Professional Coaching with Tara Treiberg (Part 2)

And we actually use one of those AGEs or ages as a marker of somebody's diabetic control. So when we do test what's called acetylated hemoglobin or hemoglobin A1C, which is tells us how somebody's glucose control has been over the last three months approximately that's actually an advanced glycation end product. It's the glucose molecule binding to the hemoglobin molecule in our blood.

Now, this can occur in our foods. And it occurs most frequently when you have a high protein food that also is heated to a high temperature in the presence of a refined carbohydrate like a sugar or a refined starch. So for example, if you take a piece of chicken and you bread it and fry it, - To get fast.

- Like a chicken finger is going to produce these advanced glycation end products. - Hi, welcome to another episode of the Healing Podcast. This is the place where you learn and get inspired to heal in, to achieve higher levels of satisfaction in every area of your life.

I am Karen Millinger-Host, and I believe that what we resist, or cis, and that we cannot change what we don't face. And it was finally when I accepted this reality and invested time, energies, and money into myself in professional support that my life was completely transformed. And now I'm on a mission to demystify this process for you to inspire you to do this work yourself.

Today we're gonna talk about how nutrition and mindfulness can affect our physical health, in this case a reproductive organ as women. To have this conversation, I'm super excited to have with me today, Dr. Basma Ferris, who is a physician and an OBGYN at Mount Sinai Hospital here in New York City, as well as a former register dietician.

Dr. Ferris is certified in culinary medicine with a master's of science in nutrition. We talked about her journey into including a nutritional lens into her OBGYN practice.

Also, sadly, why there is so little emphasis on the importance of nutrition in medical training. We spoke about the importance of certain foods, depending on our staging life, as well as particular foods and compounds to decrease, to prevent the formation of fibroids and hardening of our arteries. We talked about the importance of understanding the barriers that keep us from changing our behavior and eating better, as well as how we could support someone who needs to change their habits.

She shared her personal journey into mindfulness and how this made her the more mindful person and the amazing physician that I met and that she is today. And most exciting how she's now merging the two passions that she has as the founder of PolyPrep MD supporting women with PCOS. You can learn more about Dr.

Ferris on her website at www. polyprepmd. com and on social media at Dr.

Basma Ferris or at PolyPrep or Dr. Basma Ferris on LinkedIn. I hope you enjoy this episode as much as I did and please share it and rate it to help me help others.

- Welcome to the Healing Podcast, Dr. Ferris. I have been looking forward to this conversation for quite some time.

- Me, thank you for having me. I also have been looking forward to our conversation ever since we came up with the thought. - With the idea, yeah.

So to give my audience some context, Dr. Ferris was my OBGYN here in New York at the Wild Cornel Tribeca office. And when I met her, I loved her immediately.

It was so rare, as you know, to find a physician who understands that there's just a little more than just diagnosing a problem and prescribing medicine. And when you were asking me about what I ate and how I was doing in my personal life, I remember sharing about my kids and how in love I was with my husband. And I just loved how integrative and how I felt working with you.

And in another visit, I remember sharing that I had some sort of pH in balances and you recommended medicine. And she also said, listen, there's this natural organic, no paraben, ointment that you can use and that you will love. And I got it.

And it also, it's amazing. And I recommend it to everyone. And remember bringing my husband to one of my appointments 'cause he's like, you gotta meet her.

She's awesome. So she's no longer at Tribeca Wild Cornel, which I'm still really upset about. And I have not replaced you, by the way.

I looked at she was getting into nutrition and I looked at her bio and I'm like, okay, I love her. I need to, I'm doing a switch in the podcast where I'm really focusing on the effects of trauma and nutrition, exercise, stress, well-being into our health, into our ailments, into our pathology. And with that lens to work to heal it by, of course, medicine, but also looking at healing trauma and nutrition, exercise, relieving stress, meditation, you know, mindfulness, anything that works.

So we talked and I said, you know, I'd love to have you in the podcast and here we are today. - Yes, thank you. I'm so excited and I've listened to many, many of your interviews.

So I do feel like I have some big shoes to fill. You've had some incredible speakers on your podcast. So I hope that I do it justice.

- You will, you will, we're so excited. And I'm super excited about this conversation because in the past previous episodes, I started to ask the guest, okay, so how is that affecting our lungs and our breathing? And how is this affecting our heart?

Like literally what happens when you feel stressed and what happens when you face a trauma to our heart and how does our heart get damaged? And I had an amazing psychologist talked about how happens to our fascia and our connective tissues and how all that tension really affects our bodies. And to learn for the first time and I know nothing of how what we eat as well, I know you talk about mindfulness too, affects our reproductive organs as women.

It's super exciting. But before we get into that needy greedy, would you mind sharing with the guest a little bit about your journey into incorporating nutrition and well-being into your practice? - Sure.

So I actually started my career in healthcare as a nutritionist. So that was my entry into healthcare. I studied nutrition as an undergraduate at University of California at Berkeley.

