Ep. 47: Joel Fuhrman, MD – Recovery Nutrition: Figuring out the How and What

When it comes to food, it’s nutrients, not calories that really count.

‘Calories in – calories out’ is the motto of most fitness enthusiasts and those who want to lose weight. But there are things that are way more important than only calories – the nutrients. And not just the ‘macros’ popularized by gym culture, you know, carbs, protein and fat – it’s micronutrients that matter.

When we talk about health and healing it’s important that we focus on those (as well as getting enough calories in so that the body can recover). Because remember, healing an injury, especially a difficult one is not the time for any diets.

Dr. Joel Fuhrman has been at the forefront of the nutritarian approach to eating for decades – and besides being a six-times NYT best-selling author, he’s advised professional and Olympic athletes, lectured to athletic trainers, and world-class athletes about maximizing performance in preventing injury.

In this detailed talk about eating for true health and ‘play-span’, you’ll discover:

  • In what ways the diet differs for people who are injured in those who are not.
  • How to make a dietary plan for your recovery.
  • What to do when you’re diagnosed with osteopenia or osteoporosis after a fracture.
  • What combination works really well for the patients who suffer from fibromyalgia.
  • How to avoid tendon pain and complications by taking care of diet.

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Show notes & links

The show notes are written in chronological order.

  • Joel Fuhrman’s website: https://www.drfuhrman.com/
  • Joel Fuhrman’s book:
  • Brasky, T. M., Krok-Schoen, J. L., Liu, J., Chlebowski, R. T., Freudenheim, J. L., Lavasani, S., Margolis, K. L., Qi, L., Reding, K. W., Shields, P. G., Simon, M. S., Wactawski-Wende, J., Wang, A., Womack, C., & Manson, J. E. (2017). Use of Calcium Channel Blockers and Breast Cancer Risk in the Women’s Health Initiative. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology26(8), 1345–1348. [read it here]
  • Owora, A. H., Kmush, B. L., Walia, B., & Sanders, S. (2018). A Systematic Review of Etiological Risk Factors Associated With Early Mortality Among National Football League Players. Orthopaedic journal of sports medicine6(12), 2325967118813312. [read it here]
  • Erik Schlopy is an outstanding elite ski racer, a three-time Olympian, seven-time US championship, World Pro Super G champion, World Championships bronze medalist, and winner of a FIS Crystal Globe for his success in World Cup races.

00:00 – excerpt from the episode
01:35 – intro (listen to discover a little more about your host. Martin will tell you a new lesser-known fact about Dr. Maya)

Dr. Maya Novak:
‘Calories in – calories out’ is the motto of most fitness enthusiasts and those who want to lose weight. But there are things that are way more important than only calories – the nutrients. And not just the ‘macros’ popularized by gym culture, you know, carbs, protein and fat – it’s micronutrients that matter. When we talk about health and healing it’s important that we focus on those (as well as getting enough calories in so that the body can recover). Because remember, healing an injury, especially a difficult one is not the time for any diets.
I got connected with Dr. Joel Fuhrman in 2019 when he agreed to do an interview with me on my Mindful Injury Recovery World Summit. We talked about different kinds of diets and dietary plan for recovery, pain, fibromyalgia, and many other things that you might find helpful. Enjoy.

Dr. Maya Novak:
In this interview, I’m joined by Dr. Joel Fuhrman who is a Board certified family physician, nutritional researcher, and six-time New York Times best-selling author. He specializes in preventing and reversing disease through nutritional methods. Dr. Fuhrman coined the term nutritarian to describe his eating style, which is built around a diet of nutrient-dense plant rich foods. Dr. Fuhrman is also a former world-class figure skater and has advised professional and Olympic athletes, lectured to athletic trainers, and world-class athletes about maximizing performance in preventing injury. Dr. Fuhrman, thank you so much for being here.

Dr. Joel Fuhrman:
My pleasure. I’m looking forward to our discussion today.

Dr. Maya Novak:
I usually start the interview with a question about your story, and I’m really interested in why you decided to become a physician, and when did you become interested in nutrition as well?

