Shefaly Ravula - Nutrition That Heals Can Also Taste Good
SUMMARY KEYWORDS
people, food, eat, patients, shefali, understand, nutrition, cooking, practice, bit, hear, question, health, medicine, metabolic, classes, lipid, teach, practitioners, phil
SPEAKERS
Jack Heald, Shefaly Ravula, Dr. Philip Ovadia
Jack Heald 00:01
Welcome back to season 2, episode 26 of the Stay Off My Operating Table podcast. Our host and founder is Dr. Philip Ovadia, there in the fancy blue shirt with his name on the chest. I'm your co-host, Jack Heald with no name on mine. Phil, you need to send me a shirt, man.
Dr. Philip Ovadia 00:21
Yes, we need to get to some of the swag.
Jack Heald 00:25
And our guest today is someone I'm really looking forward to hearing from Shefaly Ravula who calls herself, let me get this right, the... Now I'm not gonna get it right. Nutritionist... Help me out Shefaly. It's this cross between two disciplines that I found really interesting.
Shefaly Ravula 00:48
Right? In fact, I had to create a Venn diagram to really explain who I was and what we do. It was like a little center point of all kinds of different medical philosophies. I'm a culinary educator, and a physician assistant, and a nutrition educator. So, it's kind of...
Jack Heald 01:06
We've got culinary expertise, physician's assistant, and nutrition. There was a fourth circle on that Venn diagram. I remember that too. Sorry. I don't mean to put you on the spot there.
Shefaly Ravula 01:20
Well, I would say that's about it. I love gut health, metabolic health, and culinary medicine. Yeah, I put them all together.
Jack Heald 01:28
Very good. Well, Phil, I think I know why you invited Shefaly.
Dr. Philip Ovadia 01:34
Exactly, I think you covered it pretty well. So, I was fortunate to being introduced to Shefaly by a mutual friend of ours in the healthcare world. And her background as a physician assistant as a clinical practitioner that she has now combined with her interest in nutrition, interest in cooking, is really caught my interest. And I think one of the phrases that I think that I first saw from her was culinary medicine. And I really love that it really, of course, goes along with what we talk about every week here on the podcast. And so, I'm looking forward to digging into that with her. So Shefaly, please go a little bit more into our back into your background. Tell us how you got to where you are today and how all of those aspects of your life have come together.
Shefaly Ravula 02:36
Yeah, for sure. Do we have 2 hours because I feel like I'm really old. And I’ve taken me a while to get where I'm at, where I'm bringing everything full circle, but I'll try to keep it short. And you can interrupt me as you'd like. So, I straight out of undergrad went straight to PA school and did a little oncology for a while, a lot of in-patients on call care in Seattle, and then moved to Austin with my husband for good and been here for a long, long time now and worked in conventional medicine outpatient gastroenterology, and somewhere along that way, my dad had a heart attack. And he survived. In fact, he's survived twice. So, he's not listening to me because he's had one twice now. But this is back in the days when he had a pager so I was paged on call. And I had to fly down to Houston to see him and he's a thin, vegetarian man. And I was completely perplexed. Coming out of PA school, you don't learn anything about nutrition. And I thought, oh, this is a vegetarian, thin man who's had a heart attack. And honestly, that's what kickstarted me into a lot of self-study in cardiology, lipidology, and then certainly nutrition for cardio metabolic disease...
Jack Heald 03:58
Lipidology?
Shefaly Ravula 04:00
So yeah, I kind of have a fascination...
Jack Heald 04:03
What is that? Oh, you gotta remember, I'm the designated dummy here. So...
Shefaly Ravula 04:08
Well, Dr. Ovadia can definitely explain better than me, but yeah, I am jumping around here, but at my most recent position in conventional medicine, it was in a urology practice. And what I did there was not urology. I was hired to do really nutrition and functional medicine; I was hired to replace a registered dietician. And so, when I came on, and I saw these patients that had low testosterone and metabolic syndrome, and I was guiding them with a nutritional protocol, really, I became pretty well versed in reading lipids and understanding advanced lipid panels and just really understanding the physiology in that so I'm not a NLA certified lipidologist by any means, but I became good friends with them, and learned a lot.
Dr. Philip Ovadia 04:56
I'm going to jump in.
Jack Heald 04:59
Hold on, what is lipidology?
Shefaly Ravula 05:06
Go for it, Dr. Ovadia.
Dr. Philip Ovadia 05:07
Well, I was gonna jump in and just say that lipidology is a newer branch of medicine, of cardiology typically, that heart specialist that focuses on cholesterol levels, and the types of cholesterol and the amount of cholesterol that we have. And it sounds all great, and it sounds all fancy, but most lipidologists look at some numbers, and then tell people that they should lower their cholesterol level. And that's what it comes down to. So, and I'm sure I've just pissed off a bunch of lipidologists out there. But this isn't the first time and it certainly won't be the last.
