Improving Food and Nutrition Practices to Reduce Arthritis Symptoms

and my guests as your weekly walking buddies. We'll hear stories from caregivers and gain tips and insights from health experts and advocates who know how important it is to take care of yourself and manage joint pain due to arthritis that often accompanies being a caregiver. Together, we'll find community ourselves and maybe even alleviate some joint pain in the process as we walk together and connect to the best parts of being a caregiver. Hello, fellow caregivers, Welcome

back to care Walks. Thanks for joining us again. All right, now, just a reminder. Right now you're listening to the full version of this episode, but if you don't have time for a full walk today, then go check out our bridged version of the same episode. It's like cliff notes for podcasts. So now that's taken care of, how have you been. We're a few episodes in now and I just wanted to check in and see how you're doing. Have you been asking for help? Have you been taking

a walk every day? Are you reaching out to find community? Don't forget these are important ways to refill your cup. And what about your eating habits. Are you getting in fruits and vegetables and other healthy foods into your daily diet. I know you have a lot on your plate, but I just want to say I am so proud of everything you've done to take care of the ones you love and the progress you've made and taking care of yourself too, and now that you've started adding move it

to your daily routine. I want to spend this episode learning about the role diet and nutrition play and combating joint pain due to arthritis and improving our quality of life. To help us better understand how our self care can be applied to the kitchen, I've invited Dr Monica Agarwall to join me on today's episode. Dr Agarwall is an adjunct clinical Associate Professor of Medicine in the University of

Florida Division of cardiovascular medicine. She's been conducting research on the impact of diet on everything from physical fitness to mental health. I'm really looking forward to talking to Dr Agarwall about her work and learning about how we might be able to use diet to treat the symptoms of our joint pain. But before I share today's conversation, let's

set out on today's walk. Let's start with loosening your shoulders and walking with ease and letting go of the day and just focusing on the in and out of your breath as you walk, take some time to reflect what has brought you peace in your body today. This moment could be anything from a tight hug, to your morning stretch or the taste of a nourishing meal. Check in with these feelings, how has this moment of peace made you feel? Carry that piece with you through our

walk today. I want you to think about all the aspects of our health that help us stay powerful and strong, And as you set your pace for the duration of the walk, we are going to dig into some simple nutrition strategies that can go a long way and helping us protect our joints from the inside out. Today I am joined by Dr Monica Agarwall an adjunct Clinical Associate Professor of Medicine in the University of Florida Division of

Cardiovascular Medicine. Dr Agarwall's book Body on Fire, How Inflammation Triggers Chronic Illness and the Tools we have to Fight it outlines prescriptions to help guide people to better health. And now she has a cookbook, Body on Fire, Anti Inflammatory Cookbook, Your Guide to eating plant foods that Fight disease. Dr Agarwall, thank you so much for joining us today. It's my pleasure. Thank you so much for having me. Tell me what first got you interested in studying nutrition.

You know, I am Indian by birth, so maybe my whole life my mom told me to eat turmeric or you know that I would do better if I slept more, or to you know, eat more kuman and mango powder beca as it was going to help me with this or that, And so I always sort of grew up in that kind of space and when I was in fellowship, So in training for cardiology, you go to medical school, then you do three years of internal medicine, and then

you do three years of cardiology fellowship. You're in school forever. And then during that time I also did an integrative medicine fellowship, so I was always interested in integrative practices, trying to maybe I don't know the combination of east and west, but it really didn't kind of hit home for me until I myself became sick. So when I finished my fellowship, I decided to have children. And when I got pregnant, it was the most amazing thing. But I decided that, oh my gosh, I you know, I'm

older now, I want to have all these kids. So I had three kids within four years. Four months after I had baby number three, I started manifesting joint pain and it started with a finger and it migrated to my knees and my shoulders. Within a two week period, I went from being a runner, active, full time doc

to being unable to climb the stair. You know, very dark time in my life where I was diagnosed with a very poor prognostic form of inflammatory rheumatoide authritis, and I went from nursing a kid, doing all the things I normally would do, and within a week of my diagnosis, I was told that I needed to stop nursing my kid and get on these medications. And that's a humbling feeling and I remember this feeling of being small and being told that there was I had an incurable illness

and I needed to get on medications. There was no way I was going to come off. So I just needed to accept that. And that's interesting for a doctor because I thought, you know, it's not that I embrace medications. I was trained with medications. But isn't there another way? Isn't there other things? Aren't there other things that we can do to make our bodies better? So I started on a path of learning about how lifestyle impacts your body. I met a woman who said, maybe your nutritions bad.

