Ep. 235: Dr. Scott Harrington - We Salute This Army Vet Turned Plant-Based Doc

Episode 235 • 8th February 2024 • PLANTSTRONG Podcast • Rip Esselstyn

[0:00] I'm Rip Esselstyn, and you're listening to the PLANTSTRONG Podcast.

My guest today is a West Point grad and proudly served in the U.S.

Army as a family medicine doctor, flight surgeon, and dive medical officer.

These days, he serves you with vegan primary care, his plant-based telehealth practice. this. Let's meet Dr.

Scott Harrington right after this.

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Introduction to Dr. Scott Harrington and his journey to plant-based nutrition

[2:54] We rightfully hold doctors in high esteem, but of course, they're just like us.

My guest today, Dr. Scott Harrington, has a journey to plant-based nutrition that may sound familiar to many of you.

As a practicing physician and U.S. Army family medicine doctor, Scott was doing what what most doctors do, seeing as many patients as possible and writing prescriptions.

[3:23] As a result, he was noticing his own physical and mental health declining until, until he watched forks over knives on an airplane at the recommendation of a military colleague.

[3:38] As he says today, by the time the plane landed, he knew he was a changed man.

In: 2020

I also asked for his recommendations on all of your common health questions like calcium intake, fiber, vitamin D, and what does it really take to build strong bones.

His energy, his passion are palpable, and I can't wait for you to meet Dr. Scott Harrington.

Hey, Dr. Scott Harrington, welcome to the PLANTSTRONG podcast.

It's an absolute pleasure to have you on the show.

Hey, Rip. Thank you so much. I'm super honored to be here. Yeah.

Now, Scott, where am I talking to you from? Where are you?

I am in beautiful Palm Harbor, Florida. It's around the Tampa area, Clearwater area. Wow.

[4:47] So you like the sunshine? Yes. Yeah.

So I grew up in Daytona Beach, Florida, but my wife grew up on this side, this coast of Florida.

And when I got out of the military, she won out, you know, because she's got a big family over here and it's great. We have a big, wonderful family over here.

Daytona Beach. I used to date a woman when I was in college whose family was from Daytona Beach, and that was just a party.

It's a party spot, isn't it?

Yes yes uh it was it was interesting because my dad had a business on the beach where we would rent floats and chairs and umbrellas and things and it was always a big spring break hub and you know and you could drive on the beach and so you know in the 80s and 90s there was always this thing where people would you know alter their cars and it was like we want to show them off off on Daytona beach.

And it was, there was MTV down there and it was always, it was always a party location and they do, um, they do the races there and bike week and that kind of thing.

Yeah. Well, this was in the, in the mid to late eighties when I was, when I was there dating this particular woman.

And I just remember leaving going, this place is insane.

Growing Up in a Small Beach Family

[6:12] Um, how does anybody get anything done around here? Yeah, exactly. Exactly.

Now, so Scott, what, tell me just a little bit about your family growing up.

Did you have brothers, sisters?

What did your parents do? Give me a little background.

Yeah. Yeah. So, uh, it was small family, mom and dad and one sister, uh, sister's seven years younger than me. She's now a dermatology PA.

So we've got kind of healthcare in the family. My parents weren't into healthcare.

Um, mom's an artist and my dad, uh, he, he was in the Navy for a little bit and he was a welder.

And then we had this beach business. Uh, he grew up on the the beach.

So we were always kind of a beach family.

I grew up surfing and, uh, just, I was a swimmer in high school, that kind of thing.

And, um, my mom basically got me excited about medicine because she was always kind of looking for the best diet, the latest, you know, and weight losses as people do.

[7:15] And, uh, I mean, it's interesting cause she had a copy of the starch solution a long time ago.

Uh, but you know, it's, it's interesting how, you know, you don't let, uh, things sink in until, you know, you hit a certain point in your life when all of a sudden the message comes through.

actually came out, I think in: 2000

So maybe it was McDougall's medicine. you're talking about that john wrote like in the 70s you're it's probably was yeah you're right if that's the timing of it it was it was a mcdougall book definitely you know he looks very young and he's like holding all the vegetables or something i think on the front yeah yeah yeah yeah yeah no it was uh might have been the mcdougall solution or mcdougall's medicine but john was such an incredible pioneer truly oh my god saying the same thing for like you know forever and you You got to hand it to him for that, you know?

Yeah, yeah. And I'm sure that we'll bring up John McDougall again over the course of this podcast.

Now, so Scott, what was it that inspired you to go into medicine?

[8:28] My grandmother, you know, she was getting older and she was just always, yeah, my grandson, he's going to go into medicine.

