Speaker 1: 0:09

Welcome to Freshly Forever, a podcast that gives you fascinating insights week after week. Here's your host, vaikumar. Welcome to podcast Freshly Forever folks. And today I have the pleasure of having here with us Dr Micah Yu. He is an autoimmune expert. He's here joining us to talk about the diet and lifestyle influences on autoimmune disorders. With his passion for learning and improving his patients' medical problems. With his passion for learning and improving his patients' medical problems, he has pursued multiple alternative medicine disciplines so that he can blend traditional and alternative medicine to give the best treatment plans to his patients. Welcome, dr Yu, to the show.

Speaker 2: 0:58

Oh, thank you so much for having me. It's a pleasure being on your show.

Speaker 1: 1:02

With you, having experienced an autoimmune condition. What do you think has helped you the most, dr Yu, in terms of diet, and when did you think you started seeing a change?

Speaker 2: 1:18

The way I discovered Whole Foods Plant-Based Diet was through my wife. My wife is a doctor as well. She's a family medicine doctor and at the residency program that we were at at Loma Linda University in California they have a lifestyle medicine program, which my wife discovered and she was learning from, and she introduced me to the concept of whole food plant-based diet. So I watched some documentaries, such as Forks Over Knives, read some books as well, so I decided I would give it a shot and see what this diet would do and, to my surprise, my pain miraculously went away and I didn't really have flares at all when I was on this diet. So, thank God. That's why I'm trying to share this message with the world, because a lot of people and a lot of doctors don't know that how powerful food can be and how food can be very healing.

Speaker 1: 2:09

Oh, very true, and I have my own story with IBD and I can certainly attest to a lot of things that you're saying, and, of course, I'm going to learn more from you as you speak, and I continue to learn every single day in my journey with health as well. You focus a lot on plant-based diet and nutrition, and does it have to be vegan, and what do you think are some of the major influencing factors for betterment of autoimmune?

Speaker 2: 2:41

health? Yeah, that's an excellent question. Um, so you don't have to be vegan to put your disease to remission? Um, there, there are so many types of anti-inflammatory diets out there. I like a whole food plant-based diet. So a whole food, plant-based diet for those that you that don't um know about it, it's pretty much going vegan, without processed food. That's what it is and I I've, you know, as a I've seen patients not go on a whole food plant-based diet that have gone through remission.

Speaker 2: 3:09

Some have gone on a paleo diet that have improved, made a trainer diet. Everybody's different. What works for one person doesn't mean it'll work for another person. Everyone's genetics is different and their disease is different as well.

Speaker 2: 3:22

With that said, fruits and vegetables have to be the core of an anti-inflammatory diet because of the phytonutrients and the fiber. With the colors in each fruit and vegetable, you see there's a different phytonutrient in them. Phytonutrients are micronutrients in these foods that are not essential to survival, but they're essential to maintaining your health and as you eat these foods, they will produce an anti-inflammatory effect in your body and it'll help your immune system. That's why it's so important to focus on these foods. I try not to put patients into one category for foods, I really try to emphasize fruits and vegetables in general.

Speaker 2: 4:07

Some people don't want to be vegan, and that's totally fine. I work with all types of patients and meet them where they want to be met. Some patients will eat meat. I mean not meat, but fish. Fish is known to be anti-inflammatory in a lot of the rheumatology studies. What I don't like about fish is that there's a lot of pollution and toxins in fish now that we didn't have thousands of years ago. So your oil spill, your pollution, goes into the fish. The bigger fish eat the small fish and then we eat the bigger fish and then we get that pollutants in our body. But overall, if you're looking at fish, apart from that, it's pretty anti-inflammatory. So I would say you got to eat your fruits and vegetables and whole grains. Whole grains are very important for an anti-inflammatory diet because of the fiber, but of course paleo cuts out grains but it still works for people.

Speaker 1: 5:01

And what about nuts and seeds and all the legumes and all the beans and stuff?

Speaker 2: 5:06

Yeah.

Speaker 1: 5:07

Talking a lot about fiber.

