Amanda Wilde: This is Hello Healthy, a Dignity Health
podcast. I'm Amanda Wilde. What makes a well woman? Today, we'll talk about
lifestyle medicine with Dr. Anne Kennard. Dr. Kennard is Associate Director of
the OB/GYN Residency Program and Director of Integrative Lifestyle Medicine at
Marian Regional Medical Center in Santa Maria, California. Welcome, Dr.
Kennard.

Dr. Anne Kennard: Hi, thanks for having me.

Amanda Wilde: So what is this medical approach called
lifestyle and integrative medicine?

Dr. Anne Kennard: Thank you. Yes, lifestyle and
integrative medicine are two newer specialties of medicine and anybody that is
in any specialty can certify and learn these disciplines. And they are
overlapping, but not quite the same. Lifestyle medicine includes six pillars,
which are healthful eating, physical activity, sleep, stress management,
healthy relationships, and avoidance of risky substances. And you see that
overlapped and also added to in integrative medicine, which really focuses on
integrating all available and evidence-based therapies. And so it has
conventional medicine and surgery along with the pillars of lifestyle medicine,
along with evidence-based supplements, botanicals, and whole health systems
like traditional Chinese medicine and acupuncture.

Amanda Wilde: So what are those pillars of lifestyle
medicine again? Healthful eating, physical activity...

Dr. Anne Kennard: Sleep, stress management, healthy
relationships and avoidance of risky substances is how they're defined.

Amanda Wilde: Okay. And what are issues thinking
about those pillars that are particular to women that you work with?

Dr. Anne Kennard: Thank you. Yes, I think that a few
stand out to me and I think about this a lot, right? I'm in OB/GYN by primary
training and women come in for so-called well-woman exams, their annual yearly
exam. And the focus of that exam often is on cancer screening like Pap
screening for cervical cancer, ordering age-related screenings, like mammogram,
colonoscopy, immunizations, et cetera. But diving a little bit deeper on that,
a lot of women I find have questions on nutrition or they're not sleeping well.
I think pretty much every modern woman has a significant amount of stress. And
so, these are the kind of deeper dive topics that I often will discuss with
patients.

Amanda Wilde: Yes. Because I just mentioned to a
friend the other day that I slept well and she had never even heard of anyone
in our age group that slept well. So that really does affect so many women. So
how do you address that with lifestyle medicine?

Dr. Anne Kennard: Yes. Sleep is such an important
topic. I mean, really nothing works well without good sleep. It's so crucial
for wellbeing, healthy metabolism, immune function, mood. It is just, I think,
probably the most overlooked determinant of well-being.

And so there's a few things that I speak with patients
about. So a few concrete tips, you know, having early morning light, like going
out in the morning for a few minutes and that resets the melatonin production
and just gets the body on a normal circadian rhythm. And then similarly,
starting to dim the lights on the evening, turning off electronics, ideally at
least an hour, hopefully two, before bed. And thinking too about the role of
food and sleep that it's difficult to sleep well or sometimes people have
issues with heartburn if they have a heavy meal before bed or snacking before
bed. And so making the midday meal the primary meal of the day, and then maybe
backing up dinner to be a little bit earlier can sometimes help folks.

But really, it gets after a deeper question, which is what
kind of rest does someone need? You know, are they not sleeping well at night?
Do they wake up in the middle of the night? Or maybe they need a different kind
of rest, like stillness to decompress or break from responsibility, connection
to art or to nature, time to do something "unproductive" or not be
helpful. You know, these are types of questions that I don't think are talked
about a lot. But the lack of these types of rest really contributes to our
feeling of burnout and not being well rested overall.

Amanda Wilde: How does a woman make her way to you?
How do you end up seeing people?

Dr. Anne Kennard: I see patients alongside the
resident physicians for integrative and lifestyle medicine consult through the
Family Medicine Center at Santa Maria, California at Marian Regional Medical
Center. And I also work as an OB hospitalist. And so if somebody comes in
needing inpatient obstetrics care, I am there as well.

Amanda Wilde: And then, how do you assess then what
is needed for each individual?

Dr. Anne Kennard: In terms of the integrative and
lifestyle medicine components?

Amanda Wilde: Yeah. When a patient comes in, what are
you looking for when you're designing a treatment plan?

Dr. Anne Kennard: Mostly, I listen to people.
Usually, folks are there for a reason, and I ask them what they're hoping to
get out of our time together and what their questions are, and then go from
there. It's really patient-centered.

Amanda Wilde: Just thinking about the sleep, like
someone might describe their sleep pattern to you, and then I assume you can
then assess and make some suggestions.

