Rip Esselstyn welcomes back Dr. Dawn Mussallem, a breast cancer and lifestyle medicine specialist at the Mayo Clinic, to discuss the latest research about the profound impact of whole food, plant-based nutrition on cancer prevention and treatment.

The conversation delves into the alarming rise of breast cancer diagnoses in younger populations, emphasizing the need for early intervention and lifestyle modifications to reduce risk factors. Dr. Mussallem passionately advocates for a dietary shift towards whole plant foods (among the other lifestyle medicine pillars), detailing how these choices can empower patients in their recovery and enhance overall health.

The discussion also includes current research, including a meta-analysis showing that soy consumption is beneficial for breast cancer survivors and insights into how plant-based diets can improve quality of life during treatment.

Dr. Mussallem encourages her patients to focus on what they can control, namely their food choices, to foster better health outcomes and support their cancer recovery journey.

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Rip Esselstyn: 00:00:00

I'm Rip Esselstyn and you're listening to the Plan Strong podcast.

Rip Esselstyn: 00:00:04

Today.

Rip Esselstyn: 00:00:05

I am thrilled to welcome back to the plan Strong podcast, doctor Dawn Musalem.

Rip Esselstyn: 00:00:13

She is an absolute ray of sunshine, and she shared her incredible life story on episode 156 of the Plan Strong podcast.

Rip Esselstyn: 00:00:22

If you didn't get a chance to listen to it, I highly recommend it.

Rip Esselstyn: 00:00:26

But today she's here in her professional role as a breast cancer and lifestyle medicine specialist at the Mayo Clinic Cancer center in Jacksonville, Florida.

Rip Esselstyn: 00:00:37

And she's going to share some of the outstanding science and research that is emerging on the benefits of whole plant foods in the prevention, treatment, and healing from a cancer diagnosis.

Rip Esselstyn: 00:00:50

There is so much exciting news here that we're going to break this up into two parts.

Rip Esselstyn: 00:00:55

Part one coming up right after these words from plantstrong.

Rip Esselstyn: 00:01:57

Just two months ago, 300 of you were at the beautiful Blue Ridge assembly in Black Mountain, North Carolina for our 13th annual Plant Stock celebration, and it was magical.

Rip Esselstyn: 00:02:13

I want to start today by letting you know that sadly, Black Mountain and the location where we hold these annual retreats suffered extensive damage from Hurricane Helene.

Rip Esselstyn: 00:02:25

And while the staff and team members are fine, the facility is not.

Rip Esselstyn: 00:02:31

So please keep the town and the Blue Ridge assembly and all those that were affected by Hurricane Helene in your thoughts, including our plan.

Rip Esselstyn: 00:02:41

Strong brothers and sisters in the area, our hearts are with you.

Rip Esselstyn: 00:02:46

And speaking of hearts, today, I welcome back our friend and one of the biggest and best hearts in the whole wide world, Doctor Dawn Musalem.

Rip Esselstyn: 00:02:58

Dawn herself is a heart transplant recipient, and today we turn our attention to breast Cancer Awareness Month at our recent plant stock event, Doctor Musalem, along with Doctor Gemma Neumann and Doctor Will Bolshowitz, discuss some of the recent studies and the emerging science, all extolling the benefits of a whole food, plant based diet on the prevention and treatment of cancers, including breast cancer.

Rip Esselstyn: 00:03:29

Don is a breast cancer and lifestyle medicine physician at the Mayo Clinic Comprehensive Cancer center located in Jacksonville, Florida, and she works daily with patients who have received a breast cancer diagnosis.

Rip Esselstyn: 00:03:43

Now they come in scared, confused, angry.

Rip Esselstyn: 00:03:49

They feel out of control.

Rip Esselstyn: 00:03:51

And little do they know how absolutely fortunate they are to have Don Musalem on their care team today.

Rip Esselstyn: 00:04:00

In the first part of this two part series, dawn shares with us her thoughts on what's driving cancer risk in today's society.

Rip Esselstyn: 00:04:10

It's a nuanced discussion, and she offers plenty of food for thought.

Rip Esselstyn: 00:04:15

And much of the discussion does center around food, because as we all know, it's the food.

Rip Esselstyn: 00:04:22

It's the food.

Rip Esselstyn: 00:04:22

It's the food.

Rip Esselstyn: 00:04:23

A whole food plant based diet is the way to prevention, healthy aging, and a smoother recovery from cancer.

Rip Esselstyn: 00:04:33

But let's hear all about it right now with our own magic bullet, doctor Don Musalem.

Rip Esselstyn: 00:04:43

Doctor Don Musalem.

Rip Esselstyn: 00:04:45

It is beyond fantastic to see you again.

Rip Esselstyn: 00:04:48

I can't even tell you how great it is to see that incredible smile on your face.

Rip Esselstyn: 00:04:55

Look at you have such a nice, wonderful blue blouse on as well.

Doctor Dawn Musalem: 00:05:02

Well, you know, I love bright colors.

Doctor Dawn Musalem: 00:05:05

It helps to just amplify the existence of this wonderful day.

Doctor Dawn Musalem: 00:05:08

That's what I would say.

Doctor Dawn Musalem: 00:05:09

And I think blue is my favorite color.

Doctor Dawn Musalem: 00:05:11

Well, that's so funny.

Doctor Dawn Musalem: 00:05:12

As soon as I say that, I'll name, like, five other ones, too.

Doctor Dawn Musalem: 00:05:15

So blue is my favorite color today.

Rip Esselstyn: 00:05:17

It is.

Rip Esselstyn: 00:05:18

It is by far, my favorite color.

Rip Esselstyn: 00:05:20

Love blue.

Rip Esselstyn: 00:05:21

I've always loved blue.

Rip Esselstyn: 00:05:22

So, dawn, for those that don't know, dawn first appeared on the plan Strong podcast probably about a year and a half ago.

Rip Esselstyn: 00:05:31

She was episode number 156.

Rip Esselstyn: 00:05:34

We talk all about her amazing journey, her story.

Rip Esselstyn: 00:05:39

And if you want to do a deep dive into all things dawn, please go back and listen to episode 156.

Rip Esselstyn: 00:05:47

It's really remarkable.

Rip Esselstyn: 00:05:50

But, dawn, the reason why I've brought you back on today is because October is breast cancer awareness month.

Rip Esselstyn: 00:05:58

This is obviously something that is very near and dear to your heart.

Rip Esselstyn: 00:06:04

what you've been doing since: 2015

Rip Esselstyn: 00:06:35

But before we do that, I think it's important that we do take a step back and let people know that you yourself are a breast cancer survivor.

Rip Esselstyn: 00:06:45

Correct.

Doctor Dawn Musalem: 00:06:47

So I actually had stage four non Hodgkin's lymphoma when I was in medical school.

Rip Esselstyn: 00:06:52

Oh, my bad, my bad.

Doctor Dawn Musalem: 00:06:54

No, no.

Doctor Dawn Musalem: 00:06:55

There's an interesting backstory to this.

Doctor Dawn Musalem: 00:06:57

So that was 23 years ago, and then that, of course, caused the complications, and I ended up with heart failure, had the heart transplant, and then last year was the first time they were able, after my heart transplant, to do breast mris, because previously I had the defibrillator and all this hardware in my chest because of the heart failure.

