Hi everybody. I’m Karen Hartglass and you’re listening to another episode of It’s All About Food. Of course, I’m so glad that you’re here. I’m just coming off from a trip to Belgium. I’m back in New York and I’m feeling a little I’m feeling that that time change. But I’m also happy to jump right into what I love doing most, which is talking about food and how food affects so much of our lives. We can’t live without it. Right. Right. And I was so fortunate to meet many wonderful people at a recent event hosted by Plantpowered Metro New York. You all know about that great organization. And we’ve spoken with Lyanna many times, the founder. And today we’re going to be talking with Dr. Ovie Shaw, who is a boardcertified hematologist oncologist at Memorial Sloan Ketering. And she treats many things including multiple myyoma and other plasma cell diseases. But what I’m really interested in is her specialty of healthy dietary changes. So a very warm welcome and I mean it warm because it’s still hot here in New York. It very much is. Thank you for joining me, Dr. Shaw. Thank you so much, Karen. It’s a pleasure to join you and I appreciate the invitation. Yeah. So, I want to know a little bit more about you before we dig into what you do and reading about you on the Memorial Sloan Ketering website. I didn’t know this when I met you, but you had a personal experience that guided where you are today. And that’s what I want to start with. Sure. So back uh when I was in my training to be an oncologist, so in my hematology oncology fellowship, right at the end of the first year, uh I noticed some lymph nodes in my neck and a fatigue and I was kind of being in training, I knew what’s what and I was like this doesn’t make sense. It doesn’t seem like an infection. And so by the and this was of course a Friday afternoon. So Monday morning I went in to my um attending who I was on rounds with and I said, “What do you think? Should we do some testing?” And he was like, “Yeah, I agree. We need to get a scan today.” And so then that put everything into motion and I got diagnosed with Hodgkins lymphoma. I needed chemotherapy for 4 months. Now this is almost 10 years ago already. But um that experience got me seeing like what it is to be a patient with cancer and the experiences that my patients face now and brought things into perspective I think in a very different way. Um and during that period I had friends and family say, “Oh, you should eat this, try this supplement, try this food.” And then I realized as a doctor and an oncologist, I really didn’t get much training in nutrition. And I didn’t really know the research or evidence behind all of these things and if there really was any. And that got me thinking about it and reading more like a side hobby. never thought I would make a career doing this, but just reading about it and thinking how interesting these connections are and what are modifiable factors that affect cancer risk and how do we address them to lower risk and that led to me when I became faculty at Memorial Sloan talking to my chief and saying can I do one dietary study and he was very supportive and said sure which was nice and that led to me building multiple studies we six ongoing and planning more already.
So, well, I’m sorry you had to go through a diagnosis and treatment for Hodkins lymphoma, but you know, and I don’t like to do this, but it seemed like a gift in some ways in order to guide you in terms of how you treat patients. And we need more doctors like you that connect the dots with nutrition. And and I know it’s not possible, but maybe it should be part of the training that you give a doctor a disease before you let them practice. I had a friend of mine who is a psychiatrist and he teaches and directs programs at Colombia. I had him on this program a while ago. He wrote a book called When Doctors Become Patients. Nice. Yeah. And it’s quite an eyeopening experience. I can’t say that I understand it, but doctors really need to learn empathy. I couldn’t agree more. It’s very true. Well, there’s a there’s an arrogance and I don’t know if it’s part of the training or what, but doctors, many doctors feel like they know everything and then it’s not until they’re on the other side that they see a whole different world hopefully and then apply it to their own practice. I I I wouldn’t say all doctors, but many you could have that. And I do think part of it is, you know, maybe it’s a coping or a way to deal with it because they’re dealing with such complex situations and if they don’t feel confident to be able to handle it, then they’re not going to be able to do their best. But I agree that at the same time with that being able to hear a patient’s perspective and uh really take that into consideration with the discussions is so important. And I even though I was an oncology fellow in training and surrounded by other oncologists, I still had experiences where well-meaning colleagues or friends who are also doctors would say things that I was a bit surprised or taken a back by and realized then that you know there’s a lot that we as doctors also need to learn in how we communicate with patients or people going through difficult situations. Absolutely. And I can’t say that I entirely empathize with your experience, but uh I have been in this plant-based vegan movement for a very long time and educating about the powers of a plant-based diet and doing some coaching as well. I’m not into coaching, but occasionally I have coached. And when it came to diagnosing myself, well, first it I was in complete denial because I had all these symptoms. 20 years ago, I had advanced ovarian cancer and I was really in denial and ignoring the symptoms or at least going on the internet and interpreting my symptoms the way I wanted them to be. And then once I realized what I had and and jumped into taking care of it, in addition to all the doctors and medical professionals around me, I also knew how to do my own research. But researching for myself was a very different experience than researching for other people. And I’m wondering about your experience. Oh, very true. Because when we are doing it for others, even though we might feel the empathy or feel for them, there is still that side that can be a little bit more objective and mechanical in the way we can do it and that allows us to make the best decisions often for the patients. But I think when you’re going through it, your emotions and other things can also take into consideration. And even though for Hodkins lymphoma for example the prognosis is excellent. So um you would say that this is the best kind of cancer to have. Um at the same time the treatment is very uh difficult at least at that time it was the old school chemotherapy that require like had hair loss, nausea, vomiting, all of those things. And um when you’re going through it, you realize that even the rarest of side effects, it’s not it could be possible. And so your mind can go to those things can which can make it more stressful.