Dr. Joel Fuhrman:
Well, I first became interested in nutrition and natural healing in my teenage years after a combination of my own competitive athletics, my ice skating career and wanting some better stamina for performance. But also that my father was sickly and overweight, and he had medical pain in his back and his body, a lot of muscle spasm. He learned about nutrition, lost weight, improved his inflammatory, and reduced his inflammation. So I started reading the books he was reading also when I was a teenager. When I finished my skating career – and I did have to curtail my skating career because of an injury – a severe injury. But then I realized I had a passion for nutritional excellence as a therapeutic modality to help people get well from being overweight, from diabetes, from autoimmune conditions. My exposure to natural therapeutics in my younger years showed me that people could make a complete recovery from chronic diseases like lupus, psoriasis, fibromyalgia, and pain syndromes, as well as get rid of diabetes and not have heart attacks and strokes. I knew that the medical profession had deviated into a direction where drugs and prescribing medications became the primary tool they utilized, which left the cause of disease untouched and unaddressed and people were suffering and dying needlessly. So I became excited about being a physician and utilizing nutrition as a primary therapeutic modality and then pursued going back to medical school for that purpose. So I didn’t become a doctor first and then develop an interest in nutritional medicine. I developed an interest in nutritional medicine first, and that drove me to go back to medical school and get my degree. Then I’ve had this 28-year career now of being a physician specializing in nutrition with tremendous personal satisfaction from watching people make recoveries from what are considered incurable illnesses. People getting well from psoriasis, autoimmune, hepatitis, fibromyalgia, asthma, severe and advanced heart disease, multiple sclerosis. In other words, I’ve been able to use nutrition to see people make complete recoveries that you can’t achieve with medications. I mean the first thing we learned in medical school that people have to recognize is that drugs are toxic, and many of them, perhaps the majority of them, even increase the risk of cancer and are mild carcinogens. Blood pressure medications – a lot of them are documented to increase the risk of cancer. For example, a study of calcium channel blockers to lower blood pressure showed it doubled the risk of breast cancer after 10 years of use in a study that was recently published. So we’re saying here that we want to give people the opportunity to make complete recoveries without relying on drugs and being medically crippled and having to take drugs for the rest of their life. Nutritional excellence is tremendously powerful and that therapeutic potential has been unrecognized and not considered by the majority of our population.

Dr. Maya Novak:
So did this knowledge that you had about nutrition – how did this help you in regards to your performance as a figure skater? Did you notice any difference? Can you talk about this a bit?

Dr. Joel Fuhrman:
Yes, because as an athlete myself, but also as a coach and giving my input to hundreds of word class and Olympic athletes, we noticed that it’s not – and there’s a lot of top athletes that are using this nutritarian, high nutrient eating technique today to extend their career. You can imagine that the top tennis players in the world like Roger Federer and Djokovic and Rafael Nadal, for example, they want to prolong their career, and not be injured. They want to keep more youth for longer. It’s not just being able to run fast or hit the ball harder. It’s to be able to keep their youthfulness so they can keep their recovery and their agility and their speed. The point is the same thing is true whether you’re a basketball player or a tennis player, or a world-class skier. Look at Eric Schlopy from Park City, Utah. He was in four Olympic games. He prolonged his career by eating so healthfully and I advised him about how to eat healthily and eat all these high nutrient foods which make you age slower. So what I’m saying right now is the same factors that enable us to live to be a 100 years old, and enable us to age slower and to keep our mental faculties, and our physical ability intact as we age, are the same things that’s going to keep athlete aging slower. And maintaining their physical power and agility and athletic ability into the longer years and to be able to prolong their competitive careers. Do you follow me? So it’s not just about seeing the immediate results, because you may not see immediate results. Of course, it does give you better stamina and better response to exercise, but still, the immediate result – because you can be a great athlete eating junk food too, but the problem is you’ll burn out your career and you won’t last because you’ll age yourself too fast. The people – the occupation with the shortest lifespan according to the NOSH study are linebackers on football teams who ate a diet to get so big. So they now weigh between 250 and 300 pounds and they diet they needed to eat to get that large cut short their longevity and they die prematurely of heart attacks and cancers and they age very fast. So the goal isn’t necessarily to be as big as possible or to be as strong as possible. The goal is to be as fit, to be lean, to age slower, and to be able to – whatever athletic ability you have – to maintain that and not lose it as you age. I mean I’m a good example. I’m 65 years old and I can do – I downhill ski on Mobiles, I surf and do sand volleyball, whatever is on the plate. I play singles tennis a lot, or whatever it is I’m doing. I enjoy doing sports that I did when I was younger and I can still do them at the same level I did when I was in my 20s and 30s, even better because I’ve had more time to perfect my technique in tennis, for example. So I haven’t lost my speed, my agility, my enjoyment of doing physical things because I’m eating so healthfully. So it makes – we’re talking about health span and we’re talking about lifespan and we’re talking about play span. The word play span means you want to fully enjoy all the things you want to do in your life, and the reason why I encourage people to eat so healthfully is because you learn to like it and you get used to eating it. You can make natural foods taste great. You can really love eating this way, but it gives you that play span ability in life to enjoy playing and enjoying your life more as you get older. You don’t just become a couch potato.

