system has evolved to meet expectations for convenience and taste and the lack of diversity of the foods that we're eating, we're eating the same thing year round year round means that we're not getting a diversity or a variety of foods.

Speaker 2: 7:03

Why does that matter for an individual? I get it that it matters for the planet.

Speaker 3: 7:08

Absolutely. So an individual's diet being diverse is super important for our gut, the health of the gut microbes that our life depends on.

Speaker 2: 7:18

Are you gonna start to talk about poop and bacteria now, if

Speaker 3: 7:20

You want me to yeah.

Speaker 2: 7:22

<laugh> is that what you mean? That's

Speaker 3: 7:23

What exactly what I mean? So we have this amazing collection of microbes in our intestines, on our skin, throughout all of our membranes and tissues that are really what our life depends on. We have more of those than we do of our own original cells. It's an amazing field of exploding research on the gut microbiome. And those microbes are absolutely dependent on what we eat and the diversity of what we eat keeps them healthy. And it provides the right nutrients to feed the, the quote, good bacteria, the good microbes when those microbes are only exposed to a very limited number of food products. In addition, if they're exposed to pesticides and other toxins and plastic residue and all this other stuff that ends up in our food, then it kills off the good bacteria and the, what we call pathogenic or harmful bacteria. They can outnumber the good bacteria. So that's,

Speaker 2: 8:19

That seems to make sense to me. And as two doctors, we know that there are infectious complications of a absolutely of, of the intestines, you know, and people maybe who listening have heard of that. Mm-hmm<affirmative>, but we all don't walk around infected all the time. You know, some people, especially those who have had cluster difficile or others, mm-hmm,<affirmative>, they know about infections, but we're not all walking around infect. Does it matter to our, our day to day wellbeing?

Speaker 3: 8:44

It actually does. And there's this fascinating branch of the whole gut microbiome research about the gut brain access gut brain connections. So that the microbes in our gut actually have communication neurologically and like in signaling cell signaling with our brain. So it matters for mental health. It matters for our immune system because the gut microbiome is constantly in communication with our immune system, right around the wall of the intestines, that gut associated lymphoid tissue. Do you remember learning about that in medical school? School?

Speaker 2: 9:19

Yeah. Well, vaguely I maybe was me too. I was vaguely sick that day. Right.<laugh> right. When we talked about the gut brain connection, but there's a, this is not exact, we're not talking about the microbiome, but there's long been a connection with people's mental health and their anxiety and their gut and their neuro absolutely. The nervous system. For

Speaker 3: 9:37

Sure. And have you ever heard the expression? I have a gut feeling. Yes.

Speaker 2: 9:41

Right.

Speaker 3: 9:41

Yeah. We feel stuff in our bodies when we feel emotions. That is all because our gut, literally that core part of our body, the intestines and all their surrounding organs, those are intimately connected with our brain and our emotions and our nervous system and the food that we eat fuels that system. And also the environment in which we eat has a huge impact on that system.

Speaker 2: 10:03

Wow. This is fascinating stuff. And when we come back from this short break, we're gonna talk to Dr. Shafto more about things like inflammation and, and its relation to food. We're gonna talk about things like, well, how does your food affect your mental health, your physical health? How does it affect things like people's ability to manage pain in their life, all of this and more when we come right back after this short break, stay with us,

Speaker 1: 10:27

You're listening to the healthy matters podcast with Dr. David Hilton, have a question or a comment for the doctor become a part of our show by reaching out to us at healthy matters at HC M E d.org. Or give us a call at six one two eight seven three talk that's 6 1 2 8 7 3 8 2 5 5. And now let's get back to more healthy conversation.

Speaker 2: 10:51

And we're back, we're talking to Dr. Kate Shafto about food and nutrition here on the healthy matters podcast. Okay. Let's shift gears and talk about some of the effects on individual's health. And I, I mean, things like your mental health, mm-hmm,<affirmative> your physical health, your ability to manage stressors in your life, take that where you will, how does what we eat affect for instance, our, our mental health.

Speaker 3: 11:15

It affects it dramatically. So the standard American diet is often abbreviated S a D sad.

Speaker 2: 11:23

Oh, okay.