Yeah. Now, as I said, I went through chemotherapy 20 years ago. I was fortunate because I was connected to a doctor outside of Chicago, Dr. Keith Block. He has the Block Center. I don’t know if you’re familiar with it, but he was one of the first, a pioneer perhaps in the integrative cancer treatment approach. He believed in nutrition, nutritional excellence. He wasn’t a vegan, but he promoted a nearvegan diet and also a variety of neutrauticals, supplements that are based on food. Uh, and uh, he did vitamin therapy during the chemotherapy. I’d get a vitamin infusion. I got massage. And it was really, I called it the club med of chemotherapy. I have only good memories and I didn’t really have the nauseous experience. I had a sensation in my belly but I think everything he was giving me really worked in concert. I did have hair loss and they did make mistakes because they first treated me with the standard protocol and it was a cocktail that didn’t work for me and then uh I had to go in for more surgery and blah blah blah and then had a different cocktail that did work and I’m here 20 years later and still talking about it at nauseium. Anyway, it’s an interesting thing but I but I know we’ve evolved quite a bit so how how did you get the food element into your practice?
So, um since I’m I I’m at an academic institution where we do quite a bit of research and I was trying to figure out what my research focus and interest would be. when I started as faculty, I was hired kind of into the role of thinking that I even I thought that that’s what I would do is doing uh immunotherapy research and looking at different immune therapies and what leads to people responding versus not and but it was also the time in the cancer that I was treating that some of these imunotherapies were very early so we had very few patients who had had them. So it was harder to do that kind of research if you didn’t have enough samples. And so while that was taking a while to pick up, I decided to look into things like obesity, diabetes, diet, the microbiome, all those aspects and then build the newvention trial, which is our first pilot study. And we took patients with this precancer state of MGUS which is monoconal gammopathy of undetermined significance or smoldering myoma. These are basically precancer or precursor disorders that patients eventually could progress to a blood cancer called multiple myyoma. And those who have a BMI over 25 have double the risk. And this evidence was already there before I started. And that got me thinking, what if we could address these modifiable risk factors like obesity, um the diet, because foods rich in more plant foods um seem to have less myoma, people who ate more of that. And then the microbiome, inflammation, all these things have been associated with myoma. And so we decided to address all of these things through a high-fiber dietary intervention and then see if we could delay progression.
And what did you find out? Yeah. And and that one study led to us, you know, building others. So now we have six studies. In that study, we saw that uh just with 12 weeks where we provided meals, we would ship them lunch and dinner weekly and provide coaching for snacks and breakfast. Um we’ve never calorie restricted said eat to satiety as long as you’re focusing on unprocessed or minimally processed plant foods. We had a dietician and coach working them with them very closely through that 12-week period. But also after the 12 weeks, the meal stops for 12 more weeks. We would just provide coaching. And then we followed them for a year. So six more months to see what they’re doing after we’ve stopped the coaching and the meals. Are they still continuing it? And what we saw was that patients lost about 7% weight on average and maintained that weight loss to one year out. we saw that um there was a change in um insulin resistance. So actually despite them eating the same number of carbohydrates carbo um the insulin resistance actually improved. Some people patients who had diabetes were able to reverse that. Uh we also saw a patient who was on insulin 30 years who was able to stop in a month or two of changing his diet. Um and then next things we looked at was the microbiome. We saw you know features of a healthy microbiome such as more diversity or um more butrate producers which are the healthier bacteria that ferment our fiber richch foods and carbohydrates increased. These make these short- chain fatty acids that have anti-cancer anti-inflammatory effects. So in line with what we would want to see we also saw improvements in inflammation. So there was a reduction in the C reactive protein significantly in all patients and then also changes in the immune subsets to a more anti-inflammatory um immune um environment and lastly the most couple things is you know how did patients feel. So the quality of life of patients actually improved. None of the patients said it was difficult actually which was surprising. Many of the patients continued these changes long-term well beyond the study intervention period which was also really nice to see because I think they felt good and benefited. A lot of patient reported symptoms like GI issues, depression, anxiety, arthritis, uh um body image all of these things like self-confidence improved and um then we also looked at the trajectory of this protein. So like if as the protein rises that suggests that there’s progression towards the cancer and we had two patients whose disease or proteins were rising clearly for about 20 months before going on the study and we did see a slowing or delay um of that protein increase in those patients. While it’s a small number of patients because it was a pilot study, it is encouraging and suggests that maybe in some situations or some cases where we can um strengthen the immune system microbiome metabolic environment, we could potentially maybe delay progression to a blood cancer myoma.