He's going to take care of me. and so that was just like you know a microchip implanted in my brain where i was i was just going to be a doctor that's that was just what i was going to do and um i i went into the army to pay for college you know i went i was at west point for undergrad and then i went through the hpsb program through medical school through the army i'm still technically i'm still reserve army Army Medical Corps.

So I still get to serve my country and it's great to keep my foot in the Army as well.

Well, yeah, you're a colonel in the U.S. Army Reserves, right?

Scott's Roles as a Flight Surgeon and Dive Medical Officer

[9:13] Absolutely. Yeah. And so in the U.S. Army, you were a medical doctor.

Were you also a flight surgeon? Is that right? Yeah.

Yes, yes. So there's a great job in the military called flight surgeon where you work with pilots and you fly a little bit. In the army, they don't teach you to fly.

So I've heard rumored that in the Navy, you actually get to become a pilot as well.

But in the army, you sit next to the pilots and you get to know them, you live in their environment. And so I worked closely with pilots and with parachutists and would do know all about flight physiology.

And it's a big part of flight safety is making sure that you get basically grounded if you're if you're sick with something that could alter your your ability to fly.

So that was one of the coolest jobs in the Army, for sure.

I imagine it would have been. And then you're also a dive, a dive medical officer. or what was that like?

[: 10:17

And we learned how to do navigate underwater and various skills.

And so once I became a physician, then I could then I use that course.

And then I became a dive medical officer.

So that's, that's key for helping, you know, getting people set up for scuba jobs, underwater jobs, and that kind of thing.

So, you know, I never really did any kind of crazy underwater missions or something, James Bond missions or anything like that.

So, but it was a lot of really cool training.

Oh my God. I mean, flight surgeon, dive medical officer, officer medical or family medical doctor.

That's, that's all sounds great. And you also spent two years in Afghanistan.

[: 11:16

It was, it was great to be a big part of a large team where you're really counting on people.

And, And we ran into situations that were just, you know, hair raising situations and getting to help the Afghan people. That was a big part of it.

So medical outreach, people would come to the base and they would have severe medical problems and we would help them.

And then also, of course, working with injured soldiers.

And it was, I mean, it changed my life. It, it, um, it's, it's, uh, we could spend the whole time talking about it. I'm sure.

I mean, there's, there's lots of, um.

[: 12:10

So you have to kind of be creative and, and use your medical resources, the, um, uh, get them to go the farthest, so to speak.

And also seeing, um, areas like, like in Afghanistan, for instance, since they don't have rabies vaccination program in many areas of Afghanistan.

So I saw patients with rabies. And so I just can't even.

So were you in a hospital setting? Were you in a tent?

What was what were the facilities like?

There was about 15 months where I was in a tent, basically.

And we but working with the surgical team and it was a small group, kind of like you can imagine, almost like MASH, you know, like a small.

[: 13:05

So if people got injured, we'd be right there available for them.

So it was a great experience and just it was a real honor to serve working with the soldiers and all the medical team.

Scott's Role as a Brigade Surgeon in the Army

[: 13:27

[: 13:35

And then I was in charge of, you know, kind of where people, you know, using our skills and the resources from our staff to the best of their ability.

So where you're trying to find who'll be best in a certain location, depending on the risks or, you know, operations and that kind of thing.

I was, so yeah, I was a brigade surgeon on the second, the second one year deployment.

And I was, it's kind of like all the King's horses, all the King's men, you know, you're, you're one of the group.

And it was one of the neatest times of my life because I was a part of this big organization and everybody's there in a room.

Everybody's an expert and, you know, advising the commander.

And it just was seeing the moving parts of a big organization like that.

It was I felt like, man, we could be curing cancer or something if we could just turn all these smart heads in one direction.

It was amazing what you could do with, you know, all those people at your disposal, so to speak.

Yeah. And how many of those smart heads do you think are whole food plant based these days?

[: 14:42

But, you know, because I don't know, everyone seems to be kind of focused on getting their protein and that kind of thing.

You know, honestly, it was a special forces soldier that, that, that kind of turned me on to plant based diet, you know?

[: 15:06

Yeah. Yeah. It was my right-hand man at the time. Uh, he was a special forces PA.

He was like, I had tried to lose some weight, you know, I was 35.

I had, uh, sort of gained one or two pounds a year and it, I needed to, I needed to lose weight, get my runtime down.

And, and, uh, I had tried to go portion control, you know, and it just doesn't work.

Portion control does not work. So he's like, Hey, you should check out this, uh, this movie forks over knives and the plant-based diet.

And so my, my story is I was traveling somewhere and I watched it on the plane.

And by the time it landed, I was, I was vegan. That was it. I was convinced. Yeah.

