Latest / NHA Today Podcast / How to Close the Gap Between Lifespan and Healthspan with Charlyn Black, MD, ScD
Transcript
- Stephan Esser MD: Hello and welcome to another edition of the NHA Today podcast. I'm your host, Dr. Stefan Esser. And today I'm delighted to welcome Dr. Charlotte Black to the podcast. She's a professor emeritus of population and public health at the University of British Columbia, physician, researcher, author, educator with a longstanding interest in promoting health and preventing disease at both the individual and population level. Dr. Black completed her medical and public health training in Manitoba, Canada, her Doctor of Science and Health Policy at the world-famous Johns Hopkins University Bloomberg School of Public Health. Charlene's personal experience of the transformative power of a plant-powered lifestyle inspires her deep passion to promote this approach to others. She first became a vegetarian in 1980, made the leap to a whole food plant-powered diet in 2018, and hasn't looked back. Dr. Black, welcome to the podcast. Charlyn Black: Thank you very much, Stefan. Stephan Esser MD: Wow. I mean an amazing journey. I'm fascinated by this, right? Because you have this remarkable pedigree, Johns Hopkins, et cetera, and experience. And here you are advocating for some of the really the simplest approaches to human health, food and movement. Why is this so important to you? Charlyn Black: Well, I guess my interest in prevention started from a very early age. My mom was interested in nutrition. and as a teen she developed arthritis and she started taking me to yoga classes and her arthritis just cleared up. So I became Stephan Esser MD: Wow. Charlyn Black: a yoga teacher at age 16, and when I got into medicine had hoped to incorporate yoga into medicine, but those were the dark ages before there was any soul. Stephan Esser MD: Right. Charlyn Black: to show that there was a benefit. But, you know, I carried that forward into a career in public health, so which is really interested in health, not disease. Stephan Esser MD: Beautiful. You know, and I think that's the model that it sounds like you've been kind of living out in your own personal life, but also with the research that you've done, the work that you've done, and the now this latest book that you've written, which we're gonna hear all about. You know, how have your colleagues responded to your take on nutrition over the years? Charlyn Black: well, you know, I think they've accommodated me, but I haven't really I would say coming to this as an academic pursuit has come later in my career. And so it's really arisen as I've approached retirement, which I just retired at the end of June. And you know, I really feel that there's there's really perspective that public health can bring to this movement that you and others are promoting. So, you know, I I'm early on in this journey, but I think there's lots of perspective from public health that really hasn't I haven't seen it show up so much. So that's a Stephan Esser MD: Right. Charlyn Black: mission of mine in retirement. Stephan Esser MD: Awesome. Well, and it's isn't it true that in public health really is where the biggest gains can be made and often in a society, right? I mean, at the at that larger, higher level. Yeah. Beautiful. Charlyn Black: Right. Yeah. Yeah. Yeah. Small changes across the entire population can have a huge impact on health. Stephan Esser MD: Right. It's interesting you say that I just saw that in Poland at their federal level, they now mandated that there has to be one plant powered meal in the schools kind of per week, that it's a hundred percent the whole day is that, and that each day there have to be options for their students. So, you know, does that sound like a public health sort of policy you could get behind? Charlyn Black: Absolutely, absolutely. I think really pu public institutions, hospitals, schools, universities are really easy places to start encouraging these changes. Stephan Esser MD: You know, I noticed that you use the term plant powered in your writings. Other people use the plant based or vegan moniker. Why do you choose to speak of your nutritional approach as plant powered? Charlyn Black: well there were a number of reasons and I was a big advocate for this. One of one of the as a scientist, one of the things I recognize is that, you know, plants are the original source of all the or I will say there are some exceptions, but most of the energy, the protein, and all of the nutrients in our food systems. we know that, you know, animals eat the plants to get the nutrients, so why don't we just go directly to the plants to get our sort, you know, as our major source of nutrient Stephan Esser MD: Right. Charlyn Black: nutrition. So, you know, photosynthesis, I mean it's just such an an