Doctor Dawn Musalem: 00:07:16

So they could never do breast mris.

Doctor Dawn Musalem: 00:07:18

But I was very high risk.

Doctor Dawn Musalem: 00:07:20

The risk for young cancer survivors who have had radiation is actually the same as that of BRCA survivors.

Doctor Dawn Musalem: 00:07:27

This is actually a great thing to talk about is breast cancer risk.

Doctor Dawn Musalem: 00:07:30

Sometimes you can't avoid some risks.

Doctor Dawn Musalem: 00:07:34

My risk was over 75%.

Doctor Dawn Musalem: 00:07:36

They found something on my mrI.

Doctor Dawn Musalem: 00:07:38

It wasn't amenable to biopsy, so I actually, last year, had to do a bilateral mastectomy for situation.

Doctor Dawn Musalem: 00:07:45

They weren't sure if it was cancer.

Doctor Dawn Musalem: 00:07:47

It turned out not to be high risk lesions, but fortunately, I am fine from that.

Doctor Dawn Musalem: 00:07:52

My grandmother did die of metastatic breast cancer, so it is very personal to me.

Doctor Dawn Musalem: 00:07:56

So it is very interesting that I had to go through that, and it's made me such a better doctor because of it.

Doctor Dawn Musalem: 00:08:03

In terms of how do I counsel my patients when they're young or middle aged or old?

Doctor Dawn Musalem: 00:08:08

It doesn't matter.

Doctor Dawn Musalem: 00:08:10

It really does change how you perceive and feel your body for some period of time.

Doctor Dawn Musalem: 00:08:16

Even though before this happened, I never thought I would be that woman, it actually was very hard for me emotionally.

Doctor Dawn Musalem: 00:08:23

So it allows me really to be in that space with my patients and in such a tender way that I love that I went through that.

Doctor Dawn Musalem: 00:08:30

So, yeah, I didn't have breast cancer, thank God, but I had to do the prophylactic side of it.

Rip Esselstyn: 00:08:34

Got it, got it, got it.

Rip Esselstyn: 00:08:35

Thank, thank you for clarifying all that.

Rip Esselstyn: 00:08:38

Now, tell me a little bit about your position at the Jacobi center for Breast Health.

Rip Esselstyn: 00:08:47

And is this something that you devised?

Rip Esselstyn: 00:08:51

Was it something, a position that was there, and you kind of applied for it and got it.

Rip Esselstyn: 00:08:57

And who are you working with exactly?

Doctor Dawn Musalem: 00:09:00

Thank you so much, rip, for asking this question.

Doctor Dawn Musalem: 00:09:03

And at Mayo Clinic, across our enterprise, we have three sites, Rochester, Florida, and Arizona.

Doctor Dawn Musalem: 00:09:09

We are the only place besides Cleveland Clinic, and we partner with them in some educational opportunities internationally, actually, that have diagnostic breast clinics.

Doctor Dawn Musalem: 00:09:19

It's a breast clinic where we work with women who are at an elevated risk of breast cancer.

Doctor Dawn Musalem: 00:09:24

We work with women at the time of their diagnosis, they come in to see us first.

Doctor Dawn Musalem: 00:09:28

From there, they go and see the rest of the oncology team, the surgery team, the radiation oncology team, and then it's a holistic practice that they come back to us in that diagnostic breast clinic for survivorship care.

Doctor Dawn Musalem: 00:09:40

Now, in: 2015

Doctor Dawn Musalem: 00:09:58

And it really is the first of its kind, the only of its kind.

Doctor Dawn Musalem: 00:10:01

It's an immersive program that is built on the foundation of lifestyle medicine.

Doctor Dawn Musalem: 00:10:05

And pretty much 95% of what my conversation is with my patients is on whole food plant based nutrition.

Doctor Dawn Musalem: 00:10:12

And it's so exciting.

Doctor Dawn Musalem: 00:10:14

And the reason it's really important for NCI designated, you know, that's a national cancer Institute designated cancer center.

Doctor Dawn Musalem: 00:10:23

To have a program like this is because so many cancers are preventable.

Doctor Dawn Musalem: 00:10:28

We know that the American Cancer Society says 40% of all cancers are preventable.

Doctor Dawn Musalem: 00:10:32

And we know that's a huge underestimate.

Doctor Dawn Musalem: 00:10:34

Actually, that's just the best we can do.

Doctor Dawn Musalem: 00:10:35

Regardless, even if that's an underestimate, that is a huge number of preventable cancers.

Doctor Dawn Musalem: 00:10:41

When we look at breast cancers, we know at least 33% are preventable.

Doctor Dawn Musalem: 00:10:45

And we really feel if we were able to make changes earlier on in young girls lives, maybe even as far back when they're in utero pregnant, whether mom is pregnant with them, there's even risks that occur then that maybe 75% of breast cancers can be completely eliminated.

Doctor Dawn Musalem: 00:11:01

That's why primary prevention is so important.

Doctor Dawn Musalem: 00:11:04

I believe in mammograms.

Doctor Dawn Musalem: 00:11:05

Women need to do mammograms at the age of 40.

Doctor Dawn Musalem: 00:11:08

That's how we find breast cancer early enough so it's easier to treat.

Doctor Dawn Musalem: 00:11:12

And if a woman has a family history of breast cancer, particularly a family history of breast cancer, that occurred in young women, that woman may need to start her mammogram earlier, ten years younger than the youngest relative ever diagnosed.

Doctor Dawn Musalem: 00:11:24

But, you know, going back to primary prevention, that means let's live a healthy life, so this cancer never has to happen.

Doctor Dawn Musalem: 00:11:32

And we are seeing a rapid rise in cancers in young people.

Doctor Dawn Musalem: 00:11:36

I currently have a 20 year old young woman with breast cancer, and it gives me chills to talk about this.

Doctor Dawn Musalem: 00:11:42

And, you know, the first thing that happens in that visit is the mom and the daughter say, how did I get this?

Doctor Dawn Musalem: 00:11:49

How did this happen?

Doctor Dawn Musalem: 00:11:50

You know, so it's really, it's really scary, honestly.

Doctor Dawn Musalem: 00:11:54

And some of it's not totally in our control, but what's in our control is what we're going to talk about today.

Rip Esselstyn: 00:11:59

Yeah, but let me, let me go back, and I have two questions for you based upon what you just said.

Rip Esselstyn: 00:12:06

One of them is, so you, you mentioned that I think you said 75 or 80% of your job, maybe you said 90%, is talking to your patients about whole food plant based nutrition.

Rip Esselstyn: 00:12:18

That absolutely makes you giddy.

Rip Esselstyn: 00:12:20

And my question is, how do the vast majority of your patients respond to your suggestion of whole food plant based nutrition?

Rip Esselstyn: 00:12:31

Do they take it?

Rip Esselstyn: 00:12:32

Are they interested?

Doctor Dawn Musalem: 00:12:33

Yeah, you know, there's so much support.

Doctor Dawn Musalem: 00:12:35

It's really exciting.

Doctor Dawn Musalem: 00:12:36

It's kind of a fun thing.

