S8E9: Plant-based diets and MS: the science of food, inflammation and the gut microbiome

Elizabeth George (00:00)

I like to go into restaurants that aren’t necessarily plant based. And I look at their menu and I look at the waitress and I say, or waiter, and I say, I see your chef is very creative. And then I say, do you think they could take this wonderful vegetable, this, this, this, and steam them together, not in oil, just maybe some wine or broth, and then serve them over a nice pasta. And you have pasta verde right there. And tell him to put his favorite spices on it. By doing that is you’re letting the culinary world know people are interested in this. And they also see how easy it is with the foods that they’re already serving to do it.

 

Overcoming MS (01:18)

Welcome to the latest edition of the Living Well With MS podcast. This edition is the science of plant-based eating for autoimmunity. And I’m pleased to welcome Dr. Elizabeth George. Elizabeth George is a board certified family physician and co-founder of the Healthy Eating Adventure, the science success stories and recipes for a plant-based lifestyle. She spent over 40 years treating patients with a focus on preventative care and lifestyle driven disease reversal. A graduate of Brown University Medical School, Dr. George has led multiple community wellness initiatives, both in the US and abroad, and has helped hundreds of people adopt a whole food plant-based lifestyle through her signature 28 day program. Her work emphasizes the connection between diet and chronic disease, including autoimmune conditions. She’s presented on plant-based nutrition for physicians, medical residents, and the public, and is a passionate advocate for better nutrition education in both healthcare and culinary fields. Now based in Florida and Washington, she continues to lead healthy eating initiatives that empower people to take control of their health through food. So welcome very much Dr. Elizabeth George.

 

Elizabeth George (02:22)

It’s so good to be here. I just love sharing and talking about this because the results we’ve seen have just been amazing.

 

Overcoming MS (02:30)

Well, we’d love to hear some more about this. To start off with, could you introduce yourself, your work and your interest in plant-based eating for autoimmunity?

 

Elizabeth George (02:38)

So I’m a family physician and my goal and my husband’s a family physician and our goal in setting up practice in a small town, Mercersburg, Pennsylvania in 1980 was to take care of the whole patient and the whole family and in their lives and to emphasize healthy lifestyles and including healthy eating. And this we enjoyed and then going into the later nineties and 2000s, it was clear that the American population was really becoming unhealthy and that lifestyle seemed to be leading that decline and especially the American standard diet was on that and the other thing that was going on was there was a big push from pharmaceuticals and some and physicians to try to treat everything with pills. And people were ending up on more and more medications. Five diabetic medications went back when we were practicing. If you talk to them about lifestyle and they might need a medication, maybe not. So it was getting frustrating and I wanted to look for a way to change that. And in 2009, the statistic came out that this generation, the next generation of kids was going to live shorter lifespan than ours. So to me, it was a real imperative to look at creating lifestyle changes. And in our community in Mercersburg, we set up wellness programs, which included trying to make sure the town was walkable, there were bike routes, healthy streams, and cooking classes and stuff. And then I came across the work by Caldwell Esselstyn and he showed that a whole foods plant-based eating plan could actually reverse heart disease, open up closed arteries. And I was really impressed with that. And his son, his son actually, Rip Esselstyn had done a program, a 28 day program with Austin Texas Firemen and showed just how improvement they had in terms of weight, the sugars, cholesterol. And I called Rip, hi Rip, because he had actually been to school in Mercersburg. So I called him and said, this, Rip, this is Dr. Elizabeth George. You don’t know me, but I’m from the town you graduated from a number of years ago. I’d like you to come and start a program with us, kind of like you did with the Austin, Texas people. So he came to Mercersburg, Pennsylvania, and we had a great show of people who came to join and give this a try. And we did a 28 day adventure teaching people whole food plant-based eating because of this incredible research.

And we started creating different community wellness programs. And then I came across this information about the whole food plant-based eating and how that would work. And everybody’s going, whole foods plant-based, this is dairy country. And I said, yeah.

 I said, you can’t fight the results. Look at this. And we did a sort of a pilot program and the planners just felt great with it and their cholesterols came down and they had fun cooking. So then we did the real program with Rip Esselstyn and close to 100 community members came. Even some of the dairy farmers’ wives came.

 

Overcoming MS (06:00)

Well, one of my group is, her family of dairy farmers is, she’s following a vegan diet, but she was actually on television on our local news talking about dairy farming.

 

Elizabeth George (06:12)

We had to find some common ground, which ended up being talking about the environment and stream borders and everything.