And I chose the path of diatetics, which is the path to becoming a registered dietician. I moved back home to New York and enrolled at Brooklyn College and they had a combined program of masters in nutrition with a diatetic internship, which I completed. And then back then, the sort of idea was, you're supposed to sort of cut your teeth by being an inpatient dietician.

And then you can, you know, if you're lucky enough to find a job as an outpatient dietician, then you can transition into that. And I rejected that. I did not want to be an inpatient dietician.

I didn't feel like that was really the right move for me. So I said, I'm not gonna do that. I'm just gonna keep looking until I find a job as an outpatient dietician because I really wanted to be able to actually counsel people.

And so that's what I did. And so I worked for several years as an outpatient dietician in Brooklyn. I used to go, I worked at a hospital in Bushwick.

And then I worked for the Department of Family Medicine. And I would go to some clinics like in all of these different far reaches of the city. So every day it would kind of be someplace different.

I was in some not very safe neighborhoods. - I have very stressful. - From that time, I'm trying to go and just help and share my knowledge in the community.

I learned sort of quickly that a lot of the challenges were really beyond just the knowledge. There was so many barriers to people caring for themselves and eating well. And I also found, I was restless and was trying to figure out what the next step was for me as a professional, was I going to go into management, was I going to go get a PhD and do some research.

And then I decided to return to school to become a physician. But I did work as a registered dietician before medical school for a little over five years, five to six years. I then, before I went to medical school, I transferred to an amazing organization.

The Children's Health Fund, I worked in the South Bronx. I created programs for families that had children who were dealing with obesity and that centered around the family unit and fitness and you know, worked in partner with different community organizations. So that was very rewarding.

And then I entered medical school with the thought that I was going to be maybe an endocrinologist or a gastroenterologist, something that aligned a little bit more with nutrition and then just somehow found really much more enjoyment in obstetrics and gynecology and taking care of women in pregnancy and just taking care of women in general. And so I made that shift. But it was a bit challenging trying to figure out how I was going to align nutrition and my background and what I was already doing with my new career, my new skill set really was the challenge.

I practiced medicine through the lens of nutrition, right? That was my way. Yeah, the transitioning to medicine, which by the way is fascinating.

And I always tell women, it's like Michelle Obama talked about we're always becoming and we're becoming something new. And I also had a similar trajectory from I did psychology and I was between psychology and business. Went into business, loved it, loved it, loved it, except I was always fascinated with people's psychology.

And I sold to surgeons for 10 years and what I loved the most about my job in dinners and dining was getting to know them and what ticked them and what made them be who they are today. And I'm like, let's try this coaching and let's try this deep dive into psychology. And so and now I'm back to like incorporating, like you are, how do you incorporate this passion for two things, both business and mental health.

And I'm still in that journey of becoming. Why do you think there's such little education or emphasis in nutrition within medical school or the entire physician career? Like as you know, my husband's a surgeon and he claims to have taken maybe half an hour of nutrition and as someone who dying and wine doctors for 10 years, most of them had zero health and well-being and very few of them really did take care of themselves.

And even when I met my husband 10 years ago, the stuff he ate was awful. - Yes. So historically this goes back to the early 1900s when there was a report, there was a, yes he was an education specialist.

So the Flexner report sort of dictated what medical school should teach. And that was the beginning of standardized medical education. And a bunch of medical schools were recommended to close and these included schools that taught different disciplines, including naturopathian, homeopathy, and sort of any sort of, I think herbal medicine - Or Chinese medicine.

- Yeah, anything that was not falling into the mainstream and this endeavor was funded by some of the big tycoons of the day, the Rockefellers and the Carnegie's and they had an interest, a financial interest in our medical education system because they started to get into pharmaceuticals. And so as a result, nutrition science did not make the cut, which is incredibly unfortunate. Because unlike, you know, some, there are some of the disciplines that maybe did not have the rigor with the scientific rigor that the biomedical sciences had.

But I would sort of disagree to say that nutrition doesn't have a scientific rigor because it is a very rigorous scientific discipline. It unfortunately doesn't, you know, have the, and I guess maybe this is to the point of the interest of who was creating, you know, the standards of medical education, it's that it's hard to make money off of nutrition and so, or enough vegetables. - Yeah, right?

So, you know, that's some of the historical context. And unfortunately, because of that, you know, nutrition has been excluded for many, many years. And, you know, for decades in the education of physicians.

Despite the fact that the understanding of how food gets, they've just said, ametabilized. And what is the fate of all these nutrients in your cells is actually integral to the understanding of how the body works, what makes us healthy, what makes us unhealthy. But that is, you know, it's unfortunately not included.

It started to, it's starting to change. There are some non-binding recommendations from the different governing bodies, that govern medical education, both at the medical school level and at the, you know, the graduate level. So in residency training, but they're not really, like I said, they're non-binding.

So, there's more interest. So, I'm not alone. There are physicians that are starting to be more interested.