Shefaly Ravula 05:50
And yeah, it's just one little piece of really what ultimately, I found to be more impactful is metabolic health and understanding underlying cardio metabolic disease, which is why I'm here with you guys, because that's really fundamentally what I think it needs to change. So, I'm going to back up a little bit. So, yes, my father had this heart attack. And I just became completely immersed in really nutrition for cardiac health, if you will. And it was mostly all self-taught, lots of conferences on integrative medicine, functional medicine, this, that culinary medicine conferences, I just did it all. And came to I then decided to quit my job in conventional medicine and raise my kids. And when I raised decide to raise my kids, I was like I'm going to become a cooking instructor. And I'm going to teach people how to how to cook and eat. And this was obviously, because of the GI patients I saw, but mostly because of my dad and the family history. And I started teaching Indian cooking classes, and did that for years. And then I realized one day, I don't eat Indian food every day. And the Indian food that I grew up with is completely unhealthy. And it's just it, particularly my region. Now, that doesn't mean all Indian food is unhealthy. But my regional Indian food where I grew up was very, not only westernized, but even in India in the region is not quite the healthiest. And so, would you
Jack Heald 07:23
Would you real quick, just give us the headlines on what that style of eating or what those foods are?
Shefaly Ravula 07:29
So, it's from the West in the state of Gujarat, which is predominantly vegetarian. Now rurally they're eating certainly better than in the bigger cities, meaning from the farms, lots of whole grains and legumes, lots of dairy because that's how they got their protein. But really, it changed over time over westernization. So, what I grew up in the US with, I was born and raised here, was a westernized version of Gujarati food, which was basically three quarters of my plate was carbs. And maybe I don't know, an eighth or a fourth of it was vegetables that were soaked in seed oils. Our favorite, right? From inflammatory seed oils, simple carbs, white rice, and really watered-down lentil curry. I grew up in a vegetarian household and all my family in India all 140 of them to count are strict vegetarians. I am not and I haven't been for many years. So that's good dropping food now. There's a lot of other regions. My husband is from South India, one region there. That's a different type of food. So really, the macros do change a little bit. Spices change a little bit. Yeah, they vary too. So, and then the grain component does change. The South are kind of more known for rice and the north and west are a little bit more known for flat wheat and other things. Really, so hopefully that helps. Yeah. So, I stopped teaching Indian cooking classes and I moved to Food as Medicine cooking classes, more of what we were eating at home. So more just unprocessed, Whole Foods, all kinds, all cultures. Because that's a passion of mine and I'm a foodie first, I think. I'm a foodie before being a chef or cook instructor, and I think taste is so important. And flavor is so important. And I think if we don't master that, we lose a lot of people in in patient care. I mean, it's just important.
Jack Heald 09:437
Phil, do you mind if I if I ask her a question about food real quick? This is not metabolic health. I am definitely a foodie. I'd like to hear your experience with teaching people how to, I think you said master flavors or master taste. Can you just 2 minutes real quick? What? Yeah, what the challenges are and, and how you're succeeding? Because my gosh, there's great food that was available to us.
Shefaly Ravula 10:23
Yeah. And I think if you start thinking outside American food and we start playing around with experimenting with spices around the world, condiments are key. Any kind of condiments, so sauces, dressings, vinaigrettes, whatever you name it, if you can get a handle on that, and really pack in the flavor. And whether it's bitter, savory, spicy, pungent, you can carry your vehicle the food that's giving you the nutrition a long way. Right. So, I think that yeah, I think condiments are key.
Dr. Philip Ovadia 11:03
Yeah, it's interesting that here in the United States, sugar has become the predominant flavor. There was a, and I forget where I was listening to this conversation or involved in the conversation of someone talking about, they were European, and they were bringing a product into the American food market. And basically, they were told that you have to add more sugar. Because Americans at this point, have gotten to a point where all we can taste is sugar, essentially.
Shefaly Ravula 11:41
That's absolutely right. Yeah.
Dr. Philip Ovadia 11:43
And I would love to hear your thoughts on what I've seen in myself. What I've seen in many of my patients, is when you take the sugar away, then they can actually start tasting good food again.
Shefaly Ravula 11:59
Yeah, I mean, and also the other preservatives and chemicals too. The purer the food we can get, the more people are going to actually enjoy it and discover it. I mean for example, brussels sprouts right now are a big thing, or have become a big thing. I think in Austin, we have a very famous restaurant named Uchiko that started the whole brussels sprouts craze, and they flash fry them and shred them and flash fried them and have this amazing sauce, and now you see them everywhere, but if you don't understand and learn how to prepare them, and they don't have to be that complicated. But if they're pure, as pure as possible, and then you dress them with something slightly or heavily, you can appreciate the real flavor. Like I said, I think the brussels sprouts are vehicle for flavor. Now, the brussels sprouts themselves are flavorful, too, but they could be a little bit more of an acquired taste if you're going to eat them playing or whatnot. So, yeah, I think sugar, I mean, Doritos, even chips I think now you and I can detect the sugar on the chip. But growing up, I would not have known.
Dr. Philip Ovadia 13:22
Yeah, we definitely build up that tolerance, and then you end up needing more and more of it. I want to step back for a minute, though, because you said you were traditionally trained physician assistant in the traditional health care world, and your dad has a heart attack, and you thought about the food that he ate. Whereas the traditional health care world, we think about, well his cholesterol was too high, he wasn't taking this medication. And we don't think about the food that people are eating, that leads to them getting these health problems. So, what do you think led you there?