Dr. Maya Novak:
Yes, true. So would you say that there is a difference – I think that you already sort of answered this - but would you say that there is a difference in regards to the diet if a person is completely healthy, those who are injured, or those who have chronic disease. Is the optimum diet for them the same, or is there any kind of difference?

Dr. Joel Fuhrman:
Well, I think what you’re saying is true and the idea is basically correct. In other words, the same diet that maximizes lifespan and is so healthy for your immune system to fight cancer is going to make for better profusion of antioxidants, phytochemicals, and nutrients to the tissues to allow them to heal and reduce inflammation after an injury or with a pain syndrome. So that’s true, that the general nutritarian diet checks off every box and doesn’t miss anything that will extend human longevity and slow aging. However, with the response to an injury or with healing - the response to certain injuries – we have to make sure as the diet is largely plant-based that we have adequate protein, adequate calcium, adequate Vitamin D, adequate Omega 3. We have to make sure we have enough of all the nutrients needed to maximize healing, and that’s where we use certain foods that are high in plant proteins to help healing like hemp seeds, it might be edamame, or it might be something like Mediterranean pine nuts. We use a lot of beans and green vegetables especially broccoli. We use grains like quinoa that are higher in protein. In other words, we still want to keep the diet relatively low in animal protein, because animal protein can be pro-inflammatory and promote gram-negative bacteria in the gut. Those gram-negative bacteria can then promote TMAO, which is Trimethylamine N-oxide, which is a pro-inflammatory compound increasing the risk and decreasing circulation and increasing inflammation. So we want to still keep animal protein low. To do that, we want to look at certain foods that are more adequate in plant-proteins. So we’re letting the person, obviously, we’re still eating fruits and whole grains, but we’re not making the diet predominantly fruit. We want people to have enough higher protein plant material and that, of course, means beans, nuts and seeds and green vegetables included sufficiently in the diet to keep to that 30 grams of protein – at least 30 grams of protein per 1000 calories to get people at least over that. We try to get people up to that 60-80 grams of protein day, even if their diet only has 1600 to 1900 calories, we still want get them to at least 60 grams of protein a day. So we modify that and we adjust the diet accordingly. It’s almost like the same diet style you would give to a world-class competitive athlete. And by the way, Venus Williams was a person who had Sjogren’s syndrome, who had to leave the tennis tour because her autoimmune disease was too severe and the pain was too severe to play tennis. Then she changed her diet, went on essentially – what’s essentially my nutritarian approach – recovered from her Sjogren ’s syndrome, and went back to playing tennis competitively at a world level again. So it just gives you an example of how this anti-inflammatory approach can promote healing. If you have an injury like after a car accident, or surgery, then we have to just take the same approach but make sure we pay attention to the protein adequacy. And some nutrients that as your diet moves towards a vegan diet, or flexitarian diet, as you reduce animal products in the diet to lower levels, then you are getting less zinc and less DHA. So we have to make sure we supplement appropriately to make sure we have enough Vitamin D for healing, enough zinc, and enough DHA. And perhaps a little bit of food derived calcium in very low amounts. Not in high amounts. Like we’re talking about not taking a 1000 milligrams of calcium, which could spike calcium in your blood and make for calcium and depositing calcium in spots where it shouldn’t be deposited. We’re talking about food derived calcium, so we’re getting a diet that has about 500 to 700 milligrams of calcium in it and then we might give a little more, like 150 to 200 extra with each meal of food derived calcium to make. So we don’t spike up calcium high in the blood but just supply sufficient amounts coming in during mealtimes as food to maximize the body’s repair of bone tissue that’s been injured.

Dr. Maya Novak:
So would you say that after an injury, since we are talking about injuries, would you say that it’s really important for a person to work with a registered dietitian or a physician like yourself to make a plan in regards to diet? Or is this something that people can test and do on their own? Or is it better to also ask? If we are talking about getting nutrients from diet, how do we know how much we have to supplement?