Shift to Whole Food Plant-Based Diet

[: 16:00

And, and then being, then seeing like seeing the light basically.

Well, that to me is, It says a lot to me about your personality that you're open-minded enough to see something like the documentary Forks Over Knives.

And then let me ask you this.

[: 16:26

So you've been out there for a while practicing medicine. What was it? Can you remember?

What was it about that movie that was so pivotal in you basically going whole food plant-based?

[: 16:54

I was just so impressed with this guy. And they're like, he says it's, it's, it's evidence-based and it's, it, it makes sense.

And so I had sort of my, uh, defenses off, you know, I was like, and I had come from this dark place.

So from, from the, from the get-go, I'm like looking for a right answer, looking for a message and sort of in, in the right place, ready, ready to hear it, ready to make a change.

And at that point I had never gotten anybody off off of any medications.

And here I am a family doctor.

And so this is just like hitting on all the points that were really salient to me, uh, that one, you know, I, I became a doctor to help people.

And right now it doesn't feel like I'm helping people.

It feels like I'm just prescribing more pills and, and this kind of thing.

It gave me hope. It gave me hope like, okay, well, if I do this diet and I'm going to see if it works, I don't tell, I don't do anything.

The Struggle with Losing Weight

[: 18:15

[: 18:23

So what was the dark place you were in? Meaning what the standard American diet?

Was that the dark place you were in?

No, no. The dark place I was in was the fact that I had tried to lose weight.

And at the time I was having to tell all my patients, look, you've you've got to lose weight, you know, you've got metabolic syndrome, you've got fatty liver disease, you're, you know, it's going to help your blood pressure and all these things.

[: 18:50

It was like a mountain I could never climb.

You know, it was a bridge too far because I was, I felt like with a portion control, you know, diet, just eating smaller, sad, standard American diet meals and exercising a lot.

I felt hungry all the time. and um and basically i failed i failed to lose weight so that was kind of the dark place i was in i felt like oh my gosh my patients are they're not going to be able to lose weight and they're just going to need to have like a gastric bypass when they're you know 100 pounds overweight or something like it felt like this was key to my um to my career and and uh so i was having an existential crisis kind of thing got it got it well you're right i mean the current formula that that everybody, or paradigm, that we need to eat less, move more.

It's a formula that doesn't work and it's obviously not sustainable.

[: 19:58

Let me ask you this, Scott, because I'm sure you get asked this all the time and I'd love to get some clarity.

So why did you go, why'd you become a DO and not an MD?

And what What are the advantages, disadvantages to, you know, a DO versus an MD?

If there are any, do you have the same medical school education?

All that jazz.

[: 20:27

So I'm an osteopathic doctor and in the United States, you can go to allopathic school, MD school, or you could go to osteopathic medical school.

And, you know, honestly, when you're, when you're trying to become a physician, it's like, it's like where, where you can get into wherever, wherever you get into.

And I was accepted to an osteopathic school and I was super, super glad to be able to get in because, you know, it's difficult.

There's so much competition.

So and I was lucky. I was lucky because an osteopathic school, there's, you know, a mind, body, spirit focused.

[: 21:08

And so this, this MD, Andrew Taylor still decided that he was gonna not use any medications and that he was going to do manipulation and trying to let the body heal itself.

So I mean, basically, what we think of is kind of like like chiropractic type manipulations, but osteopathics don't like, osteopathic doctors don't like you calling it chiropractic manipulation.

But with osteopathic manipulation, you basically.

[: 21:59

And so this was a big, uh, as this was a major aspect of, uh, the philosophies of osteopathic medicine for years and years and years.

However, then antibiotics came out and some of the osteopathic doctors were like, Hey, this is, this is really good. Antibiotics help people.

And another sort of milestone in osteopathic medicine was during the Vietnam war where people were getting drafted and the MDs were like, Hey, you know, these osteopathic doctors claim to be doctors and they're, they're not getting drafted.

So basically, once they drafted osteopathic doctors, they had to federal government had to standardize kind of the medical, the medical education system.

And so now in both MD schools and DO schools, you have two years of books, book training and two years of medical rotations where you shadow doctors.

And and so it's standardized in osteopathic school. you still learn how to do osteopathic manipulation.

[: 23:19

And, you know, this was fertile ground for me because now I'm, I'm board certified lifestyle medicine doctor, and it just, it's, it's fertile ground.

It just aligns perfectly strictly with the osteopathic principles of lifestyle medicine.

[: 23:45

Yes. Yeah. So, uh, just like in MD school, anatomy is one of the first courses that you undergo.

