Jaime Lewis (Host): Meaningful Medicine is a Novant Health Podcast, bringing you access to leading doctors who answer questions they wish you would ask. From routine care to rare conditions, our physicians offer tips to navigate medical decisions and build a healthier future.

Today, I am sitting down with Dr. Mark Guido, an endocrinologist and Lifestyle Medicine physician at Novant Health. We'll be discussing practical tips to feel better and think more clearly as we age. Welcome, Dr. Guido. Glad to have you here.

Mark Guido, MD: Thank you so much. I appreciate you having me.

Host: I think a lot of us believe the narrative that cognitive decline is just inevitable as we get older. To kick us off, could you just tell me, is that true?

Mark Guido, MD: Yes and no. Some slower processing speed as we age can be a normal part of aging, but it shouldn't get to the part where it's interfering with your daily life. If it gets to the point where it starts to interfere with your daily activities, that's when it's a disease, and that is not set in stone at all.

Host: Okay. Well, I've read that 80% of chronic health issues are preventable with lifestyle changes. And I'm wondering if that's also true for functional and mental health.

Mark Guido, MD: Yes, it very much is. We do like to say that mental health is just health. All of our lifestyle things that we think about, good sleep, good diet, good exercise, they all help improve your mental health as well.

Host: Okay. Speaking of mental health, I'm thinking about being on the internet, reading conflicting information there, social media and in the news about trends in preventing and managing and treating chronic disease. But as an endocrinologist and Lifestyle Medicine-trained physician, is there any of that that's of concern to you?

Mark Guido, MD: Yeah. And so, I think there's a lot of things that we can do better when it comes to preventing a lot of these chronic diseases. Unfortunately, the way that our modern lives are set up is to set us up for all of these diseases. We have stressful jobs. Stress management helps prevent these diseases. Our diets are high in processed foods. Low processed diets will prevent these chronic diseases. We have sedentary jobs. We just sit around where physical activity helps prevent these diseases. And so, there's a lot that we can do, but it takes some practice.

Host: Okay. Well, I want to get to exercise for sure, but let's talk first about diet. If I, say, was a patient in your exam room right now asking for advice on how to feel better, how to think better, what kind of a diet would you recommend to me?

Mark Guido, MD: Yeah. And so, the absolute best diet out there is something called a whole food plant-based diet. It also goes as the Dean Ornish diet. Dr. Dean Ornish is the one that has been kind of the pioneer for this, and it has been shown and proven to improve a bunch of different things. It can improve heart disease, it can improve diabetes, it can improve weight, might even help slow early Alzheimer's disease as well as prostate cancer.

 What it is, is it is pretty much that you're a vegan and that you make everything else up at home. And so, you stay away from meats. You know, some meats can have inflammatory properties. You stay away from all the processed foods that do all the bad nastiness to our body. And it can really do a bunch of amazing, amazing things for your health. It's just very hard to do.

Host: Okay. So if this diet is essentially vegan, what about fish? Because I know we hear a lot about fish, salmon high in Omega-3. Should we eat fish or should we just take a supplement?

Mark Guido, MD: Yeah. And so, a pescatarian diet can be a sub-variant of that. That's where you're a vegan except for eating fish. Some fish are great in having these healthy, fatty acids that we need, especially for brain health, especially the fatty fish such as salmon and tuna. With everything, if you get it from the whole food instead, it's better than just taking the supplement because you get the other beneficial aspects too. The other vitamins, the other minerals, the healthy protein, and the acids that are in the fish are just absorbed better. We're designed to eat that instead of just take the supplements.

Host: Well, I know that you specialize in treating and seeing patients with autoimmune disorders. Does this make diet changes even more difficult for folks like that? What advice do you have for new patients?

Mark Guido, MD: Yeah. And so, believe it or not, this diet is actually perfect and probably even better for folks that have autoimmune disorders, because it can help reduce the inflammation that we get from all the processing in our foods. It can help prevent chronic inflammation in our gut, help us grow healthy gut microbacteria that can help reduce inflammation as well. And so if anything, probably even more beneficial for those that have autoimmune disease.

Host: Okay, excellent. I don't want to assume that our listeners are already experiencing some degree of cognitive decline today, but for myself as a 47-year-old mother of two teenagers, I'll speak for myself and say that I definitely am experiencing that. So, is it too late to slow the effects or reverse course for someone who's already feeling that?

Mark Guido, MD: It's not at all. And so, primary prevention, you know, preventing it in the first place is always best. But if not, if there are early signs, then it's not too late to try to make the switch and help slow the decline.

Host: Okay. That's good news. That's very good news. Let's talk about exercise and movement. We all know exercise is important to help us with so many different things, but what other benefits come from exercise as it pertains to this conversation?

Mark Guido, MD: Exercise does a bunch of great things. And it is hard to lose weight, just with exercise only. That's why the diet is really the big piece when it comes to weight loss. But exercise is very, very important that when we lose weight, that we lose the fat and not the muscle. Keeping our muscles active helps keep them healthy, keeps our muscles strength and our muscle tone while we're losing weight. It is also beneficial the days that you're active, that you exercise, you have better sleep. And if we could put good sleep in a pill, it'd probably be the best thing ever. It's important for weight maintenance. Once you lose that weight, it helps lower blood pressure, helps lower cholesterol, helps lower blood sugar. Exercise does a magnificent thing for all kinds of different parts of our body.

Host: Oh. Kind of a wonder drug. Well, let's talk about some other things. So, some people swear by crossword puzzles to keep themselves sharp. Do those actually help? And if so, or even if not, what other kinds of things can help keep us mentally fit?

Mark Guido, MD: Yeah, great question. And they really do. And so, I like to think of the mind as just muscle. If you don't use it, you lose it. And so things like a crossword puzzle where you have to actively think that can help. Things like learning a new language or reading, other board games, puzzle games, chess, all of those can help.

Host: Cool. Okay. I actually took an adult ballet class once. It was so challenging, spatially, mentally. It definitely tested my mental fitness as well as my body, and it was great for that. Well, this is kind of a funny question to end on, but I'm curious, what made you decide to become a doctor? What got you into Endocrinology?

Mark Guido, MD: Absolutely. And so, last name's want to. I come from a big Italian family. When I was a kid, my Italian grandmother used to make us spaghetti dinner every Sunday after church, but she also had type 2 diabetes. And so, I remember her having to give herself an insulin shot before we sat down for dinner. Eventually lost both her legs and her life to the disease. And so, I decided that's something I wanted to fight against for my career.

Host: Well, that's a very good reason. Yeah. Thank you so much, Dr. Guido, for meeting and sharing all your insight with us.

Mark Guido, MD: Thank you so much for having me.

Host: Once again, that was Dr. Mark Guido, endocrinologist and Lifestyle Medicine physician at Novant Health. To find a physician, visit novanthealth.org. And for more health and wellness information from our experts, visit healthyheadlines.org. And thank you for joining us.