Doctor Dawn Musalem: 00:12:38

The breast center, they tell the patient, she's our magic bullet.

Doctor Dawn Musalem: 00:12:42

You need to meet with her.

Doctor Dawn Musalem: 00:12:43

Oh, my God, I love this.

Doctor Dawn Musalem: 00:12:45

So the patients come.

Doctor Dawn Musalem: 00:12:48

I have them do a 24 hours food journal.

Doctor Dawn Musalem: 00:12:51

I have them let me know what their history of preference with nutrition and the relationship with food is, how much they exercise, how much alcohol they consume, what supplements they take.

Doctor Dawn Musalem: 00:13:02

So I have a good understanding of where that patient's at before I even join them in the visit.

Doctor Dawn Musalem: 00:13:07

That really helps me.

Doctor Dawn Musalem: 00:13:08

And from there, the first thing, you know, after we get to meet each other and we share names and just a little bit of background about each other, I ask them, what are your goals for this visit?

Doctor Dawn Musalem: 00:13:19

I say, you know, I know what I want to review with you.

Doctor Dawn Musalem: 00:13:22

There are some things that are very important in a breast cancer journey, but it's really important for me to know what I can do for you.

Doctor Dawn Musalem: 00:13:29

I want to start there.

Doctor Dawn Musalem: 00:13:30

You know, some women may not be ready for this.

Doctor Dawn Musalem: 00:13:32

They may have emotional trauma.

Doctor Dawn Musalem: 00:13:33

They may have something completely, completely different that they need to talk about.

Doctor Dawn Musalem: 00:13:37

But within that year, after their breast cancer diagnosis, we have completely unveiled and unraveled the nutritional aspect of their care.

Doctor Dawn Musalem: 00:13:47

We support the women with breast cancer retreats where we do whole food plant based meals for the women.

Doctor Dawn Musalem: 00:13:52

And then every month, I have a drop in session for all my patients at lunchtime, and we just talk about any questions they have about food.

Doctor Dawn Musalem: 00:13:59

Fun new recipes, fun new studies related to food and breast cancer.

Doctor Dawn Musalem: 00:14:03

So it's really exciting.

Doctor Dawn Musalem: 00:14:06

The women love it.

Doctor Dawn Musalem: 00:14:08

My patients really do pretty darn well during treatment, during chemotherapy, during radiation.

Doctor Dawn Musalem: 00:14:16

And, you know, I have someone that are running marathons or doing dragon boat races after the breast cancer diagnoses, when they're really working on their body compositions, they're having remarkable weight loss, successful weight loss.

Doctor Dawn Musalem: 00:14:29

And I get these comments, Goshen.

Doctor Dawn Musalem: 00:14:32

I don't even feel like I'm dieting.

Doctor Dawn Musalem: 00:14:33

I'm enjoying food, and I'm losing weight.

Doctor Dawn Musalem: 00:14:36

I feel good.

Doctor Dawn Musalem: 00:14:38

I have one woman, I shared that slide at plantstock this year.

Doctor Dawn Musalem: 00:14:40

She said, I feel better now than I felt before my breast cancer diagnosis.

Doctor Dawn Musalem: 00:14:45

That gives me chills.

Doctor Dawn Musalem: 00:14:47

That's why I love my job right there.

Rip Esselstyn: 00:14:49

Incredible.

Rip Esselstyn: 00:14:50

You mentioned that 20 year old that you recently saw that has breast cancer.

Rip Esselstyn: 00:14:56

Do you have any thoughts on what caused her breast cancer?

Rip Esselstyn: 00:15:00

Or just, I mean, that seems really young.

Doctor Dawn Musalem: 00:15:03

Obviously, it is so young.

Doctor Dawn Musalem: 00:15:06

And, you know, the first thing we would think is, oh, there must be a genetic contribution to this.

Doctor Dawn Musalem: 00:15:12

Her genetic testing was actually negative.

Doctor Dawn Musalem: 00:15:14

There was no family history of breast cancer.

Doctor Dawn Musalem: 00:15:16

We know that genetic links to breast cancer account for about five to 10% of breast cancers, maybe up to 15%.

Doctor Dawn Musalem: 00:15:24

That number will keep on growing as we know more about the micro, about the genome project, and we're identifying more genes, potentially another five to 10% are family history.

Doctor Dawn Musalem: 00:15:33

So you hear what I'm saying, only about 25% or so are from family history and genes.

Doctor Dawn Musalem: 00:15:38

The rest is from environment, lifestyle.

Doctor Dawn Musalem: 00:15:43

There's a lot that gets unpacked.

Doctor Dawn Musalem: 00:15:45

We now know, and you shared that article with me, Rip, about the exposure to pollutants and microplastics that was just recently talked about in frontiers.

Doctor Dawn Musalem: 00:15:56

And there is suggestion that when moms are pregnant with their daughters, their exposure to microplastics may in and of itself even start to affect that fetus.

Doctor Dawn Musalem: 00:16:06

There's exposures many years ago moms were exposed to called des, at increased breast cancer risk.

Doctor Dawn Musalem: 00:16:11

But you know, as a young girl is growing up, we know that weight gain during the younger years can be a trigger for increasing breast cancer risk.

Doctor Dawn Musalem: 00:16:20

We know having a period at a younger age.

Doctor Dawn Musalem: 00:16:24

And you know what's interesting, again, going back to that article with the plastics, we know some of these microplastics can mimic estrogen.

Doctor Dawn Musalem: 00:16:31

And their suggestion that maybe that's what contributes to this earlier menses in young girls and that drives breast cancer risk.

Doctor Dawn Musalem: 00:16:41

So for a 20 year old girl, those would be a few things.

Doctor Dawn Musalem: 00:16:44

In addition to sedentary, she wasn't active, she did not exercise much.

Doctor Dawn Musalem: 00:16:49

In young kids nowadays, they don't move, they sit a considerable amount.

Doctor Dawn Musalem: 00:16:54

And then alcohol exposure.

Doctor Dawn Musalem: 00:16:56

We have young kids starting to drink at very young ages.

Doctor Dawn Musalem: 00:17:00

Some parents are actually accepting of that.

Doctor Dawn Musalem: 00:17:03

And we know that alcohol exposure throughout the life cycle is extremely toxic to breast tissue, particularly when the breasts are developing.

Doctor Dawn Musalem: 00:17:12

And then we think about vaping, you know, vaping, we don't, we haven't even begin to understand what those concentrates do in the breast tissue for these young individuals who are really frequently using these products nowadays.

Doctor Dawn Musalem: 00:17:26

So it's quite scary when you think of all that these young folks are being exposed to.

Doctor Dawn Musalem: 00:17:30

And I didn't even talk about food right then.

Doctor Dawn Musalem: 00:17:33

We have the ultra processed food.

Doctor Dawn Musalem: 00:17:34

And we know that ultra processed food in our young people accounts for 67% of their diet.

Doctor Dawn Musalem: 00:17:42

We know baby formula has monoun diglycerides in it.

Doctor Dawn Musalem: 00:17:47

Mono and diglycerides have been linked to a 24% increased risk of breast cancer.

Doctor Dawn Musalem: 00:17:54

I know we're not talking about prostate cancer, but mono and diglycerides have been linked to a 46% increased risk of prostate cancer.