So, yep. We, so, uh, anatomy class and, um, you know, going through it and it's, that's always a big, uh, a big slap in the face or, you know, it's like, oh my gosh, you know, but, uh, you get used to it.

That's the kind of the weird thing, you know, then you go to a Natalie class and then you're hungry and you go to lunch. This is kind of kind of creepy.

Background and Philosophy of Being an Osteopathic Physician

[: 24:28

And it seems like with your background and being raised by somebody, your mother, who was an artist, it seems like maybe this is more dovetails more with kind of your upbringing and the whole mind, body, spirit kind of philosophy that is part of being an osteopathic physician. physician?

Yeah, you know, I mean, my grandma giving me, you know, wanted me to take care of her, I kind of putting that in, and just that I'm always going to be a physician.

So I've always had that kind of in the back of my mind. And I really lucked out getting into osteopathic medical school.

Because, you know, one, the the manipulation to the sort of focus on the body healing itself.

When when I have patients, I'm looking for ways that what can they do with their lifestyle that, that, so we don't have to give somebody a medication that's potentially toxic.

Now, I don't, I don't say that I'm against medication.

I can still prescribe all the pills, but the goal is to avoid a bunch of pills, uh, that cause more problems sometimes than they're worth. So, yeah. Yeah.

Now, so you are a physician.

[: 25:45

So yeah, so a lot of people ask me, how did I get so many licenses?

After I got out of the military, active duty and went to reserves, I went back to my wife's hometown.

And I started to work for a local hospital, Tampa General.

And I was telling people about the plant based diet and my hair was on fire.

And uh it was actually it was it was kind of frustrating to the other doctors are like scott you're spending so much time talking about diet you know you got to stop that and uh and that just i was like what this is crazy i got to get out of here this is this is not what uh that's not what i want you know i want my patients to know all about it and uh so then i decided you know what i'm working more now than i was in the military so i decided to work from home so i I got a job with a company called American Well, AmWell.

And they had me on staff. And as a staff member with American Well, they got me licensed in lots of different states. So all the states west of the Mississippi.

[: 26:59

And this was great because I got to see my family and be close to them, especially coming off of uh you know 12 years in active duty long deployments and this kind of it was really good it was it was great but you started doing telemedicine but what what year was that that you started doing it with uh with a marijuana maybe 2000 late late 2017 something like that okay so because okay so telemedicine was just kind of coming into being vogue then that kind of a new thing. Yeah.

Transition to Telemedicine and Starting Own Business

[: 27:35

[: 27:48

But it started to become kind of the same thing over and over again.

So maybe I would see 40 colds or 50 colds, you know, people, people complain about colds, and everybody kind of wants antibiotics.

And I'm like, I don't recommend antibiotics for viral illnesses.

And so it just, it started to become ridiculous, you know, that I knew I needed to kind of move on, because I'm armed and dangerous with this plant-based diet that I just want to, you know, sing it from the, I'm going to shout it from the mountaintops, you know, and, you know, I would always be working it in, you know, they had a cold.

I'm like, but have you considered the plant-based diet? You know, they stubbed their toe, but have you considered the plant-based diet? You know?

And, and so I'm like, I just need to start my own business.

And, and so that's, that's after After the pandemic hit and people were more willing to utilize telemedicine, I thought, hey, now's my chance.

I'll start my own business.

[: 28:54

I was worried about starting vegan primary care, just opening up my shingle locally because I was kind of worried that there wouldn't be enough interest and it's sort of a plant-based practice.

And so I was able, thinking I could just open this up to nationwide kind of.

egan primary care yes october: 2020

[: 29:46

And, and so I'm really glad I did because now I'm still working from home and I get to help.

I get to reach out to the vegan plant-based community. And I have, I have patients who's, who are vegan or plant-based.

I have, I have families who, you know, maybe they're worried that my, my child wants to go plant-based and I don't know if it's a good good idea.

I have people who are just starting. I have, I have patients who are, have been plant based for years and years, you know, longer than I have and, and just need a doctor.

And many people sort of say, are you sure you shouldn't be like smokers and drinkers primary care because you're not going to have any patients because vegans are not going to need very much care, you know?

So, you know, that, that can't actually be a problem because I, you know, I might see someone once a year, once every other year, because they're so healthy.

[: 30:42

Choosing the Name "Vegan Primary Care"

[: 30:49

Well, I think that vegan primary care, one, you know, I started for health, I started the plant based diet for health.

But then over time, you know, it's like, do I really like harming animals?

No, I don't like harming animals.

And the footprint that the plant-based diet has is much, much less than the footprint for animal food and burning down the rainforest to make grassland for cattle and this kind of thing.

And so I started to become vegan. I started to become vegan.