Speaker 3: 11:23

Yeah. The standard American diet, that's actually a term in the scientific literature. Really it is. And the standard American diet is characterized by the things that we were talking about kind of as a, a result of this industrialized food production system. So lots of corn wheat, soy dairy, which is also very industrially produced in our country meat and kind of a absence or a lack of vegetables and corn by the way, is not a vegetable. Corn is a grain. So it's really heavy in grains and grains are great, but the way that they show up in most of the American diet is very refined. Meaning they've had the fiber taken off and they're milled down really fine into a fine white powder and then made into all kinds of goods, baked goods and pizza crusts, and et cetera. Potatoes are also an important part of these standard American diet. And they come and not just a whole potato form, but usually French fries and chips and that kind of thing. So that colorless or lack of color and lack of diversity and lack of a lot of different plant foods, plants I'm referring to more like vegetables, nuts and seeds fruits means that we're not getting the minerals, the vitamins and the antioxidants that come from those colorful plant foods, antioxidants and minerals and vitamins are essential for our mental health and for our physical health. And in fact, I've seen some patients recently who have significant vitamin deficiencies, vitamins seed deficiency, and had all sorts of symptoms that they were not sure what were causing and their diet was extremely limited.

Speaker 2: 12:54

And they're living here in our very modern society. They're not a sailor on an old, British ship getting scurvy

Speaker 3: 13:00

Scurvy. I know I learned, we learned about that in medical school. And I was like, I'm never gonna see that in my day, cuz we have a modern food system, but no vitamin deficiencies are actually probably more prevalent than we're aware because we've taken out of our food system, all the places where the vitamins are, the whole grain, which means that it has three parts bra, germ, and endosperm. And that those three parts are super important for the B vitamins and some fat soluble vitamins like vitamin E and B vitamins are intensely important for our mental health, for our sleep for numerous, um, nervous system reactions for our nerves to actually function. And so I work in chronic pain actually. That's where I have my clinical practice from a holistic and integrative perspective. I help folks with chronic pain and I see the effects of vitamin deficiencies and this standard American diets inflammation in intensifying pain. And often chronic pain goes along with mental health concerns and struggles with sleep and mood and anxiety and all this wrapped together. So there's not just one dietary problem that causes one clinical problem. Um, it's so complex and interconnected these days

Speaker 2: 14:13

In your practice. Do you talk about diet with, with your patients, almost every single who are experiencing chronic pain. Yes.

Speaker 3: 14:20

Yeah. And most of them say, you're the first doctor that's ever asked me what I eat, especially related to pain.

Speaker 2: 14:27

Yeah. I'll bet a lot of people listening to this or living with chronic pain and I'll bet most of them have not been asked that.

Speaker 3: 14:33

Yep. And we're talking about food, but many times people don't think about beverages as a part of their diet. That is one of the places I think we have the most opportunity to intervene with our patients. And for any of you listening, you don't need a doctor to tell you this individually you can, can start making changes in this today. The beverage industry is one of the most toxic industries to both individual health and our planet, all of those beverage products in all those plastic bottles, with all their colors and their artificial sweeteners and their sugars of all manner, those aren't doing nothing good for your

Speaker 2: 15:12

Health. What do you recommend for people in beverages?

Speaker 3: 15:16

Well, as I always say, the one beverage that nature provides is water and water has been used by humans for all of history to keep ourselves alive.<laugh> right, because we're made up of so much water in our bodies. So that's another common thing I see in my chronic pain patients is like a low level kind of chronic dehydration, which means muscles are more stiff. Joints can get dehydrated and not function as smoothly. And then in general, just tissues, skin and other soft tissues that are dehydrated are gonna be less flexible, more inflamed. And if we're drinking any of the sodas, I'm from the east coast. So I say soda,

Speaker 2: 15:56

Yeah. I was gonna say no. And anyone listening from the east coast knows what you're talking about. The rest

Speaker 3: 16:00

Of us, they say pop, right? So pop soda, co whatever it goes by. Um, I, and also the whole aid family, that's spelled a D E or a, I D doesn't matter. Kool-Aid Gatorade, power aid, blank aid, whatever, all of it is very inflammatory to the joints, the tissues to our brain, to our gut. And it's not essential for living. So it's like a totally optional part of our food system.

Speaker 2: 16:29

I didn't know. There was a food group called the aid

Speaker 3: 16:31

Food group. There is yeah. The AI

Speaker 2: 16:33

A non-essential food

Speaker 3: 16:34

Group. Yes. So that would be one place to start for anybody wanting to make a change in their health for the better, through food and drink. You're gonna help your environment. You're going to help your grocery bill and you're gonna help your health tremendously. Okay.

