Transcript
Alyssa Paschke: Happy New Year and thanks for tuning in to our live Q&A. This time of year many people consider their eating habits and want to make positive healthy changes, but sometimes our big plans for new year's resolutions can fall short.
Alyssa Paschke: My name is Alyssa Paschke and today I am speaking with Dr. Andrew Freeman, who's a cardiologist at National Jewish Health, and he focuses on a holistic approach to overall wellness and health by focusing on diet, exercise, mindfulness, and support. So today we're going to talk about why diet plays such an important role in our health and how simple lifestyle changes can really add up over time. We're also going to discuss ways that you can maintain those healthy habits throughout the year. Feel free to ask your questions in the comments and we'll try to get to as many as possible.
Alyssa Paschke: Thanks again Dr. Andrew Freeman for speaking with us today. We titled this Q&A Food is Medicine. Could you go into more detail about what that means in terms of a healthy diet?
Dr. Freeman: Definitely. First, thanks for having me and happy new year to the audience. This is definitely the right time of year, but actually I would argue every time of year is the right time of year to think about it and become more aware of what we take for granted every day, which is eating. Most of us don't even remember what we ate for breakfast, but it's really important. It's not just me, Hippocrates, the founder of modern medicine, actually said, "Let food be thy medicine." And it's funny that everyone thinks this is so innovative and
causing great positive outcomes as of late, and it's sort of like full circle back from ancient times if you will.
Dr. Freeman: So in short, the foods that we take in every single day have a major impact on our overall wellbeing. And it's completely under recognized, both by the general public and also by physicians and healthcare providers. What happens is, these days, there's so much misinformation out there that some days this food is good and this food is bad. And then everyone throws up their hands and says, I don't care, I'm just gonna eat whatever. But believe it or not, the same basic tenants of what we should eat has actually been active in the science and evidence based for a really long period of time and a little bit of the choir voice we hear in the background.
Alyssa Paschke: Awesome. That's a really good background because I wanted to talk about the food trends that are out there because I know myself and probably others watching, there's so many different conflicting pieces of information and it's kind of hard to tell what's actually been proven to work by science. What are some of the trends you're seeing out there right now that are actually unhealthy for us but people are subscribing to it?
Dr. Freeman: Yeah. First, it seems every day there's a new super food. It's kale or it's spinach or acai or coconut oil, or whatever it may be. But at the end of the day, the true super foods have always been there. They're not anything more special. Spinach and kale and broccoli are indeed super foods, but that doesn't
mean that if you don't have acai berries ready to go that you are going to die or something like that. So that's one.
Dr. Freeman: Two is, there's a lot of unhealthful trends out there. One of the biggest ones in recent times is the coconut oil thing. Coconut oil is absolutely decadent and delicious, but when it comes to health, it actually has more saturated fat than butter or lard and we know that saturated fat is highly associated with heart attack and stroke and all of that. Topically, it's an excellent moisturizer. Of course in Denver area, once you wash that down the drain and it hits the cold pipes it can congeal and create all kinds of plumbing problems. So you should tell people to kind of be mindful of that particular issue. But in general, that's a big one.
Dr. Freeman: The other one that I see a lot of is this sort of Keto Diet. Now, Keto in itself, depending on how it's done, is variably implemented and there are some versions that are healthier than others. But if you're eating bacon and hot dogs every day, those are now considered to be as cancer causing as cigarettes by the World Health Organization. And yes, they may not have many carbs or no carbs, but you're eating things that are really dangerous. So, in general, Keto overall has some interesting results in the last couple of years. There appears to be more unhealthful outcomes, meaning more incidence of stroke or heart attack, whereas people will lose weight when they cut out all the other gobbledygook in their diet.
Dr. Freeman: David Katz, from Yale, a really famous nutrition scientist, he'll tell you, Keto will help you to lose weight and so can cholera and other things out there that we don't want to give people.
Alyssa Paschke: Sure.
Dr. Freeman: Now, you can do a Keto in a, or a low carb diet with a vegetable based approach and that actually can be healthful, but it requires some real discipline. I always tell people, just be careful what's going on out there. And I would say that if you look at the summation of all the evidence to date and you look at what the US dietary guidelines for Americans recommends and you look at what nutrition scientist had been recommending, it is a predominantly plant based diet. And depending on who you read and who you follow, it may be a fully plant based diet, which I would say is a great thing, and minimal amounts of processed foods, minimal amounts of any of added oils and sugars. That's basically it, and that's stood the test of time.