Rip Esselstyn: 00:18:02

They're in so many different food products.

Doctor Dawn Musalem: 00:18:04

Yeah, they're in every.

Doctor Dawn Musalem: 00:18:06

They're in yogurt, they're in some plant milks.

Doctor Dawn Musalem: 00:18:09

So mono and diglycerides are a no no.

Doctor Dawn Musalem: 00:18:11

Caring.

Doctor Dawn Musalem: 00:18:12

Guillen's admitted to a 32% increased risk of breast cancer.

Doctor Dawn Musalem: 00:18:15

This was a study that they looked at a large group of individuals, they followed them over seven years.

Doctor Dawn Musalem: 00:18:21

There's associations.

Doctor Dawn Musalem: 00:18:22

It doesn't mean that the direct.

Doctor Dawn Musalem: 00:18:24

You consume this, you get this, but there's an association that's certainly risky.

Doctor Dawn Musalem: 00:18:28

And so we want to consume food that's as close to nature as possible.

Doctor Dawn Musalem: 00:18:33

The biggest part about a whole food, plant based diet is the whole food part, you know?

Rip Esselstyn: 00:18:37

Yeah.

Rip Esselstyn: 00:18:38

I've got to remember how thorough you are at answering every question.

Rip Esselstyn: 00:18:45

But those are a lot of different factors that come together to kind of make it very, very difficult for somebody to steer clear of these cancers, these diseases, unless you're really, I think, making an effort to eat whole food, plant based, not vape, not do alcohol, you know, be mindful of your, what you're being exposed to, all those things, you know, another doctor that's going to be part of this October breast cancer awareness month is going to be doctor Christy Funk.

Rip Esselstyn: 00:19:22

And do you know Christy?

Rip Esselstyn: 00:19:24

Have you ever met Christy?

Doctor Dawn Musalem: 00:19:26

I need to meet her.

Doctor Dawn Musalem: 00:19:27

I have never met her, but she's awesome.

Rip Esselstyn: 00:19:29

Well, she is awesome, but, you know, we were talking about alcohol.

Rip Esselstyn: 00:19:33

She, because of the.

Rip Esselstyn: 00:19:35

,: 2024

Rip Esselstyn: 00:19:41

So it's great.

Rip Esselstyn: 00:19:43

Pretty, pretty good.

Doctor Dawn Musalem: 00:19:44

I agree.

Rip Esselstyn: 00:19:45

Yeah.

Rip Esselstyn: 00:19:46

Yeah.

Rip Esselstyn: 00:19:46

Let me ask you this.

Rip Esselstyn: 00:19:47

You mentioned, you know, how much you love your patients.

Rip Esselstyn: 00:19:51

How many patients, like, roughly, are you seeing at one point in time?

Rip Esselstyn: 00:19:58

Are we talking 20?

Rip Esselstyn: 00:19:59

Are we talking 100?

Rip Esselstyn: 00:20:00

I have no idea.

Doctor Dawn Musalem: 00:20:02

Yeah.

Doctor Dawn Musalem: 00:20:02

No, I really like to have my visits one on one with patients for the first time.

Doctor Dawn Musalem: 00:20:07

And my visit with patients is 90 minutes, and that's not even enough time currently.

Doctor Dawn Musalem: 00:20:12

This week, I had two residents shadowing me, and when I shared with them, I had 90 minutes.

Doctor Dawn Musalem: 00:20:16

They were, like I said, just watch.

Doctor Dawn Musalem: 00:20:18

Watch what happens.

Doctor Dawn Musalem: 00:20:19

And I still go over.

Doctor Dawn Musalem: 00:20:20

I'm still late.

Doctor Dawn Musalem: 00:20:21

I have to ask for forgiveness.

Doctor Dawn Musalem: 00:20:22

The rooming folks, I have a telehealth practice because my patients are actually from all over the world, so it's really cool.

Doctor Dawn Musalem: 00:20:29

And so the folks that room them, like, electronically through Zoom, they work at Mayo clinic, and I have one person assigned to me, so she lets all the ladies know you're going to be waiting a while.

Doctor Dawn Musalem: 00:20:39

Go do something.

Doctor Dawn Musalem: 00:20:40

She'll yell out to you, come on, I'm here.

Doctor Dawn Musalem: 00:20:43

But I don't like to rush them.

Doctor Dawn Musalem: 00:20:44

You know, if someone's 60 years old, you're unpacking 60 years of their lifestyle into the conversation.

Doctor Dawn Musalem: 00:20:50

But gosh, it's so cool.

Doctor Dawn Musalem: 00:20:53

My resident this week, his name is Doctor Klein.

Doctor Dawn Musalem: 00:20:56

He is studying to be anesthesiologist.

Doctor Dawn Musalem: 00:20:59

And he said, it's so interesting.

Doctor Dawn Musalem: 00:21:01

He goes, we prescribe pills in milligrams, but we eat food in pounds.

Doctor Dawn Musalem: 00:21:08

That was really good.

Doctor Dawn Musalem: 00:21:09

I thought, that's great.

Doctor Dawn Musalem: 00:21:12

But in addition to that one on one time, I do those drop in visits for my patients at lunchtime twice a month.

Doctor Dawn Musalem: 00:21:19

And then we do these big retreats with at least 100 women in those retreats a few times a year.

Doctor Dawn Musalem: 00:21:24

So that's really exciting where we can do more immersive, and we usually offer those out zoom as well.

Doctor Dawn Musalem: 00:21:29

That started during COVID which was really nice.

Doctor Dawn Musalem: 00:21:31

And at that time, we would have multiple countries joining us just for that educational component, which is wonderful.

Rip Esselstyn: 00:21:37

Yeah, so we, we lived it up at plan stock this year, you, huge part of the success of plan stock.

Rip Esselstyn: 00:21:49

And we had a panel discussion with the docs that were there yourself.

Rip Esselstyn: 00:21:54

So doctor, doctor Will Bolshowitz, Doctor Gemma Newman, and doctor don Musalem.

Rip Esselstyn: 00:22:00

And during this panel discussion, you brought up some really, I think, compelling and exciting research that's just gone on in the last two, three years that is very, very, I think, hopeful for women breast cancer.

Rip Esselstyn: 00:22:16

So do you want to start with the first study?

Rip Esselstyn: 00:22:19

ncer society meta analysis in: 2022

Rip Esselstyn: 00:22:23

Is that a good place to start?

Doctor Dawn Musalem: 00:22:25

Yeah, let's start out there.

Doctor Dawn Musalem: 00:22:26

So I love that.

Doctor Dawn Musalem: 00:22:28

ety, they did their update in: 2022

Doctor Dawn Musalem: 00:22:44

You know, to this day, I can speak to a group of doctors or to patients.

Doctor Dawn Musalem: 00:22:48

I would say every day, about 80% of my patients I see are terrified of soy.

Doctor Dawn Musalem: 00:22:54

It's so cute.

Doctor Dawn Musalem: 00:22:54

They'll say, I don't even eat soy sauce.

Doctor Dawn Musalem: 00:22:56

I'm like, well, soy sauce doesn't even have soy aclavin.

Doctor Dawn Musalem: 00:22:58

So you actually could have done that.