amazing concept that plants take energy from the sun, convert it into food that we can eat. It's Stephan Esser MD: Amazing. Charlyn Black: amazing. So and and then you know there's this connection to nature and traditional food wisdom and you know just how they can fuel every every aspect of Stephan Esser MD: You know, just strikes me, just the way that you poetically s pause to think about photosynthesis. You know, it's so awesome. Because it's like some of the I think the most intelligent people who've spent so much time kind of exploring and learning, et cetera. I mean, I guess get I get the sense you're a lifelong learner. You know, someone who just loves to yeah Charlyn Black: yeah, yeah, I Stephan Esser MD: it Charlyn Black: I I tell people I have a serious educational habit. Yeah. Stephan Esser MD: That's awesome. As we all should. I love it. now you recently published a book. what is the title of that book and what what is it all about? Charlyn Black: Well, let me just say I am a co-author with the very well-known Brenda Davis and Vicanto Molina. So I have been a big fan of their work for my own learning and understanding for years, and it just felt like a real privilege to be included with them in writing this book. So the book is called Plant Powered Seniors, and it's really a book that's aimed at those of us who are in our senior years. Brenda's in her 60s, I'm in my 70s, Vicento's in her 80s. So we have lived experience. And when we looked at, you know, the the literature that's available to the public, there was really very, very little about what seniors need. And we know that our you know there are changes in our bodies, there are changes in what we need. So We we felt it was time to write a book like this. So yeah. So Stephan Esser MD: Awesome. Now, when you've talked about public health, let's talk a little about I'm gonna go off a little bit of a tangent here. I want to get your thoughts. You know, we've got this rapidly booming baby boomer generation, and we have this rapidly increasing amount of chronic disease. Charlyn Black: Yes. Stephan Esser MD: How does your book kind of address some of those areas? Charlyn Black: Well, I would say that that is one of the reasons I I mean, I've taught a course on addressing our epidemic of chronic disease to masters and PhD students. and so over my lifetime from a public health perspective, we've seen the burden of morbidity or things that make us sick and kill us, move from infectious diseases to Chronic diseases, these chronic diseases that plague most of us as we move into our senior years. And they have become the major health burden, increasing health care experiences, right? Spending time at the doctor, being in hospital, Stephan Esser MD: Right. Right. Charlyn Black: and health care costs. So, you know, I mean, addressing this epidemic of chronic disease, ideally we would have anticipated it and prevented it. but at this point, you know, we are faced with this epidemic of chronic disease. And so this book that focuses on what people can do at an individual level can help people work to address if they don't have any conditions to prevent them. And even if they do, to how do you mitigate the impact of chronic diseases, specific chronic diseases that you have? Stephan Esser MD: You know, yeah, I mean, I hear you talking there, and that is part of the problem, isn't it? That we we are seeing this aging population that is becoming more and more dysfunctional, disabled, chronically diseased. So we might be living quote unquote longer, but the quality of that life is not what we want for many of us, right? So Charlyn Black: Yeah, I think you're talking about the difference between lifespan and health span. So yeah, Stephan Esser MD: tell me. Charlyn Black: so lifespan is, you know, how long we live and we've seen that increase. I have some statistics somewhere, but but health span is the number of those years we spend in good health. Instead of making trips to the doctor, being hospitalized, taking a pile of medications, Stephan Esser MD: Right, right. Charlyn Black: and slowly declining. So, this difference between our lifespan and our health span is something that we as public health researchers have long been interested in. And in the early 80s, there was a theory that we would be able to compress morbidity. There was a famous compression of morbidity hypothesis. Well, the opposite has been true. Instead of reducing the length of time, that time that people spend in ill health has actually increased. Stephan Esser MD: Yeah. Charlyn Black: And the most recent data I think suggests for the US that it's like over fourteen years, higher than any other country, and is increasing Stephan Esser MD: Mm. Charlyn Black: over time. So, you know, people spend over a decade in poor health. how can we reduce that