So all immorally, everything sort of lined up.

And I just thought to myself, plant-based, no, I'm vegan. And so I'm vegan.

So I'm going to create vegan primary care.

And, you know, it's like, I don't care who knows about it. Vegan primary care, that kind of thing.

I just felt, I felt like it was, uh, supporting a group, uh, maybe a smaller niche, I guess you could say, but, uh, it, it, that's, uh, that's where I fell.

Now. Fantastic. And, and with your, um.

[: 32:00

Yes. Yes. It's changing all the time. It's changing. I was right now it's about 22.

[: 32:12

And, and so, you know, it's been kind of, if I don't have any patients there for years and years, I've kind of let some of them go, but, uh, honestly, you know, around the coast, you know, Washington, Oregon, California, you know, this kind of thing is, uh, is kind of those, those licenses will never go away.

Cause I, you know, I have a lot more patients, uh, from those, uh, for the States.

So I used to have a license like in New York, but, uh, like when I was getting malpractice, uh, if I included New York, it would be like two or three times more expensive. So So that's why I don't have New York.

I had to let my license go. So, yeah. Right.

Well, if anybody's interested in seeing all the states that you that you're licensed in, you can just go to veganprimarycare.com and you've got a list of all those. Absolutely.

So, Scott, I would love to ask you some just some general questions that I'm sure our listeners would love to hear the answers to.

[: 33:19

Building Strong Bones and the Impact of Sedentary Lifestyle

[: 33:25

I know that, you know, osteopenia or osteoporosis is kind of running rampant in this country.

What's the reason for that? Is it a lack of calcium? What exactly is the, would you say, in your opinion, is going on here?

Well, sedentary lifestyle is probably one of the biggest things that I worry about.

I guess you assume in sort of a natural environment, we'd always be moving around and we'd be carrying things. We wouldn't be sedentary for sure.

[: 33:58

And so bones are a use it or lose it phenomenon. So you're going to want to do weightlifting activities.

And for people who are trying to basically reverse a diagnosis of osteopenia, so moderate bone density loss or osteoporosis, severe bone density loss, loss, uh, you need to lift heavy, lift heavy.

Uh, and I recommend that you get a trainer to kind of, to kind of help you out.

You start off light and you start off, uh, getting your form down and then starting, you know, slowly progressive.

However, the mineral density aspect is just one aspect of, uh, uh, people, people, um, getting injured and having fractures related to osteoporosis.

The biggest thing is flexibility and.

[: 35:08

Um, so yeah, I use the, use a three-legged stool scenario where you, you, you know, used to be, you tell patients, you know, calcium, vitamin D and exercise, you know but i kind of switch it around where it's exercise vitamin d and then calcium calcium has some negative press because it causes if you're taking high dose of calcium supplementation it can actually increase your clotting risk and people have higher heart attack rates and stroke rates with high dose calcium so i've stopped recommending calcium as a what i've tell people people to do is use a food logging app, I recommend chronometer.

[: 36:05

And with a goal of 750 milligrams of calcium by the diet.

Vitamin D Supplementation and Sun Exposure

[: 36:22

Milligrams you actually have to you know make sure that i mean without greens without greens and beans it can be tough it can be tough so if someone is not even getting that then then i would suggest maybe a small dose calcium like 250 we have to take it with food uh you don't want to take on an empty stomach because that that um puts you at more risk for the clotting aspect of calcium so um okay, So you mentioned the three-legged stool.

You started with exercise. You said you've reversed it, exercise, vitamin D, and calcium.

What's your recommendation with vitamin D?

[: 37:12

We don't all live in Florida, my man.

on, I recommend getting about: 2000

And and so I am pretty paranoid about the sun myself because I'm so fair skinned.

And, you know, you start to get little lumps or bumps.

And my sister is a dermatology PA.

So every time I see her, she comes over and she checks me out.

And, you know, luckily, I'm hanging in there. but my dad's, my dad's had melanoma.

He's been out in the, you know, we, we had that business on the beach.

get my vitamin D through, uh,: 2000

Right. Okay. So, so you're supplementing on a daily basis.

Yes. Yes. And you've got to do it to the, I mean, I recommend people getting through the vegan, vegan version.

Um, I think that vitamin D may be through sheep's wool lanolin, believe it or not. I believe there's some. That's right.

People are like sheep's grease. That's gross.

Yeah. Yeah. Yeah. Yeah.

The Controversy Surrounding Vitamin D

[: 38:29

You do not want to be low in vitamin D. And then I'm hearing, well, the jury's still out. And, you know, there's really no such thing as a deficiency unless you're below 10.