Doctor Dawn Musalem: 00:23:00

You know, it has salt.

Doctor Dawn Musalem: 00:23:01

That's for another conversation.

Doctor Dawn Musalem: 00:23:03

Society had published in this: 2022

Doctor Dawn Musalem: 00:23:14

And what they showed is something that we've known, but what they showed is that after breast cancer diagnosis, those patients that had more soy compared to those that had less soy, those with more soy had a 25% reduced risk of breast cancer coming back.

Doctor Dawn Musalem: 00:23:28

And this was a strongly statistically significant finding.

Doctor Dawn Musalem: 00:23:31

There was no wavering on the fact that this was real.

Doctor Dawn Musalem: 00:23:35

This didn't happen by chance.

Doctor Dawn Musalem: 00:23:37

So very wonderful study.

Doctor Dawn Musalem: 00:23:40

We've known this for decades, though.

Doctor Dawn Musalem: 00:23:42

There's been plenty of studies that said the same thing.

Doctor Dawn Musalem: 00:23:44

But it feels really good to be able to be in that room with patients and let them know that this isn't my opinion.

Doctor Dawn Musalem: 00:23:50

This isn't just one study.

Doctor Dawn Musalem: 00:23:51

This is a review of several studies.

Doctor Dawn Musalem: 00:23:53

There was almost: 8000

Doctor Dawn Musalem: 00:23:56

And so it feels really good to give patients that support.

Doctor Dawn Musalem: 00:23:59

Now, what it showed us is that in this study, there was more benefit for those women that had estrogen receptor negative breast cancer.

Doctor Dawn Musalem: 00:24:06

But the women with estrogen receptor positive breast cancer still got benefit too.

Doctor Dawn Musalem: 00:24:12

At the end of the day, there's no harm, right?

Doctor Dawn Musalem: 00:24:15

And you can replace animal protein when you consume the soyez.

Doctor Dawn Musalem: 00:24:19

And that kind of brings us right to the next study.

Doctor Dawn Musalem: 00:24:21

I mean, I think it dovetails right into doctor Neal Barnard's study about soy.

Rip Esselstyn: 00:24:25

Before you dovetail into that one, can you let people that don't know, like myself, what's the difference between an estrogen negative and an estrogen positive type of breast cancer?

Doctor Dawn Musalem: 00:24:37

Oh, that's a great question.

Doctor Dawn Musalem: 00:24:39

The majority of breast cancers that are diagnosed are estrogen receptor positive, about 75%.

Doctor Dawn Musalem: 00:24:46

That is going to be closest to what you would expect a breast cell to be like.

Doctor Dawn Musalem: 00:24:50

There's estrogen receptors on a healthy breast cell, and there's estrogen receptors on 75% of breast cancers that are diagnosed.

Doctor Dawn Musalem: 00:24:58

Now, as those cancer cells start to mutate and become more differentiated, they become more different than the natural breast cell.

Doctor Dawn Musalem: 00:25:06

Things start to change.

Doctor Dawn Musalem: 00:25:07

That estrogen receptor becomes less positive.

Doctor Dawn Musalem: 00:25:09

So as you get estrogen receptor negative breast cancers, those are the more aggressive breast cancers, actually.

Doctor Dawn Musalem: 00:25:16

So that's what's so fascinating about that.

Doctor Dawn Musalem: 00:25:18

Here we're dealing with a more aggressive breast cancer, one that you really want to make sure you reduce the risk of it coming back.

Doctor Dawn Musalem: 00:25:25

And soy is accomplishing that in this meta analysis by Nuchetta and colleagues.

Rip Esselstyn: 00:25:30

So just a remarkable study and two things, two comments.

Rip Esselstyn: 00:25:36

You mentioned soy isoflavones.

Rip Esselstyn: 00:25:40

What are the best foods that have soy isoflavones if soy sauce doesn't have it?

Doctor Dawn Musalem: 00:25:47

Great question.

Doctor Dawn Musalem: 00:25:47

So I like to go as close to nature as possible.

Doctor Dawn Musalem: 00:25:49

So let's start with edamame.

Doctor Dawn Musalem: 00:25:51

You know, and I do recommend, when I recommend edamame, definitely non gmo, which the majority of soy for human consumption is non gmo, but there's still some out there that aren't.

Doctor Dawn Musalem: 00:26:01

I love soy nuts for my patients, too.

Doctor Dawn Musalem: 00:26:02

So if they're traveling and they don't have access to soy because they're traveling, they'll pack soy nuts.

Doctor Dawn Musalem: 00:26:07

I pack soy nuts all the time when I travel suitcase.

Doctor Dawn Musalem: 00:26:11

And by the way, at the airport, when you go into the airport store and everything else is so expensive, the soy nuts are the least expensive thing.

Doctor Dawn Musalem: 00:26:16

So fire soy nut and, you know, soy milk.

Doctor Dawn Musalem: 00:26:20

I consume a lot of soy milk.

Doctor Dawn Musalem: 00:26:21

Soy milk is amazing in coffee.

Doctor Dawn Musalem: 00:26:23

Coffee is actually another thing that has shown some breast cancer benefit, hasn't shown harm.

Doctor Dawn Musalem: 00:26:28

So that's cool, right?

Doctor Dawn Musalem: 00:26:29

Because I love my coffee, but what's cool with coffee?

Doctor Dawn Musalem: 00:26:32

I know I'm going on a sidetrack, but this is a fun food fact right here.

Doctor Dawn Musalem: 00:26:35

I have to share.

Doctor Dawn Musalem: 00:26:36

You know, the chlorogenic acid is the polyphenol that's in coffee, and you get the most benefit.

Doctor Dawn Musalem: 00:26:42

If you have light and medium rose, you kind of lose that benefit with dark roast.

Doctor Dawn Musalem: 00:26:46

But you know what else?

Doctor Dawn Musalem: 00:26:47

If you put dairy, cow dairy in coffee, you lose the ability to absorb it as effectively.

Doctor Dawn Musalem: 00:26:52

So use that soy milk in your coffee.

Doctor Dawn Musalem: 00:26:55

You get some nice natural fat.

Doctor Dawn Musalem: 00:26:57

You know, you don't want to use oat milk with fat.

Doctor Dawn Musalem: 00:27:00

Actually, I use plant strong oat milk, too, in my coffee.

Doctor Dawn Musalem: 00:27:04

So you can do the oat milk, but you want to make sure that, that that plant milk doesn't have oil in it to make it fatty.

Doctor Dawn Musalem: 00:27:09

So soy gives you that nice level of fat, you know, tofu, tempeh.

Doctor Dawn Musalem: 00:27:13

Today for lunch, I had nice tempeh.

Doctor Dawn Musalem: 00:27:15

It's great in a salad or however you want to have it.

Doctor Dawn Musalem: 00:27:17

So those would be my top four that I recommend for patients.

Rip Esselstyn: 00:27:21

Are you don, are you dangerous on caffeine?

Doctor Dawn Musalem: 00:27:27

I don't know.

Doctor Dawn Musalem: 00:27:28

You'd have to ask people that are around me when I have it.

Doctor Dawn Musalem: 00:27:31

How many?