Dr. Joel Fuhrman:
Thank you for that question. Well, I have a book called Super Immunity which I think is a good book that can address this issue for people. Because they can’t count on their local dietician, nutritionist, or doctor giving the right advice because the advice scans the gamut of all types of advice from good to bad. There are people advocating high protein diets like paleo diets, or ketogenic diets after an injury and those are a very dangerous way to eat. Then there’s other people not being careful and telling you to just eat potatoes and rice like a macrobiotic diet or something and that’s going to be adequate. So I think we have extremes in the dietary political spectrum and we have to focus. I think the World Health Organization and most nutritional scientists today recognize that fruits and vegetables in sufficient quantities, nuts and seeds, and beans, are extremely important to get the phytonutrient exposure we need to maximize healing. I have an acronym – that’s GBOMBS. Greens, Beans, Onions, Mushrooms, Berries, and Seeds. Seeds referring to flaxseeds, chia seeds, sesame seeds, sunflower seeds. So in other words, I describe this - and I went into that in my book Super Immunity – how each one of these food categories are very powerfully protective against cancer. The same foods that are maximally protective against cancer reduce inflammation, reduce your chance of getting an infection, and increase your body’s ability to heal after injury. So we want people to have a lot of green vegetables in their diet. Like their meal for lunch, for example, might be a big salad with a nut and seed based dressing, so the lipophilic nutrients that absorb with fat can maximally absorb. And then, of course, a vegetable bean soup, where you get the beans into you. So we have the diet designed in a way so people can make it structured to make sure they’re getting the most powerful level of nutrients in their tissues. Then as move people towards a diet that’s plant-based or predominantly vegan, we’re saying that the animal product consumption in the diet that maximally enhances healing and longevity, should never be over 10% for anybody – of calories. And preferentially, it should be below 5%. So we’re talking about in that 0-5% range of animal products. Either your diet is vegan, or you’re just using animal products as a condiment in small amounts because too much animal products in your diet drives up certain factors. Like we’re talking about TMAO and inflammatory compounds, or IGF1 it drives too high and that promotes cellular replication and growth too much, which is not good for adults where excess growth can promote cancer. So we’re keeping animal products relatively low, and even if you go up to a little higher levels, to 10%, they shouldn’t go past 10%, and then after you’re done with your recovery, you should go back to 5% again, or below. So we’re talking here about modulating that. Then the nutrients that people would need, we’d consider supplementing with when they’re after an injury to improve healing because we’re looking at the nutrients that should be supplemented in a diet that’s restricting animal products. Those are the fatty acids, EPA and DHA that we commonly get from fish or animal products, so a little supplement of that. B12 which is present more in animal products, zinc because you only absorb about 20% of the zinc in plant foods and zinc is very important for immune function and to promote healing. We have to make sure that the diet has enough iodine because iodine – it comes from sea vegetables and sea-foods - but if you’re not eating seaweeds and sea-foods, we just have to pay attention that there’s an iodine source in the diet. Then we’re also looking at giving a person after an injury a little extra K2, and a little bit of extra food-derived calcium. So it’s making sure Vitamin D, K2, and food derived calcium are supplied to maximize bone healing and that kind of repair. So think that pretty much covers the supplements that people should consider. Also, I think I – in my books and on my website I try to give people guidance and give people the information obviously they need if they want to have – treat their diet – to make it so therapeutically excellent so they can maximize healing. But also maximize healing and getting well from autoimmune conditions like multiple sclerosis, and lupus, and scleroderma, and even things like asthma. So we want people to maximize their nutrient intake and recognize that if you do the whole picture, they’ll be best off long term - the whole picture of all these factors. A high green diet, usually mostly greens, beans, onions, and mushrooms. So when you eat the greens, beans, onions, and mushrooms it helps the growth of the favorable bacteria in the gastro tract, the anti-inflammatory bacteria. These same anti-inflammatory bacteria from eating greens, beans, onions, and mushrooms, they thicken the microbiome – the biofilm that covers the bile. So my fingers are the fingerlike projections that form the lining of your intestines, your small intestines, and they get coded with bacteria that now slows the absorption of glucose. So if you eat a mango, the sugar from the mango comes through more slowly because you regularly eat greens, beans, onions, and mushrooms. So the whole diet is put together in a way that maximizes the benefits and minimizes any negatives to make you age slower and heal better.

Dr. Maya Novak:
That’s perfect. So much great advice. I have a question in regards to percentages because we all understand what 100% is and what zero percent is. However, when we are talking about – let’s say 5% of animal products. If someone doesn’t want to go completely plant-based or they’re doing this slowly, what does it mean, 5% in a diet? Or what does up to 10% mean? Is this like one egg per day? Or is this more like a weekly basis?

