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Intro: Here's another edition of the BayCare Health System's podcast series, BayCare HealthChat.

Deborah: Welcome to BayCare HealthChat. I'm Deborah Howell, and I invite you to listen as we discuss the relationship between diet and health. Today, we'll find out how the food we eat can actually be our medicine.
I'm joined today by Dr. Julia Jenkins, a board-certified family physician with BayCare Medical Group and a full-time faculty physician educator at the University of South Florida's Family Medicine Residency Program. Dr. Jenkins, a true pleasure to have you with us today.

Dr Julia Jenkins: Thank you so much, Deborah. I'm very grateful for this opportunity.

Deborah: Well, and I've been looking forward to asking you this question, how can certain foods either fight or fuel disease?

Dr Julia Jenkins: That is one of my favorite things to talk about. We absolutely have a pandemic in primary care of lifestyle-related diseases. And when I say lifestyle, I think one of the biggest factors in that is what we eat. So we know through some really good research that lifestyle-related diseases like heart disease and stroke and diabetes and arthritis and your mood are absolutely impacted by the foods we eat. And a lot of times, food can be a very impactful treatment, but also in preventing these diseases.

Deborah: Sure. And what body systems are impacted by signals related to the types of foods we eat?

Dr Julia Jenkins: I would say nearly every body system. So when you eat something, you have your taste buds and immediately have feelings associated with what you eat. But it impacts your immune system, your digestion, your bone health, your mental health. So there really hardly is any aspect of your body systems that are not impacted by the food that you eat.

Deborah: I can say that I'm emotionally attached to my sundaes, I'm sorry, after dinner.

Dr Julia Jenkins: As are many.

Deborah: All right. Is there any current evidence for which diet is heart-healthy?

Dr Julia Jenkins: Well, that's an excellent question because there's a lot of good evidence on which types of diets are heart-healthy and I think the messaging does get a little confusing. Years ago, there was confusing messaging about how fats, particularly saturated fats and trans fats, were not healthy for your heart. And we had this concept of you are what you eat. So if you eat a lot of fats and you eat bad fats and you eat a lot of cholesterol, that you're going to have high cholesterol, and you're going to have cholesterol blocking your arteries. And I feel very confident to say that that is absolutely wrong.

So the research is now showing us that it's the food and the way that it signals inflammation and affects the way that we process fats and that we process certain nutrients that leads to these changes in your insulin and these changes in whether or not your blood vessels and your heart is healthy or not healthy. It is not as much to do with the fat, but it has a lot to do with sugars and carbs and the signaling that the body gets.

Deborah: Fascinating. Always learning and it's always changing, right? So let's bust some myths about high cholesterol foods. What are the worst offenders?

Dr Julia Jenkins: Well, I mean, absolutely trans fats. And then I think there's still some debate, but things like saturated fats. So you want to be very careful about processed foods. These are the most tasty foods usually, but the things that kind of have the trans fats, so fried foods, packaged foods, things that are high in animal saturated fats, like your greasy cheeseburgers and bacon. I know. I'm so sorry. But those are the things that we know you really need to be careful about and can be unhealthy.

Deborah: But they do have some really great Beyond Burgers now and plant-based burgers that you really almost can't tell a difference.

Dr Julia Jenkins: Yes, they do. There's a lot of fantastic options now.

Deborah: So I'd like to talk a little bit about the role of inflammation and heart disease. What's the connection with diet and inflammation?

Dr Julia Jenkins: Well, you know, your body, when you eat something, it has this very sophisticated system. And it has to decide if what you put in your mouth is going to be harmful or helpful. So when you eat something that might be contaminated with a bacteria or have something potentially life-threatening in it, it's going to create this immune response where it's going to send in all of these very active white blood cells and inflammatory cytokines, is what we call them, but it's our soldiers that are going to fight off a potential infection.

And on the opposite end of that, if you're eating something healthy, you know, it has to quickly decide if that's going to be something that is not harmful and that we actually need to help rebuild and to help us heal. So for example, I like to share with patients that if you eat 200 calories of apple slices, your body can pretty easily recognize apples. They're from nature. It has fiber and nutrients and a lot of wonderful properties. So it's not going to create inflammation.

But the bad news is that 200-calorie bagel, even if it's marketed as a whole wheat bagel or healthy bagel, it has a lot of additives and a lot of foreign ingredients to the body. So it's going to recognize that as potentially being harmful and create inflammation. So if you're eating foods like that on a regular basis, you're going to have this chronic inflammatory state sending totally the wrong signals to your body.

Deborah: Now, why are fiber and plant-based foods so crucial in our diet?

Dr Julia Jenkins: That's a little bit of a complicated answer, but I'll kind of touch on two things. I mean, one, plant-based foods are what we call nutrient-dense. So they have a lot of the things that our body needs to function well. Plant-based foods have fiber, they have vitamins, they have nutrients, they have antioxidants, there's even properties about plant-based foods that we don't even fully understand yet. And so that's why a lot of the diets that are heart-healthy really emphasize eating plant-based foods. And I would say about that too, that plant-based foods doesn't mean salad. So that includes nuts and seeds and beans, whole grains, sweet potatoes, you know, things that are not animal products.

Deborah: Okay. Well, that's fair. And that certainly widens the list a bit. We've touched on this a little bit before, but let's get some more examples in there. It's important to know which foods promote inflammation. Can you go over that list with us?

