I have worked as a Cardiologist (medical doctor who specializes in the prevention and management of cardiovascular disease) in my hometown of Fort Myers, FL, since 2005. In treating tens of thousands of patients over the years, I began to recognize some recurrent trends. My patients have been getting progressively more obese and less active. They have been taking ever-increasing numbers of prescription medications, yet feeling progressively worse. In fact, some of the most common complaints I encounter are profound fatigue and lack of stamina. As a Medical Doctor, I began to feel that I was failing my patients. After all, my job is not only to prevent and treat cardiovascular disease, but also to improve my patients’ sense of well-being.
With all the medical advances in the field of cardiovascular disease, we cardiologists have done an adequate job at controlling high blood pressure, high cholesterol, and diabetes, and encouraging people to stop smoking. As a result, we have been able to lower the rates of heart attacks and strokes (although they remain the number on cause of death in our country, with cancer deaths being a close second).
These medical advances, however, have turned out to be a double-edged sword. We have come to rely too heavily on them, and as a result, many of our patients become overmedicated and over-tested as a means of managing their chronic diseases.
At almost every visit, my patients ask me which medications can be reduced or discontinued in an attempt to minimize various perceived side effects, financial burden, and complex regimens of pills. Sadly, during many patient encounters, I reluctantly must add or increase doses of these very medications.
One of the major factors contributing to overmedication, and thus a poor sense of well-being, is the increasing prevalence of overweight (BMI >25) and obesity (BMI>30) in our population. In the United States, over two-thirds of our citizens fall into one of these two categories.
Obesity and inactivity play a major role in contributing to cardiovascular risk factors, and are largely responsible for the epidemic of cardiovascular disease in our country. Discussing obesity and lifestyle with patients is always the proverbial “elephant in the room”. Many patients are self-conscious about their weight, some are in denial, and many oftentimes feel they are already consuming a healthy diet. Most have tried a variety of weight loss programs and visited with dieticians, but have failed to meet with long-term success.
Most physicians are so busy treating acute and chronic conditions, that they just don’t have adequate time to have a meaningful discussion about lifestyle during a routine office visit. Sadly, Medicare and commercial insurance does not consistently cover “obesity” as billable diagnose to cover a visit with a physician. This is unfortunate as it is truly at the root of most other billable diagnoses that are bleeding our Medicare system dry.
As a result, lifestyle recommendations are usually ignored or discussed only briefly. Studies confirm that, while we have made great strides in controlling blood pressure, cholesterol, and diabetes, and in getting people to stop smoking, we have made very little progress in getting people to change their diets or increase physical activity. Our diets and activity levels are habitual, and neither is easy to change without intense counseling and follow up.
Recognizing these many pitfalls, I decided that something needed to change in my practice to allow my patients to have an opportunity to not only manage their chronic diseases, but also to feel better.
It was around the end of 2013 (which coincidentally coincided with my fortieth birthday) that I began to take a greater interest in the role of food as medicine. I had always lived what I thought was a healthy lifestyle. I have exercised regularly since my early teenage years, and consumed what I thought was a healthy diet. The definition of “healthy eating” has changed a lot since I was a child, but I have always tried to avoid overindulging in things we always knew were blatantly unhealthy such as fried foods, butter, salad dressings, creamy sauces, and excess sugar. Despite this, my own cholesterol began to increase to levels that put me at risk for cardiovascular disease. I saw this as an opportunity not only to help myself, but also to help my patients.
Watching the documentary “Forks Over Knives”, a film which documents the benefits of a plant-based diet through the eyes of Dr. Caldwell Esselstyn, was life-changing for me. It marked the beginning of my journey down the road of incorporating dietary advice as means to treat not only myself, but the many patients I encounter daily.
I went on to watch several other documentaries which touted the many benefits of a plant based diet. I voraciously read books by experts in the field, including the landmark China Study, and subsequently earned a certificate in plant based nutrition through Dr. Colin Campbell’s course at Cornell. I started a recurring 10-day “jumpstart” program that allowed participants to fully immerse themselves in a food-provided, plant-based study for a short period of time and assess the relatively immediate health benefits. I began lecturing about plant based nutrition to physicians and in private communities around town to help spread the knowledge I found to be so vitally important. I became one of the original members of a “Food is Medicine” workgroup in our hospital system, an entity which has allowed us to change the way we provide nutrition to our hospitalized patients, staff, and visitors. Because of this renaissance, I’ve gotten the opportunity to meet some of my plant-based idols when our hospital system brought them into town to speak to the community. It was fascinating to s
peak one on one with Dr. Caldwell Esselstyn and Dr. Joel Fuhrman, and to enjoy plant-based dinners with Rip Esselstyn of Engine 2 fame, Nelson Campbell, and Dr. T. Colin Campbell. I continue to spread my passion for plant-based nutrition through social media. In essence, this movement has come to define who I am as a Cardiologist.
Despite my efforts, I feel that I have only scratched the surface of bringing this movement to its full potential. As I continue to work as a full-time cardiologist who attempts to incorporate lifestyle medicine with traditional medical care, I have been somewhat limited in my ability to distribute this knowledge to all of those who can benefit. It is my hope that this Vibrant Beat website will serve as a forum for people to gain knowledge on plant-based health, physical fitness, and traditional cardiology.
I hope to bridge the gap between conventional medical care and lifestyle wellness, and to provide nutritional advice and physical fitness guidance to those who are searching.
Now that I have introduced the concept of the Vibrant Beat, I’ll take a brief opportunity to review some of my own professional background. As mentioned, I currently work as a Cardiologist in Fort Myers, FL, having moved back to the town where I was raised once I completed my medical training. My wife and I both attended the University of Florida for undergraduate studies and medical school, and I am honored to currently be serving a four-year term on the medical school alumni board there.
I met my wife in medical school, and we both completed our residency training at Virginia Commonwealth University in Richmond, VA, where we both served as Chief Residents in our respective fields (she in Pediatrics, and me in Internal Medicine). We then moved to St. Louis where I completed my Cardiology Fellowship training and served as the Chief Cardiology Fellow at St. Louis University. Since returning to town, I have been actively involved in the Southwest Florida Chapter of the American Heart Association. In addition to serving on their executive leadership team for many years, I was co-chair of the Lee County Heart Walk in 2014, and currently am serving a 2-year term as the Board President. I was also fortunate to spend 6 years as a board member for the Florida Chapter of the American College of Cardiology, which enabled me to have some advocacy roles and influence political policies regarding healthcare.
When I am not working, I love to spend time with my family. We love to cook, eat, watch movies, travel, and stay active. I have always had a passion for cooking, which has been another reason I so thoroughly enjoy teaching a about plant-based diet and food preparation. To me, perusing recipes online, reading cookbooks, and just preparing meals in the kitchen is a great way to relax, and I am excited to share some of the many wonderful recipes and food blogs that I routinely enjoy. I hope that you will enjoy reading my blogs as much as I enjoy writing them!