and address that is a real challenge. Stephan Esser MD: Well, and it's a real tragedy, isn't it? I mean, so many people that I see right in my medical clinic who are coming in, you know, here they're working their fingers to the bone, if you will, right? Day in and day out working with the anticipation that when I hit 65, I'm finally gonna be able to relax a little bit. And they hit 65 and retire, and their health is tragically diminished. They're on eight Charlyn Black: Yeah. Stephan Esser MD: to twelve medications. They can barely walk because they're chronic arthritis, they're severely depressed, they're impotent, they're this, they're that, you know, and it's just like, what are we doing? Yeah. And so Charlyn Black: It's Stephan Esser MD: it sounds like the the candidates to read your book would be A, individuals who want to prevent this sort of life, and B, those individuals who are in that sixties, seventies, and eighties who want to say, What can I do to improve my health? Is that correct? Yeah. Charlyn Black: Exactly. Yeah, cr absolutely correct. So we've written it saying that, you know, it should be of interest to anyone fifty and above or who wants to be there. Stephan Esser MD: Yeah. Charlyn Black: and for seniors who are healthy, but also those who have chronic conditions that they would like to mitigate and see if they can reduce the medication load that they're on. But also for kids who are interested in keeping their grandparents healthy. Stephan Esser MD: Right. Well, you know, and I hear some of the viewers already saying, some of the naysayers, it's too late for me. You know, it's too late. I wish I would have had this information. What do you say to those people, Dr. Vine? Charlyn Black: I say it is never ever too late that you know you can make a difference in your health and even in the way you feel with a couple of weeks of change. and you know, I c I'll also say that change doesn't have to be really, really hard. You can make gradual and subtle changes. Just even adding a few more plants, getting to learn a few plant-based recipes can be really, really quite simple and we have some really simple approaches to doing that in the book. Stephan Esser MD: So you're saying that if I adopt the sort of behaviors you're recommending in your book, that I should be able to see some improvements in just weeks, not months, not years, that I can see something that quickly. Charlyn Black: I think so. You know, I I can notice a change in my diet. If I fall off the wagon a bit, I notice a change right away. Stephan Esser MD: Yeah. Yeah. Charlyn Black: And, you know, I made some shifts last year that, you know, were amazing how quickly they even tweaking and improving the diets the diet I was on. Stephan Esser MD: Right. Well, you know, and I think that reflects on just the person that you are, which I love to hear, right? You talked about being a lifelong learner. And then here you are with your health. So many people write fall-in behaviors and patterns, and they think that's for a lifetime instead of it. Sounds like what you're advocating in your book is that as we age, there may be some tweaks and changes that we need to make, even if we've been eating a pristine diet for decades. there are modifications in our behaviors that may be more beneficial to us as we age. Is that correct? Charlyn Black: Absolutely. Well, I mean there're some real changes in our bodies, some real physiologic changes. Stephan Esser MD: Yeah, tell t share sharef share with us. Charlyn Black: And so, you know, our stomach acid declines, making it harder to absorb certain nutrients. Our muscles become less responsive to, you know, protein and what we eat, and we can't jump as high and we lose fast twitch fibers. even our sense of thirst becomes less reliable so we can get dehydrated. And Stephan Esser MD: Mm. Charlyn Black: you know, we have changes in appetite, movement, which decrease our caloric needs. We are taking medications that may make us feel kind of sluggish. So it's it can really make it challenging to get the nutrients we need and we need a change in nutrients. There's some specific things we really need to pay attention to. Stephan Esser MD: okay. So that's quite a bit, kind of all different levels in the body with some changes with that Charlyn Black: Yeah. Stephan Esser MD: aging process. You know, I'm curious if you don't mind sharing. You know, as you've entered into your sixties and seventies, what are some of the, you know, major changes or adaptations you've made? You just mentioned a couple of changes that occur with us we age, and yet you've been eating a healthy program for decades. And, you know, so you know, tell me a little bit about what you've changed in the last number of years that you know. might be a value to our viewers as they age. Charlyn