Rip Esselstyn: 00:27:31

How many, how many cups of coffee do you have a day?

Doctor Dawn Musalem: 00:27:36

Usually two in the morning.

Rip Esselstyn: 00:27:38

Got it.

Doctor Dawn Musalem: 00:27:39

Small ones.

Rip Esselstyn: 00:27:41

Got it.

Doctor Dawn Musalem: 00:27:42

Actually, I can't wait.

Doctor Dawn Musalem: 00:27:43

I cannot wait to get up in the morning at my coffee.

Doctor Dawn Musalem: 00:27:45

It's like, my favorite thing.

Doctor Dawn Musalem: 00:27:47

It really is.

Doctor Dawn Musalem: 00:27:48

I so look forward to it.

Rip Esselstyn: 00:27:49

mail from you this morning at: 03:18

Rip Esselstyn: 00:27:57

and I was like, gotta be a mistake.

Rip Esselstyn: 00:28:01

You're right.

Rip Esselstyn: 00:28:02

418 your time.

Rip Esselstyn: 00:28:03

So that makes me feel a little bit better.

Rip Esselstyn: 00:28:06

Wow.

Rip Esselstyn: 00:28:06

I don't know you, in our last conversation, we talked about what time you get up in the morning.

Rip Esselstyn: 00:28:13

I think it was like 411 or something like that.

Doctor Dawn Musalem: 00:28:17

Yeah, I love the morning.

Doctor Dawn Musalem: 00:28:20

Honestly, I wish that sleep was not one of the pillars of healthy living, because I just don't have time for it.

Doctor Dawn Musalem: 00:28:27

I do sleep, but it's such a waste of my time.

Doctor Dawn Musalem: 00:28:30

I want to be alive and awake, you know, so I sleep.

Doctor Dawn Musalem: 00:28:34

I really do work on that, but it's not my favorite thing to do.

Rip Esselstyn: 00:28:37

Yeah, well, okay, so we'll move on from lack of sleep.

Rip Esselstyn: 00:28:42

Let's in your email to me that this morning, as part of the, these research studies that we were going to cover today, you also said, you mentioned another fun fact that was kind of part of this first American Cancer society meta analysis, and that was an increase of ten milligrams a day of soy.

Rip Esselstyn: 00:29:03

Isoflavones does something with mortality for all cancers and mortality for breast cancer.

Rip Esselstyn: 00:29:09

Do you know those statistics?

Doctor Dawn Musalem: 00:29:11

Yeah, we see that it can decrease, it can reduce the risk of dying from all cancers by about 7% and from breast cancer by about 9%.

Doctor Dawn Musalem: 00:29:19

So again, this is really exciting.

Doctor Dawn Musalem: 00:29:23

And we know that when it comes to soy, there's been a lot of data with prostate cancer and also lung cancer, which is very interesting.

Doctor Dawn Musalem: 00:29:30

So it's always fun to see these studies.

Doctor Dawn Musalem: 00:29:34

But at the end of the day, what I would say is soy is such a healthy protein because you're replacing an animal protein, you know, and you get a very high quality, complete protein in doing so.

Doctor Dawn Musalem: 00:29:44

So I really encourage the consumption of.

Doctor Dawn Musalem: 00:29:46

So you don't want to overdo it.

Doctor Dawn Musalem: 00:29:47

You know, I tell my patients one to three servings a day is enough.

Doctor Dawn Musalem: 00:29:50

You know, if you get more than five servings of soy a day, you actually start to bump up the insulin growth factor.

Doctor Dawn Musalem: 00:29:55

And that's why we stay away from animal protein.

Doctor Dawn Musalem: 00:29:58

So don't overdo it.

Doctor Dawn Musalem: 00:29:59

You know, it's, it's probably not going to hurt you per se, but you want variety.

Doctor Dawn Musalem: 00:30:03

You don't want to just have soy and there's fat and soy, too.

Doctor Dawn Musalem: 00:30:06

So, you know, make sure you're getting your beans and lentils and all the other plant sources of protein.

Doctor Dawn Musalem: 00:30:10

But soy is safe, bottom line.

Doctor Dawn Musalem: 00:30:12

That's the take home message here.

Rip Esselstyn: 00:30:13

And isoflavones, what are isoflavones?

Rip Esselstyn: 00:30:16

Are they specifically a type of phytonutrient?

Doctor Dawn Musalem: 00:30:19

Exactly.

Rip Esselstyn: 00:30:20

Yeah, yeah, yeah, yeah.

Doctor Dawn Musalem: 00:30:23

You know, and I guess a lot of people feel like it's an estrogen.

Doctor Dawn Musalem: 00:30:26

It's not an estrogen.

Doctor Dawn Musalem: 00:30:28

It doesn't bind the same way estrogen does in the breast, you know, so I don't call it a phytoestrogen, I call it an isoflavone, you know, a plant phytonutrient is what I call it.

Doctor Dawn Musalem: 00:30:39

So that there's not that miscommunication for people.

Rip Esselstyn: 00:30:41

Super smart.

Rip Esselstyn: 00:30:42

Super smart, yeah.

Rip Esselstyn: 00:30:44

The, the amount of, I think, misinformation that's out there right now swirling around soy is super unfortunate.

Rip Esselstyn: 00:30:54

So let's, so you suggest that a nice, I think, transition from this study would be to doctor Neil Barnard's.

Doctor Dawn Musalem: 00:31:04

Yeah.

Rip Esselstyn: 00:31:04

Right.

Rip Esselstyn: 00:31:05

So what, what can you tell us about his study?

Doctor Dawn Musalem: 00:31:08

You know, what a great study.

Doctor Dawn Musalem: 00:31:09

And I see the effectiveness of the study he did in my patient population every single day.

Doctor Dawn Musalem: 00:31:17

It's remarkable.

Doctor Dawn Musalem: 00:31:18

In fact, I spoke to a young woman today and she was sharing with me how much the soy has helped her.

Doctor Dawn Musalem: 00:31:24

And it's really exciting when women are struggling with postmenopausal symptoms.

Doctor Dawn Musalem: 00:31:28

And when it comes to breast cancer, again, 75% are estrogen receptor positive.

Doctor Dawn Musalem: 00:31:33

You know what that means?

Doctor Dawn Musalem: 00:31:34

That means we have to turn off that estrogen receptor for at least five years in these women.

Doctor Dawn Musalem: 00:31:39

This is really hard in women who are premenopausal because you figure, holy cow, their body actually needs estrogen.

Doctor Dawn Musalem: 00:31:46

All of a sudden you have to not just, you know, stop what they have, but then you take it even lower and it's really challenging.

Doctor Dawn Musalem: 00:31:53

Meaning that in these young girls we suppress their ovaries and then we give them a medicine to limit fat production in their body fat and peripheral tissue where estrogen is also made.

Doctor Dawn Musalem: 00:32:04

In postmenopausal women, they're already menopausal, their ovaries are no longer producing estrogen, but we further suppress them by again making sure they're not making estrogen in that peripheral tissue.

Doctor Dawn Musalem: 00:32:14

So what happens is these women with estrogen receptor positive breast cancer on these medicines have extreme menopausal symptoms.

Doctor Dawn Musalem: 00:32:22

In some situations, major hot flashes and they can't sleep because of it.