Shefaly Ravula 14:04
I just was perplexed about his body, his phenotype like he was thin and tall. And then on top of that vegetarian, so I'm like, here's a guy with no obesity, with a clean lipid panel, actually, well, LDL because that's what I was taught right LDL and total cholesterol, but then lo and behold, his triglycerides were sky high, and nobody had told him and his HDL was super low, and nobody had told him and if they did, he didn't listen. So, who knows? But I just couldn't believe that. This is when nobody knew about TOFI, right? So, thin on the outside, fat on the inside, no one really understood that, no one understood visceral adipose.
Jack Heald 14:52
I just okay. TOFI
Shefaly Ravula 14:54
Not tofu, TOFI.
Jack Heald 14:57
TOFI, thin on the outside fat on the inside, I've never heard that before.
Shefaly Ravula 15:02
Yeah, we have a lot of those in the Indian population. And not only India, but we do have a lot of thin Indians with bellies with visceral adiposity, who are metabolically completely unfit. And they have no idea because they're thin. That was my dad.
Jack Heald 15:19
Okay. Yeah, I'm learning a lot here. Okay, this great.
Dr. Philip Ovadia 15:24
So how do you find now that it resonates with people, when you come at them, I guess, from a health perspective, but centered on food? Do you find that that message is well received?
Shefaly Ravula 15:42
I think so. I think people feel empowered. They don't have a lot of control over their... When they go get their physical, I think there are in a conventional practice, they might be told a lot of things, but no one no one really is talking about diet. But the first thing people ask is, “What can I do?” This happened in conventional GI. By the way I, I didn't finish the story of where I ended up, but I continued...
Jack Heald 16:10
Sorry, that I interrupted you.
Shefaly Ravula 16:12
I continued teaching the food as medicine classes, I joined up with a local integrative physician, we did classes together. And then I went back to GI because I thought, oh my God, I'm going to bring this to GI. I am going to teach people with fatty liver how to eat. I'm going to teach people with IBS that they don't need an antispasmodic. I'm going to get them off their PPIs blah, blah. Well, that was really hard. It was hard to... It wasn't that the patients necessarily weren't ready. It was the system that wasn't ready to receive me. I was alone. And so, it's just very, it's this you guys know, system?
Jack Heald 16:57
We hear doctors every week. It's fascinating.
Shefaly Ravula 17:01
So, I left while the pandemic hit. And it just happened to work out and I left and then I went to conventional urology to do the nutrition, which is what I really wanted to do. That was what I love to do. And now, this year, I started to begin a practice and it is not an insurance model. I think I did a lot of good in insurance, but it was really, it was very hard. And the patients are different population. It's there. Some of them are not ready to hear it. So, to answer your question, Dr. Ovadia, in a conventional medicine practice, I think it's 1 out of 5, or maybe 2 out of 10 patients that are ready to hear it, what I have to tell them like and also ready to act on it. So, if they're not coming to me, it's a few more steps, you know what I mean? So, it takes a few messages. It's like your email inbox, a drip campaign, you got to keep sending the messages, keep sending the messages until Oh, it clicks. Okay, this is really what I have to do. Yeah.
Jack Heald 18:10
So, the question occurs to me, are the people who come to you do we refer to them as patients or as clients or as customers? What's the terminology? The reason for that is there's a follow up question.
Shefaly Ravula 18:22
Yeah, great question. Well, I absolutely wanted to do the right thing legally. So, I am operating under my license. There are perhaps people in my field, what my field, I don't really know what my field is, other than it's a combination of functional nutrition and medicine and even precision medicine and lifestyle medicine. It's kind of like that's where that Venn diagram came up. But operate as coaches outside of offices. I got the advice of several attorneys, and it was suggested that I not do that. So, I call them patients.
Jack Heald 19:04
All right, so what's the profile of the typical patient for your practice?
Shefaly Ravula 19:12
Yeah, they're very different from, like I said, the conventional practice. They're already motivated, first of all. To increase longevity, to act on preventative medicine, to take charge first and foremost with food and nutrition, because that's probably the focus of my practice anyway, food and nutrition. So, they come to me because they're so confused about what to eat. So, I like to tell people, my sort-of motto is that I helped solve nutrition ambiguity for cardio, metabolic and gut health.
Jack Heald 19:50
Okay, as a marketer, I think I understand what you're saying but unpack that statement - nutritional ambiguity. If I landed on your web page and saw that I go, I have no idea what this is. What do you mean? Solve nutritional ambiguity?
Shefaly Ravula 20:09
Got it. Okay, so now I need to hire you because obviously I have to change that phrase. So, I have a questionnaire that I use for the last three years for any new patient was gonna see me and it was a list of 15 questions related to their food habits and their food relationship and I would say mark the top 2 things that most distress you about your diet or nutrition. And the top number 1 always is, I am so confused about what to eat. It wasn't money. It wasn't stress, it wasn't being too busy. That the number 1 was I'm confused about what to eat. So that's why I feel like I help personalize that approach for people because not everybody needs keto, not everybody needs modified keto, not everybody needs paleo, not everybody needs to follow their macros, not everybody needs to lose weight, not everybody wants to gain weight, et cetera. And some people need more energy. Some people need a mitochondrial food plan like the Scot, I mean, it’s...