Speaker 2: 5:09

Yeah. So nuts, seeds and beans, legumes those are very important because they have fiber. Also, Like you said, they have very, very high fiber and they have protein as well. Your beans have high protein. Hemp seeds have high protein as well. So I really like those food products and I do recommend it to my patients.

Speaker 2: 5:27

However, there are going to be populations that will not be able to tolerate these beans because maybe the fiber content is too high. I know the paleo diet likes to cut these food groups out. I don't recommend that. I always recommend trying to incorporate as many food groups as possible, trying not to be too restrictive. Try to incorporate as many food groups as possible. Try not to be too restrictive.

Speaker 2: 5:48

Um, one of the reasons why some people um may react to the beans like I said before, it might be the high fiber content and they're just very sensitive to it's not because of an allergy, it's not because it's inflammatory. It's because possibly the microbiome the gut microbiome isn isn't adaptive to it. Yet A lot of people with autoimmune diseases will have something called gut dysbiosis. So your gut microbiome consists of over 100 trillion bacteria and your gut microbiome will have good bacteria and bad gut bacteria and in autoimmune diseases and almost across all of the spectrum. You have something called gut dysbiosis. So that means your bad gut bacteria overwhelms your good gut bacteria. When this happens, some of your bacteria that might be needed to digest certain foods might not be there because the gut dysbiosis needs to be replenished.

Speaker 2: 6:40

So that might be a reason why these people might not be able to tolerate beans and legumes and grains. That's why people like a paleo diet more. There is something very, very popular these days about the anti-lectin diet. So lectins are found in beans and legumes and some people potentially may be sensitive to them, but when you cook them, 95% of the lectins are destroyed, so that's not even an issue. There's no real scientific studies out there on lectins and inflammation. I only found one study in the past 10 years that have talked about this. Really, Maybe in the future we'll have more studies, but right now it's overblown and it's not really built on science and that's why it's probably important to soak the beans as well.

Speaker 1: 7:29

Correct the raw beans, you know the dry ones, yeah to get rid of the lectins and so for anyone listening here for them to transition to a better lifestyle they have heard you loud and clear so far as far as a whole food, plant-based diet and the beans and legumes, the fiber in general, the fruits and vegetables and whatnot. You talked about gut microbiome. So for someone to help build that is probiotics, a route, or even if they are not able to digest these beans and legumes, maybe they shouldn't go at it just overnight, but then start small and transition. Is that kind of like the recipe for success?

Speaker 2: 8:19

Yeah, yeah, if you can't tolerate these foods, you can work your way to success. Yeah, if you can't tolerate these foods, you can work your way to success. Try to incorporate just a little bit of it, just a spoonful at a time. Get your microbiome used to these type of foods. You certainly don't need to take a probiotic supplement to improve. There's probiotics in lots of fruits and vegetables out there. You just need to find them. There's prebiotics in these foods as well. So I don't recommend to my patients to go on probiotic supplements because they don't really need to, but I'm certainly not against these probiotic supplements.

Speaker 1: 8:51

Okay, but interestingly enough, of course, you and I here are having a conversation on a podcast forum, trying to just put best messaging out there, but this is not to be construed as medical advice or substitute for in-person medical advice. That is something we need to mention. But again, I stop my probiotic and my IBD feels a lot better, because I think it also makes me wonder there isn't probably a universal, one size fits all approach and there's not a single bottle that can cater to you and to me and to somebody else, right? So I have incorporated more and more colors into my food and all whatever you have been suggesting. Most of what you have said, I think you know I have definitely found results. So I'm completely in tune with what you're saying and I'm sure this is going to be fascinating for the listeners. So does gut microbiome also play a role in how the body reacts to medications and, in general, your mood and well-being overall?

Speaker 2: 10:06

So yeah, the gut microbiome does affect the mood. It's so important. You have a gut brain connection, so the gut is very important for mental health and also overall it's so important to everything. You can't emphasize the gut microbiome enough. So that's why food is so important.

Speaker 1: 10:30

Okay, you said mind-body connection there and I know you suggest several options for improving that situation as well, like yoga, meditation, things like that I'll have you talk about your social media follow at the very end. But if you can tell us how one can help achieve that and also a little bit more about the role of exercise in also helping to build the gut microbiome or making the immune system strong.