Dr. Anne Kennard: Right. And makes some
recommendations regarding sleep. Ask some deeper questions maybe about their
sense of their sleep and their rest. Often for women around the time of the
menopause transition, sleep can become disrupted, so evaluating if something
like hormone therapy is indicated for other reasons, along with nutrition,
exercise. Sometimes things like acupuncture can be really helpful for sleep.
And so, it just really depends on what someone's needs are and that's where we
go.

Amanda Wilde: And when you have given a treatment
plan, so to speak, do you coach people through the process?

Dr. Anne Kennard: You know, one of the nice things
about the clinic that I'm at currently is we have really long visits. We see
patients for an hour for an initial visit, 30 minutes for a followup, which is
really unheard of in conventional medicine. And so, I actually have enough face
to face time to really take time with people and talk it through. And then, we
come up with a few things that the patient is going to implement or think about
implementing or learn more about over the next few weeks. And then, generally,
we'll check back in four to six weeks and see how things are doing and make a
few more tweaks going from there.

Amanda Wilde: Yeah. It's great that you have such
follow up because when we're changing habits, we need support, right?

Dr. Anne Kennard: We do. You know, this is where
coaching comes in too, like health coaching has become a really big industry
and I see more and more insurance companies paying for that. And I think it's a
wonderful modality to have somebody trained in behavior change walking
alongside.

Amanda Wilde: Now, we touched on a few of the pillars
of lifestyle medicine, but one I want to concentrate on a little bit is
healthful eating. Because along with your other credentials, you authored a
best selling cooking guide called Nourish: An Integrative Medicine Cookbook.

Dr. Anne Kennard: Thank you. Yes.

Amanda Wilde: Can you give me an example of what's
that?

Dr. Anne Kennard: Thank you. I am proud of that work
and nutrition is really my original love. I have a nutrition science degree
from Cal Poly and love food, love culinary medicine, love gardening, and
growing own food and just very passionate about helping folks make nutritional
changes that work for their lives, things that taste good. I really love to
focus on adding things in rather than taking away and working to find solutions
that work for busy families in any budget and with folks with minimal time,
because I know that too, I have two little kids. And, you know, it's hard to
make this work for your life, so what solutions can we come up with together
that are going to really be sustainable?

Amanda Wilde: Especially when you're talking about
cooking, because that's a task that often does fall to women to bring nutrition
and healthy meals to the whole family. And I'm guessing since your book was a
best seller, that there's something simple about it that makes it successful
for anyone wanting to try.

Dr. Anne Kennard: That was the goal, to bring in
recipes that were simple, didn't have too many ingredients, did not require
previous cooking experience or skills to produce. And it was all stuff that my
own kids would eat.

Amanda Wilde: Right. That's really important. You
were already an OB-GYN. And then, what got you interested in lifestyle
medicine? I'm guessing all the things you've mentioned, combining all these
areas of life

Dr. Anne Kennard: Well, that was exactly it. Yeah,
like my background in nutrition. But I was also a yoga instructor and very
interested in well-being. And while I loved my training in obstetrics and
gynecology, it just struck me as being very acute medicine and not as much
focused on preventive and well care, which was really where my heart was. And
so when I learned about integrative and lifestyle medicine, and really the
formal study and discipline of these sorts of topics, I was really excited to
get that training and become boarded in those disciplines as well and then
integrate, if you will, all of the above into one practice, as well as teaching
the resident physicians about this, so that more doctors are knowledgeable in
practicing this sort of medicine.

Amanda Wilde: Well, this may not be a fair question,
but what's the most rewarding thing to you about your work?

Dr. Anne Kennard: You'll have to let me have two
answers on this. So the first rewarding thing is when I get to see a person and
we address whatever they want to talk about, and I see them back in a month or
so. And they say, "I am feeling so much better," whatever it may be,
you know, their energy, mood, sleep, feeling better about nutrition, they've
been successful with weight loss, et cetera. But just feeling like the work
made a difference in a way that I feel will be positive and sustainable for
that individual. So that's the first one.

And then second one, which is a close second, is I always
have a learner with me and then, seeing that resident physician become
comfortable and competent with these topics, which are not well covered in
general medical training and knowing that's going to ripple forward in their
practice going outwards.

Amanda Wilde: Yeah, it sounds like it's so much about
support and healing and then passing that on to the next generation.

Dr. Anne Kennard: Exactly.

Amanda Wilde: What a pleasure to hear about this
really holistic medical approach and way of life. Thank you for all the great
information and for sharing your time and expertise today.

Dr. Anne Kennard: Thank you for having me.

Amanda Wilde: Call Family Medicine Center in Santa
Maria at 805-739-3561 for more information on lifestyle medicine. If you found
this podcast helpful, please share it on your social channels and be sure to
check out the podcast library for other topics of interest to you. Thanks for
listening to this episode of Hello Healthy, a Dignity Health podcast.