So, you know, it's interesting for me because I'm still trying to wrap my brain around what to do with D, what in fact to do.

[: 39:00

That's because observational studies show benefit where people who have higher vitamin D levels in the blood tend to have, you know, better immunity, and, you know, issues with, you know, better, you know, outcomes with in regards to osteoporosis and things like this.

But then when they try to do a randomized double blind controlled study versus placebo, you don't, I mean, it's even shown to, I believe against placebo, not help with fracture risk, which it was a big one that came out, you know, about a year ago, I think.

And so, yes, there's some stink on vitamin D for sure.

There definitely is, you know, and it kind of leaves you like, oh my gosh, what do I do?

However, I just, I don't want to be deficient. I don't want to be deficient.

And so I'm sort of kind of meeting in the middle, so to speak.

And I don't want my patients to be deficient in case that is an issue.

Yeah. So you can test sort of vitamin D and sort of the sort of opposite hormone for vitamin D, which is parathyroid hormone.

[: 40:13

Calcium so that there's not a very good way to test your body's calcium so when you test when you test calcium the body it's always going to be basically perfect when you test your blood your blood levels and so but one of the things you can do is test parathyroid hormone if your parathyroid hormone is is high there's a concern that there's a pressure for the body to be releasing calcium from the bones and so i mean that that's sort of another sort of way to kind kind of a roundabout way to sort of analyze in patients. Yeah. Yeah.

What, what is your definition of somebody being low or deficient in vitamin D?

[: 41:04

But that's that's clearly deficient. That's that's clearly deficient.

Then there's insufficiency, which I believe is under 30.

And so I want my patients to be over 30 over, you know, out of insufficiency range.

But then, you know, so then the debate is like, well, is 40 better than 30 is 50 better than you know, and then how high do you go?

No, I've heard some people say 75, but I, my assumption is that the, the largest benefit is just being out of the insufficient into the normal range.

And that's what, um, yeah, that's where I tell people basically to stop.

So one more thing comment, and then we're going to move on from vitamin D, but so, so in your opinion, you think that the, it's a little bit better idea to supplement and And be kind of in a range above 30 as opposed to be below, let's say, 20 to be lower or deficient and any potential negative health consequences that come from that.

[: 42:14

And, and so that kind of factor hopefully is taken out of, of, of the health, any kind of issues with it.

I mean, everybody comes to me, they're concerned, they're deficient in something.

Thing. You know, it's, it's, uh, cause what, what does sort of everybody come at you with when you're on the vegan diet?

Oh my God, you're going to be deficient in this and deficient in that.

And so people come to me and, you know, I have to be like, you're normal, you're okay. You're, you're doing great.

You know, this is, uh, it's as a family doctor, you spend so much time trying to, uh, basically help people know what's normal.

And, uh, and, and so ruling out deficiency is, is, is a big thing that people want basically.

Yeah. Yeah. Yeah. And the fact of the matter is the best way to not be deficient in all these things is to be on a whole food plant-based diet, right? It's like the gold standard.

That's the, the irony here is, Oh my God, you're going to be deficient in all these things. It's like, well, really?

Um, so we've talked about, you talked talked about calcium and how really it's important that you really kind of are bringing home the beans and the greens.

[: 43:41

The concern with oxalates in certain green leafy vegetables

[: 43:52

[: 44:12

And so people can kind of overate spinach in theory because of the oxalates.

[: 44:25

[: 44:33

So, uh, but the real question is like, are we overblowing this issue with the oxalates? And I think we are to some extent.

Uh, so, uh, I, I will mention it to people, especially if they've had kidney stones in the past.

Um, I don't spend a lot of time talking about it in patients who haven't had a kidney stones in the past, but, uh, yeah, if they have, I'll say, you know, maybe no more than like a cup or two of any of these greens, you know, once a week. week.

Uh, but I try to, you know, talking to them about kale and romaine and napa cabbage and arugula and, and, and, and pushing all the other greens that, uh, to expand their palate.

That's basically what I'm trying to get people to do.

But I do think that this is kind of an overblown theoretical risk because, uh, you know, oxalates are high in other foods too, I believe like in beans and certain foods maybe nuts and stuff that uh that it's not just the greens you know but yeah so anybody who's had a kidney stone will you know be fearful about it and that'll be working they've been they're trying to avoid it at all costs but really it's trying to eat a low animal protein diet and avoid you know salt and and this kind of thing and alcohol stuff but um.

[: 46:00

So, you know, being on a low protein diet, uh, you know, is a low renal acid load diet, um, will, uh, help you avoid kidney stones.

Have you ever had a kidney stone? No, I've never had a kidney stone.

