Intro 0:03
Welcome to Maximal Being, a podcast devoted to ditching fad diets and using real science to get you healthy and feeling great. I’m Doc Mok, a GI and functional medicine doctor who harnesses the power of gut health to get you achieving your goals. And I'm Jacky P, a well informed layman who challenges the experts and ask the questions that you want. Don't forget to hit the subscribe button or leave a comment, and now onto the show.
Doc Mok 0:32
What's going on Maximal Beings, Doc Mok here with maximalbeing.com. Don't forget to hit the subscribe button. Leave us a comment, it does help us to get the word out. If you have any questions, you can email us at [email protected]. Enjoy the episode.
Jacky Homme 0:48
Hello hello hello hello Maximal Being we're back! It is I, Jacky P, your favorite layman and I'm here with my co-hostess with the mosttess, the ray of sunshine coming out of Tampa. Doc Mok, how are you doing today?
Doc Mok 1:08
I'm great. Jacky P, it's not often that I bring my work skills home but tonight was the exception. So we were feeding my son dinner and all of a sudden there was a very work familiar smell in the air and I was like I got to spring into action and just like a good gastroenterologist, I waited a few seconds before going to the emergency but I got it done, I got the poop emergency cleaned up so so so you're welcome universe you're welcome.
Jacky Homme 1:38
Nice.
Doc Mok 1:38
Another life saved.
Jacky Homme 1:40
Nice. It's it's sometimes bring home work, bring work home with you just gotta do what you got to do.
Doc Mok 1:47
Exactly.
Jacky Homme 1:47
That puts a. I'm excited. Speaking of good health and nutrition and, you know, all that fun stuff that we like to talk about this show. I mean, it's fun for us at least, we're here with licensed nutritionist Alexa Gallagher. And also Alexa, I apologize. I should have asked you but I don't know where you're from, where you're coming from. Where where are we talking to you from?
Lex Gallagher 2:10
I'm actually in Maryland.
Jacky Homme 2:12
Ah, Maryland, Maryland. And how are you this fine, warm summery day.
Lex Gallagher 2:18
I'm doing well. You know, I'm honestly kind of ready for fall. I'm a big summer person, but it's just been too hot. But I know I can't complain because you guys are in Florida, right?
Jacky Homme 2:29
I'm in Philly.
Lex Gallagher 2:31
Oh, okay.
Jacky Homme 2:33
It's been yucky. It's been yucky. You could complain.
Doc Mok 2:36
Yucky everywhere.
Lex Gallagher 2:38
Everywhere. Yeah. I'm ready for the cooler weather, that's for sure.
Jacky Homme 2:42
Yeah
Doc Mok 2:42
I'm ready for the cool too, which here is like 97? I think. So.
Jacky Homme 2:47
Oh, nice. Well, for those of you who haven't traveled to Florida during the Floridian winter, it is very nice. The Florida in winter is where it's at. And so if you have time, during November and February, you should try it out.
Lex Gallagher 3:01
Absolutely.
Jacky Homme 3:02
But let's let's let's get to the matter at hand. Right, I guess first everyone who's listening if it's your first time listening, thank you for joining us. I'm Jacky P. I am the layman. I will make sure these two wicked smart people keep the conversation on a level of everyday folks that are listening so they can keep up with what they're talking about. And Doc Mok?
Doc Mok 3:28
So I'm Doc Mok. I'm a therapeutic endoscopist, which is the GI doctor that does fancy procedures to diagnose, treat, and palpate GI cancers. And I'm also boarded in functional medicine. Jacky did they let you talk like a Boston accent in Philly or do you get kicked out of the city? I mean, because New York, I don't know if it's it's allowed, you know.
Jacky Homme 3:48
My, my office is pretty soundproof. But I did try the accent in Boston. And it didn't go over well. So
Doc Mok 3:55
It's a solid accent. I don't care what they say
Jacky Homme 3:59
I just I just Google hunting is a good, good. It was a good movie at the time when go back and maybe it doesn't age as well. But it's a great scene. So
Doc Mok 4:07
I was ready to pack the calf.