Have these results or any of them been published? Yes, this has been published in the journal Cancer Discovery. It came out earlier this year. Oh, I have to read them. Sure, I will send it to you. Yeah, I would like to to see them very much and and it is indeed very exciting and I wonder what was the feedback or response you got from your colleagues at Memorial Sloan Ketering. I think overall it’s been very positive and many are quite impressed or excited with the results where they would not have expected to see so many changes with just diet and um so so that’s been nice of course not just not at msk but just externally as you know more people hear about it there are going to be people who are skeptical or don’t believe it or things like that so we have those comments that come through as well but Overall, I’d say patients are really excited about it and want to hear more about this research especially and doctors too have started speaking about it. I think this small study and us just talking with patient support groups and populations have led to this awareness about lifestyle factors for these precancer conditions. now in many countries because um the myoma patient support groups in Australia, New Zealand, Europe, um Canada and there I’ve heard I’ve spoken at some of those events, support group meetings, but also some uh doctors or patients will tell me, oh, you know, this support group is talking about it and they’re making these changes. So it is nice to hear that and see that like a small study has led to at least some um thought around this or at least bringing some attention to it and maybe some patients also being able to make significant changes.
It takes a lot of time to move the needle but it’s moving slowly and fortunately some patients get to benefit. I like the sound of the study in that first you delivered the meals and then you let them do it on their own and then you follow them for a considerable period of time. I know some other groups have done uh I don’t know what they called them workshops or retreats where the people were on site. So again, they got the meals prepared for them. But unfortunately, when they went home, they didn’t do so well because they were influenced by what’s easier, by what their friends are doing. Restaurants often don’t give them what they should be eating. Or they could, but the people don’t know how to request them, or maybe they feel uncomfortable requesting something. And many people have said to me, “If you could cook for me, I I could eat like this.” And that’s a big obstacle that I’m not quite sure how we’re going to solve. I know the plantp powered Metro New York is doing what they can do trying to get restaurants to offer some healthier options.
Yes. And also I think uh none none of us not none but most of us don’t grow up with learning the basics of you know healthy cooking because families have also not learned this like what is dietary fiber what are foods that are rich in it how do we think about this and a lot of this is also evolving with as we learn more about the microbiome learning the benefits of these things and how they interact with immune therapies. So things are changing but I think patients often are like okay I’d like to do this but I don’t know how as you said and that’s part of what we tried to do with the study is not just provide food we only provided some meals because we were providing 12 meals per week which is like six lunches and six dinners. So one day a week they have to cook all meals and breakfast and snacks they’re cooking all plus we didn’t calorie restrict. So if they felt the meal size was small and they wanted a side soup or salad, they could get that make that on their own, that allowed them to basically learn and um you know how to get some of the food themselves like where would they buy it or what would they cook and that helps sustain longer term when you are you know doing some of those things.
You have to want to oh that’s the most important one. Yes. were these people were volunteers obviously but they wanted to be a part of it. Yeah. And that’s one thing with research right like it’s only filtering or uh taking the patients who are open-minded to trying it. The ones who are um refuse to do it will never join a study like this. So it does have a bias in terms of the population that’s going to but even within that like the baseline dietary intake for these patients was about 20% of their calories coming from unprocessed plant foods. That’s probably higher than the US average. So they were a little bit more open-minded than I would say the the general like average we would find. But at the same time it was still very far from what a high-fiber plant diet would be. So on the intervention they were able to while we were providing meals it went up to as high as 90%. Um or 92%. And a year later it was about 60%. So there is that challenge when you don’t continue to coach somebody that some of them may revert back because of all these external influences you talked about. But at the same time there are um some patients who will just continue it because now it’s a part of their lifestyle.