They come from different disciplines and different backgrounds. And there are different now organizations that are trying to fill in those gaps and provide that education at both the medical level and the graduate and postgraduate level. And I know that there's medical affiliations or it's like the functional medicine side and lifestyle medicine.

- Yes. - So there's less than, are those like completely different degrees and completely different things or are they are things that are trying to merge with medical schools? - They are postgraduate programs.

So they are additional certifications or a different, you know, specialties now. And so if you are a physician and whatever specialty you can now go on and get additional training in many different. So there's lifestyle medicine, which is probably, you know, maybe now the biggest.

There is the functional medicine, you know, group. In obesity medicine, there is a good amount of nutrition education. And then in the specialty that I chose to, you know, continue my studies, which is culinary medicine.

- Awesome. Thanks so much for letting. I'm so fascinated with this.

And especially how siloed all this areas are, right? It's like the nutrition, the exercise, the coaching, the therapy, the psychiatry, the, everything is just on silos. And poor patients are told by doctors, okay, get off the couch and get off the chips.

But how wear when, what to eat? And even, I mean, everyone can Google and be like, what are the top things I should eat for cardiac health? But then it's what I'm interested in, which is a psychology and the behavior of why am I not doing it?

Right? So let's stay on the sort of food that we, that makes us feel better or on the provincial side. I know I've had a nutritional coach in the podcast talk about exactly what happens when we eat and the God-mind connection and how it affects our mood.

And I'm super excited to have Umanaido come and talk about our brain and food and how it really has a correlation with depression and anxiety and some of the mental illnesses. But why is what we eat important in your field and for a reproductive organ or pregnancies? Sure.

So, you know, certainly nutrition is important. It impacts every single cell in our body, right? And it's going to impact different cells in different ways and it's going to, we have different requirements at different times, different times in our life.

And so if we're talking about the reproductive years, it's important that we have a, you know, for talking, you know, we can talk about certain foods or we can talk about macronutrients. We need to be focused on making sure that we're getting adequate nutrients, adequate energy, adequate protein. We need the building blocks to our home, our hormones, our hormones, our fats, their derived from cholesterol.

So when people are too restrictive in their eating, they may not have proper reproductive function because they're, you know, we don't have the building blocks to produce our hormones. When people are too restrictive, that can interfere with our ovulation. And then also on the flip side, when we eat in abundance, you know, in excess, that can also influence the, you know, very, our reproductive cycle, women, our menstrual cycle, is actually pretty complex.

There's a lot of moving parts to it. And so, you know, we have survived and we are as a species. And so the cycle itself is mostly preserved and pretty resistant.

But when we have the extremes that people find themselves in and either too restrictive or eating in excess, that can have an impact on our menstrual cycle. If we're talking about fine tuning though, there certainly are things that can influence in a more optimal way or a less optimal way. So I talk about really, I'm not a, my perspective on nutrition really tends to me from a positive nutrition standpoint.

So how can we introduce more goodness into our bodies? And I don't really like to focus on what we need to eliminate, which is what most people think of when they think of a nutritionist, somebody's gonna tell them, shake their finger at them and tell them to, you know, avoid this and avoid that. And I really try to be more positive in thinking, let's introduce more of this goodness.

And then as a result, it's gonna crowd out some of the things that are less healthy for us, right? If you're just really focused on how to get all the different particular nutrients that we need. If somebody, 'cause I think this is the question that you asked is attempting or desiring pregnancy.

A lot of times people think, well, I need to sort of shape up my life and my health three months prior to trying to get pregnant. When in reality is the egg that is recruited in a cycle to be fertilized actually is, first develops 290 or 300 days prior. So that's it, you know, several months, right?

That's about nine, 10 months that that cells are recruited. And then you think of all the things that you put in your body that either some are going to be beneficial, they're going to be full with antioxidants and prevent, you know, you're trying to reduce chronic inflammation. They're gonna influence that egg that single cell, you know, all those months preceding the ovulation.

And so you want to preserve the health of your future offspring, right? And so that's really what that is. So we have to think, I think the preconception period as being longer than three months prior, right?

So I think conventional recommendations are, okay, start taking your prenatal vitamin three months before you, you know, you tried to conceive. And that's really the recommendation so that people get adequate folic acid. And yes, that is incredibly important.

But I think we need to take a step back and really think about the whole body. And if we're really focusing on the quality of our eggs, especially for women who are trying to conceive maybe a little bit later in their reproductive life, you know, where we are concerned about equality, you need to really be thinking maybe even up to a year prior, right? And what about most of the audience in the podcast are women, my age, I started this podcast many, many years ago on sort of the divorce side of things.

And we are all in the late 40s, 50s, 60s in my current clients. You said something that I did not know, which is that food and nutrition effects are hormones and hormones are made of fat. So one of the issues we're facing in menopause and premenopause is lack of testosterone or like a disbalance of hormones.

What should we be eating or what type of goodness should we be adding to increase the stosterone, which I trying to exercise more to increase the stosterone? Yes. So there is evidence that maintaining your muscle mass actually is important for not just for that correlates, maintaining your muscle mass really correlates with health later on, right?