Black: Well, I myself, I was a vegetarian, but I loved cheese. So I you know, when I switched to a whole food plant based diet, I lost about forty pounds. Stephan Esser MD: Mm. Charlyn Black: So, you know, just it's so easy to stay healthy and keep a healthy weight. So that was one of the big changes I made. And, you know, giving up cheese was challenging. I loved it. And as a vegetarian, I found it really hard to imagine how to cook a plant-based meal without all these embellishments that made food so tasty. But, you know, I've learned new approaches. So, you know, learning to cook has been a real a healthier diet has been a real important change I've made personally. Stephan Esser MD: Nice. So the nutrient aspects there, learning different pre food preparations, things that nature. What about with movement? Have have you changed any of your sort of you talked about loss of fast twitch muscle, some sarcopenia sets in for all of us, bone density decreases with age. Have you have you changed how you exercise or workout now that you're past the age of sixty? Charlyn Black: well I will say that in my 50s I was pretty much tied to a computer and did not get as much movement as I needed. So Stephan Esser MD: Yeah. Charlyn Black: I've taken me some real focus to get more movement into my life. I've learned somatic movement, which helps us move very simply and easily and keeps us mobile and flexible. And I try and work out a couple of times a week with a personal trainer and I try and get out and exercise a lot. So, you know, it's this is something I've had to work at is bringing more movement to my life. But it's something that I feel is really important. Stephan Esser MD: You know, what I like to hear there from you is that there are other factors that work synergistically with nutrition, right? You just talked about the exercise and and maybe for you the nutrition has been something that's a little bit easier, perhaps it sounded like to me, than maybe the exercise. And yet you're still working on it and incorporating it. Tell me a little bit more about some of these other factors. Some some people I've heard talk about like pillars of health. can you kind of go explore that a little bit with us? Charlyn Black: Sure. Stefan, I don't know if you're a member of the American College of Lifestyle Medicine. I am. I'm not a physician member, but a doctoral member. And they are, I think they are one of the strongest organizations that trains physicians in lifestyle medicine. And they talk about six pillars of medicine, of lifestyle medicine and nutritional movement are ones. The other things are the importance of good sleep. And this is something that really changes and is harder to get as we age. social connection is becoming recognized Stephan Esser MD: Right. Right. Charlyn Black: as a hugely important factor for address, you know, preventing dementia, especially as we age, avoiding risky substances, and learning how to manage the stress in our lives. We all face stress, some a little bit of stress is good, but It's the chronic stress that really, really can be challenging. So there are there are tools and approaches to address all of these lifestyle medicine pillars. and you know, there's there's an important I mean we all have different challenges, right? And mine was movement, maybe a bit of stress that I put on myself, but there are I think ways to address. each of these pillars of lifestyle medicine. Stephan Esser MD: Yeah. You know, it's we've talked a lot about kind of the personal choices that people make. And sometimes it's almost like we expect people to change their behaviors or just white knuckle it, self-discipline their way to health, right? however, there's a lot more than just self-discipline involved in healthy behaviors. What's the answer from your perspective as a public policy, you know, advocate? What's the answer here? Charlyn Black: Well, y anyway, th there are a number of ways I could answer this. There we could go do an entire podcast on this, I think. But you know, one of the things is as an individual, it's not just thinking about, you know, behavior change and willpower, but really changing my identity as, you know, am someone who Stephan Esser MD: I like that. Charlyn Black: cares about my health, who this is a really important thing for me. but as a public health expert, there's we we talk about the differences between health promotion, promoting health, telling people what to do, and then the kind of systems and environments we find ourselves in. And these environments are so powerful. Just think of the number of food advertisements you see, the number of fast food restaurants you drive past every time you're in a car. We are surrounded by messaging that counters our interest in being healthy. So, you know, my thought is that we really and