Jack Heald 21:17
Okay. That's good. So, if you're listening, and you're one of those people who's thinking, I just don't know what to eat, then Shefaly’s who you want to talk to.
Shefaly Ravula 21:31
That’s right. Yep, you got it.
Jack Heald 21:33
And you're going to take it farther than that. It's not just going to be what to eat, but how to make it delicious.
Shefaly Ravula 21:38
Right? So, part of the membership practice includes access to weekly cooking classes. That's the Food is Medicine Academy that I teach. Because I just taught a class and their virtual whole practices, telehealth so I can see anybody all over Texas. But the Academy itself is actually open internationally. So, anybody can do that. And you just come in once a week, and you can watch anything recorded. You can ask questions, you can get it personalized in the sense of if you're somebody that hey, I need low FODMAP snack ideas, or
Jack Heald 22:15
I'm gonna stop you right there. I was just listening to one of our previous podcasts. Dr. William Davis used the word FODMAP, 6 times probably. What is a FODMAP?
Shefaly Ravula 22:28
It's not any one thing. It’s like five categories of types of saccharides and sugar compounds that affect some people that might that have been usually diagnosed with irritable bowel syndrome. And so conventional gastroenterologists often will put people on a low FODMAP diet to help...
Jack Heald 22:51
Okay, so FODMAPs category of food? Well, what things fall inside that category? Give me a couple of examples.
Shefaly Ravula 22:58
Garlic, onion, spring onions, certain fruits, certain vegetables, too. Yeah, it's actually quite complicated and hard for people that take a FODMAP list to the grocery store. Because it's not like it's all fruits and vegetables. It’s very specific ones.
Jack Heald 23:15
I just have heard that word so many times in the last two months. And every time I hear it, I think I should look that up and then I don't. Thank you. Yeah. All right. I didn't mean to interrupt you. But we have non-medical professionals like me who listen to these things. They're probably thinking thank you, Jack for asking what a FODMAP is.
Shefaly Ravula 23:34
Yes. Okay. Well, yeah. People ask about things like that. And we'll try to put it in the docket. Yeah.
Jack Heald 23:40
So how do you know? I mean, I assume there's obviously there's a questionnaire. Is literally just answers to questionnaires, does that point you in the foods they need and don't need? Or is there more to it than that?
Shefaly Ravula 23:53
So, if you're talking about in the actual practice as a patient, yes, it's a whole many visit, and sure diagnostics and a full metabolic evaluation that includes good bloodwork obviously, insurance covered comprehensive bloodwork, but going above that a little bit. Getting markers and looking for more optimal ranges is what I like to do. I'm a little bit more preventative, but to answer your question earlier about who's coming to see me, it's the ones that are already kind of doing the right things, and they're confused right now in my practice. So, some people like think why am I not losing weight I'm eating. I'm not eating out at all. I don't have any sodas. And so, we kind of I helped them there. I don't have a lot of people that are on the American diet.
Jack Heald 24:44
All right, you've just identified somebody who's already there. They have made the decision I need to get a hold of my health. They've come to the conclusion that the best thing they can do is eat right. And so, they started doing what they think eating right is based on whatever they they've been taught. And then they hit a wall or just aren't seeing the results that they want to see. And that's where you come in. Not seeing the reason. I'm doing that what I think is right, it's not working. Help me.
Shefaly Ravula 25:23
Right. And it's could be related to weight or a lot of the times maybe even the majority of the time honestly, it's not about weight. It's more about get me off my medication or I don't want to take a statin even though my doctor really wants me to which that's a whole another topic. I absolutely work with people like cardiologists, gastroenterologist, etcetera, I am not going to replace that person by any means. People that have low energy can't sleep. So, they're fatigued all the time. Or they have gut digestive issues that aren't getting, they're not getting the answers they want from the gastroenterologist. So,
Dr. Philip Ovadia 26:08
What kind of interactions do you have now, with the we'll call traditional healthcare system? And how did those interactions go? I imagine you still kind of at least talk with a lot of the doctors that you used to work with, and I'm sure your patients, obviously, they're seeing other physicians and other practitioners. Talk a little bit about what your interaction is with the healthcare system these days.
Shefaly Ravula 26:39
Oh, I love that question. They're very receptive. I've been here for a long time. I know a lot of the community here. I think they've seen me evolve. And they know, they've heard me speak. I'm not an extremist in any kind of food realm. And I'm also I also know my scope of practice. So, I'm not going to, like I feel like I don't want to, and I don't lose the trust of any other practitioners, because I'm still in that clinical space and had been off and on for the last 20 years, like, within my scope of practice, if that makes sense. So, they're very receptive, they're sending me patients. I've had cardiologists send me people, I've had GI, I've had some fitness trainers send me people. So, they're very interested in this approach. And I think I love the field of registered dietitians and clinical nurse, sorry, clinical nutrition specialist. And I often envy the fact that I don't have those letters behind my name. But I do think people are maybe sending them to me, because I have that medical background, and I algorithmically can, perhaps understand a diagnosis and know when to refer out. So yeah. Does that answer your question?