Dr. Joel Fuhrman:
That’s correct. I mean the American diet right now is over 30% of calories from animal products and most people eat animal products three times a day, or at least twice a day. So we’re talking about if a person goes down to not more than 10%, they should limit their animal product consumption to about 15 ounces per week, which would mean a small piece of four to five ounces, and three times a week would be 10%. As you move to 5%, it’s usually not more than eight ounces per week, which would be two servings a week. Or if you want to use animal products as a condiment, it could be two ounces or a small amount as a flavoring four times a week. So we’re talking about your diet being predominantly plant-based. The word based means the majority of calories. I don’t know if plant-based means vegan or not – do you know what I mean? So we’re not sure what that word means. We know we want to make it plant rich so you’re mostly eating plants. If you are eating animal products, you’re not using it as a main part of a meal. You’re eating it as a flavoring for a vegetable dish or something. Like cooking in a wok and throwing in snow pea pods, the bok choy, the cabbages, the onions, and the mushrooms. You’re putting all these onions and mushrooms and cabbage and nutrients, and you’re cooking it in water for a couple of minutes. You’re putting a sauce on it. I sometimes use a – I call one of my sauces – I call it a Mexican ole sauce. It has like tomatoes and spices in it. Or a put a Thai curry sauce that has hemp seeds and lemongrass. So I have all these different sauces to put on these vegetables. Then if you wanted to add some animal products to it, or a little bit of seafood into it, use a small amount per person. Or a little bit of – we’re talking about yes, that the diet – that a nutritarian diet that I’m discussing today could be vegan, and we can use the plant, you know, we can carefully design it to make sure it’s adequately vegan. Or, if a person wants to use animal products like you were saying, it’s curtailed to a smaller amount. Certainly not a maximum of 10%, but to maximize lifespan and healing from heart disease and diseases where you’re too heavy, we certainly want to keep it below 5%. So we have to adjust that because I do think that the scientific literature seems to indicate that we can slow aging, and to maximize lifespan, holding animal products below that 5% figure is probably even better than 10%. But above 10%, we see almost all genetic types start to raise IGF1 into the unfavorable level that might be able to promote cancer in that genetic subtype.

Dr. Maya Novak:
Great. So, in regards to bones and fractures - if an accident causes a fracture, this is often the first time for some people that they discover that their bones are not as strong. So they get a diagnosis of osteopenia or osteoporosis. What should you do when you get this kind of news? Usually, it is the doctors who will prescribe medication. What is your opinion about this? Can a change of diet help?

Dr. Joel Fuhrman:
That’s right. Well, you’re right that Vitamin D deficiency can increase the risk of osteoporosis and also, of course, excess animal protein because it makes too much acid in the blood, can predispose you to osteoporosis as well. But that said, the diet could help you modulate – Vitamin D and calcium and protein and things could be negative or positive. Exposure to green vegetables is very helpful with the bones. But the main factor that determines your bone mass is the exercise you do, because your bone mass is proportional to your muscle strength. If your muscles are wasting and getting weaker, then your bones will get weaker as well. And after an injury, and when you’re in a cast and when you can’t move, you have to expect some osteopenia and muscle wasting to occur. That’s where it’s so critical to do the rehab and to build back and to gradually build back strength in the muscle because muscles and bones growth together. So as the muscle gets stronger, the bone gets stronger. As the muscle gets strong, the bone gets more dense – that muscle moves. So we have to give people the right type of exercises and after injury too, we can have muscle contraction and muscle spasm. The muscle spasm and muscle contraction can impair the blood vessels bringing the nutrients into the tissue and it can impair the nerves. It can cause pain and the nerves can become more anoxic or more inflamed due to the lack of oxygen due to the contraction of that muscle tissue. Because the muscle tissue is contracted, we’re not getting anti-inflammatory and healing nutrients into the tissue as well.

Dr. Maya Novak:
We'll continue in just a moment. I wanted to quickly jump in for two things. First, thank you for tuning in. And second, I’m sure you have at least one friend, colleague, or family member who would very much appreciate this episode. So share it with them and help us spread the word. Now let’s continue…