It helps when your doctor tells you good information about diet and many doctors just don’t have that information. What was the most surprising thing you learned from these studies so far if there were any surprises? One was that u patients didn’t find it as difficult as you know most doctors would think it is. We surveyed um out of the 20 patients who took part, 15 had filled out the survey by the end of the study because we added it in later. And none of those said it was difficult. All said very easy or somewhat easy. Nobody said somewhat difficult or very difficult which was really nice to see that one of patients supported like they’re really able to do it. And then the other thing was um the patients actually many of them continuing doing it to this day. So I follow many of them in clinic and now some of them are like five years out of the study or four years and it’s nice to see that they still say they’re following all of these things.
I’m I’m blown away just for that response alone that they said it wasn’t difficult or not that difficult and we now have much larger studies that we are asking the same questions. So we’ll be able to show or see if it’s similar in terms of when we have a much larger population. Beautiful. What was your diet before you had your cancer experience and how has it changed since then? So for me um I think prior to this food was uh more of just like um eating to live or sustain but never thought about it as nourishment or thinking about like what foods are important or not. I think overall my diet I would have thought at that time was pretty healthy but I realized as I moved to the US it did end up becoming a much more processed food diet. it ended up being um a lot of dairy, cheese, and uh eggs and things like that. So, it may even though it I was vegetarian, I would say, you know, and this is what I tell patients, it’s not about whether you’re vegetarian, vegan or omnivore, it’s about how much percent of your calories are coming from unprocessed plant foods. And I think that there was a time where a very little of or maybe a small amount of my calories would have been coming from unprocessed plant foods. And even fruits and veget fruits were things I didn’t buy regularly. Didn’t think about that. So I think after this and as I read more of the research, I have gradually made changes to incorporate or match things that I tell patients. So I don’t feel it’s right if I’m going to talk about something that I don’t follow. But I’ve also personally seen the benefits with making these changes. So I and I do enjoy eating this way now. And I do think our taste buds change very much. Like and I’ve seen that with patients too where they think that they may never like something but like after you’ve eaten it for some time, you then start craving it or you want to eat that more regularly. Um
I’m wondering uh this whole experience you’ve been through it. Well, one thing I like to say to people is um you were saying people don’t have to be vegetarian or vegan or omnimore, but I I personally think like dairy foods and white flour foods are a recipe for disaster. and and many people who are vegetarian. Uh I had one friend in particular, she lived on bagels and cheese and pasta and she ended up getting multiple sclerosis. Yeah. And you know, I jumped in, cleared out her kitchen, and put her on a raw food diet to start with, just like cram that fiber. And you know, she’s doing much much better today. Uh, and that that’s exactly what I agree with that it’s a lot about the unprocessed plant food. So, somebody can be vegetarian and be a junk food vegetarian or a processed food or they could be their diet could be mostly animal- based if they’re mainly eating eggs and dairy and cheese with it. So, even though they’re vegetarian, they’re not on a high-fiber plant-based diet. And the same thing could be sometimes with a vegan diet, too. though it’s less likely but a person could be eating French fries or Oreos or things like that. So I think focusing on that minimally processed plant foods for majority of the calories is really where the benefit lies and I agree with you on that.
So we’re all individuals. We all respond differently to this world. I often think that an unhealthy diet, the standard American diet as some of us call it, uh the diseases we get from them are all the same disease. It’s just we as individuals fall apart differently. And I’m just wondering, you’re young and you were young to get your disease. Do you reflect on that or have an understanding of why you might have gotten what you got? Uh, one is that hotkins lymphoma does affect younger individuals. So, this is a known age group that it does. It’s not unusual. Um but yes I I don’t think that I was living a very healthy lifestyle with being in residency fellowship in terms of um work hours sleep hours stress um dietary changes physical activity all of those things and those like five years preceding it were not great I’d say and um so I’m sure some of that contributed uh it is hard to fully say what or one thing alone. Um, but some of it could just be also luck or the situation of it. But I do agree that like some of these things are things that we can modify and reduce our risk.