And it's ironic because I was vegetarian. And I was probably a jerk to her because I said, like, yeah, no, I'm vegetarian. I got this, But I was an unhealthy vegetarian as many of us are. What does that mean? An unhealthy vegetarian? Stop right there? Yeah, yes, a good question. I feel seen right now, So tell me what that tell me what that means? Well, that's a that's a

good question. And so there are many people who call themselves vegan or vegetarian that eat a lot of unhealthy foods, And to be fair, veganism is often an ethical choice and not necessarily a health choice. But we have to remember that there are many vegetarian and vegan foods that are not super healthy. Doctors actually get very little education and nutrition. So it took me years of training after my training to learn how to educate people and how

to heal my bone body. And so I had to learn a lot about the impact of what we eat, how dairy infects your body, how fats affect your body, how all of this stuff triggers inflammation, how inflammation triggers illness. And I went through this process over years of educating myself. Well, let me go back a little bit too. When you're talking about out being a mom of three and then you get this diagnosis, I'm a mom of four. I started off with twins at I'm completely blacked out those years.

I don't remember a whole lot, but what that that must have been, and you touched on it a little bit, But that must have been so difficult to be raising these little ones and then you get this diagnosis. It's remarkable, but I mean, this is your journey. I want to shift to the way we can care for ourselves and how we can take better care of our bodies with nutrition. So let's talk inflammation because I know you know a lot about that. What exactly is inflammation? How does food

contribute to or combat it? Yeah, so inflammation. I always described to people that inflammations like your body is mad at you. That's why the title of the book is called Body on Fire, and I always describe it to people is that your life is full of stresses and resources. And just think about the stresses in your life. Well, there are lots of them, especially in two thousand twenty two. There's our constant dinging of our phone. There's the lack of sleep, the job stress. Am I going to get

this job? And do I have this job? Do I have enough money? There's lack of exercise, there's the foods that we're eating. All of these things are stressors on our body. But then there are all these resources too, and that's something that we forget. And there's all these resources like healthy, clean eating. There's sleep, there's movement, there's gratitude journaling, there's all these things that you can do switching off your phone and these are things that you

can do for resources. And it's funny because you know your cell phone goes to seven percent and you panic, right, you run over and you're like, I need a charger. I need a charger. But we've forgotten how to charge ourselves. Right. We heard so much focused on the demands in our life. God, I remember when I was in medical school used to talk to people and be like, pulled an all night

or ace the test. What a jerk I was? You know, Like who talks like because you're so proud, like you were as a badge of honor that you didn't need the sleep, But you know, we should honor people who sleep and who take naps and take time for self care and recovery. You brought up nutrition, and so what we're focused on in terms of nutrition. Gosh, there's so many things you can do with your diet and people

don't realize, like, wait, what, There's so much you can do. Absolutely, So there's all these toxins we put in our body right now, and some of those toxins are things like refined foods and processed foods. So think about all the instant foods that are out there, or the open up the box and put it in the microwave for three

seconds and it's made. Those things are very refined and What happens with all those refined foods is that they go inside your body and they activate your insulin, your sugar levels go up, and they process really fast, and they're actually the foods that give you the high and low.

So if just think about, for instance, you worked all day and then at midday whatever, you go to lunch with your friends, you go to olive Garden or something like that, and maybe I shouldn't have said all of garden by some restaurant like that, and then I know. And then you you eat like a pasta meal which has no fiber in it, and it's loaded in cheese and fat, and you eat the bread that comes with it. And so people are like, oh my gosh, I'm so tired,

I'm not getting enough sleep. I know what I need. I need more protein. Well, actually that's not the case at all. Most of the time, it's neither of those things that they just need to cut out their sugar. So a lot of those refined foods and sugars are source of inflammation. Another big sources animal fat, unfortunately, and mostly fried animal fat. People say, well, what am I supposed to eat if I don't eat that kind of food? Well, gosh, there's so many things out there, and really the foods

that we want people to eat our anti inflammatory. There are fruits that are antioxidants, like blueberries and berries in general. There are spices like turmeric that are super potent in anti inflammatory. So all these things that you can do to combat to take out those inflammatory foods, and you add back some of that anti inflammatory food and boy, there you go. You know, when you say refined sugars, it sounds a lot like uh that is also carbohydrates.