In our later years. But unfortunately, you can't wait to your later years to work on increasing your lean body mass or your muscle mass. But yes, having higher lean body mass does improve testosterone levels.

So that's really important. And so I think we need to change our thinking, right? For better or for worse, many people in their, you know, 20s, 30s, the focus is on a certain aesthetic, a certain appearance, a certain weight.

And we really need to be shifting that thinking to our strength, being strong, maintaining our lean body mass, appreciating the fact that our body composition may change and being okay with that and being okay in our skin because some of these changes are out of our control, right? We can't try and fine tune it. The goal even of care through the menopausal transition is to feel well and feel good in our bodies and minimize some of the unpleasant effects that occur in menopause.

But it's not to replace everything and be exactly the way that we were before, right? So it's embracing our new selves and that may include accepting the fact that we are have some changes in our body, but also focusing on preparing for later and how do we maintain our health and how and part of that really is through maintaining our lean body mass. In order to do that, because if you're somebody who really has not focused on your muscle mass until this point, because now we're hearing about it, right?

We didn't really use to hear about it. Now everybody's talking about it, which is great, but if you are playing catch up, then you need to make sure that you are getting at a quick protein and you will hear from everybody as to which kind of protein is better and how much do you need? And some will say you need old plant protein and somebody else will tell you, no, you need old animal protein and that can be very challenging.

There's lots of different messaging out there. My personal views that I think we need probably a combination of both and you can get your protein sources from many different places and there are benefits to both. And so that's sort of how I approach my own nutrition.

I think if you really truly are honest, or if we are truly honest, telling people that they can get all of their, meet all of their protein needs through plant protein is very challenging for most people, right? You have to be very, very specific and very focused on individual nutrients. And that is not good for everybody, right?

To be so controlling about how they eat, many people have, you know, disordered eating behaviors in the past and, you know, being so having to really be so fine-tuned to every gram and every meal, I think, maybe it runs counter to people's emotional well-being. But if someone is able to do that, right? And I know that I've tried to be vegan for a long time after listening to, you know, forks over knives in all this program.

I'm passionate about health, so I know enough. But could if I'm disciplined and make sure I'm having enough lentils and protein and peas that are really high in protein and broccoli and avocados, can someone replace? You can, you can.

But I think you have to work really hard in it. And so, listen, I love steak and chicken and fish. But at the same time, there are people out there really promoting this very high protein, very low carbohydrate, very high animal protein diets.

And there are some big influences out there promoting that. And I also don't agree with that because you're losing out so much on the benefits of all the fibers that you need for your gut, microbiome. And, you know, for the increased risks of colon cancer that come along with eating so much animal protein.

So we can ignore, you know, or just look at sort of different issues or problems in isolation. And I think that's what gets lost. Unless you have like a belief system that tells you you have to eat a certain way.

And that's fine. And I respect that. And then that's your motivation.

But if your motivation purely is health, I think we have to be honest. And that's where mine is, right? My priority is my health.

And that's what my that's my belief system. And so if we truly, truly are going to be honest, I think a some sort of balance where we're getting our protein from both plant and animal sources really is the way to go. Yeah.

And like you know, everything in life, I think balance. And balance is the way. You honor people's cultures and history, right?

Because when you remove that, then what? No, that's so much a part of you. And you have to find joy and not feel bad because you're honoring.

Yeah, because you're honoring your culture, but that's somehow wrong. I think that that's also not healthy. Yeah, not healthy.

And sustainable. I don't know if you've seen it. And if not, I highly recommend the Netflix series, Blue Sones and it's a study of centenials and what makes them live longer.

And I know that beans, it's one of the big things. And because of their high in protein and fiber. And I just happen to be the fibers.

The fibers are very important. And there's so many benefits for the test fibers I'm from the last talking about culture that I'm of Latin American descent. And we eat a lot of beans.

So for me, it wasn't this really hard thing to embrace to make lentil soup and chili concardin and black beans and have beans every week. So now I did hear you talking one of your videos about ages, advanced, like, occasion in products. And I really didn't get it.

What is it? What type of foods are they found in? And you're saying we should avoid them.

So what are they? We should limit them because some of them occur naturally. Right?

There are some naturally occurring ages. And what they are, an advanced, location in product, is when a protein or even a fat, or what we call lipoproteins, these are different chemicals that are found in our foods, are bound to a glucose molecule and glucose is the form of sugar that circulates in our blood. Right?

And that's glucose is the preferred fuel for our cells. Now, when the glucose molecule binds to the protein molecule, it forms this complex called an advanced, location, and product. And this can occur in the body.

If you have an excess amount of sugar in your bloodstream, it can bind to certain protein molecules. And we actually use one of those AGEs or AGEs as a marker of somebody's diabetic control. So when we do test what's called acetylated hemoglobin, or hemoglobin A1C, which tells us how somebody's glucose control has been over the last three months, approximately, that's actually an advanced, location, and product.