Dr Julia Jenkins: There's a couple of different things that can promote inflammation, so one, if it's a processed food. So, again, the easiest way to do this is to look at the ingredient list. If you're looking at the ingredient list and you need a degree in organic chemistry to understand what it is that you're reading, it is probably processed and it's going to be inflammatory.

So I tell patients whole foods like chicken and rice with beans, things that are one ingredient is really your best bet. But if you're going to get packaged foods and convenience foods, you really should recognize what those ingredients are. It's also critically important to limit sugars because sugars and processed carbohydrates will also trigger inflammation. So we need to be very, very careful about those as well.

Deborah: I remember grocery shopping once with a friend and he looked into my cart and he said, "Dude, it's all dead food in your cart. It's all cereal, there's nothing live in your cart at all." And so maybe that's a clue as well.

Dr Julia Jenkins: You know, what I've said to patients before is that a quick way to get a general gestalt of how healthy your food is when you've gone grocery shopping is to look at your foods when you're checking out and just look at what's on the conveyor belt. If it looks like food, if it's fruits and vegetables and chicken and beans and things that are recognizable, then you're doing pretty good. If you're seeing a lot of boxes and bags and bottles of soda and things, then you really should think about what it is you're buying there.

Deborah: And what about canned foods, I mean, canned vegetables? Do they still have some good properties?

Dr Julia Jenkins: Yes, there's some caveats to that. But in general, frozen and canned fruits and vegetables are just nearly as healthy as the fresh fruits and vegetables. And so people talk about how expensive it is to eat healthy and a very good way to be able to keep your fruits and vegetables is to get frozen vegetables or canned vegetables and that's very reasonable.

Deborah: I'm so glad to hear you say that. Okay, now this one really hits close to home, sugar addiction. It is prevalent in our society. Some of it's our own fault. We know, we eat too many sweets. But sugar is also hidden by food manufacturers and sometimes we don't even realize we're consuming it, right?

Dr Julia Jenkins: Absolutely. This is where I try to take the guilt away from my patients, because we like sugary things, but it's not just a willpower issue. I feel like the marketing and the way that food is manufactured, it's confusing, and the messaging that we're giving when we tell people what's healthy or not healthy.

The job of the food industry is to get us to buy more, not necessarily to help us to be healthy. And so a lot of the sugar in our foods is being hidden. And so some of the words you might see is dextrose or corn syrup or fructose or dextrin. And although this isn't explicitly sugar, it is just as harmful as sugar is.

Deborah: What about honey?

Dr Julia Jenkins: Honey and agave and some of the more natural sweeteners are a little less inflammatory than some of the other types of sugars. And so there is a benefit to having more natural sugar, but the dangerous part of those types of sugars is that they still raise insulin and insulin is what's causing a lot of the health problems that we see today. So if you're going to have honey or agave or sugar, have it, but just really limit it.

And what I'd want to share with people that are listening is look at the grams of sugar, no matter what sugar it is, because four grams of a sugar, whatever that sugar is, is a teaspoon. And you really shouldn't have more than two, maybe three teaspoons, in a meal or in a serving.

So I was quite shocked when I went to go get my kids very small organic chocolate milks from one of the local coffee places and it had 22 grams of sugar. And that is not what I'm wanting to give my ten-year-old.

Deborah: Yeah. This is also a little bit confusing. Maybe you can help us out with this doctor, the importance of food timing.

Dr Julia Jenkins: Well, this is a fantastic way for patients to be able to prevent the insulin spike that happens with carbohydrates and sugar. So, one, I just want to clarify that when we talk about sugar, we also need to talk about carbohydrates, especially what we call white or simple carbohydrates, because that essentially becomes sugar after you eat it, but you can block the insulin spiking after you have sugar by making sure to eat your protein or your fat first.

And so an example would be if you're having chicken and rice, and rice becomes sugar pretty quickly in the body, it has what we call a high-glycemic index, eat your chicken first, because if you eat your chicken first, when you have the rice, you won't get the insulin spike, and then you're going to have less weight gain, you're going to have less inflammation and you're not going to be as impacted by that carbohydrate as you would have if you would have had the rice first. And so I think it's a fantastic tool for helping people be able to eat carbohydrates and try to balance it.

Deborah: Fun little trick. Okay. Now, fasting is also a current craze. Is it okay to fast to promote health?

Dr Julia Jenkins: It depends. And so fasting has gained a lot of popularity over the past several years. There's been some really fascinating research on how fasting can help in certain disease states because, when you fast, you go into this process called autophagy where the body kind of breaks down weak cells and goes into a rebuilding phase, but it really depends on your medical conditions and the medications you're on.

So I wouldn't start doing fasting unless you spoke with a certified nutritionist or with your primary care physician, just to make sure that it's safe for you, but there's a lot of really good fasting methods that can help people overcome some of these issues that they're having with their diet and with their lifestyle.

Deborah: Well, Dr. Jenkins, this has been so enlightening. Thank you so much for all the good information you've given us today. A great gift.

Dr Julia Jenkins: Oh, thank you so much.

Deborah: I'm going to go have a plant burger.

Dr Julia Jenkins: With some green tea.

Deborah: There you have it. And some lettuce on top. And that wraps up this episode of BayCare HealthChat. Head on over to our website at baycare.org for more information and get connected with one of our providers. Please remember to subscribe, rate and review this podcast and all the other BayCare podcasts, so we can share the wealth of information from our experts together.

This is Deborah Howell. Have yourself a terrific day.