Doctor Dawn Musalem: 00:32:27

They wake up soaking wet, they're tossing and turning and then they feel cold and they're hot.

Doctor Dawn Musalem: 00:32:30

It's really uncomfortable for them.

Doctor Dawn Musalem: 00:32:32

So what Neil Barnard study showed is that with a half a cup of edamame a day, this is such a cool study, I get chills.

Doctor Dawn Musalem: 00:32:39

88% reduction in hot flashes and 50% of his cohort had complete amelioration of the hot flashes.

Doctor Dawn Musalem: 00:32:45

But it gets better.

Doctor Dawn Musalem: 00:32:46

In this study, he also showed that the mood was better.

Doctor Dawn Musalem: 00:32:49

This is great here.

Doctor Dawn Musalem: 00:32:51

Libido is better.

Doctor Dawn Musalem: 00:32:52

And over a twelve week study, these women lost eight pounds.

Doctor Dawn Musalem: 00:32:56

I mean, just amazing.

Doctor Dawn Musalem: 00:32:57

And I see this in my patient population every single day, and every single patient I see.

Doctor Dawn Musalem: 00:33:05

And it's so awesome because sometimes women come in to see me, and they saw a traditional medical doctor who's not really focusing on some holistic means to control hot flashes.

Doctor Dawn Musalem: 00:33:16

And the last thing a woman wants to do is to take another pill because a pill's causing a symptom.

Doctor Dawn Musalem: 00:33:21

And I oftentimes see that doctors on the outside will prescribe gabapentin.

Doctor Dawn Musalem: 00:33:26

It's a medication that's used even for neuropathic pain, and it can cause weight gain.

Doctor Dawn Musalem: 00:33:31

Like, that makes no sense.

Doctor Dawn Musalem: 00:33:32

Right?

Doctor Dawn Musalem: 00:33:32

It makes them tired.

Doctor Dawn Musalem: 00:33:34

So here you have a poor woman being treated for breast cancer with hot flashes, and her doctor gives her a pill that's gonna cause weight gain and makes her tired.

Doctor Dawn Musalem: 00:33:43

And instead, we can use soy extremely effectively.

Doctor Dawn Musalem: 00:33:46

So it's really a hopeful thing.

Doctor Dawn Musalem: 00:33:48

And I see a lot of success with the use of.

Doctor Dawn Musalem: 00:33:49

Of the soy in that situation.

Rip Esselstyn: 00:33:52

Yeah.

Rip Esselstyn: 00:33:53

And when you hear half a cup of edamame with your patients, do you just suggest that they go down to the store and get some frozen edamame and then just kind of eat it like that?

Doctor Dawn Musalem: 00:34:06

You know what's cute?

Doctor Dawn Musalem: 00:34:07

I use Jane's be a plant based woman warrior picture on the COVID I really recommend that cookbook to all of my patients.

Doctor Dawn Musalem: 00:34:14

It's how I onboard them with eating a healthier lunch is by doing the grain bowls.

Doctor Dawn Musalem: 00:34:18

So we look at that picture, and she has edamame on it.

Doctor Dawn Musalem: 00:34:21

So that's usually how I have them do it, is to sprinkle it on their salad.

Doctor Dawn Musalem: 00:34:25

I have them thaw it out.

Doctor Dawn Musalem: 00:34:26

Those edamame are blanched, so you really don't have to cook it.

Doctor Dawn Musalem: 00:34:29

I think it is better to cook it from a digestion standpoint.

Doctor Dawn Musalem: 00:34:32

But bottom line, I usually have them put a little lemon juice, a little bit of, you know, hot sauce, seasoned up however they want, heat them up, keep them in their refrigerator, and then just add a half a cup to their salads.

Doctor Dawn Musalem: 00:34:42

Or they can just have them as a snack throughout the day.

Doctor Dawn Musalem: 00:34:44

But I use a via plant based woman warrior that.

Doctor Dawn Musalem: 00:34:47

That image, and then they.

Doctor Dawn Musalem: 00:34:48

They buy the cookbook.

Doctor Dawn Musalem: 00:34:49

They really enjoy that.

Doctor Dawn Musalem: 00:34:49

The title is so awesome.

Doctor Dawn Musalem: 00:34:51

Anyways, for the topic we're talking about, it's very empowering for them, and there's just so many recipes in there that really help to support the women and what they're doing for the lunch.

Doctor Dawn Musalem: 00:34:59

And, you know, when it comes to behavior change, you have to enjoy it to be successful at it.

Doctor Dawn Musalem: 00:35:07

And that's why I love working with my patients.

Doctor Dawn Musalem: 00:35:10

I mean, I am giddy about, I love this stuff.

Doctor Dawn Musalem: 00:35:13

I feel so great because of it.

Doctor Dawn Musalem: 00:35:14

I feel so fully alive, so vibrant, and I see that my wit, when they come back, they're really excited.

Doctor Dawn Musalem: 00:35:21

Last night during the hurricane, one of my patients is a retired pediatrician.

Doctor Dawn Musalem: 00:35:25

She sent me a picture of her dinner last night.

Doctor Dawn Musalem: 00:35:27

It was like this amazing grain bowl.

Doctor Dawn Musalem: 00:35:29

It's so cool.

Doctor Dawn Musalem: 00:35:30

I get pictures all day long on my patient portal of food.

Doctor Dawn Musalem: 00:35:33

My patients are cooking when my colleagues are, you know, getting messages about things that are maybe not going quite as well.

Doctor Dawn Musalem: 00:35:39

So it's really such an exciting experience to see patients leaning in, nourishing their body, enjoying it, having this positive behavior change that's going to improve their breast cancer outcomes, help them attain their vitality and flourish after.

Doctor Dawn Musalem: 00:35:51

So it's really terrific.

Doctor Dawn Musalem: 00:35:53

So thank you, and thank your family for making it more possible for people.

Rip Esselstyn: 00:35:56

Listen, listen.

Rip Esselstyn: 00:35:58

You mentioned leaning in, I think.

Rip Esselstyn: 00:36:00

I can't help but think that one of the huge reasons why all of your patients, or let's just say many of your patients are embracing this is because of how you have leaned in to this lifestyle.

Rip Esselstyn: 00:36:14

The amount of joy and as you just said, giddiness, that it just emanates from you around the lifestyle.

Rip Esselstyn: 00:36:21

It's like, people are like, man, I want what she's having.

Rip Esselstyn: 00:36:23

I want what she's eating.

Rip Esselstyn: 00:36:25

Give me.

Rip Esselstyn: 00:36:26

Give me twice as much.

Doctor Dawn Musalem: 00:36:28

Well, you too, rip.

Doctor Dawn Musalem: 00:36:29

I mean, but it's true, you know, you go to a lifestyle medicine conference, and holy cow, there's no burnout.

Doctor Dawn Musalem: 00:36:35

Everyone's so high energy, everyone's running.

Doctor Dawn Musalem: 00:36:37

It's so cool, you know?

Doctor Dawn Musalem: 00:36:39

So I agree.

Doctor Dawn Musalem: 00:36:40

You know, it really is such a blessing to be in this space, but you have to be authentic to your message if you're going to work with people in this space.