Yeah. Yeah. Well, knock on wood. Neither have I.

I've talked to some friends that have said, male friends that have said it's worse than childbirth.

And it's like, Oh, how would you know?

But anyway, yeah. Oh my God.

But supposedly it is, it is ruthless, right?

[: 46:59

Do you have a certain amount you're, you're shooting for, or if you're, do you feel if they're eating whole food plant-based exclusively, it ain't a thing?

Well, for a number, I throw 50 out there. I throw a big 5-0.

The importance of fiber and bowel movements

[: 47:22

So I throw that out there, but people don't come at me with, you know, how many grams of fiber should I eat?

You know, people, I kind of ferret this out by asking them, are they having, you know, tell me about your bowel movements. And I love talking about bowel movements.

[: 47:53

And if not, how can we up your numbers? And one of the unsung heroes is the whole grains and beans, of course, but getting people to eat whole grains, a prebiotic mix. Dr.

Greger talks about his broil bowl, and he influenced me.

He influenced me with this broil bowl thing, and I've been doing all sorts of – basically, oat groats is kind of my new passion. passion is, is I ate oatmeal rolled oats for a long time and now it's oat groats and it's way better.

It's a, he said, you'll never go back. And it's true. It's really nutty.

Yeah. You're up in your game. Cause you know, I, I've been a steel coat oats fan for a long time.

And, um, I've been told by many people go to the groats, the oat groats.

It's like, like the purest form of the oat.

And then I was interviewing Dr. Greger a couple months ago and I asked him what he had for breakfast and he said the oat groats and, uh, he's, and then he got all excited about him.

[: 48:57

So what you said, you, you love talking about stools or poop.

What, uh, what should we be looking for in our bowel movements or not looking for?

Um, you have any thoughts on that?

Besides one, one big, one massive dump a day, but yeah, you want to be, you want to be having huge stools.

Uh, you know, I gave a lecture, you know, the scoop on the poop and, uh, in, in the studies, basically the people did better, had lower colon cancer rates, like the larger their stool was basically how much stool mass are putting out.

Um, you're getting all this prebiotic mix, all this food for the colonic bacteria.

And what you should be looking for is basically you want to be having large bowel movements every day on the regular.

[: 49:55

But but a large mass of stools is, is what you're looking for.

And if you're for some reason becoming constipated, uh, you might be, and, and constipated in a vegan is, is, I don't know.

I mean, it's just like once every other day to me, that's practically constipated if you're a vegan, uh, because there should be so much volume in bulk.

If you're not getting that, you're not doing it right.

That's an oxymoron, a constipated vegan. right and i had i had honestly before about before going vegan i was uh i had pretty much lifelong constipation and it's kind of an underrated aspect of uh of the vegan diet is is normal normal bowel movements well yeah not only normal but i would say incredibly um.

[: 51:02

And then I'm like, after 10 seconds, I'm like, why did I bring this in with me? It just makes no sense unless I just want to hang out in my own stink. Right.

Oh my God. Yeah. You know, the, the joke is that you should be able to have Bauman before you can, you know, finish your pee for, for a man, I guess, you know, it's like, right like that's so but one of the thing that's interesting about this is the the stool kind of burden or whatever that is different in vegans is that what's very common is when i see my patients who maybe they've gone to the urgent care or you know maybe they've had a ct scan for some reason the radiologist always said comments they're like this patient is full of stool you know full of stool full of stool that's it so if any of your readers here or listeners hear that full of stool um it's not that you're constipated normally the radiologist would assume that the patient's constipated because they haven't evacuated their bowels but uh they're just not doing it right you know vegans should be have their have so much stool and and then that they see it and they think it's like a problem because they don't see it very often they think it's a problem and they'll mention it on the, on the radiology report. Right, right, right.

[: 52:24

The reference for that is one of Dr. Greger's videos about it.

Uh, and so he's really, he's really referenced up.

So, uh, he did mention it on one of his, uh, uh, one of his videos about like how frequently you should be having having stools.

And, and so I haven't seen the reference myself.

However, uh, the, um, the definition of normal bowel frequency is, uh, up three per day, uh, down to once every three days, that's considered the normal us bowel movement frequency.

So more than three per day just is kind of concerning a little bit for looser stool and diarrhea kind of thing.

The Joy of Eating and Digestion Habits

[: 53:13

[: 53:55

You know, it's, uh, all the fibers been removed, all the nutrients been removed from the fat, uh, in terms of the calorie density, it's like, uh, the worst possible thing you can do.

It's, uh, you know, if you filled up your stomach with oil, it would be like seven or 8,000 calories or some kind of ridiculous number, you know?