Speaker 2: 11:10

Yeah, so relieving stress is so important for immune health and to fight autoimmune disease. You can eat so good, so anti-inflammatory, but if your stress levels are high it's going to create inflammation. Still, you're gonna you're probably gonna flare if you have chronic stress. So there's so many techniques you can do out there. Um, you can do mind, um, guided imagery, you can do guided imagery. You can do meditation, yoga, tai chi, mindfulness, eating, just being mindful throughout the day, gratitude, journaling, coloring books and all these different things out there. There's so much you can do for stress reduction, biofeedback, getting a therapist, getting over traumas Past traumas are so important to get over for autoimmune disease as well. So there's so much you can do and I learned a lot of these techniques through my fellowship that I'm in right now through the University of Arizona's Integrative Medicine Fellowship.

Speaker 2: 12:05

It's a two-year program and it talks about all these different things you can help and you don't have to have autoimmune disease to do these things. You don't have to have any illness. It's very therapeutic and just to maintain one's health as well and just going to exercise as well. Exercise is anti-inflammatory. You have to exercise. It attacks the reactive oxygen species. It's a natural way for your body's immune system to get stronger. So if you can't walk, then stretch. If you can't run, then just walk. But any type of movement is very helpful.

Speaker 1: 12:40

And every small bucket of time that one can find I seem to read a lot about those kind of things these days suggested by doctors Every small bit that one can do like five minute, 10 minute intervals, all those are helpful.

Speaker 2: 12:55

Correct, Exactly.

Speaker 1: 12:57

Okay, something is better than nothing, definitely.

Speaker 2: 12:59

Yeah, okay, and.

Speaker 1: 13:01

I know you have like a quick breathing technique that you try to teach people like the four, seven, eight. Would you tell the listeners about it here?

Speaker 2: 13:13

Yeah, you can do this throughout the day as many times as you want. So this brings you back to mindfulness. So what you do is you breathe in for four seconds and then you hold it for seven seconds and you exhale for eight seconds, and I like doing this. It just helps me focus on my breath. If I'm really stressed about everything else, if I'm focused on my breath, I can't think of anything else. Some people also like to do the 5-5-5 technique. So instead of doing 4 seconds, 7 seconds, 8 seconds, they'll do 5 seconds of breathing in, holding it and then breathing out as well, and this can help with anxiety, depression and so many things.

Speaker 1: 13:52

Maybe even improving sleep as well. Right Like being able to fall asleep and does the longer exhalation like make you like more grounded? Is that why the eight in there?

Speaker 2: 14:07

I'm not sure. Yeah, that's a great question. I mean, when I do the eight seconds, it really makes me focus on the eight, because it takes a long time to get to eight seconds. So it just makes you more aware of the situation. That's why I like the eight seconds.

Speaker 1: 14:24

And just to touch back a little bit on the fruits and vegetables and the whole food plant-based diet is it important for someone to eat, necessarily organic?

Speaker 2: 14:37

Yeah, that's an excellent question. So the reason why I recommend organic is because of if you don't eat organic, you'll get something called glyphosate, which is a pesticide, and it's a breakdown of the pesticide. So you get glyphosate and that ends up in our fruits and vegetables. And the glyphosate has been associated with the leaky gut, so it does affect the gut microbiome. But you certainly don't need to eat organic in order to get better. I think the important takeaway here is to eat your fruits and vegetables, whether they're organic or non-organic. Just get them in. If you can't afford it, then eat organic. Glyphosate is an environmental toxin that I try to stay away from. But at home I mean if the price is right, then I'll get organic, but I mean sometimes organic is too expensive on that particular day in the grocery store.

Speaker 1: 15:31

Mm-hmm, and in those cases also, I think from my own personal experience. I just would like to share that growing our own fruits and vegetables whatever possible, even in like small container garden type of situations. I think that helps to at least give us peace of mind that what you're eating is not pesticide laden. Plus, it also helps connect with nature, with the ground, you know when we are out and about gardening.