organizations like yours should be advocating for how do we advocate for policy changes. You talked about Poland and introducing school lunches that are plant-based. We know that in Denmark, Denmark has made huge strides in introducing plant-based food guide and policy shifts. So we're starting to see Amsterdam has banned the advertising of meat. You know, we just we're seeing huge shifts, but there are tons of things that would be so easy to do. And you know, give my one of my concerns is the amount of chronic disease we're starting to see up in see showing up in children. And, Stephan Esser MD: Yes. Charlyn Black: you know, I saw something about screening teenagers, or maybe it was at age 12 for cholesterol. I mean, this is crazy. Why don't we just stop food advertising to kids? Stephan Esser MD: Right. Right. Charlyn Black: you know, I always feel so sorry for the moms who are checking out with hungry kids and right right there there's candy Stephan Esser MD: That's right. Charlyn Black: I have candy. So there are some real changes in in what we subsidize as food, in the policies we make and don't make, that you know could change the influence of big what Dr. Gregor calls big food. You know, he says there's no big broccoli, but why not? Couldn't we make big broccoli a a a force to be reckoned with? So Stephan Esser MD: Right. Charlyn Black: What what are the policy changes that can shift the environments we're in? and I think there are things we can all do to advocate for for these changes. Stephan Esser MD: What you're saying makes so much sense because when we think about like the reduction in smoking, right? What has the been the biggest thing? It's just it's been ostracized by so many people at this point, right? The whole culture, right? You and I grew up at a time when you could walk into a restaurant, people were smoking, or at the very least, right? You had smoking sections and non-smoking sections or whatever, you know. And now, like anybody smoking around a restaurant, you'd be like, What's going on? Why is that person here? Yeah. Charlyn Black: Absolutely. Well, yeah, and I can remember my mom and dad sending me to buy a pack of cigarettes at the drugstore. I mean it was crazy. It was crazy. but Stephan Esser MD: Right, right. Charlyn Black: but I think tobacco does provide a very, very good case study for what we can do. because the tobacco industry knew for years that it was causing harm. and it took education like what you're doing, it took some real regulation, removing enticing images on cigarette packages, making them less interesting and attractive, regulating environments, making things first non-smoking and making non-smoking environments, making it illegal to smoke in certain places. So this combination of both individual and policy changes has created. So my hope is we can do the same thing for our food environments and the Stephan Esser MD: I Charlyn Black: the environments that help us stay move moving and healthy, et cetera. Stephan Esser MD: Right. So look forward to that day, right? Because I I'm thinking about the comparator, like with you know, kind of processed meat, right? We know it's a type one carcinogen, according to the World Health Organization, over 200 studies, you know, et cetera. And yet ballpark subs never or ballpark, you know, hot dogs never lost a dime on the market. You know what I mean? When the media, you know, said, yeah, it's type one carcinogen. And moving on today's weather, you know, it's like what's going on? Charlyn Black: Exactly, exactly. Yeah, yeah. Yeah. And I I remember one of the things I did was bring Dr. Michael Clapper in to give a talk. I remember one mum she was helping me set the the the program up and she said, I guess I shouldn't pack processed ham in my kids' sandwiches anymore. I said, Yeah Stephan Esser MD: Yeah. Yeah. Charlyn Black: Right. I mean it's just incredible how pervasive it is. Stephan Esser MD: It right? Well, and I think what I'm hearing, right? What we're talking about here is this normalization of certain behaviors societally puts such a huge pressure on people, even cognitively, to think that this is normal and okay. But I think about alcohol, for example, right? The consumption of alcohol at the levels that are being consumed, we know increases the risk of seven different types of cancer, so on and so forth, all this stuff. and yet people think it's normal, I think, in large part, because everybody's doing it. So it's just, it can't Charlyn Black: Yeah, absolutely. Stephan Esser MD: be that bad, right? Everybody's Charlyn Black: Well, Stephan Esser MD: doing it. Charlyn Black: right. And for years we had this what's called a J-shaped curve, that it actually looked healthier to have one drink per day. And what that was was that at the low end, people who were having zero