Yes. So, well, what we saw with that was that people in that 28 days, their cholesterol came down, their weights came down, their diabetes improved, blood pressure and everything. And the coaches that I had been with, said, Dr. Liz, we’ve got to continue this. And so we then created an ongoing program that several times a year spent 28 days with people and they would sign up for 28 days and every week we would meet for a pot luck. They’d commit to cooking Whole Foods plant-based and we would teach them how to do it. We did demonstrations and every week they would bring in a dish. So every participant had like 40 dishes to taste. And you know, they’re talking in community and they’re saying, wow, how would you make this? Where’d you buy this? This is so good. If you can do this, I can do it. And like by the end of the time, they really are successful.

 

Overcoming MS (07:24)

So could you tell us what led you to create the Healthy Eating Adventure Programme?

 

Elizabeth George (07:28)

Okay. Well, I was seeing that in the United States, the American health overall was declining significantly, increasing diabetes and hypertension. And, and it was really frustrating to me to see that in our community as well. And it was pretty clear that the standard American diet was really robbing people of their health. was telling them, don’t take time to cook, you know, get your, get your food through the car window eat this, eat that, processed food and they were getting rid of home ec in the schools. So we really felt like we needed to get something going to help people learn to cook again and learn to eat healthily. And also I came across this research by Caldwell Esselstyn, which he had amazingly shown that if you put people with even severe heart disease on a whole food plant-based diet or eating plan, you can open up their arteries. He has pictures and I have pictures in my book of the arteries opening, which is really amazing. Cause your statins don’t do that. Your cholesterol medicines won’t open it. They’re a little help, but they don’t open it. So then I came across Caldwell’s son, Rip Esselstyn wrote a book about putting firemen, on whole foods plant-based eating.

 

Overcoming MS (08:34)

Mm-hmm.

 

Elizabeth George (08:45)

And they did it. got them convinced. They saw how healthy he was as a triathlete and they had remarkable results. And then by chance, Rip had actually, my gosh, yeah, he’s a macho triathlon man. And he got these, you know, these Texas firemen who are used to getting fast food as quick as they could and taught them how to cook. I mean, it’s really not hard to cook whole foods plant-based. In fact, it’s easier and I did not like cooking until I started cooking that way.

And in fact, the next year, Caldwell Esselstyn came to be a speaker at our thing. And a friend of mine from, or a person from across the other end of the county came and heard it. And she said, Dr. Liz, we’ve got to take this program beyond your Mercerburg community and beyond here. And so we had it now, we had it several places all around the county. And it’s we it’s 15 years now, 15 years we’ve been doing this program. And it’s amazing the results we’ve seen. And it isn’t just cholesterol and hypertension and diabetes and weight that’s improving. This is what really floors me.

 

Overcoming MS (09:53)

So I think it’s fairly established that a healthy diet will certainly improve cardiovascular health, but can it help with an autoimmune condition like MS?

 

Elizabeth George (10:04)

Yes, it can, and it’s amazing. And you’re just going to have to listen to me first, say, but people also go, I’m not depressed anymore. My anxiety is gone. I have energy. I feel like getting out and running. They join marathons when they haven’t done it before. So it has this broad set of effects. And then regarding the autoimmune and the inflammatory. Yes, it has. And we’ve seen it. We had one woman stand up two weeks after she was in it. She goes, my joints don’t hurt anymore. I was diagnosed with ankylosing spondylitis a month ago after having 15 years of pains all over the face and in my back. And they finally diagnosed ankylosing spondylitis. That’s an autoimmune disorder. And she said, I went to my family doctor because the rheumatologist wanted me to put me on some, you know, one of those drugs.

 

And he said, no, go see Dr. Liz’s healthy eating adventure program. Go there first. Because he was a, he’d been in the program. He was a family doc like myself who really believed in making a difference with how you’re treating your body. And, and so she came and within two weeks her symptoms were gone. And, and she has lived without ankylosing spondylitis ever since then.

During COVID, we had to do virtual meetings, but we had a person whose Hashimoto’s thyroiditis went away and that’s autoimmune. We celebrated our 15 year anniversary the other night. So the other thing that’s been happening is fabulous research on the gut microbiome.

You know about that, right? Okay. Okay. So the gut microbiome lives on fiber. It loves fiber, which means you’ve got to give it lots of plants. Plants have fiber. Any animal stuff doesn’t have fiber. And, that fiber, the gut bacteria turn it into a molecule called butyrate.

 

Overcoming MS (11:42)

So how does that influence immune function and brain health?