Jacky Homme 4:09
Yeah.
Lex Gallagher 4:11
That's pretty good.
Doc Mok 4:12
Thanks
Jacky Homme 4:13
Alright. So Lex, first of all, thank you for joining us. As always, we always want to learn about the people that we have here speaking with us, so if you can, tell the wonderful people that are listening to us. Give us your superhero origin story. How did we come to speaking with the Lex that is in front of us today?
Lex Gallagher 4:34
Yes. Well, thank you so much for having me. I'm so excited to be here today. So I, like you said I'm a licensed nutritionist. I have a master's in science clinical nutrition with a focus in integrative and functional medicine. And yeah right. And how I got into nutrition is kind of interesting. I grew up in a health conscious household. My parents were pretty into healthy eating, or I guess I would say more so than the average family in the 90s. And, you know, my mom would make me these little black themed salads and little lentil dishes. And I would take them to lunch and middle school, while the other kids are eating peanut butter and jelly, and they're like, what is she eating? But, you know, moderation was key growing up. So we did have some junk here and there. But it was a focus on whole foods. And then when I got to high school, my grandpa was diagnosed with pancreatic cancer. And that was really hard for us, of course. And I remember him meeting with a nutritionist. And at the time, I didn't really know what they do. I mean, I knew what it was, but it wasn't really something that I thought about. And he already ate pretty well, relatively well. And she gave him a bunch of tips on how to improve his diet, how to maybe heal a little bit. And as a family, we just decided, well, let's all eat even healthier together. And I remember sitting at the kitchen table this big round table, my immediate family and my grandparents. And we have these veggie burgers and this giant salad with cruciferous vegetables and a homemade salad dressing with olive oil and lemon juice and fresh garlic and just a lot of whole foods, and no processed foods, of course. Now just kind of thinking, if food is so important to our bodies, why are we waiting to improve our diet after we get a diagnosis? Why aren't we talking about eating healthier before you know, disease prevention. So that's kind of where the gear started to turn a little bit for me. And then in college, I studied community health. But I still didn't really know what I wanted to do with it. And I kind of just blindly applied to this graduate program in Maryland. I said, I have to do something after school. So let's just go for it. And I got in. And they also focused on functional medicine, and nutrition, of course. So I thought, alright, let's just go for it. We'll see how it goes. First day, walk in, first class, it's all about micronutrients. And I swear all of my classmates were falling asleep. And I was so amazed. I just fell in love with it. And I never turned back. I just really got into nutrition then and I knew I was in the right place. So now I'm a licensed dietician nutritionist and I have my CNS certification as well. So certified nutrition specialist, and I work with seniors for a living. I just really love it.
Jacky Homme 7:49
That is really cool. And also, it's very interesting. I don't know Doc Mok, if you if you're noticing this trend here. So I'm obviously a comic book nerd for the I don't know, I mean, people watch on YouTube, but you know, I've got Spider Man back there and Avengers over here. And there's always this like, this moment that like gives someone an AHA to like what they want to do. And it's very interesting to see like how that just becomes, if anyone watched Spider Man across the universe, no spoilers, spoiler alert. A canon event, right. Because I feel like it grounds and creates that passion for you because you saw like the impact, right? So it's really cool. Really cool.
Doc Mok 8:40
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Jacky Homme 11:13
I think, you know, nutrition is, especially as a lay man, very difficult in this day and age because and I don't want to get into, you know, big food, big, big cereal, big whatever. But words,
Doc Mok 11:31
Big carrot
Jacky Homme 11:32
Big carrot. But there's so many things that, you know, you said, you know, you said that your grandfather already ate pretty well. And a nutritionist helped them eat healthier, right? And I would like to maybe talk about that a little bit. Because there are sometimes things we do that we think is the healthy option because of information we get. And it may not be particularly like the best thing but and I know obviously this wasn't just yesterday, so but like if do you remember or even maybe now with your patients? Like maybe you have a patient that comes in and say, oh, you know, I eat pretty healthy and they think they're doing the right thing. But they weren't. Like what would you say is a like one of those common misnomers?