Dr. Freeman: US dietary guidelines for Americans recommends a plant based diet, a Mediterranean diet, which is a predominantly plant based diet, and if you read it carefully, the US dietary guidelines also recommends a plant based diet, but you can see where there's a lot of industry influence in there. For instance, they want you to have 13 servings of fruits and vegetables every day and most of us are getting three or less.
Alyssa Paschke: Right. Well that's good to know because I know Keto is super popular.
Alyssa Paschke: Along that same line of thinking, many people are interested in losing weight as a new year's resolution. So making sure we're eating that balanced, healthy, mostly plant based diet, what is a healthy way to continue that weight loss and keep it off?
Dr. Freeman: Yeah. I always caution people about diet, and when I say diet, diet to me is what you do every day, what you eat. But when you go on a diet, they don't seem to last because people have to make a big alteration and they see it as temporary. When I see patients, and particularly those that have heart disease who are at much higher risk, I really want them to do this sort of all or nothing and I want them to stick with it and see it as a lifestyle as opposed to this is something I'm doing temporarily. Just like I'm not eating this chair that we're sitting in and I'm not eating your index cards here, they're not food to me. When someone says a cheeseburger and puts it in front of me or they put bacon out or whatever, I just don't see it as food.
Alyssa Paschke: Right.
Dr. Freeman: I want people to see the same thing that this really should be a whole life diet, not a short term, I'm going to eat no carbs or I'm going to no sugar or I'm going to eat these mixes and shakes and whatever. And those may help people to lose weight. But at the end of the day, I want them to keep on this.
Dr. Freeman: The nice thing about eating a plant-based diet is if I fill out this whole room with cucumbers and somebody ate every last one, they'd be so full they could barely move, but at the end of the day, almost no fat, almost no cholesterol. And in general, people have very limited amounts of calories with lots of bulk so they stay full.
Alyssa Paschke: Gotcha. So really it's about balance and also making sure that you're not thinking of it as a temporary solution. Kind of more of an overall lifestyle change and a mentality shift.
Dr. Freeman: Indeed.
Alyssa Paschke: That's really important. Since you've been talking about plant- based diet, how is someone out there that's maybe thought about it or done a little bit of research but isn't fully invested, how would they even get started and what are some of your suggestions for things to maybe kind of ease into that diet and lifestyle?
Dr. Freeman: Yeah. There's two kinds of people out there and I would say that most of us are wired in the sort of all or nothing type of approach. Because we all suffer from the once in a while syndrome. We have hotdogs once in a while, I have cheese steaks once in a while, I only have cream cheese once in a while. Before long, every day has the once in a while.
Alyssa Paschke: Yeah.
Dr. Freeman: If you look at the success of the Atkins or Paleo and all these things, why is that people kind of go all or none and they do it. And I would say that when people do that they're much more likely to stick with it. Whereas, if you introduce sort of what "gateway drugs," if you will, the cheese steak or the hamburger or the fast food or whatever it is, it's very hard to maintain that path.
Dr. Freeman: So for most people I recommend trying to do it all or none. And then for the people that are really unwilling, I recommend that they cut out as much as they possibly can, and if they have to have any kind of animal product, fish or chicken over red meat or processed meat.
Alyssa Paschke: Okay.
Dr. Freeman: And in a really tiny portion, as the garnish to the dish, one meal a day. And then I really tell them to be conscious of the dairy. There is milk, cheese, butter and yogurt in everything. You go out to dinner, it's baked into the bread. They serve it with butter. They come out and they put cheese on whatever it is you order.
Alyssa Paschke: Definitely. I've seen that.
Dr. Freeman: You have three, four, five servings without even realizing it.
Alyssa Paschke: Right.
Dr. Freeman: I always tell people to really try their best to challenge themselves, to go this way. And then as a result, it's not fair for me to say to somebody, if I see them as a patient, "Hey, this is how you should eat, see you later." I give them a whole bunch of resources and I usually encourage them to watch documentaries, such as "Forks Over Knives" or "Eating You Alive" or "Game Changers." These are all really powerful ways to kind of get inspired.
Dr. Freeman: And then, the Physicians Committee for Responsible Medicine has a 21-day vegan kick start. They have a vegetarian starter kit that you can download. These are great ways to start reading books and getting knowledgeable, like you would do about anything. We spend more time researching a car we might buy versus the foods we put in our bodies every day. So spend a little bit of time reading and learning and then say, "Oh wow, I can do this."