 

Elizabeth George (12:07)

Butyrate is a very important molecule that your gut lining uses as energy. And so that’s what it uses to make its tight junctions. And when you don’t have that butyrate, when your gut bacteria are unproducing it, then you get leaky gut and you get inflammatory molecules seeking in. And the other thing is that because the wall’s healthier, the linings, the, areas just beyond the gut wall that helped make your lymphocytes and your immune cells, all of those things are more stable. And what the thing of it is when you put, foods in like processed food and meat and dairy, you get a different set of gut bacteria. you don’t get the same ones and the bacteria you get, like they’re enterotoxins, the toxins they make enter it.

They helped destroy the gut lining and you get the leaky guts and you get the inflammation from that. And they’re horrendous. So you get a different set of gut bacteria from eating junk food, meat and dairy than you do from eating whole foods, plant-based. And that’s where the inflammatory drive and then the autoimmune gets kicked in. The proteins in meat and dairy often create reactions in our body. Our white cells go, hmm, don’t like it. And then they start reacting around. MS is really interesting. You know, it’s the destruction of the myelin sheath on the nerve fibers. And that’s related to inflammation. it’s just amazing what the microbiome and the gut has to do with it.

 

And the reason I wanted to, jumped in and said, you’ve got to hear about the mood. The also relates to your mood, the gut brain connection. ⁓ a healthy gut microbiome takes tryptophan from what you eat and lets it get across the gut. And then you make serotonin and that gets to the brain. Well, the tryptophan goes to the brain and the brain makes the serotonin. But the nasty bacteria, if you’re eating animals and junk food, they take the tryptophan and chew it. So it’s amazing how much your microbiome has to do with it and has everything to do with inflammation and autoimmune and to do with your mood too.

 

Overcoming MS (14:18)

So there seems to be increasing evidence that a healthy, less processed plant-based diet is better for us. So why don’t most doctors receive training in nutrition? And is that changing?

 

Elizabeth George (14:26)

Yeah. It is starting to change. And I guess years ago, all they knew about was scurvy. And no, they just didn’t know. It’s starting to change, but slowly. And like myself and other doctors, I’m working with Brown University to try to get them to include it. there are some curriculum for including nutrition. One thing that happens is they feel like they just have to talk to them about you need to eat this food, this food, this food, which they do. But what you need to explain to doctors is the science behind it, like explaining what happens with the gut bacteria. So when they’re being taught microbiology, they should learn about the gut bacteria and the role they play. And when they’re being taught cardiology, they should be talked about the gut bacteria and the role they play with a molecule called TMAO. I could go into that, but I won’t. But it’s all connected, and it’s all connected to the biology, the microbiology, the biochemistry. It should be really deep into the education, but it’s slow, but it is happening

 

Overcoming MS (15:33)

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Overcoming MS (16:01)

So do you think you can actually get a reversal of effects of chronic conditions from lifestyle changes such as diet and stress reduction?

 

Elizabeth George (16:09)

My gosh, yeah, we see it. That’s the one I described with the pancreatic spondylitis. We’ve seen rheumatoid arthritis. You can have, like think of your skin conditions like your acne and psoriasis and seborrheic. They can come in and a month later their acne is gone. That’s related to largely the casein in dairy but also other inflammatory molecules. had a young woman who was a patient for a long time and she had this really nasty seborrhea all up through here. And I kept saying, you know, I’m pretty sure if you give up the dairy, you give up the cheese, that’s going to go away. And she goes, I can’t give up the cheese. I’m from Wisconsin. And then one time she comes in, she goes, I gave up the cheese. And it went away, reversed.

And I had a farmer’s wife come and say, Dr. George, I did what you said. I gave up the dairy. My asthma’s gone. So I mean, and you know, it really makes sense. Our body is very, it’s very complicated. And then what the different cells do and the molecules and the chemical reactions and everything, you’ve got to put the right things in for it to work. And you can’t be putting stuff in that isn’t I mean, you wouldn’t put sand in your gas tank, right? You can’t put stuff in that the body goes, can swear right here and say, do that and expect it to work. causes it.

 

Overcoming MS (17:29)

Many years ago, someone on the podcast, a doctor said that no species on earth evolved to have breast milk as an adult. And then when you think about it that way, it’s true. And he said, and we’re having breast milk from another species. We’re not evolved for that. That’s, it’s just not normal if you think about it.

 

Elizabeth George (17:37)

No. Yeah, well, yeah, we are exactly no other species eat some other animals milk.

 

Overcoming MS (17:54)

So I think one of the things with you talking about the American diet, we follow you in the UK as well. I think many countries, of Western countries are similar, that there’s been a massive shift in the food that we see in our supermarkets, in our shops towards heavily processed food is very, easy to cook. You put it in the microwave. Yeah, I can remember that I’m old enough to remember this sort of invention of the microwave and the revolution that it caused in the kitchen that you can literally put something in a few minutes later, you have a meal made of what might be suggested to be food. So how can someone who’s got limited time, maybe limited resources start eating a more plant-based diet.