Lex Gallagher 12:19
Yeah, I would say a very common one is fiber. So you can put into Google, good fiber choices. And what's the first thing that pops up cereal, right. Fiber One bars, these fiber products. If you go to the grocery store, high in fiber, but if you actually pick up the box and you are educated on how to read a label properly, you would see all the sugar that is in the product. So obviously, that wouldn't be the best fiber choice. So I would say fiber sources. So instead of looking at the cereals, like I said, or pasta, even if it's whole wheat, I would prefer a quinoa or brown rice or a sweet potato as a carbohydrate. Instead of those processed carbs. And of course, fruits and vegetables, you can get all of our fiber from fruits, vegetables, nuts and seeds. So why not incorporate those whole foods instead?
Jacky Homme 13:16
Wow, what a Maximal Being answer. I love it.
Doc Mok 13:19
I love it.
Lex Gallagher 13:19
Thank you, thank you
Jacky Homme 13:21
If it's a carrot, eat the carrot. Snap, snap, snap, snap, snap. So, you know, let's go back to reading the labels, because I also think that's a good point. So you know, I think we don't as a society read labels enough. But what have you, you know, of course, with the fiber and the sugar. I think a lot of people are very aware with the sugar now. But what would you say is another something that people should be looking for? Right, in in the label if there's something with a label or something that they should be avoiding? I know that's a broad question. But maybe if you want to.
Lex Gallagher 14:00
I think it depends on what product you're looking for. So two tips that I have that I talk with clients often is for bread. When you're buying bread, you want the fiber grams to be higher than the sugar grams. That's how you know you have a good bread. And then of course, look at the ingredients. Is it a short ingredient list? Or is it a long paragraph, it doesn't look like a whole story on the back. Of course, you don't want to buy that type of bread. And then for something like a Greek yogurt, you would want the protein grams to be much higher than the sugar grams. And that's also how you know you're getting a pretty decent yogurt. So I think it really depends on what the person is buying. So when I meet with a client, we talk about what they eat in a day. And we go through all the different products and what their goals are and then I can pick out okay, have you read your yogurt label? Do you know what the brand is and then we kind of go through each thing together.
Jacky Homme 15:00
Wow, I'm picking up some good notes.
Doc Mok 15:02
Yeah. Alexa, how on earth can yogurt not have fat in it? I've always wondered about that.
Lex Gallagher 15:11
Don't get me started on that
Doc Mok 15:12
How did we get there. And why did, I know why people think it's healthy, and I know exactly who to blame and we've talked about him before, Ancel Keys. If you listened back to our two part episode with Dr. Ankur Kalra who's a cardiologist? We talk about Ancel Keys. Google that guy right now you'll see what I'm talking about. You, this guy is a bad dude. And he just looks like a villain from Spider Man. You know, he just looks like an evil scientist from Spider Man. And because of the Seven Countries Study that he started, he basically bullied us in America, bullied politicians and everything to saying that fat is bad. And that, you know, whole grain cereals and carbs and all these things are fine for cardiovascular disease. And now here we are fatter than ever.
Lex Gallagher 16:02
Wow.
Doc Mok 16:03
Yeah. But how do we end up there with with fat free yogurt? I mean, gosh.
Lex Gallagher 16:10
I don't know. The labeling and the products these days are just wild with the fat free or the sugar free and then they add so if there's anything that says free, they add more of something else right? So if it's fat free, they add more sugar, it it's sugar free, they add more fat. So it just keeps going
Jacky Homme 16:32
I thought we were onto something I forgot how long ago, was like a couple weeks ago, but they were trying to label was it Aspartame or one of those sweeteners as like basically like not like in the EU they can't use it, but I don't think it's going anywhere so. All the, all the Coke Zero drinkers are still good or Diet Coke I think it's in. But alright, so let's talk about your your, your your practice and what you do on a day to day ,right, so you work with a lot of seniors. And I don't want to talk about a demographic and jumps conclusions. But what are some of the, for all our seniors that are listening, what are some of the things you see more more common on the day to day? Like? What are some issues you might be seeing? Or like limitations that you see more often than not?