Dr. Philip Ovadia 28:07
Yeah, I think that was a great answer. As much as I recognize the shortcomings of the healthcare system, I think that more and more individual practitioners, individual doctors are waking up to this fact that what we eat is a major impact on our health. And we need to start addressing that if we're going to meaningfully change people's health.
Shefaly Ravula 28:37
Absolutely, yeah. And if you have a large gastroenterology group, or oncology group that doesn't have a dietician on staff, well, then it is going to be up to the practitioners, the PAs, NPs, MDs to answer those questions from the patients that ask, “What can I do about my fatty liver? You mean, I can't do anything?” or “Am I supposed to be constipated my whole life? Is there anything I can eat for it?” So, we've kind of kind of encouraged into having that role. so glad that you see that and appreciate that.
Jack Heald 29:22
So, what is you are left as queen for a day, huh? The entire country is required to sit down and listen to you. What is what's the one or two things that you're going to say start eating or stop eating? And I'm asking this question, because there's people who are going to want to get started here, but we got to keep it small and simple, small baby steps. If you're doing this, stop it or if you're doing that, if you're not doing that, start it so everybody's listening to the Shefaly, what's the one or two things you'd say?
Shefaly Ravula 30:04
That is so hard? Can the queen have an impact on like the farming industry and stuff like that? Or is this more the...
Jack Heald 30:20
You're the queen? You’re the sovereign. Your word is the law.
Shefaly Ravula 30:28
The queen should give everybody land and good soil and teach everybody how to garden and farm and raise animals or whatever it is that is from the earth that we need to eat. Okay, that's, that's kind of too big. If you're wanting, we want more...
Jack Heald 30:49
It's big. So how do we get there? I'm your average person who's thinking about Gosh, I wish Shefaly was in Iowa where I could... Where she could be, we could have a doctor page or page or I could be your patient, but I'm not. So, what will I do? Is there one thing I need to do that I'm not doing or one thing I should stop doing? Okay, that's fairly common across the culture.
Shefaly Ravula 31:17
Yeah. So, I would say cut out pro inflammatory foods. So, seed oils, processed foods. Cut out. It's hard to say cut. I don't want to say cut out carbs. Because that you need some carbs. Generally speaking, but since the majority of the United States and maybe the world I'm not sure, but I know that the United States is metabolically unfit and has some degree of metabolic inflexibility, that's probably a wise approach is to reduce simple carbs. And reduce pro inflammatory oils, sugar, things like that. I didn't pick one thing, did I?
Jack Heald 32:04
No. That's okay. You're the queen. And I think we've kept it simple. So, you're sitting here listening to this. And the queen has said cut out pro inflammatory oils and sugar and simple carbs. Queen, what are the biggest examples of those three? That I need to take out of my kitchen.
Shefaly Ravula 32:25
Yeah, so commercial vegetable oil, commercial canola oil.
Jack Heald 32:30
But I thought canola oil was good for you.
Shefaly Ravula 32:32
Right? So, it is chemically processed. It's been stripped up anything nutritious if it had anything in the first place. This is why we look for expeller pressed or manually pressed if you are going to have, for example, olive oil, I think all of those great, but if you're going to do that, you want to expel our press. You want too unfiltered. You do want it organic. You want it everything as local as possible. Local is hard but the other things are not that hard, depending on if you're living in a food desert.
Jack Heald 33:03
So, we can replace seed oils with olive oil?
Shefaly Ravula 33:07
Oh, I don't do blanket terms. I can't say that.
Jack Heald 33:12
We're trying to make it simple for folks to take that first baby step.
Shefaly Ravula 33:17
Sure. So, I would say the way to cut those out is simply by reducing the processed food because you're getting a lot of that on processed foods. So, if you cut out the processed food, by a good chunk, you will be cutting out a good chunk of those pro inflammatory oils. And then maybe you can cook with it at home because you're cooking at home. So, you've replaced eating out or processed food with cooking at home and then it's a little bit okay because you've done the math and you've cut it by like what two thirds maybe
Jack Heald 33:50
Thank you, your majesty, I appreciate it. So now, is there one thing, one food I should start eating or one category or something? Help me out here. I just want one more small step to get better.
Shefaly Ravula 34:05
I think protein. Most of us are deficient in protein. If we're going big like a big topic. Macros. Protein. I think a lot of people are deficient. I think when women and men get older like 50s, etc. your testosterone is going down. You're in perimenopause. You need to maintain protein intake to continue to not have issues with sarcopenia and I'll just describe that that is loss of muscle mass, which is a big problem. And if you are looking at longevity and wanting to live long and be able to bend down to pick up something when you're 75 or have a have a bath or a shower standing up without worrying about falling, you'd better work on your bone health and your muscle mass
Jack Heald 35:01
Now that's two really actionable things that someone can do, Phil. Yeah, cut out the processed food, increase the protein.
Dr. Philip Ovadia 35:07
Exactly. Eat whole real food, as we say, so often here. Talk a little bit more about the power, though, of people learning to cook, people learning to make their own food. And going beyond what a lot of people think of as cooking, which is taking a package out of the refrigerator or the freezer, and putting it in the oven or microwave, I'm calling that cooking.