Speaker 2: 16:48

Kate, so maybe not rules, but guidelines or tips from an expert like you, could you give us maybe one or two things that people could do or should not do in their own personal life to take some first steps towards a more healthy, uh, relationship with food?

Speaker 3: 17:05

There is a very cute and easy to read book called food rules by Michael pollen, the

Speaker 2: 17:11

In defense defensive food

Speaker 3: 17:12

Guy. That's right. Yeah. And Michael poll's food rules, you could check out at your library. You could probably find it online in lots of different forms. It has just cute little phrases that I find really helpful and memorable. And I often share them with patients. And one of them is if your grandmother wouldn't recognize that as food don't eat it. And also the other, if you can't recognize the word on the ingredient label, don't eat it.

Speaker 2: 17:37

So actually read the labels.

Speaker 3: 17:39

So read the labels. I tell patients that is their superpower. So we've, we've been kind of brainwashed in my opinion, to look at the numbers on the label, the calories, the grams of fat, the grams of whatever that doesn't matter, nearly as much as what's actually in the product. So if you look past those numbers, which are intentionally bigger to make your eyes go to those numbers on the label, look to find the ingredients. And again, if you don't recognize that if there's more than like five ingredients, maybe think about a different choice.

Speaker 2: 18:10

What about, um, somebody once said maybe it was even from Michael poll, um, stick to the perimeters of the grocery store. Yeah. What do you think of that idea?

Speaker 3: 18:18

I think that's a great idea because that's where most of the food ingredients are going to be. So the produce section is usually the perimeter, the dairy cheese meat section. And, um, that's a great place to start because those are real foods. I also just wanna mention that I, I recognize how it can feel overwhelming for people to make major changes in their, their food habits and food ways. And so that's why I often recommend starting with the beverages because that's a very common place that people are spending money for one thing and another very real and legitimate concern, especially now with our significant struggles with inflation money is a big deal when it comes to and

Speaker 2: 18:59

The stuff when the perimeter is expensive, sometimes is

Speaker 3: 19:01

It is sometimes so

Speaker 2: 19:03

Kale is expensive, right?

Speaker 3: 19:05

But not as expensive if you buy it at a farmer's market, mm-hmm<affirmative>, there is still a good amount of time here in Minnesota to go frequent your farmer's markets snap and E B T dollars are tripled at farmer's markets

Speaker 2: 19:19

Snap and E B T means yes.

Speaker 3: 19:20

So snap is supplemental food

Speaker 2: 19:22

Assistance,

Speaker 3: 19:22

Nutrition assistance program mm-hmm<affirmative> and E B T is the electronic bank transfer those. So food assistance programs, if you spend$10, you bring your E B T card to a farmer's market, they will give you$20. So you'll have$30 to spend on produce at the farmer's market.

Speaker 2: 19:37

That's super cool. And people are listening to this all over. So look for your

Speaker 3: 19:41

Look for your local farmer's market. There's

Speaker 2: 19:43

Farmer's markets everywhere.

Speaker 3: 19:44

And when kale is in season, which is thankfully now for a while, not just kale, any other greens, collared greens, spinach mustard, greens, charred. You can buy a bunch of those if your finances permit and then freeze them so that you have those in the winter, you could buy a bunch of tomatoes, cuz tomatoes are also kind of coming into season right now and you can freeze those. Um, and so there's ways to kind of plan ahead, which I think is an important food skill that a lot of people have not lost forever, but haven't been practicing lately. I would say, get to know a farmer, um, a farm stand if you're, if that's available. And there are farmer's markets all over the Metro area and um, different days of the week. So pretty easy to find and then consider buying in bulk. So this can be a really cool cost saving and environmental saving mm-hmm<affirmative> approach. And more and more grocery stores have bulk sections. So you could get two cups of lentils or beans for super cheap and you've saved the packaging. And the thing is you need to know a little bit of cooking skills to be able to make those into food that you can eat. You can't eat dry lentils, but you, uh, can cook them pretty quickly

Speaker 2: 20:54

Be like eating gravel. Yeah.

Speaker 3: 20:56

It, I don't recommend it.<laugh> yeah. So some basic cooking techniques can also make food dollars stretch and don't have to take all night or all day to make some good food.

Speaker 2: 21:05

These are great tips. I have heard reexamine your beverage choices probably as number one, I've heard number two by local. And if you can, you know, locate a farmer's market and buy in bulk, those are three things that most of us with a little, little planning, a little a forethought could do. Yep.