Is that accurate? So our carves something that we should widely avoid. Oh, I'm so glad you asked that because there's such a fear of carbs and I kind of added to that just now, and I appreciate you bringing that up. So, you know, I think the thing that people need to realize is that carbohydrates are this humongous bag of different things. And there's complex carbohydrates and then

they're simple carbohydrates. Well, complex corbohydrates or foods that when you eat them, they take a long time to digest. And so because of that, your insulin level goes up slowly, your sugar level goes up slowly, You feel full longer, and you don't feel hungry. Well, those are complex carbs like beans and keen wa and whole whole whole grains that don't have other additives in them. And so when we tell people we want to avoid cobohydrates, we want

them to avoid those simple carbohydrates and refined carbohydrates. Then those are things like your candies and your cookies, and your crackers and your sodas. Those are the foods that we want people to avoid. Now, one of the caveats is fruits, because fruits, and while they are simpler, they are loaded with so many nutrients and fiber which make them healthier and cleaner. In fact, study show that people should eat about fifty of their diet on a daily

basis should be carves. I'm curious about what a day in your life look like for you. What is the favorite part of your work. I spend an hour long with my patients and I do a preventive evaluation. And it's intensive. Isn't it that we're treating the whole person? Right?

We've just forgotten that. And so I find that sometimes in my practice, the best thing I do is I teach people how to meditate, or I give them sleep techniques, or I teach them how to move their body when they have severe arthritis, or I teach them how to eat better and cleaner. I talk to people about touch and intimacy and love and connectedness. And you know, I'm a hugger, and you know COVID was hard because couldn't hug for a little while there and write at a

sad story. Recently write a patient. I asked her to look in the mirror, and I said, what is it about yourself that you love? And she didn't want to look. She didn't want to look in the mirror. She didn't want to see who she was. She said, there's nothing about me that I love. And you know, I think that there's a lot of people out there that are suffering from that sort of lack of self love, the joy. There's just so many areas there. And so I think maybe the thing that I love most. You asked me,

what do I love most about my work? I love most. When people walk out, they say, you know, I feel better, or they'll say, now that I've talked to you, I know I can do this. But for me, I think you can't feel hope until you take time for you, for that moment for that pause and really sort of appreciating what it is in your life that you have. It's the beauty of the earth, It's the people in your life, the people who give you love and love you and you love. It's your plan, it's your puppies.

It's those things that allow you to feel like, Okay, I'm okay, I'm okay, I can't get through this. And I think I'm a big fan of gratitude journaling. I was just gonna say, you feeling so much gratitude listening to all of the things that you're saying that hope emanates from, and yes, that's so important. I do that as well. Oh I'm so glad you do. And I

really encourage that. I tell people, get a journal, doesn't have to be some fancy thing, and just get, you know, right every night, right, three things in there that give them joy or that they're thankful for, and they will see and you will see and everyone will see how much they feel better. You know. They's sometimes simple things that we enjoy in our life are okay to be happy with. And then it's just starts this process right of sort of remembering and appreciating the things that we

do have. We'll be right back with more from Dr Monica ager Wall. And now back to my conversation with Dr Monica ager Wall. It can be really hard to change our eating habits. What would you say is the simplest nutritional adjustment someone can make that would have the most impact on someone's movement. So I know that change is hard. People tell me that every day, um and

certainly I have gone through it myself. But I always remind people that even though change is hard, change is good and that a little bit of change every day can be very impactful. So if I were to tell people something that I would like them to do, to cut out inflammatory foods or sort of make a choice so that they can feel better, I would say two things, and I would know you said one, but I would say cut out two things. And I would say cut out your red meat and cut out your instant pro

cess food. Start there as the remove and you will see I promise. In fact, if I'm wrong, you should send me an email and tell meybe, and I will send you a gift certificate to your favorite restaurant, because I will tell you that in six weeks you're going to see such an improvement. I mean, this is what I study. And so in fact I put people on this dietary change. In six days, I was able to show people's blood pressure got better, their cholesterol got better,

they felt better, their quality of life was better. It was incredible. I mean, six days you can make a change. So if you give people six weeks of a lifestyle change, the sky's the limit. The other thing that I'm really not a huge fan of is a dairy. I'm not a huge fan of dairy. That data in terms of dairy is controversial, is what I would say. And so I think that people have this perception that milk it does your body good. Right, we all grew up with

that I need milk to make healthy bones. But if you look actually around the world and you look at the countries that have the most milk intake, well it's America, Sweden, Europe, Australia. We actually take in the most dairy in the world. And if you look at the countries that actually have the highest amount of hip fractures and bone fractures, what are those countries, Well, it's America, Sweden, Australia. So the same countries that have the most amount of milk in

take actually have the highest fracture rates. In fact, the countries that have the lowest fracture rates have the lowest milk intake, like India, Africa, Peru, where they have very low amounts of dairy intake and they actually have very little joint pain. And that just shows to show so many things that you know, dairy isn't the end all. Yes, we do need calcium, but we need vitamin D which comes from the sun. We need vitamin K, which comes