Shefaly Ravula 35:34
Yeah, exactly. I think time is such a... People are so worried about time. So, because it takes time. 20 minutes, 30 minutes, you can make a good meal in 20-30 minutes, but that's still time and you're starving. So, you've got to... If you had a 9 to 5 job, and you're coming home, you're gonna come home hungry, if you haven't eaten a great solid lunch. So, I just can't emphasize enough that you can't come home hungry and cranky. You're gonna be cranky, because you've had a long day or whatever. But you can't also be hungry. Because if you're cranky and hungry, you're going to want your beer, and you're gonna want your fast food or whatever, so try to eat nutritionally mid-day, maybe even a good little snack in the middle of late afternoon, so that when you come home, you have a little time and you're not starving. And maybe you've had some brain food with almonds or whatever at 4pm. So that when you come home, you have 30 minutes, and you make time to cook. I will say, again, cooking classes empower people, and it's gotten much more streamlined now, because of the pandemic and everything's virtual, you can take cheap cooking classes. I mean, my program is cheap. It's like $37 a month right now, for a bunch of prerecorded classes and live classes and recipes and knife skills, etc. And it's not just me, it’s a lot of people out there. So, start a program, learn to cook, watch Food Network, I don't care. That's how I learned. I didn't go to culinary school; I learned... A funny story. I just spent literally; I had a job where I had 1 month off every 5 months. Great job. My first job out of school. So, for the one month, what did I do, I spent every waking hour watching Food Network, and then spent the next 3 hours, 4 hours cooking every day. That's how I learned.
Jack Heald 37:33
That's pretty cool.
Shefaly Ravula 37:34
It was I feel blessed. Yeah. I also learned from my mom growing up so.
Dr. Philip Ovadia 37:39
And what about that connection with our food? I think we have become so disconnected from our food, you just go to the supermarket and you buy some food, or, as we like to call it here on this podcast near food objects is a lot of what we end up buying. But for the most part, people don't know where their food comes from. They don't know the process that that food went through to get to them. And I think that that is a large part of what has gone wrong with our health is that we don't think of food as something to fuel our bodies anymore. We just think of it as this other... It's just something we need to consume, basically. And we don't think of it as being a powerful force, in our life and in our health.
Shefaly Ravula 38:40
Yeah, I totally hear you. I think, it's personally, I'm on that spectrum of like, okay, I started here at the, the upbringing I told you, and then I went to college and started eating probably more standard American diet type food, and then I've learned and learned and learned, but I still have a ways to go. I don't garden, I just kill plants in my yard. And so, I have that next step to go to, and I think that I'm still missing that food connection. I do go to the farmers market and I belong to a CSA. We have to belong to a CSA here and there. So, there's a little bit of that and we can't ask everyone too much. So, it just depends where my where my people are coming from. If you're a truck driver, and you are in the car all day long sitting and all you can get is whatever, Dunkin Donuts or Wendy's or whatnot, then I can't ask you to go to the farmer's market, right? So, but I can ask you to like maybe meditate for 5 minutes and think about... Well, maybe meditation you're not supposed to think about stuff, usually I'm not thinking I suppose, but you get a little, you train your brain you appreciate you have gratitude. I love gratitude journaling. And maybe that's the connection for some people where you may not actually go meet the farmer and understand where the food is coming from. But maybe you actually do a gratitude journal every day, and you write five things every day that you're grateful for, and it could be the food that you are going to have today, whatever it is, so yeah.
Jack Heald 40:27
Is this what you just describe something that you work with your patients with?
Shefaly Ravula 40:31
Yeah, I do. Because stress is... So back to my dad's case. I know we can't quantify this just yet. But in maybe not an Ayurvedic philosophy is, I'm not sure. But definitely, in India, there's a whole component of things that you can't measure, like these old Eastern medical philosophies that existed before evidence-based medicine. And so, there's some truth to it right now, turmeric is here to stay well, turmeric, I mean, I grew up on turmeric. And I grew up on my mom telling me things that still to me don't make much sense. But I'm much more open-minded about it now, like, eventually, there's going to be science that proves it. Like the bitters that she drinks every morning out of a bitter melon to help her try to reduce her blood sugar and actually, there is some science on bitter melon, it tastes terrible, you guys. I'm gonna say one thing about food as medicine, and that is, there, we can get a little crazy with food as medicine and get to negative food behaviors and negative food relationships. So, I think in our field, we have to be a little careful, because we obsess about it so much. But we have to be careful not to drive forward eating disorders and things like that. And mental health issues. And so, I tread that carefully. And it is a screening question on my questionnaire like and I work, if that came across, I would work with those people in my community that can see that. So, it's something to think about.
Jack Heald 42:20
Well, the reason I asked is because you talked about scope of practice. And one of the things, one of the common complaints we've heard from the various health care providers that we've had on when they were operating inside the insurance system, was how narrowly confined they were both in terms of, I guess, primarily in terms of time, but also in terms of what the insurance company would allow them to talk about, or prescribe or recommend, not so much that it was outside their scope of practice as a health care provider, but just, “Oh, no, if you tell them that we're not going to pay for it.” And so, it's exciting to me to hear that that a health care provider outside the system, such as yourself, can recommend to a patient, hey, maybe what you need to start with is a gratitude journal.