It's the glucose molecule binding to the hemoglobin molecule in our blood. Now, this can occur in our foods. And it occurs most frequently when you have a high protein food that also is heated to a high temperature in the presence of a refined carbohydrate, like a sugar or a refined starch.

So for example, if you take a piece of chicken, and you bread it and fry it-- - Chicken fat. - --like a chicken finger is going to produce these advanced, location, and products. - So this is very scary because we feed our children and our entire society with chicken fingers and fries, and some of this fries are powdered with flour.

- Yep. - Correct. - It's pretty scary stuff.

Yes, and any sort of sweet marinade that you may use or a glaze also can form these advanced location and products. - Yeah. - Like teriyaki sauce, if we heat it-- - Correct.

- --high, if it have to be heated and added to a protein. So teriyaki chicken could create ages, which is bad for our bodies. - Which is not great for us.

Now, we do have the ability to metabolize and excrete these ages. But when you consume more than your body's ability to excrete them, that is when we end up with problems. Because what happens is-- and we're not really sure why our cells have these receptors.

There may be some actually real function for these receptors in our cells. The age binds to the rage that's receptor for advanced location and products. Our cells have these receptors naturally.

Why we have them? It's unclear. But when that age molecule binds the receptor on the cell, it turns on different processes in the cell.

And so, and some of them can be negative. So the process of developing aphorosclerosis, which is the hardening and narrowing of our arteries, actually is this process where we have these advanced location and products binding to these rage complex. And this is causing fibrosis, which is scarring.

And that causes the narrowing and hardening. The arteries become less flexible. This can occur in many different places in the body.

I talk about it in PCOS. Because when this occurs in the ovary, it causes some thickening and scarring in between the little pockets. We call them-- they're follicles that house our eggs.

And it causes this thickening and scarring in between them and makes them more difficult for them to ovulate. And this can be a problem, even in somebody that doesn't have PCOS. But if they have this scarring and thickening around the ovary, additionally in the ovary in PCOS, when this molecule, this age binds to the rage, it actually turns on testosterone production, which is already a problem in people with PCOS.

And so I think this is a concept that is really under-disgust in popular and social media when we talk about nutrition and health. But I think it's a potent lever that we can utilize by making these changes. And it's not to say you can't enjoy them ever.

There are opportunities for you to-- you want to have-- it's like-- Fourth of July, and you're going to have barbecue. Great. You're going to have barbecue.

But should you be eating that multiple times a week, multiple times a month, overwhelming your body's ability to excrete them, probably not? So it doesn't mean never. It just means not all the time.

And the same goes for those chicken fingers and whatnot that shouldn't be your food every single day, every single meal. It doesn't mean you can't have them ever. But let's not overwhelm our body's ability to cope with it.

Can you revert the condition with nutrition? So if there are someone's working with you, and they're having a hard time ovulating, and they have a history of having McDonald's three times a week, and Popeyes and Chick-fil-A, and this is their main diet, can they revert some of that heartening in the vessels and in the-- But once you start to develop fibrosis, whether it's in your arteries or in your ovaries, that is much more challenging. Some of that, yes, many of the metabolic changes, so changes in the metabolism can be modified.

But once scar tissue develops in the body, it's very hard to reverse that process, wherever it is in the body. Well, this is really scary information, because I have teenagers who are yet to want to start chicken. I'm not here to scare people.

But we have to be knowledgeable when we-- Yes, and make choices. And I just think that we do change our biology every so often. You know, we regenerate tissue, and the more we eat better, the higher chances we have.

So you talked about PCOS, and I know that I had no idea what that was before the last two months that I met you, and I know we were discussing a few of my daughters. We think of this condition. Can you explain what PCOS is to my audience?

So polycystic ovarian syndrome is a condition that affects people with ovaries, mostly during the reproductive years. And I say mostly during the reproductive years, because even after menstruation ceases after a metapause, it doesn't go away completely as what was previously thought. And it is a metabolic and reproductive condition.

So a hormonal condition in which people with this condition do not ovulate regularly. They tend to have high levels of the antigen hormone. So this is higher levels of testosterone and higher levels of possibly the adrenal antigen.

And it goes along with insulin resistance. The vast majority of people with polycystic ovarian syndrome have insulin resistance, and that's part of the pathology. And it results in difficulty ovulating.

So either absence of ovulation, delayed mentees, irregular periods, infertility, because if you don't ovulate, you can't get pregnant. It also results in dermatologic conditions like cystic acne, facial hair growth, allopetia. So that's a lot of-- And that's fear of the extracellular testosterone?

Correct. That's because of the extracellular testosterone. It also results in difficulty losing weight, or-- Because of gaining weight and resistance.

Because of the insulin resistance, depression and anxiety are much more preperate in people with polycystic ovarian syndrome. And that's probably due to some organic factors, the elevated androgens and insulin resistance, and the impact that both of those have on the brain. But also the stressors of having a chronic medical condition as well, and how that impacts people's sense of well-being and stress levels and body image and all of that.