Is there do you know is there any plan to change the way medical students get their training because like what you just mentioned medical students often in their residency or whatever they don’t sleep they’re not taking care of themselves and what what are we what are we teaching teaching ourselves when we want these medical professionals to make us well and they can’t even follow a plan to keep them well during their training. It is a challenge. It is unfortunate that uh the way training is set up is that the residents are ending up doing long shifts and long hours. Some of it does allow you to learn things that you know when you’re staying longer with the patients or after hours you might see those things but and I do think it’s gotten better over the years where um there is some checks and bounds in terms of the number of hours that a resident can work but there is no kind avoiding the night shift somebody has to be there in a hospital at night and u so that is going to always be the reality of it where there are going to be time shifts in terms of when the a resident can sleep and function or things like that, but they have improved some of those checks and balances. And I I agree there’s still room for improvement, but it’s it’s a slow process always usually.
And why did you decide to choose oncology? So I was always drawn to um the whole body or just thinking about how different organ systems and the person interacts or the whole person care. So when I was deciding my specialty for residency, I thought about um you know neurology or psychiatry or medicine surgery and what drew me to medicine was that again you’re learning about all aspects and you really get a comprehensive understanding of the human body and there’s interactions are interesting. But I also liked that you have long-term relationships with your patients as a medical doctor. Usually surgeons will operate but then they the medical doctor is the one that follows. So that led to me wanting to do internal medicine and those same principles applied when I was thinking about which specialty and I liked that oncology especially taking care of patients with blood cancers requires a good understanding of not just cancer but um the blood system the different organs that it could affect cardiovascular because when you’re thinking about treatments diabetes like all these things you have to have some understanding I think because you are taking care of the whole person when you decide treatment plans and I like that I uh you know that patients are at their most difficult or vulnerable position. So there is an opportunity to really help patients get through something that’s really difficult or challenging and you build these bonds with patients that you’re now following for years which is very different than some specialties where they may come in once and that’s it.
I know that as a cancer patient 20 years ago, I had wished that there was one person who was following my journey and I didn’t have that. But it wasn’t entirely my it wasn’t entirely the medical profession’s fault. I was seeking out the best people I could find wherever they were. So, I was going to Chicago for chemotherapy, but I had surgery here in New York. And I was like, all you people have to work together because I want the best for me. But it would be nice if you could have like one person who like gets it all and is skilled and experienced enough to help you through your journey. Agreed. I don’t know what you’d call that person other than, you know, your medical advocate. And if there’s even a a a course of study at university where you could get a degree in that sort of thing, that would be that that’s kind of like what you’re talking about is the primary care doctor of a patient who should be the one that is being able to support the patient and work with all the subsp specialists that they’re working with. But often when it’s a patient who has cancer and quite like when they’re during their active phase of treatment, I think the oncologist often will take that role of the primary care because the patients already coming so many times to see the oncologist that then they ask they want the oncologist to approve or answer every question before they they go to anybody else. So I I do think oncologists do take on that role often in some ways.
And do you do you advise or recommend to your patients h what they should be eating and are you allowed to do that or you have Yeah, I I do talk about it especially in patients who I think it uh you know they’re open to listening or it would benefit. I also don’t bring it up at the first visit if they are newly diagnosed but if they want to hear about it I would. So, I do individualize it to what the patients needs are and how they are whether they’re open to talking about it or not. I’m I’m curious too um percentage-wise, not that you would have these numbers, but how many patients actually want to participate in their care versus just say, “I’ll do whatever you tell me, just make me better.” So, so I think this uh it’s it’s a bit different in different institutions and where you practice. I think being at Memorial Sloan catering a lot of patients seek out care on their own and may come to us and being in New York is a place where there are a lot of well um informed people who live and want to come. So I would say that a lot of my practice is patients who h have read a lot before they come in and they have a long list of questions that we go over. I have patients who come from across the country sometimes who fly in for a second opinion, third opinion, fifth opinion. They want to know um you know what you would say in this situation, but they already know a lot of the basics. So you’re really talking about like nuances and refinements in terms of ways to handle it. And I do appreciate it that they are doing their homework or reading and they are also true advocates in their own care and asking the right questions. So I don’t have a problem with patients actually uh questioning me asking questions because that really leads to you know keeping us on our toes as well but also allowing them to really feel comfortable with whatever decision they’ve made. And I do encourage patients to get a second opinion or third opinion or whatever they feel to make the right decision. I don’t think that um they need to only see me or one specialist. If they would like to get another opinion, I have no issues working with another doctor for it because I think in the end the patient needs to be happy and satisfied with the decision. And within oncology care, there’s a lot of um that there’s a lot that we follow guidelines and clear like everybody would do the same thing, but there’s a lot where there are nuances and differences of the way doctors practice and some things might sit better with one patient and some with another.