Shefaly Ravula 43:28
And so, to answer your question about the stress management, we talked about that a lot. And I think it's a driver of chronic illness, too. I just, we can't really quite correlate, and we have so many other things that contribute to chronic illness as well. So, I think my dad blames his heart attack on stress. He fully does, he thinks it's not his triglycerides, but whatever it could have been everything.
Jack Heald 43:58
So, I'm really interested in this, this food as medicine and with food as medicine. What are the handful of the most medicinally powerful foods that most of your patients and most of your cooking customers could incorporate into their daily lives?
Shefaly Ravula 44:21
Yeah, so if you're already off of the standard American diet, and you're not eating a lot of processed foods, and you're...
Jack Heald 44:29
We're gonna assume that’s who we’re talking to, the people who've already taken that step.
Shefaly Ravula 44:32
Yeah, yeah. So, then I think and this is where I'm at, this is what I, what we do, is really nutrient dense foods like avocado, good quality olive oil, nuts and seeds all the way, good quality eggs, lean, doesn't have any lean, meats, but for me, we use them in moderation. I just think I'm able to do that. Not everybody can then. And of course, sourced well, right, we want them sourced as sustainably as possible. Salmon is excellent. And you can get good sustainable salmon sources. Let's see...
Jack Heald 45:15
I want to put a pin in it here real quick, because it's very interesting to me that what Phil has been saying for a solid year, as we've been doing the show is eat whole real foods. He's not coming at it from the food as medicine standpoint, like you are. And yet, it's the exact same message. That's what I just heard you say? Eat whole real food.
Shefaly Ravula 45:39
Real foods. Yeah.
Jack Heald 45:41
Sorry, I don't mean to interrupt you. But I just realized you're, you're from a completely different angle, you're saying the exact same thing.
Shefaly Ravula 45:47
It really is. And yeah, in my classes I in with my one-on-one patients, there is a little bit more like, okay, I really want you to have beans, because they have a lot of trimethyl, glycine, or whatever for your methylation cycle, or, hey, I want you to have blah, blah, blah for magnesium, because your magnesium is a cofactor needed for the Krebs cycle or iron or whatnot so we're looking at it a little bit. biochemically, if you will.
Jack Heald 46:18
I'm just looking at from the big picture, the overall. You have 100 people who walk into your office, and you're gonna say, basically this stuff to the all hundreds of them.
Shefaly Ravula 46:29
Yeah, I would have been focused on really nutrient dense real foods, like you guys talk about here. And it was something else I was gonna say. Well, I forgot what I was gonna say.
Jack Heald 46:45
I have the same problem.
Dr. Philip Ovadia 46:46
So, one of the, I guess, criticisms that often will come up, when I start talking about eating whole real food and other people that I interact with bringing this message is oh, it's so expensive. And most people can't afford to eat that way. So, talk a little bit about what that looks like for your clientele and how you think this can be done affordably for people.
Shefaly Ravula 47:19
Yeah, for sure. So, my clientele right now is different, because they're already motivated, they're paying outside the system, they understand, they've already got the message, right. But the clientele I had in all the years past and conventional medicine. In a way, it's definitely something that really bothers people and it can be very, very difficult to change that mindset. I remember doing group visits, I did group medical visits for cancer patients for a little while. I love group medical visits, by the way, that should be a whole topic, but really talk about community and impact. That's like what a cooking class is to, right? Community and impact. And I remember one older gentleman with a history of prostate cancer, who was like, wait, you're telling me I need to buy organic milk instead of regular milk? I mean, that's $4 more and, and so it is and so, but there are so many staples, dried foods and space staples that are really budgetable. We have an organization in Austin called the Sustainable Food Center, fantastic group. They do cooking classes for low income, and they give them the whole bag of food, paper bag of food in these classes, and they teach how to sustainably use that bag of food for the whole for the whole week. And I mean, dollars wise, I can't remember I did, I taught those classes more than 10 years ago. But I want to say it was like $30 for the bag of food. And then they also did a class where they taught how to break down a chicken and have it last for the whole week, right? I'm sure you've heard of those types of classes, but it's doable. You have to get it's the mindset like, do we need to be having the cigarettes that costs blah, blah, blah, and do we need to be having that Frappuccino? Cut that out. And you could get yourself a really nice piece of salmon.
Dr. Philip Ovadia 49:34
Yeah, and then of course, what does that cheap food end up costing you in the long run? When you're going to the doctor's all the time and you're on all of these medications, which are certainly not inexpensive.
Shefaly Ravula 49:51
Right? Yeah, I wish we could change that mindset at younger ages. And I think that mindset needs to change at a younger age so that you're not stuck at 60, diagnosed with prostate cancer and then decide to change your ways. Those kinds of diagnoses do flip a switch for people but a diagnosis of prediabetes doesn't sadly.
Jack Heald 50:17
Yeah. What's your favorite patient story?