Lex Gallagher 17:30
Yeah, there are a few things I would say one, that I see all the time is diabetes, of course, type two diabetes, pre-diabetes I work with all the time, then digestive issues like constipation happens a lot with seniors. IBS is pretty common as well. You know they tend to just, I don't want to say stuck in their ways. But they're eating a certain way for so many years. So then when you tell them, okay, you actually have to change a lot. That can be very overwhelming.
Jacky Homme 18:08
So how would you how would you practice? How would you approach that obstacle like so let's say let's talk about that digestive because that's the gut stuff. And I know that's Doc Mok's favorite category to talk about. So let's say we talk with a senior they're, they're constipated. And let's let's let's go through a sample client right or so? What is something that you would uncover that a seniors like or I guess a habit that would lead to the constipation that you're trying to have them adjust or change?
Lex Gallagher 18:41
Yeah, well, first, if someone is very overwhelmed, that they need to change a lot, what we focus on is, what can we add in that will help you instead of taking away everything that you're used to, and that's always a good start for people. So the first thing that I would look at is water intake of course, I know that sounds obvious, but as we age, we lose that feeling of thirst. And medications can affect that as well. So they just don't think about drinking as much. So we always want to look at water intake and then movement. If you know they are not exercising enough, the low levels of physical activity will affect this. And then fiber intake of course, and then maybe not consuming the right types of fiber.
Jacky Homme 19:30
Okay, so movement, fiber, hydration, right. And I guess you're of course nutrition.
Doc Mok 19:43
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Jacky Homme 21:33
Doc Mok I know you have something to say, I could tell, I could see your eyeballs, I could see the gears turning back there.
Doc Mok 21:40
I have a lot to say because I talk about this every day but but and I also have a question you know Lex about fiber. So I think of constipation like you do is definitely a dietary illness most of the time. We recommend that you talk to your friendly neighborhood gastroenterologist, we really got a Spider Man theme running.
Jacky Homme 22:03
Yeah, I like it.
Doc Mok 22:04
Yeah. Anyway, we recommend that you talk to your friendly neighborhood gastroenterologist, your primary doctor about your symptoms, if you and I want to say to everybody that constipation is a relative term. So if since birth, you've gone one time a week, your entire life, your definition of constipation may be different than somebody that's going multiple times a day and goes to one time a week. So it's in relation to what your normal bowel habits are. And then also it has to do with what your stool looks like, so did the quality of your stool change and most important, I think, is to rule out cancer. Although people there are incidence of colon cancer, the number of people with colon cancer who present with new onset constipation is very low. It's about .06 or .5% depending on which study you're reading, it can be a sign that you do have an obstructing mass or a polyp or something that can be contributing to your symptoms. So I would recommend if you have not had a colonoscopy, that you get that done, even if you have had a stool test to measure for blood or whatever e-neg d-neg, get a colonoscopy done. And then I think of it like a systemic condition, right. So our electrolytes are micronutrients, like you mentioned, those things can all affect the way that our colon moves and shakes. And so can hormones like our thyroid, if you have a slow thyroid, that controls your colon too, and so you're not going to move your bowels appropriately. On the flip side, you know, you could have an autoimmune condition that can also affect it, so so your doctor needs to think about that you as a as a whole person, which is what Lex and I do with our integrative and functional medicine training, right? We look at you rather than just a colon, we think about you as the entire system. I've one other tip that I tell patients in the morning and then I want to ask you about fiber. And that is that most people have carbs for breakfast, like we've been taught, we've been told through advertising to eat cereal every morning for breakfast, or oatmeal or whatever, and that stuff is good. But your stomach, the organ the stomach, sends a signal to your colon in the morning. If you fill it with fat, the macronutrient fat, so if your breakfast doesn't have fat, it's gonna blunt that signal between your stomach and your colon. So have a little bit of fat in the morning. It's good for your metabolism, you know, especially if you're going into a ketogenic process, it keeps that going. And then it also stimulates your colon to actually move and a glass of water can have some effects on that as well. So let's talk fiber. So, you know what, what, what are the different types of fiber? What's your go to fiber supplement and do you recommend any fiber or supplements that have added bonuses like prebiotic properties or those sorts of things. It's a three part question.