Dr. Freeman: And you know, for a lot of people, like, I grew up in New York with seven inches of the best pastrami you've ever seen, and three inches of cream cheese on every bagel. A lot of people think, oh no, I'm going to miss out on all the foods that I love. But once you give your body about two weeks to detox, if you will, you'll suddenly find that carrots taste way better than you ever imagined. And things like tofu, which I grew up thinking was a spongy block of awfulness, can actually be really delicious if it's prepared properly.
Dr. Freeman: Then you start learning about ethnic foods, Thai, Vietnamese, Chinese, Ethiopian, and you're like, wow, how did I not eat these foods ever before? And in Denver, where we are, and in lots of places in the country, ethnic food is everywhere and it's like many times completely sort of just ignored, but it's really good stuff. Most ethnicities around the world know how to make foods with no animal products that tastes really good.
Alyssa Paschke: Yeah, that's definitely true, and I think there's so many delicious cookbooks and different resources online for ways that you can cook different foods that you might initially think are not so good, but make them super delicious.
Dr. Freeman: Right. And I do want to caution people though. You can easily go out and get vegan junk food.
Alyssa Paschke: Sure.
Dr. Freeman: The double fake cheeseburger and the fried this, and the potato chips and the coca cola and the Oreo cookies and all that. And yes, those are plant based, but not what I intended.
Dr. Freeman: One of the best things I'll tell the listeners about is something called an Air Fryer, which is pretty neat. It's a way of making things crispy without all the heavy oil or lard or whatever people are frying things in. There's some technological advancements in the way we cook now that makes things easy. And then for the busy person, there's instant pots and slow cookers and all these great things now that make it so easy. You throw in all the ingredients, you set it and forget it, you come home and a meal is ready, which is pretty amazing.
Alyssa Paschke: Which is great. I have a question that came in earlier this week
from an audience member and I'll try to pronounce your name as best as I can, Mireya, and she wants to know what nutrition changes would you suggest for someone that has a recent diabetes and nonalcoholic fatty liver disease diagnosis?
Dr. Freeman: Right. Nash, which is nonalcoholic steatohepatitis, is one of the major reasons for hepatitis in this country, and it usually precedes the development of diabetes.
Alyssa Paschke: Okay.
Dr. Freeman: Now diabetes, a lot of us in medical school and other places, we're taught that carbs are the enemy. Carbs are not the enemy. Let me say that again. Carbs are not the enemy. But they have to be whole grain, minimally processed carbs.
Alyssa Paschke: Gotcha.
Dr. Freeman: If you look in the 1940's, a very famous doctor at Duke by the name of Walter Kempner, he was treating diabetics back when we didn't have a lot to treat diabetics with. If you got a diagnosis of diabetes or end-stage heart disease back then, you were done for. He took the people that nobody else wanted and he put them on a rice and fruit diet, white rice and fruit diet. So he fed them sugar. That's it. No fat, just sugar. And they walked all over Durham, North Carolina to the best of their ability. 95% of those patients were cured.
Alyssa Paschke: Wow.
Dr. Freeman: Diabetes is really a disease of fat excess. And the reason is you get fatty liver, you get fat infiltrate in the muscles and everywhere else, and the receptors which suck up that blood sugar don't work so well anymore, and so the blood sugar goes up and then you create this awful cascade of events. But if you deplete the fat stores, the receptors start to work again and the sugar can go down. It may seem counterintuitive to feed a diabetic sugar, and I'm not recommending that you do that, but if you did for the long-term, their diabetes could go into remission if it's not been there forever. But for the short term, their sugars could go up, which people are afraid of.
Dr. Freeman: And it's true that carb counting and carb control will control blood sugars, but what I'm talking about is a potential cure for blood sugar elevations or diabetes. What I usually recommend people is to go on a low fat and predominantly plant based diet. And the ADA now fully endorses such a diet. I know it seems crazy to think that they just did this, but it's actually been proven for quite some time and pretty powerful. I know it sounds very strange to the audience to hear that you can eat carbs as a diabetic, but you can, it just
has to be done in a way that's very carefully monitored by the people that are taking care of people.
Alyssa Paschke: Great. Well that's really news to me, a lot of that information. I hope that helped you, Mireya. Any other questions that have come in from the audience?
Speaker 3: Yes, we have several. First one, what are your thoughts that inflammation is more harmful regarding heart disease versus high cholesterol? From Kathy.