Speaker 2: 16:02

Exactly Playing with the soil and all that stuff. Yeah, I agree with you completely. I think growing food in your backyard and your yard is the best because you know exactly what's going in it. Because even if something's called organic, it can still have glyphosate and these pesticides on them. That doesn't really mean it's pesticide 300%, because if they're growing well, one side of the farm is organic, the other side of the farm is not organic. The wind can blow all the pesticide over to the other side.

Speaker 1: 16:32

And being connected with nature, the skin is also a source to build microbiome. Is that correct?

Speaker 2: 16:37

Yeah, exactly.

Speaker 1: 16:39

Okay, okay, okay. Having talked about all this, let's just talk about some of the inflammatory markers that you said you typically check. Can you tell listeners what CRP is, what ESR is, and how important is it for someone to have their doctor check these if they experience aches and pains that seem to be indicative of inflammation?

Speaker 2: 17:06

Yeah, so C-reactive protein and ESR, which is sedimentation rate, are two inflammatory markers we frequently get in medicine. C-reactive protein is produced by the liver and sedimentation rate is just talking about how the red blood cells flow down in the test tube and the rate of it will help tell us whether there's a lot of inflammation or not. However, these inflammation markers are not 100% accurate all the time. It doesn't mean that just because it's negative doesn't mean that you don't have inflammation in your body. They're just biomarkers. I've certainly seen patients flare right in front of me with normal C-reactive protein and ESR, so it's just something nice to get, but it doesn't tell me the complete picture. And your ESR-CRP can go with autoimmune disease, but it can also go with infection, can go with cancer and it can even go with being obese as well. So there's so many reasons why ESR-CRP will go up and you really have to have the overall clinical picture of the doctor and the judgment of the doctor to determine whether this is significant or not.

Speaker 1: 18:11

Okay, having said that, if this is significant or not. Okay, having said that, do you believe that these markers can shift periodically based on what someone eats or how they carry on their lifestyle? Can say, any of these factors, like food or meditation or anything else, exercise, have a positive effect on these markers?

Speaker 2: 18:34

Oh yeah, definitely. I've seen patients who eat anti-inflammatory diet and their markers start going down. There's a really big study out there off the NHANES data that I think. They observed patients over 10-20 years and they found that the higher amount of fiber you ate, the lower the C-reactive protein of the population as well. So definitely food plays a huge role and stress reduction does as well.

Speaker 1: 19:02

Oh wonderful. What about gluten, doctor? Is it something that you tell patients to avoid, or is it okay for certain people to be eating gluten and certain others not?

Speaker 2: 19:18

So gluten in medicine mainly affects celiac disease patients. So if you have celiac disease, you cannot tolerate gluten because of an antibody. It will affect the small marcovilli in your small intestine and so there's a couple of groups out there. There's the celiac disease group and then you have your non-celiac gluten sensitivity group. So these patients do not have celiac disease, but the gluten does affect them and some patients do have a wheat problem as well. With that said, gluten can potentially affect patients with autoimmune diseases.

Speaker 2: 19:52

The reason why I say that is because when you eat gluten there's Dr Fasano from Harvard. He discovered this that gluten does produce the leaky gut. So when you eat gluten it can open up the little cells, up the tight junctures. Each cell is connected to each other very tightly. When you eat gluten it will open up the cells, the tight junctions a little bit, so small food particles, viruses and these things can flow through and then interact with the immune system. However, I don't think we have the full story here, because gluten can affect immune disease. But I have a lot of patients who eat gluten that have gone to remission. I eat gluten and most of the time I'm pain-free. So I think we need more research on it, but certainly gluten is one of the factors I look at when a patient comes to me.

Speaker 1: 20:44

Okay, maybe worth a try, but not necessarily something to avoid altogether, if it works.

Speaker 2: 20:51

Exactly Because if you are avoiding gluten, it's heavier on your pocket, and avoiding gluten doesn't mean the food's healthier. Studies have shown that people that eat gluten are generally healthier in the population because they're not restricted to the certain foods that they need to eat.

Speaker 1: 21:08

Okay, we referenced paleo diet earlier and all of that and say there's Atkins diet. There's so many different types of diet. Do you think any of these are like a tailor-made approach for anyone?