And so there is a multitude of different-- it's a syndrome. And so every person who has PCOS, their PCOS looks slightly different to somebody else's. It's just really a cluster of related conditions that go together.

And so sometimes people have it, have a lot of the dermatologic symptoms. And somebody else really has very little. Somebody else is what we call lean PCOS.

So they're a normal or low body weight. And somebody else is overweight. So it's challenging in that it doesn't look the same for everybody.

Right. And so when someone has some of these symptoms, it would be really good to work with someone like you to understand one, do they have it? And I believe they need a very customized solution to how to tackle it.

Yes. The challenge for whatever reason, oftentimes for many people, isn't getting diagnosed, which they're very now clear diagnostic criteria. So I think it's a problem still of education, educating practitioners on how to make the diagnosis.

And oftentimes people are not-- they don't get care because they're not given a diagnosis in a timely matter, in a timely fashion. So there's an education gap there, even amongst health care professionals. And then, yes, the customization-- it's time-consuming.

And it takes dedication both by the person who's experiencing the condition and also the person who's providing the care. It's time-consuming. It really, you have to develop this long-term relationship.

And we don't have these quick, easy fixes. And so, historically, what has occurred for many people with PCOS, if they were not interested in pregnancy at the time, the fix was oral contraceptives, which isn't wrong. It's still part of the toolbox of managing PCOS, but with very little education and very little other solutions to manage the condition.

And it wasn't really seen as the chronic medical condition that it is. And I don't think people really were receiving the education that they needed, connecting all the docs, all the different things that they were experiencing, and what their health risks are. And so, if you talk to somebody with PCOS, depending on where they are in their life, you may really learn so many other things.

And then you put them together and you say, "Oh, it's actually all part of the same condition." And so, we're treating isolated problems. And sort of just, you know, it's like, what's that game where you just hit the whack-a-mole, right?

You're just sort of like trying to hit things as they arise, but not really treating the condition as a whole, and not really looking at it in relation to somebody over the course of their lifespan. We're just sort of treating people where they are right now, and not really thinking about, this is what you, this is what to expect in the future, and this is how we can make the best of it. - Yeah, and it's part of the problem with the medical system and having one view, and even like one medical record of just working with you versus the same person going to a therapist or a psychologist to talk about their depression and anxiety, and the dermatologist to talk about their acne, and it's just everything is so...

I know that part of my business pursuits or visions is sort of having an all-united medical record that when they come to you, they see all this history and all this testing and all this exams, and all the meds that they're taking together with the nutrition to get that sort of holistic care. So it's part of your treatment in a poly-MD nutrition. - Yes.

- It's part of the solution to manage PCOS. So when you are helping someone through nutrition, are you also a coach, like a nutritional coach, to help them with their behavioral change aspects? Because there's, education is one of them, and it's really important.

Like I know that I change who I was physically after educating myself on what happens to my body when I eat processed food. So education is paramount. - Part of it.

- But it is, I am a coach, and I do help a lot of clients with weight loss and health, and it's not at all, I don't give any education. I'm like, Google it, you know, read this book. It's more about what your thoughts about who you are, and how do you feel about yourself?

And if they say, "Well, I think is I my thoughts love?" Okay, how is that affecting your emotions? And when you feel depressed because you think you're a fat club, what do you do?

I eat the cookie. So what do you rather think and where is that thought coming from? And how true is it?

And like so we work on that, as well as all this malfunctional beliefs that we grew up with with finishing everything in your plate. - All right. - And growing up with a scarcity mentality about eating out, and so you've never gone out, you know, your family grew up with small means, and you went out for dinner once every three months, you ate everything, you ate the entire buffet, and now we are professionals that can eat out every week, and we still eat the entire buffet, 'cause we...

So do you provide that? Do you refer that? How do you help people on the behavioral change aspect of nutrition?

- So it's a great question, because I get asked this all the time if I'm a coach, and I don't have any formal training in coaching, and I really am not familiar with the coaching literature, per se. My training, and this goes back to when I trained to be a a dietician, you know, and this is what, and then in the 90s, right, and 90s, and then early 2000s, when I was training to be a physician, was, you know, utilizing different strategies, and then some of the strategies I've sort of learned on my own. So I learned all about the trans theoretical model, right, this changes of change.

That was sort of the prevailing model of thought of behavior change, and I know there's multiple different models, and that was back, you know, back in the 90s. I trained to learn how to use smart goals, which I know are very popular, and it's very trendy now for people to use them, but that comes, and you probably know that that actually comes from management, right, the management literature, the development of smart goals really came from, this was in the 80s, and that came from business training, not from coaching, and now we've applied that in many ways to behavior change, right, but that doesn't come from, you know, we've taken many different disciplines, and I think there's a lot of overlap just in what we started talking about in terms of business and psychology and coaching, right, there is a lot of overlap, so you can use these different tools, and then utilizing mindfulness, which is so, that's such a, it's such a broad, right, that's a broad umbrella, and I first learned about, sort of mindfulness, 'cause I started to utilize, you know, mindfulness-based stress reduction back when I was, you know, struggling with infertility, but I didn't really fully appreciate what mindfulness was until much, much later when I just started to learn more about it, and wanted to be able to utilize some of them mindful eating approaches, and so I will use some of the mindful eating approaches with my, you know, my patients and my clients, but if somebody really has, 'cause for some people, they really need even more than what I'm able to provide, then I will refer, and so some people really need, you know, a coach because the, you know, just the mind shifts that need to occur are just more profound. For some people, it may not be coaching that they need, sometimes they really need psychiatric care or therapy to, so it's really gonna depend on what people's needs are.