Dr. Freeman: Okay. Yeah. Great question about inflammation. I would say that the root of pretty much every disease is inflammation. And if you think about the lifestyle that I advocate, which is not just diet, which also includes exercise and stress relief and good sleeping and not smoking, in connection and support with others, but what does that do? It puts the body in an anti-inflammatory state. An environment where the body has a chance to heal.
Dr. Freeman: If you think about it, when your body gets sick for a variety of reasons, we tend to beat it up by throwing it inflammatory substances and it never has a chance to heal. If I were to kick you in the shin every day, that bruise would never heal. But if I suddenly stopped kicking you in the shin and give it a few days, your body has the environment that it needs to heal. I would say that in general, cholesterol is a surrogate for something we don't exactly know how to measure, but it is correlating with risk. Cardiovascular risk in particular. And that also correlates with inflammation and we know that higher inflammation and higher cholesterol often go together. I think, if we can put the environment right for one's body, the ability to heal becomes much easier.
Alyssa Paschke: Great.
Speaker 3: Another question that came in from Debbie, she's asking, what thoughts do you have for a diet for people with COPD or specifically emphysema?
Dr. Freeman: The question was about a specific diet for COPD emphysema. I guess what I would say is first, if they're a COPD emphysema, there obviously was some degree of cigarette smoking or at least exposure to some sort of smoke. So getting rid of that is a big thing. In terms of diet, there's not a specific diet known well for COPD and/or emphysema unless there's an inflammatory component or an asthmatic component, where did the type of diet that I advocate also works.
Dr. Freeman: I would tell you, incidentally, and I don't have enough data to tell you that this is the clear cut science, but the patients that I have that have COPD and emphysema that follow this type of approach, they seem overall to do much better. It seems to reverse a lot of the chronic inflammation that comes often, but not always, with COPD emphysema. I recommend trying it and seeing what happens.
Dr. Freeman: Oftentimes it may be the exercise that also has a big improvement for people with COPD and emphysema. This retraining your lungs to work with your body, even though they are damaged in some way. I think a lot of people give up, but I've had enormous improvements in patients with chronic lung disease just by following this type of approach.
Alyssa Paschke: Great. And I think we'll get to exercise a little bit in a few minutes here, but any other questions?
Speaker 3: Yes. Here's one from Alexandra, what about using unsweetened hemp milk or flex milk instead of nut milks for peanut or tree nut allergies?
Dr. Freeman: The question is about the specific types of milk. I would say that in general I have no specific recommendation about milks to use. If you're obviously allergic to a nut milk, you should avoid it.
Speaker 3: Sure.
Dr. Freeman: Then, for hemp or the other ones, many of them have lots of beneficial and great nutrients. It's important though to be wary and read the labels because they oftentimes will add sweeteners, sugars and thickeners. Some of the thickeners can be dangerous. Carrageenan in particular can sometimes be associated with stomach irritation. I usually tell people to just be mindful of what they're taking in and read the labels, but I have no specific recommendation on that.
Alyssa Paschke: Alright.
Speaker 3: Well here's a question, what are good steps to become a vegan for a red meat lover?
Dr. Freeman: Good steps to become a vegan. I would say that first, there are many alternatives to the usual meat that we all eat and or enjoy or used to enjoy, at least in the past. Many of them are better than their meat versions, but they may not be health foods. What I would say is that if you have a craving for a burger and you have not found a bean burger or whatever it is that you may like, and there are a lot of good ones out there, there are some amazingly close facsimiles of a beef burger. For instance, the Impossible Burger, the Beyond
Burger. These are not healthful food in the slightest, they're very, very high fat, and they're very highly processed. But boy, you will be fooled because you'll think that you're eating meat. That's one option.
Dr. Freeman: But I guess what I would say is that many times if you give your body just two weeks where you're not eating the same stuff, you're going to find that your brain suddenly resets and says, oh, I don't need this anymore. For instance, I used to eat cheese every meal almost, every day, and I haven't had cheese in almost a decade at this point, and I don't miss it at all. It's hard for me to even believe that I could do that. But there are lots of great other foods out there. For instance, a little slice of avocado in with my beans and rice, if I'm going out for Mexican, is very satisfying. Or on the rare occasion that we're at a friend's house and they happen to be plant based and they're doing grilled cheese, they'll use some sort of nut based cheese that's surprisingly good, and I don't mind it at all.
Dr. Freeman: Or even better is, we'll go out for pizza and I don't get cheese at all because it's perfectly good. Where I grew up in New York, most of the great Italian restaurants had tomato pie, which was crust, sauce, and veggies without the meat and the cheese and it's still really good. So bottom line is, I guess what I would say is I would take steps to try new foods and experiment and see what you could come up with and many times you'll be surprised at how good things are.