Speaker 2: 21:22

So I would say so. You're going to hear stories that people on the keto diet get better. I don't on the keto diet get better. I don't recommend the keto diet because there's so many complications that can happen from this. I mean, heart disease is one of the top killers of the world and also with lupus patients, one of the top killers is heart disease. Rheumatoid arthritis is heart disease as well. One of the top killers is heart disease. Rheumatoid arthritis is heart disease as well.

Speaker 2: 21:53

So if you get better on a keto diet, you're missing out on the fruits. A lot of fruits have phytonutrients in them and potentially, if you don't eat vegetables too, the refined carbohydrates can be so healthy for patients. So that's why I don't recommend the keto diet. All the saturated fat I don't think it's leading to any good out there. And for the paleo diet I mean I don't recommend the paleo diet if a patient doesn't need to cut up grains because, like I said, grains are very healthy. I mean you're cutting out quinoa, rice, beans and all these things that can be very, very therapeutic for patients and sometimes it's a mental block. If you can't eat these foods, it can be very stressful as well. Not everyone needs to cut out these foods to get better. So I think everyone's microbiome is different, but because they have a disease already, their microbiome is out of balance. That's why certain diets work better for certain people. But I think once their microbiome is restored, you can certainly introduce these foods back into your system.

Speaker 1: 23:03

Can someone not realize that they are even stressed?

Speaker 2: 23:07

Can someone not realize that they are even stressed. Oh yeah, definitely. I think if you're not mindful, if you're used to such a high stress level already sometimes your high stress level is your norm and you don't realize your stress. And chronic stress is unfortunately one of the root causes of autoimmune disease.

Speaker 1: 23:23

Okay, and you were on an Atkins diet earlier, when you were a football player, because you felt like you needed protein. What's your message to someone that says athletes need animal protein to thrive?

Speaker 2: 23:37

Yeah, so you certainly don't need it. There's a lot of athletes now professional athletes that are on a plant-based diet that are thriving. I think there was a documentary the Game Changers. The Tennessee Titans were on that documentary. They're a football team and a lot of the athletes on there were eating a plant-based diet and they were doing very well. So it's something that our society has to get over, but you don't need an animal protein to build muscle.

Speaker 1: 24:04

Okay and yeah, you had your story there in terms of okay, you just ended up eating a whole lot of protein, but then you didn't focus on your plants or your fruits and vegetables, and that was initially when you felt all that inflammation also correct in your life.

Speaker 2: 24:25

Yeah, exactly.

Speaker 1: 24:26

Okay. So on the flip side, can someone be vegan and have an energetic and vibrant lifestyle? Is that possible?

Speaker 2: 24:34

Yeah, you can certainly be vegan and have a very vibrant life being vegan. You just have to be. You can get all the protein. There's a lot of different amino acids out there. Not every fruit and vegetable and grain will have all the um amino acids you need for your protein. But if you eat all the combinations eat the rainbow, everything you can certainly get all the amino acids you need. So it's a myth that, um, you can't get enough protein when you're um vegan and being vegan, um, you're going to eat a lot of fiber, so fiber is very anti-inflammatory. It's good for the immune system. So there is certainly no drawback to being vegan. But not everyone can be vegan and it's everyone's a little bit different in their genetic makeup. Some people say they don't feel as well when they're vegan, and I certainly believe it. So you can, but the main point here is still eat your fruits and vegetables. That's the main thing for every type of diet.

Speaker 1: 25:30

Yeah, so I think you have emphasized it very nicely. Thank you so much for taking the time to talk to us today, and I really appreciate you taking the time to do it here on Podcast Freshly Forever. Thank you so much, dr Yu.

Speaker 2: 25:45

Thank you, Vi. It's been a pleasure to be on your show forever.

Speaker 1: 25:48

Thank you so much, dr Yu. Thank you, vaai. It's been a pleasure to be on your show. Listeners, as always, follow the podcast, rate the podcast and leave a review from your podcast app of choice. Follow me on Instagram and YouTube at Vaai P Kumar. That's V-A-I-P-K-U-M-A-R for all things digital media and lifestyle. Until next time with yet another interesting guest and yet another interesting topic. It's me Vi saying so long.