So, uh, you want to avoid it every, every, you know, you want, you know, foods that are dried and fried and have oil on it, they're going to, you know, their calories are going to like double and triple. So yeah.

And I think there's a potential for oil also to be, to be problematic, honestly.

I mean, obviously your dad mentions about the endothelium and flow mediated dilation studies showing that problems with oil, relationship to meals.

And so, yes, no oil. Try to get that oil out.

Get that oil out and get your fat from whole foods like nuts and avocado and that kind of thing.

Bam. Absolutely love it.

Well, Scott, before I let you go, I need to find out, what have you had already to eat today?

We're fascinated to know what you've had.

A Plant-Based Meal for Breakfast and Lunch

[: 55:20

And for lunch so far, I had arugula.

I had cooked arugula today. I kind of cooked it down.

So like a big old thing of arugula. And then I ate leftovers from last night, which was a cranberry farro and cinnamon, kind of like a holiday mix with cut Delicata squash.

So it was great. I'm glad you asked. Glad you asked. It felt like a pro meal for sure.

It sounds great. And who does the cooking? Is it you, your wife, kids? kids?

My wife, Jennifer, my wife, Jennifer, but I do have to mention, uh, my sister and brother-in-law, my wife's an identical twin and her twin has moved two houses down from us.

So we have like this compound and we, and, and, uh, she's vegan too.

And we, we, um, we cook, we take turns cooking. So we're, we're in a great situation.

Yeah. Wow. Uh, let us know when the house in between you two comes on the market.

So one of, one of our lucky listeners can move in and, um.

[: 56:42

Oh, I want, I wanted to mention something to, uh, my mother-in-law asked me, you know, Oh, Scott, is there, is there a book I can learn about the plant-based diet?

And I talked about prevent and reverse heart disease by your dad.

And I told her about this and, you know, I give out book recommendations while she, she got the book.

[: 57:05

Right. Yeah. Right. Right. Uh, very black and white for him like that.

Uh, in fact, Scott, it is his 90th birthday today.

Oh my God. Now, obviously this is going to air a little bit later, but today is his 90th birthday.

So, so happy and proud of that guy. Oh man. Yeah.

So, um, Yeah, I just feel so lucky to be, you know, here on the show.

[: 58:12

And I'm sure it's going to be really helpful getting out to your to your listeners. I really appreciate it.

Yeah. Yeah. Well, Scott, thanks for your contributions. Thanks for your passion for all things vegan. vegan, even started a business, vegan primary care, man, you went for it. Love it.

All right, Scott, until next time.

Awesome. Keep it plant strong. And can you give me a virtual fist bump on the way out? Virtual fist bump. Bam.

Bam. Pow. Pow.

Dr. Harrington's Service to Patients and Country

[: 58:56

Dr. Harrington, I want to thank you so much for your service to our country and your service to the health of your patients.

Now, before we head out today, I want to play a little testimonial that I got from a listener that I think all of you may enjoy. Here you go.

Eight years ago, I had been going to see my doctor, and every time she saw me, she would tell me that my cholesterol was too high and that if she didn't see me lower it, she'd be putting me on cholesterol drugs.

I didn't want to do that, and that happened a couple of times.

And then finally, I happened to be going to see a speaker who was going to talk about his plant-strong rescue diet, which was obviously Rip Esselstyn.

So I went to go see him speak. I had no idea that it was a vegan thing.

And at first I was like, meh, I don't know. And then after I listened to him, it was fabulous.

I not only bought his book, but I didn't just follow it for the seven days.

I followed it for six weeks.

When I went back to the doctor and she She saw that my cholesterol had gone from 237 to 160.

[: 1:00:20

She just was shocked that it had gone down so much. And I told her about my experience.

Didn't seem to sway her very much. But after that, I've been PLANTSTRONG for eight years.

I'm still moving on with it. I enjoy it very much. And I'm so grateful for that opportunity to hear Rip speak and talk about this great lifestyle change. Thank you.

[: 1:00:52

You epitomize why I, for all those years, a decade, I traveled from state to state sharing the good news about plants.

Huge, huge congratulations on staying the course and being the proof, even for our own health care providers, that optimum health can be achieved with simple changes at the end of your fork.

Thanks everybody as always for keeping it PLANTSTRONG and I'll see you next week.

Closing Remarks: Sharing the PlantStrong Lifestyle

[: 1:01:35

If you like what you hear, do us a favor and share the show with your friends and loved ones You can always leave a five-star rating and review on Apple Podcasts or Spotify.

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

As always, this and every episode is dedicated to my parents, Dr. Caldwell B. Esselstyn Jr.

And Anne Crile Esselstyn. Thanks so much for listening.

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