Where are you with supplements and cancer treatment? You know, that’s a big field that I I know a lot of conservative medical places are very wary of supplements and I had my personal experience and I took a lot of supplements when I was being treated. So I think supplements have a place and a role when there are clear deficiencies. uh the American Institute of Cancer Research and the World Cancer Research Fund have 10 cancer prevention guidelines amongst them there’s a clear one that says do not use supplements to prevent cancer really diet physical activity these lifestyle factors are the most important in terms of um types of supplements like we are doing some research with supplements too I think it is important to study it similarly like we study drugs to understand truly whether it is making a difference. The challenge is that um I’d say there are two kinds of supplements, right? One would be things where you have a clear nutritional deficiency. So somebody has an iron deficiency, a vitamin D deficiency or um a vitamin B deficiency and in those situations repeating that supplement or understanding why that deficiency happened in the first place. But supplementing can actually benefit the patient. I have done that in so many different cases where patients have felt better whether it was neuropathy that got better after we supplemented or um a vitamin D deficiency leading to lot of fatigue or you know low levels where we do try to replete even in cancer patients. So those are some things iron deficiency and patients would feel better once the anemia is improved. So those are examples of clear-cut deficiencies that we can address. Another side would be all these herbal supplements that are not really for a deficiency but patients are taking because they think they have anti-cancer effects or they might make them feel better with certain symptoms. So even magnesium is another one that is commonly used and I think in some situations there might be the right place or use for it.
Magnesium is found overwhelmingly in plant foods or fiber richch plant foods. So as we know that there’s a fiber deficiency in the country and the world. I think there is a magnesium deficiency probably similarly because that if you’re not getting enough of those plant foods you’re not getting enough magnesium. Um but those are some of them and we’ve done research where we are looking at things like curcumin and omega-3 in this precancer population of musin smoldering. The study’s not completed, but we’re looking to see what does those supplements do to the microbiome, to inflammation, and the disease because there have been prior smaller studies that showed maybe it could help with delaying progression in some patients, but the data is so little and um not strong enough to recommend it to every patient. And patients are taking it like the number of patients. We surveyed over 500 patients to see like what percentage are taking these supplements. and the it’s a it’s a huge proportion of the patients and I think that’s why understanding if it’s helping them or are they just spending money on things that you know is not necessary and um we’re trying to understand some of those things.
Yeah, it’s hard because there’s so many variables. Yeah, exactly. So many variables. I know uh 20 years ago I spent about $800 a month on neutrauticals. Um, some of the things I took were like a concentrated mushroom supplement, a concentrated broccoli sprout supplement in addition to like eating so many leafy greens and mushrooms as food and berries. I I don’t know what worked. All I know is it worked because I I’m still talking about it. Do you have any feeling about uh with food for example like green juicing? I made my own green juice with kale and collards and celery and lemon and ginger. Maybe I added some other things daily for 10 years after my cancer diagnosis. Do you have any feeling about that? So, I think it’s a way to get uh um the the nutrients in a much faster and a larger proportion quickly and it allows you to not have to think about like, okay, how should I cook the greens today? Do I have them? Like, it becomes a regimented thing where then you end up taking it every day. So, I’m not against it. I think that that could be a way for people to ensure that they get their greens daily. Um, and we know that greens have a lot of benefits and so, you know, I I don’t see anything wrong with it.
What about raw food? Because I know a lot of doctors when they’re treating people with chemotherapy feel that they’re immuno compromised and raw food may come with well, especially now it’s cycllospora, but may come with things on it that could make people ill. And so they say don’t eat any raw food. So um there are certain situations where patients can be very immuno compromised like allergenic stem cell transplants where you’re getting a transplant of stem cells from another donor. Um that’s usually done in leukemas. Um then also the initial treatment of leukemia when they initially get chemotherapy. So these are certain situations where a patient can be quite immuno compromised. Stud we’ve had two studies done in this space where they allowed liberal intake of fruit and vegetable and one of them showed that there was no increase in infection. So they said you should eat liberally fruits and vegetables. And then a more recent study came out and they’re saying that they noticed an increase in infections with fresh fruit and vegetable. So they kind of said uh we think that patients should not do that in only these certain settings which are like really immuno compromised neutropenic for a long time and things like that. I think that um most cancer patients are not in that situation where they are so immuno compromised and there is more benefit than risk. So patients should be continuing to eat um plant foods, but there is also a way that it can be done where you’re washing it really well, picking certain ones that might not have um more of the risk of contamination and also maybe cooking the foods. So I think cooking foods could still continue to give you most of the benefits and allow you to continue to eat plant foods. So um I don’t think that it’s a issue that should lead to people not eating plant foods. It’s just how do you adapt for that period and then as soon as that period’s done you can go back to as much you know raw as necessary if that is a concern for a patient and their doctor.