Doctor Dawn Musalem: 00:36:47

And that's what I show my residents, you know, in the afternoon, I say, hey, I want you to go to the gym.

Doctor Dawn Musalem: 00:36:51

Hey, I want you to go to the grocery store and go buy some plant based food, make a plant based meal tonight.

Doctor Dawn Musalem: 00:36:55

They kind of love working with me.

Doctor Dawn Musalem: 00:36:57

That's probably why I have so many residents that want to rotate with me.

Doctor Dawn Musalem: 00:36:59

Go, go rotate with her.

Doctor Dawn Musalem: 00:37:01

She'll send you to the gym to go work out, and, yeah, she'll make you go to whole foods to buy some healthy food.

Rip Esselstyn: 00:37:09

nt based proteins came out in: 2024

Rip Esselstyn: 00:37:18

Right?

Rip Esselstyn: 00:37:19

Just you know, like, this year, January.

Doctor Dawn Musalem: 00:37:22

Yeah.

Rip Esselstyn: 00:37:22

Yeah.

Rip Esselstyn: 00:37:23

Can you tell me, like, what this study is saying?

Doctor Dawn Musalem: 00:37:27

So this is so cool, because, you know, I always have women say, but don't I need some meat for iron?

Doctor Dawn Musalem: 00:37:32

Or, like, actually, that's why I don't want you having me, is because of the iron.

Doctor Dawn Musalem: 00:37:35

We talk about that.

Doctor Dawn Musalem: 00:37:37

Don't I need dairy for my bones?

Doctor Dawn Musalem: 00:37:39

Don't I need fish to get some omega three fatty acids?

Doctor Dawn Musalem: 00:37:43

So when I share with them this nurses health study that had almost 50,000 people, 50,000 predominantly women, they followed them for about 30 years.

Doctor Dawn Musalem: 00:37:51

Every four years, they did an update on the nutritional pattern, and what they showed is that the path to healthy aging, which, holy cow, isn't that what we should be trying to do, is be the healthiest versions of ourselves for as long as we could possibly be on earth.

Doctor Dawn Musalem: 00:38:05

Right?

Doctor Dawn Musalem: 00:38:06

So it answered the most important question possible.

Doctor Dawn Musalem: 00:38:09

And what it showed is the path to healthy aging was with plant protein.

Doctor Dawn Musalem: 00:38:13

It outshined dairy and animal protein.

Doctor Dawn Musalem: 00:38:16

Otherwise, you know, what's cool is in that study, if you just read it, it makes it still look like there was some benefit of dairy and animal protein, but there wasn't if you controlled for the fruit and vegetable intake.

Doctor Dawn Musalem: 00:38:29

So really, the only benefit was with plant protein.

Doctor Dawn Musalem: 00:38:32

And that's amazing.

Doctor Dawn Musalem: 00:38:33

And it was a 38% benefit.

Doctor Dawn Musalem: 00:38:35

So it was a really fascinating study.

Doctor Dawn Musalem: 00:38:37

Patients love hearing it.

Doctor Dawn Musalem: 00:38:39

You know, I'm not in the business of making women whole food plant only.

Doctor Dawn Musalem: 00:38:42

My goal to start them off is, listen, breakfast is easy to make.

Doctor Dawn Musalem: 00:38:45

Whole food plant only.

Doctor Dawn Musalem: 00:38:46

And if they're doing an animal product, it's going to be processed meat, and that's a carcinogenous.

Doctor Dawn Musalem: 00:38:51

We know that it is linked to cancer, so there's no room for that.

Doctor Dawn Musalem: 00:38:55

So let's definitely make breakfast.

Doctor Dawn Musalem: 00:38:57

Whole food plant only.

Rip Esselstyn: 00:38:58

What do you recommend as a nice, simple breakfast?

Doctor Dawn Musalem: 00:39:03

My favorite breakfast is overnight oats.

Doctor Dawn Musalem: 00:39:05

For women, it's so easy.

Doctor Dawn Musalem: 00:39:07

If they have children, I have them involve their children with it.

Doctor Dawn Musalem: 00:39:09

At nighttime.

Doctor Dawn Musalem: 00:39:10

You can vary it with, you know, if you want to use berries, which is predominantly what I encourage them to do.

Doctor Dawn Musalem: 00:39:17

Just get the frozen.

Doctor Dawn Musalem: 00:39:18

We know frozen berries have the same nutritional value as freshen, probably more.

Doctor Dawn Musalem: 00:39:22

I encourage the wild blueberries.

Doctor Dawn Musalem: 00:39:24

They can save some money so they don't have to buy the organic ones, which are usually more expensive.

Doctor Dawn Musalem: 00:39:28

But I also encourage them to get variety through the week.

Doctor Dawn Musalem: 00:39:30

You know, do some apples that you cut up, maybe buy some frozen peaches that you put in there.

Doctor Dawn Musalem: 00:39:35

Just have fun with it.

Doctor Dawn Musalem: 00:39:36

Do the overnight oats.

Doctor Dawn Musalem: 00:39:37

I have them do oats with some flaxseed.

Doctor Dawn Musalem: 00:39:40

Of course there's soy milk and cinnamon.

Doctor Dawn Musalem: 00:39:44

I like for them to use some Ceylon cinnamon just because that can help to lower a little bit of the blood sugar too in that response.

Doctor Dawn Musalem: 00:39:50

So I try to have them get a teaspoon of that in there.

Rip Esselstyn: 00:39:55

Love it.

Rip Esselstyn: 00:39:57

Wow.

Rip Esselstyn: 00:39:57

Wow, wow, wow, wow.

Rip Esselstyn: 00:39:59

Isn't she spectacular?

Rip Esselstyn: 00:40:01

Now I'll make sure to link to these studies that we discussed today in the show notes so that you can learn more.

Rip Esselstyn: 00:40:08

And be sure to stay tuned because dawn will be back in two weeks to share even more studies and good news about plants.

Rip Esselstyn: 00:40:16

I understand that a cancer diagnosis is really complicated and there are many factors at play as we discussed today.

Rip Esselstyn: 00:40:25

However, I love what Don said, that there are so many things out of our control.

Rip Esselstyn: 00:40:33

So let's focus on those aspects of our health that we can control and that includes our food choices.

Rip Esselstyn: 00:40:41

Doctor Musalem is here to help and we here at Plantstrong are here to help as well.

Rip Esselstyn: 00:40:47

Thanks again for listening and remember to always, always keep it plan strong.

Rip Esselstyn: 00:40:56

The Plantstrong podcast team includes Carrie Barrett, Lori Cordowicz, and Amy Mackeyde.

Rip Esselstyn: 00:41:03

If you like what you hear, do us a favor and share the show with your friends and loved ones.

Rip Esselstyn: 00:41:09

You can always leave a five star rating and review on Apple Podcasts or Spotify.

Rip Esselstyn: 00:41:14

And while you're there, make sure to hit that follow button so that you never miss an episode.

Rip Esselstyn: 00:41:21

As always, this and every episode is dedicated to my parents, Doctor Kawal B.

Rip Esselstyn: 00:41:27

Esselstyn Junior and Anne Kryle Esselstyn.

Rip Esselstyn: 00:41:31

Thanks so much for listening.