Alyssa Paschke: eah. And luckily, this day and age there's a lot of alternatives to ease you into probably that full plant-based lifestyle. I know for myself speaking, I tried to cut down meat as much as possible, but like you said, the tofu and the veggies and all that really makes a big difference to have options.
Dr. Freeman: Definitely.
Speaker 3: Samantha is asking about coconut oil, is it healthy?
Dr. Freeman: Yeah. We just reviewed some of the data on coconut oil. I would say, in general, I would use it topically but would not ingest it, just so I don't repeat myself completely.
Alyssa Paschke: Alright. I think we'll move onto some of the other aspects of your holistic approach and the wellness recommendations that you have for people. I wanted to get into the mindfulness topic and just wanted to have you describe what mindfulness, for anybody that might not know about it. I know it's kind of out there in the media a lot these days, and how does it help with your overall health?
Dr. Freeman: Yeah, I think if I was going to break down mindfulness, which appears to be very abstract to the vast majority of people, it's just really being aware. But not like, oh, here I'm sitting next to a person. For instance, when we're talking about food, realizing what you're eating. Where did this come from? And why does it look like this or taste like this? Or, how did it become this particular shape? Or whatever it may be. Or, being aware of your day to day activities, how they may impact others, where you wouldn't normally think about it. Or being aware of some of the stress that we have all live through. Stress tends to accumulate, and when you are mindful about that stress, many times you can actually help to diffuse some of that.
Dr. Freeman: If you think about the very words we use all the time, disease is lack of ease, disease, or hypertension, which is high blood pressure, too much tension. What can we do to diffuse some of that? And many times these techniques have been proven to improve cholesterol, improve blood pressure, and reduce the risk of a heart attack. We know, for instance, the type A personality is actually much more likely to develop heart disease than someone who's not type A. We know that people who practice meditation many times will have longer telomeres, which means they're aging process has slowed down.
Dr. Freeman: I'm sorry that I keep getting calls here.
Alyssa Paschke: No problem.
Dr. Freeman: Bottom line is, there's a lot of really great things that can happen when one is mindful, but it takes a little bit of effort. And how people become mindful, a lot of different ways. It can be yoga, it can be meditation, and it can be practicing some of the religious and spiritual practices of many different religions. If you look really deeply at almost every religion, there's some mindfulness or meditative component. If you ever ask yourself, why in the church, the synagogue, the mosque, is the ceiling so ornate and the music so captivating and the hymns so ... I feel like I have to be part of it? Right?
Alyssa Paschke: Yeah.
Dr. Freeman: That's designed to help you get to that meditative state in some way.
Dr. Freeman: There's really interesting things when you really spend the time to become aware of the little details that are there, and I think people really underestimate how powerful they can be.
Alyssa Paschke: Great. I think there's a lot of good tips there for people to incorporate on a daily basis, or even today if they were thinking about where their food comes from or how different things in nature, because that's
something that I would find to be getting me into that mindful state for sure.
Alyssa Paschke: The next thing I wanted to talk about was, what do you mean when you talk with patients and others about support and how that also incorporates into overall wellness and health?
Dr. Freeman: I think a lot of people would be surprised to hear that cardiologists are talking about love. The medical word we use is social support, but really what we're asking is, what's your connection with others? And in fact, the CDC and the Surgeon General recently identified loneliness as a major risk factor for cardiovascular disease. We're all connected on Facebook and all these other things, but many people are actually lonely.
Dr. Freeman: In fact, there was a study that showed that some people have lots and lots of friends on Facebook actually may be the loneliest, surprisingly. It's important to have real face to face connections and social interaction with people, but also to have a really good support network. Be it a significant other, a confidant, a spouse, a friend, a pet, a church network, or a religious organization, whatever it may be, but the people who have that seem to have the least amount of disease overall and they seem to feel the happiest, which is really important. And if you go to places in the world where there are blue zones, where people live beyond their average life expectancy of the rest of the world, these people tend to live much longer, but they also have very tight knit social networks.
Dr. Freeman: Interestingly, there was a paper that showed that the sport that people seem to live the longest in is not running. It's not swimming. It's badminton.
Alyssa Paschke: Wow.
Dr. Freeman: Why? Because there's a social connection there and people work as a team and I think that when you work in a place where it feels very happy as a team, people feel better, they feel happier, they're less stressed. This is true in life also.