Lex Gallagher 25:09
Okay, so well, let me let me talk about my go to fiber sources that I do with people. And I don't know if you guys have suggested this before to people, but Chia seeds are my friend. I love Chia seed and two tablespoons are about nine grams of fiber, which is pretty high for teeny little seeds that don't have much taste. So if someone's dealing with constipation, we always want to start in the morning. So like you said, Doc Mok glass of water in the morning having fat. I always tell people add your chia seeds to something in the morning. That will kind of kickstart your day. So that's a big suggestion that I always give people.
Doc Mok 25:56
Yeah. And then there's insoluble and soluble fibers, right? So the the big difference is the reaction between those fibers and water, right. So insoluble fibers tend to stay relatively undigested, soluble fibers tend to dilute a little bit better in water. And you kind of need both for proper bowel function in my opinion.
Lex Gallagher 26:19
Yeah. And then what was the other prebiotics? You said?
Doc Mok 26:23
Yeah, is there a fiber supplement like so do you recommend psyllium husk for everybody, which is trade name Metamucil, we're not paid by them. We're not trying to disparage them. But that's what everybody takes is that your go to or you reach for something different?
Lex Gallagher 26:37
I actually don't really do prebiotic supplements. We do a lot of fiber sources, of course, but if someone needs more support, sometimes we'll talk about prebiotic foods. So we think we'll talk about artichokes. We'll talk about jicama, bananas that are under ripe. So, if the banana is a little bit more green, it actually has more prebiotics and less sugar. But once it ripens, to be more yellow, yep, has more sugar and less prebiotic fiber. So little things like that. It's so easy. If they're already eating a banana for breakfast, I'll say alright, just grab some in the store that are just a teeny bit more green and they're already getting a little bit more of a boost. So that's actually make a big difference. Yeah, with just one small change.
Doc Mok 27:26
Jacky P there also was a study that they randomize people to get Metamucil or psyllium husk versus two Kiwis a day. Like they said one group gets Kiwis, one group gets Metamucil, which is what every gastroenterologist, every internal medicine doctor tells their patient to take as fiber, I guarantee it. And the group that had two Kiwis a day actually had better improvement in their bowel scores. And in there was a subset of irritable bowel patients, those patients had better the alleviation of their irritable bowel symptoms. So two Kiwis a day has soluble insoluble fiber, really delicious, affordable, doesn't come out of the can. Pretty cool.
Lex Gallagher 28:15
Oh, my question my question about that is do you think that they included the skin with that? Because kiwi skins have so many great nutrients and fiber and I actually like to eat my kiwi skin if it's organic. And some people think that I'm absolutely crazy, but I think it helps a lot. So I wonder if they incorporated that in the study?
Doc Mok 28:34
Yes, I believe that they did. They kind of just sliced it in half. And then we're done with this. That's also an awesome observation.
Jacky Homme 28:41
Wow, wicked smart. Wicked smart.
Doc Mok 28:44
I reach, I reach for Foss and citrus pectin and inulin is kind of my go to fiber slash prebiotics because they kind of do both. They're relatively cheap most of the time. And it's just something different. You know, for a patient you're getting the prebiotic benefit and then also, you're getting fiber if they don't want to eat it the real way. That's the best way of course.
Lex Gallagher 29:07
Yes, I agree. And inulin is great. Forgot to mention that one.
Doc Mok 29:10
Yep
The content included is not intended to be used as medical advice and viewers should consult their physician or health care provider should they have additional questions. The viewers should not rely on information contained in these presentation for immediate or urgent medical needs. Additionally, if you think you have a medical emergency, call your physician or go to the emergency department or call 911 immediately. Never disregard professional medical advice or rely on seeking medical care or delay medical care due to information contained in this presentation.
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