Shefaly Ravula 50:28
Oh, gosh, I love reversing metabolic dysfunction. So, if I show them their numbers and like resolving prediabetes, resolving gut health, getting people not bloated, getting people pooping. You asked me about one favorite one, let's see if I can think of our favorite. I feel like I've had a lot of different areas I can tell you one from right now. Yeah, I'll tell you this one. This is a woman who's an environmental chemist, I believe. And she is tired. She has ADHD, she goes to work, she's on site, and she comes home. And she's like, I just can't focus. I can't get off my ADHD medication because it saves me but I need help with that. I need help with my digestion, and I just need help my energy. And I've had her now for 3 months. And she is just sending people to me left and right, because she's so happy with her outcome of just improved energy and improved concentration. And this is all by... I do some supplements and nutraceuticals. But my motto is more that that's just to tide you over in the short run, because ultimately you want to get that with food. So, while you're learning how to cook and understanding what the right foods are for you, if you need a few nutraceuticals that are medical grade quality, we'll do that. But ultimately, I don't want you to be taking a bunch of pills, because I got away from that. Yeah.
Jack Heald 52:12
So, you did this just, she did this... Y'all did this together. Yeah. Just with changing what she ate. Yeah.
Shefaly Ravula 52:20
I can't take credit. This is more work for my patients than me. Absolutely. It is so hard. It's hard work. And it's commitment and slow baby steps. And it's doable. You need to give it time. Everyone's on a spectrum. I just told you mine. It could take several years before you get to a healthier place.
Jack Heald 52:44
Seventeen years ago, I was in severe metabolic crisis. And I was fortunate enough to stumble into an integrative practitioner who was able to diagnose me and put together a treatment plan. And I said, Doc, how long is it going to be till I feel better? I will never forget his words. He said you didn't get into this overnight. You're not gonna get out of it overnight. Yeah. And it was really helpful to have him say that because it set my expectations.
Shefaly Ravula 53:12
Yeah, it was a great statement.
Jack Heald 53:14
Yeah. Yeah. So
Shefaly Ravula 53:17
One other fun...Not fun, but we can talk about just maybe in a future, if you ever want me back, we can talk about nutrigenomics which is really cool. Up and coming.
Jack Heald 53:30
54 minutes into it, and you come up with a word like that, that I want to know everything about seriously? Nutrigenomics sounds like nutrition and genetics. Yeah, yeah. So, it's all okay, I got to commend you, because now we gotta have your back. Well done. Set the hook and leave us dangling there.
Shefaly Ravula 53:55
Well, I'm not good at marketing since we figured out my motto is at work. So that happened to be an inadvertent one.
Jack Heald 54:02
It was well done. And I seriously want to learn more about that. We should definitely have you back. Honestly, I would bet about 80% convinced I'm gonna sign up for your cooking class because I love cooking. But I'm also mostly a moron.
Shefaly Ravula 54:22
Well, you said you're a foodie. Right. So.
Jack Heald 54:27
Well, all right. Well, Phil,
Dr. Philip Ovadia 54:30
I gotta ask you one last thing before we go though. So, do you think it was destiny that your parents named you Shefaly and you ended up being the chef?
Shefaly Ravula 54:42
That is so funny. No. Okay. how Indian families have in general there's a generalization about Indian- Vietnamese having parents being tiger moms. etc., and academics, academics, academics, and my parents were a bit of anomaly and they really my mom really wanted me to run a household. Learn how to cook. I started making Indian food at age 9. And so, I'm not sure if the name was the destiny, because they didn't my mom didn't speak English until she immigrated here. And then she took English classes, so she didn't know what chef meant probably so no, probably not destiny.
Jack Heald 55:32
It is. I disagree. I think there were larger forces at work, perhaps guiding your mom and that choice of name. Yeah. Shefaly, it's been an absolute pleasure. And I want to just ask you a question after question after question after question. But we're not going to do that here. If folks want to know more, what's the best way to connect with you?
Shefaly Ravula 55:59
Yeah, so I have a couple of websites because I have the gold cooking instructor website. That's shefskitchen.com. So.
Jack Heald 56:07
Chefs, and that's chef with an S, shefskitchen.com.
Shefaly Ravula 56:11
And that'll point you to the medical practice and the courses and vice versa. So, the medical practice, if you're in Texas, and you want to take charge of your metabolic and gut health, it's precisionmetabolichealth.com.
Jack Heald 56:26
I have lots of friends in Texas. I’m going to point them to you. All right. Very good. Well, I'll remind our listeners, you'll find this information in the show notes. So, if you failed to remember it, just check the show notes. And it'll be there. Phil, any last words before we say goodbye to Shefaly for the first time, and then set her up for discussion and nutrigenomics? Did I say that right?
Dr. Philip Ovadia 56:50
As we've been saying season 3 is just gonna be going back through season 2 and getting all these wonderful guests back on. But it was great talking with a Shefaly and I look forward to continuing to work with you.
Shefaly Ravula 57:05
Yeah, I love being on and love talking to you guys and really appreciate the opportunity. Thanks for having me.
Jack Heald 57:13
You brought something different and it was really cool. I've loved it. Alright, well for Phil Ovadia, I’m Jack Heald. And this has been Shefaly Ravula. I was so close. This is the Stay Off My Operating Table. We had a Naiyiri Mississian last week. I’ve been practicing that one all week long. This is the Stay Off My Operating Table podcast. Thanks for joining us. Be sure to subscribe. We drop a new episode every Tuesday. And we'll talk to you next time.