Dr. Joel Fuhrman:
So it’s not just exercise, we’re also – what my patients and the patients that come to our retreat too, after an injury – we give them what we call regenerative, neuromuscular therapy. Which means that we give them pressure, pumping pressure on the injured muscle tissue in the area of injury, especially we palpate and try to find, for example, where the spots are that are tender, and where the muscles are that are becoming hard and aren’t soft. Healthy muscles should be soft and they shouldn’t be tender, and if you present on it, it shouldn’t be in pain. As muscle gets injured, it gets harder and more tender and blood is not flowing. So we don’t want to rub that tissue. We don’t want to massage it. We want to just pump it down enough. We just want to get pressure on it. We want to use fine skills of palpation and you can’t always do to yourself, you need a therapist or somebody to do this for you. You want to feel and find the tissues that are more hardened, and the muscles that are more tender and an irritated. The practitioner can feel it because they can feel which muscles are harder, and then without rubbing to irritate to issue, they can just press with a tool or with their thumbs or with their hands or with their wrists or with their elbow. They can just compress the tissue by moving their compression up and down, by just moving an eighth of an inch at a time up the muscle. And we want to treat the whole muscle from origin to insertion, not just the area in the center where the trigger point is, or where the pain is or it is isolated to. So we want to treat the whole muscle because the blood vessels and the nerves run the whole length of the muscle, and we want to increase the fluid and the lymph – we want to move the lymph and the blood out and in by pumping the tissue. By pumping the tissue and by pressing it down enough and flattening the muscle and allowing blood to rush in, and flattening the muscle and allowing blood to rush in we help to move lactic acid, we help restore blood flow. We can, with a time of doing that therapy, soften the tissue which helps increase healing. So all of these things play a role in the healing process and removing pain because you can’t exercise the tissue too well if it’s in spasm and the muscles are too tight and not getting flow. You’re just putting strain on the other muscles that are healthy and when you strain a muscle, it can go back into spasm or it can go into spasm. So we want to increase all the muscles because if some are in spasm and you exercise it too much, it’s not going to be good for the other muscles to put so much strain on them. So we want to restore the function of all the muscles in the area by giving it a little bit of what we call regenerative therapeutic – regenerative neuromuscular therapy – which is a type of massage, but the reason I don’t use the word massage is because massage means rubbing the tissue. If you rub the tissue, you can irritate it and then you can’t do it the next day because the tissue got sore from rubbing. So we don’t want to do rubbing on the tissue to press it or rolling the tissue to get it soft. We want to just straight down with pressure in one direction and release it to come up on the tissue and not rolling, pressing or rubbing too much. By doing it that way, by using the technique of just moving an eighth of an inch at a time, and just using downward pumping pressure, we can make it so you can do the therapy every day because your muscle doesn’t get sore if you don’t rub. So you can do it on Monday, you can do it on Tuesday, you can do a therapy again on Wednesday. You can do a little therapy if you want, twice a day. It doesn’t irritate the tissue. With more traditional massage or even Thai massage, which are deep tissue massages, sometimes the tissue gets irritated and you need a few days of rest before you can massage again because the tissue is too irritated by rubbing. So this, even though it may be more uncomfortable to press hard tissue with such strong pressure, you’re not going to irritate tissue. And the person, after you’ve finished the therapy, they’re going to feel fine. They’re not going to feel sore after the therapy. Do you know what I mean?

Dr. Maya Novak:
Yes. I wish I had known about this six years ago when I fractured my ankle because I can share with you that, first of all, I was non-weight bearing for 12 weeks, but the recovery was long. I experienced so many – I called them muscle knots in my calves.

Dr. Joel Fuhrman:

Dr. Maya Novak:
So I think that what you just described with the therapy, this is exactly what would have helped me and can help people, right?

Dr. Joel Fuhrman:
Yeah, absolutely. It’s so common to have these cords in your calf that tighten up like ropes. They’re like ropes, and they’re tender and they hurt. There’s no way you could fix that just by stretching it or exercising it. You need somebody to get in there and to soften them with the therapy we just described. So it’s very, very helpful for something like that because it’s common. People get them in their neck, in their shoulders, in their scapulas, they get them in their thighs, they get them in their hamstrings. They get them around their hips and their glutes too, and they think oh, it’s hip pain and back pain because your hip and your glutes are connected to your lower back and in your back and when you get these spasms in your glute muscles it can cause pain in your lower back, so these pains radiate. What’s the word – it’s so effective when you combine the high nutrient type with the right type of physical therapy that we’re talking about. Gentle stretching, the muscular rehab, the therapeutic – the therapy on the muscle – because we’re finding that we feed the body with these greens, with these high green nutrient foods, with these green juices and the high nutrients. The nutrients don’t get into the tissues, into the muscles for healing, unless we start to restore the muscle flow due to relaxing some of those tissues because the type of muscles that are in spasm and contracted, even though you’re eating right, could prevent healing. That’s why when people come to us with what’s called fibromyalgia, which means they have pain all over their body. They have pain, it hurts. Their back hurts. They’re sore over here. They’re sore in their neck. They’re sore in their glutes. They’re just sore all over. You try to do therapy, it doesn’t work. You try to feed them right, it doesn’t work. But if you combine the two, if we give them super good eating with the therapy, they can make progress and get well. I have a retreat in San Diego where people come and we have them live there for a month or two. We’re able to give them therapy on a regular basis while they’re eating really super healthily and we have a lot of people with these conditions that are able to get well from fibromyalgia and pain conditions because we’ve softened the tissue and fed the body with lots more nutrients at the same time.