from our green leafy vegetables. And it's the combination of these kind of things that actually will build bones. And it's not necessarily the milk and the cow's milk that people focus on. And I think caregivers and people who are sick, they off been, you know, they feel stuck too, and so I think that it's really key to sort of say, well, gosh, you know, I can make simple changes and I might feel better. So let's start with these small things. And um, almond milk is super easy

nowadays because it's everywhere. You just have to be careful because there are a thousand brands and half of them have stuff in that I've never even heard of. So try to get an almond milk where the ingredients are almonds and water. Um, if you write like so, why can't almond milky as easy as almonds and water? But somehow it's just not. So. The other thing you can do is you can make your own almond milk, which

is super easy. I'm not going to ask you to soak almonds and peel them off all of what you can do, but you can just take almond butter, and you take almond butter, you put a few scoops into your blender with some water pressed blend, and there's your almond milk. Crazy easy and super cheap. So I like almond milk there. My husband is a little bit more into those plant based cheeses that are out there right now that are um cocon and oil and oil based.

You just have to be careful because they're not healthy and so they're not going to make your cholesterol go down. The other thing you can do. Another trick is nutritional yeast, which is high and beach twelve, which most of us need, is a great way to get that cheesy flavor. Yes, we speak to a lot of caregivers on our show and and with many caregivers. Their time is dedicated to focusing on the health and wellness of others. How do

you approach nutrition with time boundaries? Like finding fresh veggies, cooking whole really good meals, snacks on the go. That's something that I know I struggled with. So a couple of things you can do is pre cooking. I'm a huge fan of, So don't be embarrassed used frozen food first of all, like embrace frozen foods, and then batch cook like cook ahead of times and buy an instapot.

Insta pot is like heaven on Earth. The other thing for snacks, you know, I carry those baby carrot bags around, and I carry tubs of hummus around, and I carry peanut butters or almond butters, which are really good ways to get snacks. Those are sort of clever ways to get them, in very clever Hocken. Movement and physical activity aid in our approach to nutritions. Specifically, can it help our bodies absorb nutrients better. So there's nothing negative about movement. Okay,

that's wrong. If you overdo it, as you overdo anything, you can definitely impact your health negatively. But in general, movement is going to be really good for your body in every way because it helps you process your food is better. It helps your digestion better. If you have extra sugars in your body, you're going to process them better when you move. If you're eating those healthy, anti

inflammatory foods, your body will move better. And so the most important thing that our person can do who has oustoth right is they can start doing activities that cause impact. We call those weight bearing exercises. So movement where they have to walk and move is very good for austro arthritis. The problem I think where people don't move as much

as because they're so darn tired. People are just tired, and I think that taking that time for that sleep, you know, really trying to stay away from television at night. And I always tell people that if the goal is to sleep first, first of all, the average person should sleep seven to adults should sleep seven to nine hours a night. Most Americans and do not do that. Seven to nine hours is accurate. And you'll see that the

people will rest more. You rest more, you eat, you'll be interested in eating more better, You'll want to eat better, you'll make better choices, and you'll want to move more just because you slept. You know, the life of the caregiver is hard, and it's usually women, isn't it. You know, we as women, we ignore our own health in favor

of taking care of others. In fact, if there's a random statistics that women actually they hell have symptoms of angina or chest pain that's related to heart pain for so much longer before they actually go to the hospital because they downplay everything. They downplay their own symptoms and that's very, very common and sort of tragic to me.

Something that's why I really focus on self care. So it's tricky when you're in that situation where you have to take care of people and yourself, Like, how do I do it all? And if I give people anything, I give people that hope because as a patient myself, I was given no hope. I was told that I had an incurable illness, that I would not get better and I just needed to accept it. And that's not something that I ever want to do to anyone else. And so I think maybe if I do anything, I

give them hope. Yes, And that's so important. Dr Monica Agarwalla has been so awesome speaking with you. I have been taking notes. Boy, this has this been very very enlightening. So I really appreciate talking to you today. Thank you so much for joining us on care Walks and that was an honor. Thank you so much. I appreciate you having me. I want to thank dr Agarwall again for

being my guest today. You know, I'm constantly learning about my own habits and routine with each episode of this show, and I hope you will take away some valuable lessons about nutrition for you and your family. And remember keep walking and don't forget to take care of yourself too. That's it for today's episode. Don't forget to join me next week, when we talked to family caregiver Lakida caston about the importance of finding community to fend off isolation

when you're a caregiver. Care Walks is produced by I Heart Radio in partnership with al Teren Arthritis Pain Jael and hosted by me Holly Robinson Pete. Our executive producer is Molly Sosha. Our head engineer is Matt Stillo. This episode was written and produced by Sierra Kaiser, with special thanks to our partners at GSK Platform, GSK, Weber Shandwick and Omen