Alyssa Paschke: Great. Well that's really interesting information. And so, along with that, I guess to sum it up, as a cardiologist, what is the most important lifestyle change that you wish all of your patients would incorporate?
Dr. Freeman: I don't think I could pin one lifestyle change. I would pin the four that I always give people.
Alyssa Paschke: Sure.
Dr. Freeman: Which is, eating plants, ideally only, exercising more, so 30 minutes a day of breathlessness. Obviously check with your doctor first. Regular stress relief activities of some sort, and then really being connected to others. Having that love.
Dr. Freeman: Those four things, combined with obviously not smoking, maybe getting adequate sleep, really powerful ways to reduce disease and save money. Meaning that, if you can follow these plans, you might need less medicine, you might need less testing, you might need less doctoring, less procedures. Which a lot of people don't always think about because I always joke with my colleagues, when was the last time you cured somebody? And really, we don't do much with curing. We do a lot of controlling of disease and improving symptoms, which is very, very important. But at the end of the day, what if we had a chance at a cure and that's where this kind of powerful approach comes from.
Alyssa Paschke: Awesome. The one last thing we didn't get to quite yet was the exercise component. I know a lot of people for new year's resolutions want to start exercising more and January the gym is full and then kind of tapers off after that. Right?
Dr. Freeman: Yes.
Alyssa Paschke: What are your suggestions for someone who's starting an exercise routine that maybe doesn't normally exercise and they want to have a long-term approach?
Dr. Freeman: Yeah. Great question. Really, humans were meant to be active and a lot of activity. Before cars, we would walk 10,000 steps a day, easily, without any trouble.
Alyssa Paschke: Yeah.
Dr. Freeman: The key is, is how do you maintain that? First, if you're not an exerciser, you should check with your doctor before you go starting exercise because if you're in bad shape or you haven't been checked out recently or have chronic conditions, you really should make sure those are as tuned as they can be before you go out.
Dr. Freeman: That said, once that is done, then I usually recommend to find something you enjoy. For instance, if you hate running, don't run. If you're afraid of the water, don't swim. But instead find something you enjoy. You
dance, you swim, you snowshoe, you bike, you ... whatever you do, but you want to work at a level that you can be breathless. Not that you pass out, not that you're turning gray, not that you're going to the hospital. You don't want to be falling off the back of the treadmill. But you want to be working at a level where it's hard to talk and you want to stay there for as long as you can. Ideally 30 minutes a day.
Dr. Freeman: When you see everybody at the gym chit chatting with each other on their treadmills and the stair steppers, they're not necessarily doing it at the level that they probably ought to improve their overall health.
Alyssa Paschke: Gotcha.
Dr. Freeman: That's the key.
Dr. Freeman: And then, just making it part of your routine. As busy as people are, finding those 30 minutes. So 23 and a half hours every day you can be on Facebook, but 30 minutes try to be a brisk walker, and sometimes you can even be a brisk walker on Facebook if you're using a treadmill as an example. There are ways to do two things at once if you really want it to.
Alyssa Paschke: Sure. Absolutely. Are there any other questions that have come in from the audience?
Speaker 3: No, we mostly covered them.
Alyssa Paschke: Awesome. Alright. Well, the last thing I was going to ask you
was, what's your favorite thing to eat for lunch?
Speaker 3: Okay.
Alyssa Paschke: Since you're a busy cardiologist and you've got a lot of patients you're seeing all day, what's something you usually eat?
Dr. Freeman: My favorite thing actually is, we'll typically make a big batch, or sometimes will even purchase a big batch of salad. I usually like all kinds of unique things, so I'll do all kinds of greens and we'll put some quinoa in there and some dates and some cucumbers, whatever else we have. And I usually will pack a whole bunch for the whole week so I don't have to worry about doing it first thing every morning.
Alyssa Paschke: Yeah.
Dr. Freeman: And they usually last great in the fridge for five, six days and I usually have a salad almost every day. And then sometimes I'll have leftovers from a meal the night before, or that, but by and large salads are probably my favorite lunch.
Alyssa Paschke: Awesome. Well thank you so much, again, for joining us and thank you to the audience for all of your questions. I just wanted to ... hopefully it convey that you've learned something that you can apply to your life and if you have any questions, feel free to comment on this video and we will definitely follow up with you. And if you have a question you didn't think of, feel free to comment there as well.
Alyssa Paschke: If you'd like more news and information from National Jewish Health, you can visit our website by going to www.njhealth.org and sign up for our monthly newsletter. Thanks.
Dr. Freeman: Thank you.