I was always surprised as a patient that I would be served foods that were not healthy for me while I was in the hospital. And I did have an advocate which was my sister. I called her the general at the time. And she was always speaking on my behalf and talking to people to get me what I needed. And one was healthy food. But still, there was plenty of things that would be on my tray when I said, “I don’t want anything with sugar. I don’t want anything with dairy.” And yet those things would appear. And and I remember sharing a room with other women with similar diagnosis and they’d be served ham and you know unhealthy meats and I didn’t understand that and I don’t know if it’s changed at all. I think there is um more awareness around some of this. There are things where you know there’ll be markings near the food to say suggest like this is a healthier option or things. Um, I do think I agree with you. There’s still a lot of work that needs to be done in that situation, but there are more plant-based options. At least I know that at Memorial Sloan Gatering, there are plant-based options. So, if a patient wanted to pick from those, they could. Um I know that other hospitals too have been um consider like looking into this at least but you know New York City Health and Hospitals has done a great job with making their foods planned first but there is still is a lot of work that needs to be done and many hospitals that still need updates on their menus and I couldn’t agree more.
Definitely. 20 years ago, I was treated at Mount Si, but um maybe more than a decade ago, my cousin was treated at Memorial Saloon Ketering. I was very happy when I would visit her because they had tofu in the cafeteria. Unfortunately, she didn’t make it though. Oh, but yeah, that’s life as we call it. Nobody gets out of this world alive. Yeah. But we want to live as long as we can a quality life, right? Isn’t that the message? That is the message very much. Living better with being with longer. Yeah. So, are you doing anything specifically with Plant Power Metro New York? Uh, in terms of research, no. Uh, just in terms of I don’t know. And we were all at this wonderful event and I wonder what your relationship was with them. It’s more just an interest in the work they do. I do refer patients there or suggest this to many patients in terms of where they could do this on their own if they’re not part of our trials.
Okay. So, Dr. Shaw, I’m sure you have a very busy life. What does your regimen consist of in terms of food and exercise? So, exercise, I try to work out a few times a week and I do switch it up, but usually it’s yoga once a week and it’s um strength training once a week and um high hit hit or high intensity interval training or running once a week. So, it’s approximately something like that. But there could be some weeks where I do more of a certain one or less of the other. Yeah. And diet-wise, and diet-wise, I do follow a high-fiber plant-based diet. So, I do try to aim to eat minimally processed and focus really on the diversity of plant foods, getting enough dietary fiber in, focusing on plant sources of protein. So, getting um lot of beans. I think beans are probably one of my most favorite foods. Uh but yeah, and I do think that all of that helps me um stay healthy.
The bean is an amazing food and I’ve been cooking my beans from scratch for a very long time. But when I discovered the Instant Pot, that just changed my world because I used to always over boil and the water would flow over the pot and I It’s just embarrassing how many times I did that because I didn’t want to watch it. And then the Instant Pot just solved that problem. It was just close it and forget about it. Brilliant. It is great. And even soaking beans overnight helps reducing the cooking time and makes it much easier to digest and things. So I think that that’s another very important tip for anybody making beans. Absolutely. And soaking I do that too, but it’s easy because I can just put it on the counter and forget about it. It’s just when I have to watch it because uh I know multitasking isn’t supposed to be a good thing and I do a lot of multitasking and as a result I’m focused on something and I forget about something else.
And do you personally take any supplements? Just curious. I do take vitamin D um and B12. Okay. No omega-3s like DHA, EPA for you. I I have them. I do sometimes, but I’m not regular with it, I’d say. Okay. And what about um I take two tablespoons of ground flax seed every day. Oh, that’s great. Yeah, I do eat quite a bit of meaning chia seeds, flax seeds, hemp seeds. Whenever I’m making a smoothie, I put one of them in usually, but I can’t say that it’s like a daily or regular thing. But um I would say a few times a week at least it’s coming in somewhere. Yeah. When you get older like some of us um you find you you want to have a more quality of life and longevity and you’re more focused on those things. Somehow it’s easier when you’re young to not be as focused on those things. I know I wasn’t. Yeah. I I think I think about these things and I do them, but it’s uh more of like because I I don’t eat the same thing every day or the same thing. So there’s a lot of like what is convenient at that time and variety as long as it fits within my pattern of eating. So yeah, get it. I’m not a religious person, but I am religious about certain things and my flax seeds are one of them. I mean, I’m kind of nutty, but um that’s great. I grind a pound of flax seeds. I put them in the freezer. We just traveled to Brussels and I made I traveled with enough ground flax seed for you know all the time that we were there just because I gota it’s crazy to be a little obsessive but what what do you eat your flax seeds with is it well it depends. So if we’re having a bowl in the morning with fresh fruits and maybe some oats and some soy milk I’ll throw it on there or on a salad clearly. But if I find at the end of the day I haven’t had my flax seeds for one reason or another, I’ll just take a big glass of water and two tablespoons of flax seeds and chug it down. Wow, that’s amazing. Great commitment. It’s a commitment.