alcohol, a lot of them were s already sick and so were not had stopped drinking because they'd become ill. So when we went in and f did further studies to really examine what's the actual relationship between the amount of alcohol you you drink and your health outcomes. It's been shown that any amount of alcohol is not not good for us. Yeah. Stephan Esser MD: Right. Yeah. I mean it's so exciting to see as you're saying more and more organizations bringing that same model of approach to what have a nicotine now to these other areas, right? To hopefully result in these changes that we kind of get healthier youth again. I mean, like you mentioned, tripling of pediatric obesity. I mean, come on, right. And all of these issues that now come with that. It's just absolutely tragic. Absolutely tragic. Charlyn Black: Well well and and isn't it interesting that big food promotes poor health, which leads to higher use of healthcare, higher use of pharmaceuticals, and obese contributes to obesity and now the n the need for GLP one drugs, you Stephan Esser MD: Right. Charlyn Black: know, isn't it convenient? Stephan Esser MD: Right. That's right. I mean, I well, I think there's almost a schizophrenic sort of mindset that I s see in some of my patients that it's so hard to watch them, right? Because they think something is so good, valuable, and important, but then they consume it or do it. And then all of a sudden on the flip side, they begin to get disease as a result of it. And then they have to try to address it. So great example would be the parent who's saying to their child, Eat the steak, eat the meat, you know, blah, blah, blah, and eat this and that, and you know, clean your plate with all this stuff. And then here that youth is now putting on weight. And they hit their 15, 18, 22, whatever young lady, let's say an example. And then the parents are saying, you're overweight. You need to do something about this. Cause like you said, when you eat that calorie-poor, nutrient-rich, plant-powered program, the body takes care of the weight on its own and you just enter a healthy place. You know. Charlyn Black: Absolutely. Yeah. Stephan Esser MD: Yeah. Yeah. goodness. Well, you know, there I want to always leave our viewers with some tangible, actionable items. And so I want to have you share with us, if you would, a couple tangible things outside of, let's put it as number one, go out and buy the book, which the link is gonna be down below. So everybody needs to go buy the book, share it with either A, read it yourself, and B, share it with people over the age of 50 that you love and care about in your life to help them thrive. But I want to also get just some tangible actual items. So I'm gonna, if you would share with us, Dr. Black, some things that our viewers can apply to their life to improve their health. Charlyn Black: Sure. I guess my number one is, you know, just by adding more plants to your diet, you're gonna improve your health. And for those who are already plant-based, you can even do more things to address the changes that take place in our bodies as they age. And you know, writing this book with these two very very committed dietitians, I learned so much myself about tweaks I wanted to make in my diet. Given my age. Stephan Esser MD: Yeah. Yeah. Charlyn Black: The other thing is by adding, you know, movement or a different kind of movement practice, you can increase your functional status. You'll be better able to avoid a fall. These are the fall risk is one of the biggest risks as we age. We lose our balance, we can't catch ourselves, we fall, we break a bone, and it can lead to some serious consequences. So, you know, we can reduce the potential risks that are associated, but also just feel more vigorous and alive. And then I guess related to my passion about changing our environment, you know, even by asking your grocery store to stock healthier alternatives, you can begin to make a change in the the food environment that you're living Stephan Esser MD: Right. Charlyn Black: in. And you know, there are changes that we can ask for in our environments. And so let's think about not just ourselves, but changing the environment so others benefit from these wonderful opportunities that plant powered living gives us. Stephan Esser MD: Well, thank you, Dr. Black, for sharing with us. And thank you for, as you say, changing the environment that we all exist in, because your book is going to change lives and transform lives for good. So I appreciate that. And thank you for taking time to join us on the podcast today. Charlyn Black: Thank you very much. I hope the book does change a number of people's lives. Stephan Esser MD: All right, everybody, thank you for joining us for another edition of the NHA Today podcast. Look forward to having you back again soon.