 

Elizabeth George (18:37)

Well, it’s actually how much does a pound of beef cost? It’s very expensive. It’s much actually less expensive to eat plant-based. And the other thing is, I think we need to realize we’ve been suckered, suckered by the marketing and the people that make the processed food. And they’ve convinced us that we shouldn’t spend time in the kitchen and we should be able to go make it and hurry, hurry, hurry.

 

Well, that’s kind of really ridiculous that we’ve been suckered into that. What’s more important than our health? What’s more important than time with each other? I think the thing is, just realize this is a very valuable thing to be doing. And also, as much as you think it takes time, like till you run out to the store and get the fast food and bring it back, you could have made it.

 

A whole food plant based. And it’s so much fun to shop in the grocery store and buy all the different wonderful fruits and vegetables and legumes. And you can make a lentil soup as quickly as you can steam up your thing. But I think cutting out one person, one of my patients said that she went on the whole food plant face and she said, now my daughter comes in with her friends. And we stand around the kitchen counter and we cut together and we talk.

 

And it’s time together. So we also need to get rid of this whole thing that we have to hurry, hurry, hurry. mean, and one of the things in our program is that we explain the science so they know why what they’re eating isn’t working. But we also talk about how did it get way this way. Talked about how in the 50s, package of the people started making this packaged food and saying, don’t take time in the kitchen. And then the fast food places came out and then the dairy put a lot of cheese on the fast food. And then, you what else that came out with those, those places, there’s all you can eat places and the big portions. I mean, we’re literally our taste buds were stolen. Our, I’m full buttons were broken and it’s time to just take it back.

 

And, and we tell the people in our group, these things, cause we want them to go, I’m not suckering into them anymore. You know, I’m, I’m going to be myself again, you know.

 

Overcoming MS (20:45)

So you mentioned your groups and overcoming MS we have a peer-led support groups which we call circles. So what role does that community support play in making a long lasting health change?

 

Elizabeth George (20:48)

Good. Well, we’re always, we have resources and they can always be in touch and when we get together for another potluck. by the time they get to the end of it, they’ve all really, they’re all very capable. And they’ve also seen, you can see the difference in them. They’ve seen what it’s done to just how they feel. So they’ve already experienced.

You know, a change and they’ve also learned like the husband and wife say, you know, we have fun shopping together now. We have fun cooking together. So they’ve created this new lifestyle during the 28 days. And the other thing we do is we have the persons who have had fun doing it. They become the coaches for the next time. And they share, also people start, they, they have fun. when they, they’re, they get invited to a picnic or a barbecue, they take a wonderful dish and they put it out there. And I tell them, always take a bite of it yourself first or eat some first because it’s going to be gone. And it does, it disappears. So they have ways of sharing it with their community, even with their friends. And they have people for dinner and people just get to taste how good it is. And they go, wow, I taste buds again.

 

Overcoming MS (22:08)

We do similar, my circle we often do, if we have a get together, we’ll bring, because it’s easier as well, because if someone’s hosting maybe 12 people, 14 people, you don’t really want to cook for that number of people. so if everyone brings just a small dish and then you just, they just sort of say, okay, could you be doing savory and you’ll be doing some desserts and pie or something, and then we’ll have a meal sort of between us.

 

And you just discover amazing things as well. All the time we’re just going, I need the recipe for that. How did you make that? That’s amazing. And just different ideas.

 

Elizabeth George (22:41)

That’s me. Yeah. Absolutely. Yeah. Tell me what’s this your support group called?

 

Overcoming MS (22:47)

We call them circles. in overcoming MS on the website, there’s a link to circles and then you can it’s sort of regional. Most of it’s regionalised. We do have some sort of specialist ones. So like progressive MS, for example, but generally it’s in each area of so that people can get together and meet up.

And there’s your book it’s good to get advice on how people would start that sort of healthy eating adventure. think that’s, I’ve been doing it for a number of years now, so it becomes second nature after a while, but it’s that initial, if you’ve gone from eating a very junk food based diet, it can be daunting to take that leap, I think.