So for some people, it is purely an education, right? They're gonna, they need to, they just, if you know, if you have that knowledge, then if you're in the right place in your life, then you can't implement it, but if you're not, if you're not in that place, then you can know all the things and you're still not gonna do anything about it. And so that's a completely different barrier.

And then there are other barriers that people just don't have, the time, they don't have this space, they don't have the resources to be able to utilize their knowledge. And so anytime somebody needs to make some changes in their health and in their lifestyle, you need to assess what the barriers are. And I think that is probably more important than anything else, because if the barrier is mindset, then coaching would be helpful for this person.

If the barrier really is, you know, depression, then that's gonna require a different treatment, right? If really it's resources, whether financial resources, space resources, so just a lack of resources that requires a completely different solution. And so I think that that is important that we recognize it's not just about the knowledge, because the knowledge will get you nowhere if you're not in a place to implement it.

- Right, and as I'm sure you've met thousands and thousands of patients who are highly educated and know what we should be eating and doing most of us don't, especially the women you meet with children and small children and trying to get their second. We, I mean, my children are grown now, but that was survival mode. - Yes.

- Exactly. - You're just trying to person to care of yourself and that is mindset, right? 'Cause like coach some of those people and they're like, well, how's that serving you?

- Yeah. - You know, you ask very tough questions and they're like, oh, not very well, right? Like, how is that serving you?

How is that helping you be a better mom and be, you know? And I think that when you were talking about mindfulness, especially with eating, can you explain a little more about what that is? I know you talked about being aware of your hunger needs and your, I would say before, and I'm actually, I'm gonna tell you something that I've probably never told anybody.

Because when I think of mindfulness, I have to think about the absence of mindlessness, right? And all the things that we do mindlessly. And that comes as you very well know from trauma, right?

That's a trauma response. - And-- - Let's call it dissociation. - We experience this in so many different ways, right?

And especially for women, there's so many different circumstances in which this may occur where you are forced to ignore your own needs, right? And this may be due to a traumatic experience. So somebody, you know, a violent experience or some sort of abusive experience that you, you know, experienced, but it may be in you're somebody that has a chronic disease, right?

Your chronic pain, your force just out of necessity to get through your life, you ignore, right? - Ignore the pain. - Ignore the pain because you just are forced out of necessity to go forth.

- And let me add, sometimes it's, 'cause a lot of people think, oh no, well I haven't had any traumatic events. I was not hit, I didn't have a car accident. But trauma and the most, one of the most impactful trauma is complex trauma, which is being a child of someone who worked a lot and was that constant neglect or that constant, your thoughts don't matter, your opinions don't matter, be quiet, you're too much, and you grow up thinking subconsciously, I'm not worthy.

- Yeah, that you need to say you're already, that you need to not afford it. - I need to, my needs never matter to my parents because they were too busy with five other kids or working and this is not about blaming any parent. We all tried the best we can, but if you think, and that's one of the things that come with the lack of nutrition is I'm not important, I'm not a priority, and that's how we carry ourselves, us mothers, us wives, where we're giving our children and our husbands the chicken breast and the broccoli, and we end up eating the leftover pasta in the plate constantly.

Or you're just fighting, you're so tired, you're a new mom and you don't have a lot of help, and you are just getting through on chronic sleep deprivation, right? You're not paying attention to your needs out of necessity, right? So some people have, if you're a mom of an infant and you don't have a lot of resources, you don't have human resources, you don't have a lot of help, and I see that a lot.

You know, when I was in my practice, I see that a lot. There's a lot of people in New York City, they're living far away from their families. It's very expensive and they're under-resourced and really experiencing this in this postpartum period.

So that's part of, you know, our post, so if you had a challenge in postpartum period, that's another instance in where you were forced to ignore your... - That's another traumatic event. - Correct.

- I thought to heal that. And I'm going to... - I'm going to...

- I'm going to posit one more. And I know you talk about this. A medical training.

- Very traumatic. - You're forced to, and I still do it now, but I don't have to do it seven days in a row where I work at night and I'm sometimes having to function on, you know, not enough sleep and I'm having to perform highly. And this is another way in which we are ignoring our body's needs.

And all of these things lead to mindlessness. And when I first came out of training, when I was a young doctor in residency or maybe even after residency in the early days of being a physician, I will tell you, this is the point that I'm going to tell you that I've never told anybody. That patients would say to me, I took this and I didn't feel well or I took this and this made me feel badly.