Well, you know, we all have our own issues. I’m personally um well, I’m a cancer survivor. There’s that. but also um I have high cholesterol and so I now have chosen to eat salt, oil and sugar-free and adding all kinds of things based on my own research. I make myself a tea with a variety of herbs that have been shown to reduce LDL. I don’t know if it’s working. It’s something I recently added to everything else I’m doing because I’m trying to find what works for my individual body which is not entirely behaving the way I would like it to. Yeah. So we’re all guinea pigs. We’re all experiment. Right. Yes. And a lot of individualization is needed as you said like for each person.
Yeah. So I I’m just really excited about your research, this new vvention, and I just thought we could end with that. So what’s on the horizon with your research? So we’re doing a study currently in newly diagnosed myoma, so the blood cancer with over 220 patients that will enroll. It’s a nationally enrolling u randomized to us providing food versus the usual care while they’re getting chemotherapy. So we’re seeing how that goes. We have enrolled quite a few patients already. But if if any patient is newly diagnosed with myoma and interested they can reach out to us directly at shaotrevention mskcc.org to sign up. And uh we also have a study in a pre-lukemia condition called clonal hematopois that we’ve opened. Um so those are two ongoing studies and we have a couple three other studies that are now either completed or nearly completed that we are analyzing the data from and those are in the precursor condition. So this MGUS and smoldering myoma or in myoma survivors and so we’ll start by end of this year we’ll you’ll start to see some of that data too.
I’m curious about a couple things. You said you’re providing them with food. So some of them are all around the country. Where is the food coming from? The prepared food. We work with different companies and uh we um find companies that are able to ship across the country typically so that it could be so a recent one is working with modify health. Okay. And is there a control group in all of this or there people or or everybody is signed up for the program? uh only our first study didn’t have a control group, but all our current studies have a control group and they’re all randomized studies. And so that means that um half the patients get the food and half don’t or it could be a different proportion but something like that, right? So the ones that don’t, do you know what they’re eating? Yes, that’s part of the research where we do the same. Even ones that get the food, we don’t know if they’re eating it or not unless we measure dietary adherence. So, we look at adherence in both groups. And then like if if the group the control group sees like, oh, the other group’s doing well, I want to eat like them. Do you have that ever happen? That’s a a issue always in studies like this where there’s a, you know, with a drug study, it’s much easier. It’s like the patient gets the drug versus not. But when you’re doing a behavioral change or lifestyle change or something they can buy themselves, there’s always the risk of drop in effect where the control arm does a little more and the intervention arm will pro not everybody will do as much as you tell them and so that difference becomes maybe a little less and that could affect outcomes or where you might say that the diet doesn’t work but that’s because uh you have both groups you know not fully staying within that and diet also has a much lower effect size than a drug. Meaning that a drug could have a much higher response rate than maybe diet would in something like this because diet takes longer and it is a different. So you need a much larger study to see the same kind of effect which makes it more cost prohibitive and difficult to do.
What are in the meals that you’re sending people? They are fiber richch cooked meals where it could be things like um a burrito. It could be a um a patty with some um veggies and quinoa or other grains. So like we try to do whole grains, beans, seeds, nuts, grains, all of that combined. Try to pick recipes or things that would match things that patients typically eat even if it not may not be a plant-based version. and we will make a plant fiber richch version to have them feel like they’re not fully changing their diet. Have you tried some of that food? Oh yes, it’s good. I I like it all but you know I’m also biased and but what I found from patients is most of them like it and we do customize a bit so that works as well.
Okay, talking about all this food I am hungry and I need to eat. So Dr. Vishwas, thank you so much for joining me. I really loved learning about the work. I wish there were more doctors like you and I wish you great success with all your patients. Thank you. Thank you so much Karen. It was really wonderful chatting with you and u sharing what we are doing and hearing about your journey as well. All right everybody, that’s another episode of It’s All About Food. Have a delicious week.