Speaker 3: 21:20

And they're also really pretty accessible, um, resources for learning some cooking skills. If that's something that you haven't learned from your life so far, that's one of my passions is to, to help people learn how to cook. And so I teach cooking classes in various places. I co-teach with a chef, a local chef named Jenny Breen. Uh, shout out to Jenny. We do a class that is online free to the public that has been, um, put on by the sickle cell foundation of Minnesota. It's also possible to find our past episodes on YouTube under the sickle cell foundation of Minnesota, that's called cooking for your health. And we, um, try to make it a little less intimidating to make your own food.

Speaker 2: 21:58

Awesome. That's terrific. Kate and listeners, we're gonna put a link in a few links actually to the sickle cell foundation of Minnesota, uh, to the YouTube videos where you can learn a little bit about cooking and, and, uh, we'll, we'll try to put some links to some of that information from Michael poll as well. So Kate, all of what you're talking about makes perfect sense about where we should be shopping and about the food systems and the layers of care. But it strikes me that not all people have access to all aspects of what you're talking about. How do you respond to that?

Speaker 3: 22:31

That is a very important thing to recognize in this whole conversation. And it's something that's very important to me. Whenever I have conversations with people about food. Whenever I teach about food is really helping people to understand that our food system is not equitable and that many, many of our neighbors are not able to access food that is healthy, that's nourishing or that's affordable. And that access can be geographic. There's not a grocery store in their community, or they're not a good source of quality food and that's not right, frankly. And it contributes to health disparities and it contributes to chronic disease. And in my opinion, there is some intentional design behind the inequities in our food system. Just like we talk about in, in medicine. And I teach this in medical school, in my role there, it's called the social and I would say structural determinants of health. So how much access we have to food? What the environment we live in is like the air, the water, our access to green space, the levels of stress, the safety in our neighborhood, all those things bear on our health. And I will say too, that there's some really phenomenal work going on in some of our poorest neighborhoods in Minneapolis and St. Paul around more equitable food access. And so on the north side, there's a whole movement, a coalition called north side fresh and there's community gardens cropping up. There are programs for youth through appetite for change, excellent organization that I know hang up in healthcare has some partnerships with in St. Paul, the frog town farm is a urban farm. There's more and more of these kind of urban farming and gardening initiatives that are trying to address the health disparities about food access.

Speaker 2: 24:14

Well, you know, we can talk about what should I make as an individual decision and part of it's about my individual decisions, but part of it, what is, is the things that are built into our system. Exactly. That make it difficult for people. So really thank you for bringing that aspect up, um, about, uh, about this topic. You're welcome. Thank you for being here. You know, I, I started off the show saying that I hope we're gonna get folks to think about food in a different way. And I'm thinking about food in a great different way. And I just wanna tell people, you know, if you could have a doctor that talks like Dr. Shafta, wouldn't that be great? Well, we have one right here at Hennepin healthcare. I'm just so thrilled that you were able to come and share your expertise with us. Thank you so much.

Speaker 3: 24:49

It's really my pleasure. Thank you for inviting

Speaker 2: 24:51

Me. We've been talking to Dr. Kate Shafto here from he uppin healthcare about food, and I'm really glad you were all able to join us. I hope you learned something and I hope you're thinking a little bit differently about food and its relation to not only your health, but to the environment, which I think is a really interesting point that you made earlier. I thank you for joining us. I hope you'll join us for the next episode and in the meantime, be healthy and be well.

Speaker 4: 25:16

Thanks

Speaker 1: 25:17

For listening to the healthy matters podcast with Dr. David Hilton, to keep up to date with the latest in healthcare and your health, subscribe to this podcast, wherever you get your podcasts for more information on healthy matters or to browse the archive, visit our website@healthymatters.org. And if you have a question or comment for the doctor, email us at healthy matters@hcmed.org, or give us a call at six one two eight seven three. Talk to catch all the latest from Dr. Hilden and the healthy matters podcast. Follow us on Twitter at Dr. David Hilton. Finally, if you enjoyed this podcast and would like to support us, please leave us a review and share the healthy matters podcast with your friends and family. The healthy matters podcast is made possible by Hennepin healthcare in Minneapolis, Minnesota, and engineered by John Lucas at highball executive producers are Jonathan Camuto and Christine Hill. Please remember we can only give general medical advice during this program. And every case is unique. We urge you to consult with your personal physician. If you have more serious or pressing health concerns until next time, be healthy and be well.