And maybe it was a treatment I gave them. Maybe it was a contraceptive, you know, and I would think, well, you know, I wouldn't say this to them, those patients, but I wouldn't believe them. I wouldn't believe them because the evidence and the literature would tell me, no, this, this works.

- It's not supposed to, it works and it's not supposed to cause any side effects, right? Or my patients would tell me, I know my body and when I eat this, this happens, you know? And I would say, yes, yes, and I would nod, but I wouldn't believe them.

Okay. I didn't believe that people really knew themselves. - So helps.

And it's not because they didn't know themselves, it's because I didn't know myself, right? And I couldn't trust my own body because I just gone through this experience, I had twins during residency, you know, I'd gone through infertility, I'd gone through a lot of things that I was forced to not... Feel, feel.

And it wasn't until I just started and I just became, and there was never like one particular aha moment, but just in the interest of trying to really help people better. And the more you hear different things and realize that people have different experiences, for me it forced me just to open my eyes and really, you know, say, wow, people actually do really know themselves and maybe the problem is I don't know myself. And so that sort of is when I really sort of started to think more about that and be more mindful for myself.

And so, you know, so that's been a journey and trying, you know, a journey of trying to not acknowledge things that are, you know, things that are happening either in my body or in my head or in my thoughts. But yeah, that's definitely been a journey and that's just helped me to be a better doctor. - Doctor.

- Just helped me to get better - Better eye evidence. - Better eye evidence. And yeah, and so on.

- And you're not alone. It's super sad, especially in this culture. And I know you listened to that episode where it's just shocking how you wanna choose this career to help others and you neglect yourself completely.

I mean, actually, it was my OBGYN, Dr. Okin, in Toronto, in one of the best medical centers because I had placenta, Privia on my first pregnancy. So I was seeing her every week and we became really close friends.

And she delivered all three children. And Dr. Ferris, she was there on a Friday and Sunday night, she was still there on a 36 hour shift.

And I'm like, how do you not sleep? How are you awake? How are you functioning?

It's really in Montreal, they had like a human rights violation. Like pilots can only work 12 hours. Truck drivers cannot work more than 12 hours.

You are saving lives and then liable in America. At least in Canada, there's very few little lawsuits. And yeah, my husband practiced in Canada and he loves it and misses it.

Like there's no lawsuits. People are like, "Dr. you're trying your best.

You're a human being. You chose this life to help others." - So refreshing.

- Oh, he loves it. There's no one there with Dr. Google, right?

They're like, "Whatever you think, when I go to my barber, whatever they want." And you know, it's honestly, it is, you're not alone and it is a traumatic response also to work that hard. With that need of connection versus protection and that need of look how smart I am because when I was a little girl, maybe that's one of the only ways I got a lot of attention from my parents.

It's like, look at that A+ look at those good grades. It's like, you gotta keep that hamster will going and working and working instead of like, this is not okay, this is not normal. It's, you're not alone.

And I know I converted my husband who's a chief of a department and he still has balance. And I'm like, it is not okay for you to work 80 hours a week, and then still be a good husband and good father. And even provide to your department and the residents what they need when you're so overworked.

So on that lovely note, Dr. Ferris, I ask all of my guests, what is healing for you and what would be the benefits on being mindful? - Healing for me, simple, obviously food, food is healing for me.

The all aspects of it, the tactile, so taking really honestly, the joy that I get out of the experience of the knowledge that I know, but also that I can just be creative with it. And I use all of my five senses and also learn and be connected to places and be connected to history. So, you know, just really loving and embracing that in a very positive way.

And that's, I think that translates into my approach with people, which I think people find unusual my patients, they think I'm gonna tell them, this is what you have to do and this is the plan, this is how you have to eat and that's not what I do. Nature, nature is very healing for me. You know, I live and work in a busy city that I love in New York, which I do love for all of its richness, but it can be right in overwhelming to the senses.

So nature, whether it's mountains or water, is very healing to me. And then something very basic is sleep. I used to have that, you know, belief is, I'll sleep when I'm dead, right?

And I just wanted to go to a very normal-- - Very normal medical. - Belize. - And just, you know, prioritizing it as so important.

And then I realized I said, I'm spending more time awake, I'm shortening my life, right? So, you know, using sleep and I've started to sort of track my sleep and work on my sleep hygiene. And that's really important.

So I used to be like, no, I have to exercise, right? And so it's a sacrifice sleep for-- So sleep, sleep is healing. It's the time that your body uses to heal, right?

Your, your, your cells, your body, your brain. So, reasonable things. - Food, thank you so much.

I love it. Thank you so much for being with me. - Thank you so much.

- And I'm so welcome. I feel like we could talk for-- - Yes. - Hours, please.

- Yes, thank you so much for being with me. I really appreciate it. And to my audience, please follow Dr.

Ferris at PolyPrep MD and share this episode with as many people as you can. Thank you. Thank you.