Dr. Maya Novak:
Perfect, because if someone already has fibromyalgia it can be especially painful after the injury. So I can imagine how incredibly important your approach is, and this the combination. I have a follow-up question in regards to nerve pain and what you described, the contraction of the muscle, and how this affects nerves. Because people often ask me about this nerve pain and if it’s normal? Doctors usually say well, just wait and usually it’s going to get better. So can nerve pain also just be a result of this contraction of the muscles?

Dr. Joel Fuhrman:
Yes, absolutely. When the muscles contract into spasm it can create lack of oxygenation of the muscles and the nerves that penetrate that muscle and the nerves can be become inflamed and they become chronically injured from the chronic spasm and sometimes people don’t have it adequately treated. Their marginal nutrition and not treating the cause of the muscle spasm and not having that addressed means the nerves continue to get injury and they can develop chronic pain that doesn’t go away. Then they go to a doctor and they get put on opioids and narcotic medications and they give them anti-seizure medications like Gabapentin and Neurontin. In other words, it can raise a whole vicious cycle of bad health, because now you didn’t solve the problem. You have chronic inflamed nerves due to the muscles that were injured from an injury where the muscles got trained in response to the injury or the muscles went into spasm. It went into spasm, and it stayed there a long time, and the nerve now became injury. Now you have chronic pain. Then you go to a doctor and you’re not eating right and then you’re prone to inflammation due to your poor diet. Then you go to a doctor and he gives you drugs and the drugs are toxic and they reduce your pain, but they make the injury become more – how should I say – impose a degree of chronicity to the injury. You become dependent on these medications and you have a whole vicious cycle with the person and it becomes a long history of chronic pain that could have been solved more simply. We have to unravel that onion to get these people well again.

Dr. Maya Novak:
In regard to pain and medication, in my experience, after really strong pain killers like morphine and opioids in general, usually people are also prescribed laxatives because they, of course, cause problems in digestion. Now, I would love to discuss with you, can people actually do anything with their diet so that they don’t rely so much on the laxatives? Does it have any role or not?

Dr. Joel Fuhrman:
It certainly plays a role, and obviously, people are getting the idea from listening to me talk during this – from our discussion here – that I’m recommending a diet very high in vegetables and very high in fiber. The high fiber makes your bowels more normal, but that doesn’t mean some people are still not going to become constipated from opioids. In other words, some people are just going to be constipated from opioids no matter what they eat. It will still help, but it may not solve the problem completely. So opioids are still a problem. That’s where we’re knowing that if you can get some degree of pain relief from a CBD or a THC or a cannabinoid – some of those products- because some of those you can build up a tolerance to them and the – how should I say? Those products derived from marijuana which are not constipating – just like opioids, you start taking them and then you start building up a tolerance to them. They start to make you sleep and remove your pain, but then after you’ve taken them for a while you need a bigger dose for the same effect. You need a bigger dose just like opioids, so they’re not ideal either because you still need more and more to get the same effect. And you’re right, with opiates, even with some of the drugs in the anti-seizure medications that have some degree of pain relief in nerve pain, they still cause people to become constipated. So sure, some people may have to take a more standard medical stool softener and they may have to take something like MiraLAX if they’re taking the opiates, but of course, I don’t think anybody should be on opiates. The opiates are not a good – they’re just too dangerous a solution, and because of their effects on constipation, it makes them even more dangerous to digestion and your overall health. They’re just not an adequate and long-term answer for anybody.

Dr. Maya Novak:
Yeah, well I was – I can say that I was pretty lucky in that regard because I was on opioids for 10 days after the surgery and I didn’t have any problems with my digestion, even though the nurses and the doctors were telling me that I should be taking those laxatives. I was like no, everything works well. So I’m obviously very lucky in that regard.

Dr. Joel Fuhrman:
Well, that’s good.

Dr. Maya Novak:
Yes. Now I have a question in regards to tendon pain and high cholesterol. Do you have any opinion or have you done any research about it? The reason why I’m asking you is that many people have problems with athlete’s tendon, for example, or any other tendon issues - is there any sort of relationship between high cholesterol and these type of problems?