 

Elizabeth George (23:27)

It is, you know, it is, I didn’t find it that way, but I think it is for people and some of it is their taste buds are so But you know, one thing I think you have to think about your why, like know what your goal is and keep going with that is what is it you want to live to have fun with your kids when you grow up? What’s your goal? And then also, you know, embrace the positive things you’rey feeling and create community around it. The book gives the background as to how Chef Nick and neither of us had the education in school. And then it gives the background to this sneaky standard American diet and how it stole everything. we’re trying to give people a distaste, so to speak, for that. And then we present different people’s successes so they can see what people went through. And we explain the science, but then Chef Nick provides all sorts of wonderful recipes. And he’s an international chef. He has all sorts of like, you know, there’s a lot of foods in our country now that are you know, from all different countries. it, he creates those. So I think just keep encouraging yourself.

 

Overcoming MS (24:38)

And so as a final, sort of main point, how would you recommend having a healthcare conversation talking about diet and lifestyle, with what I’ll call a traditional doctor, old fashioned doctor?

 

Elizabeth George (24:50)

It’s kind of fun. I’ve had people take Caldwell Esselstyn’s book in and show it to them plus when they see your lab work, it’s a little hard for them to and you know, you just have fun. go, yeah, this is really making me feel good. My joints don’t you just have a you just tell them and thank you. You’re educating them. So we talk about in our program about how they’re going to have an opportunity to educate their doctors with it and to be brave and just tell them, you know, and if the doctors are, you go, well, I really feel great on it, you might want to read this. We talk about spreading the word. I like to go into restaurants that aren’t necessarily plant based. And I look at their menu and I look at the waitress and I say, or waiter, and I say, I see your chef is very creative. And then I say, do you think they could take this wonderful vegetable, this, this, this, and steam them together, not in oil, just maybe some wine or broth, and then serve them over a nice pasta. And you have pasta verde right there. And tell him to his favorite spices on it. doing by doing that is you’re letting the culinary world know people are interested in this. And they also see how easy it is. It’s not even on the foods that they’re already serving to do it.

 

Overcoming MS (26:07)

That a good chef will quite enjoy doing something a little bit different than the standard menu. And they come up with amazing things for me at times. They’ve said, how about because we have a little card for restaurants that sort of says what we just lists out these are the things and say, because there’s some additional things, as you said, we’d rather they weren’t fried in oil. So it just lists all those different things and it looks a bit more official when you give them a card.

 

Elizabeth George (26:12)

Exactly.

 

Overcoming MS (26:33)

And they come back and say, well, I’ve got this amazing fresh thing that we got in today. Would you like to try that? And they’ll suggest things to me once. And they’re really happy to try things out, I think. well, good chefs, would say. There’s good chefs and there’s ones who heat up things.

 

Elizabeth George (26:41)

Yeah, it’s great.

 

Thank you. Yeah.

 

Well, know, so the lot of the chefs have been traditionally like Chef Nick, my co-author, and into sugar, salt and fat. But then they do enjoy them becoming creative and learning this new way. So it’s also the books are not just about teaching doctors, but also teaching chefs to take on something new. Chef Nick had fatty liver that went away and he’ll say this way of eating saved my life. So you are seeing reversal of MS or really calming it down with your program,

 

Overcoming MS (27:15)

Right. Oh, absolutely. Yes, I think. Yeah, the majority of people following the program are, yeah, feel really healthy and, and it’s, yeah, keeping under control. I mean, we don’t say that you shouldn’t have drugs. So it’s not an anti drugs program. But, yeah, but yeah, it’s certainly a part of it. Absolutely. It’s like, I mean, it’s mostly lifestyle thing.

 

Elizabeth George (27:40)

Great. Great.

 

Overcoming MS (27:48)

So as a final point, is there anything else that we haven’t talked about? And finally, how could people get in touch with you and find out more about you?

 

Elizabeth George (27:56)

it’s not hard. First of all, it is not hard to cook this way. And it’s fun and pleasurable. Kids can do it. I enjoy doing it with my grandkids. My granddaughter, we make a marinated tofu. And I put the soy sauce, low sodium, in a bowl. She climbs up on the counter, gets the ginger, shakes again, gets the onion powder, garlic powder, and she goes, okay, now we have to put the secret ingredient in and that’s a little nutritional yeast and we put that in. But so she’s, she’s eight and she’s embracing it. then, so you make it fun, So we have a website, healthy eating adventure.org and you can actually contact us through that.

 

So they’re welcome to do that. I don’t mind getting emails on [email protected], but it’s easy to reach us through the website. when I first started this in 2010, I was kind of learning how to take it on. So I have lots of things that show how to do it, how to do it easily. Yeah.

 

Overcoming MS (28:52)

And yeah, check out the show notes as well because I have links to everything in the show notes and obviously you’ve got the book And yeah, thank you very much for joining us, Elizabeth George.

 

Elizabeth George (29:02)

Yeah, it’s been great.