Dr. Joel Fuhrman:
Absolutely there is because when you have – don’t forget your joint capsule brings fluid and cushioning between your joints, right. So the cartilage that lines joints gets its profusion of oxygen and nutrients not directly from blood vessel flow but partially through the fluid in the joint capsule, you have a very fine microcirculation to the joint capsule. So when you have sludging of the blood, and when you have more fat in your blood and higher cholesterol – what I’m saying right now is the early signs of atherosclerosis that may affect your heart when you’re 65 or 70 years old may start to affect your joints, ankles, knees, and hips way earlier than it affects your heart. Because you’re going to start to get loss of cartilage and loss of bone health of the joint tissue that lines the cartilage and increased pain. So your joints and your tissues are going to age and not heal as well because of lack of circulation. So what I’m saying now is that the discs in your back between the vertebrae and the cushions and the fluid between your joints are vulnerable to become more inflamed and more degenerate the more you have atherosclerosis in general. Those tissues can be the earliest signs of showing some degree of damage before you have obstructions in your heart. You may start to get pain in your ankles and your knees and your hips and your back before there’s ever anything you know that’s going to affect your heart years down the road. So yes, they are very sensitive to decreased oxygenation and decreased nutrient delivery from having more fats in your blood and having an unhealthy diet. So absolutely, a higher cholesterol on a diet that could eventually result in heart disease could make you more prone to pain and joint problems when you’re younger.

Dr. Maya Novak:
You mentioned before gut microbiome and how important it is to take care of it. So what is your advice after strong pain killers, medication, how do we go and take care of the microbiome so that we take care of not just healing, but health in general?

Dr. Joel Fuhrman:
That’s right and that’s where the GBOMBS come in, because if you eat GBOMBs, there’s so many mechanisms via which they make you age slower and protect you against cancer, but one of the important mechanisms is they support the growth of the best type of bacteria in your gut. The GBOMBS – greens meaning raw and cooked, you’ve got to eat a salad every day. B for beans – well-cooked beans and also some sprouts. You can’t sprout large beans, they have to be soaked and cooked very well, but some small beans like mung beans and seeds can be sprouted. If you have beans and sprouts, they are very good for the microbiome. Then we’re talking about cooked mushrooms, not raw mushrooms but cooked mushrooms. Onions, garlic, leeks, scallions – don’t underestimate the anti-cancer potential of onions and shallots and scallions and garlic. It’s got to be part of our diet, it’s such important help for the microbiome. That’s what the O stands for, that onion family. Then mushrooms. Then B for berries because low sugar fruits have very powerful effects on healing, we’re talking about cumquats and guava, and passionfruit, and berries and cherries, and things like that are super good for our health to have those colorful fruits in our diet. Then lastly, seeds have very powerful effects on healing. We’re talking about getting some seeds in your diet like sesame seeds and sunflower seeds and chia seeds and flax seeds. We have an unprecedented opportunity in human history because in prior centuries we couldn’t have all the access to all these foods all year round. We have refrigerated planes that we can ship foods from, and refrigerated trucks, and we can get – we can live in one area and still get berries and seeds whereas in that area you were just living on cactus root and vegetables. What I’m saying right now is we can make our diet have all the full symphony orchestra playing their tune. So we can include all these various foods in our diet and have it available to us with modern technology and good, really great food from great soil. So even though we have the opportunity to eat the worst diet in the world, we could eat fast foods and fried foods, and fried chicken, and French fries and burgers and bacon and hot dogs. We could kill ourselves with food. But we can also, at the same time, have the choice to eat a super healthy diet because in today’s world we have the choice the eat the best diet in the world or the worst diet in the world. A few centuries ago it was only some moderately bad diet. We couldn’t eat the best diet in the world. Now, we have an opportunity to eat the worst diet in the world because we have the worst food in the world available to us in fast food restaurants and candy and packaged foods. But we also can eat organically grown berries and green vegetables all year round, and mushrooms of various types. So it’s up to you what you want for your life.

Dr. Maya Novak:
So is there any difference in regards to frozen and fresh, for example, if we are talking about? Because fresh, especially if you are talking about wintertime, are definitely higher priced. So is there any difference at all, or is it definitely better to go with fresh whenever possible?

Dr. Joel Fuhrman:
I think the frozen is better because frozen, as you said, is one third to one quarter the price and you only take out of the bag what you need. The rest stays fresh in your freezer. When you buy fresh, it gets rotten and gets mold on it within five days usually and it’s so expensive, but they put fungicides on the fresh. So if you’re not affording organic fresh, then you have a berry treated with fungicides. When you buy frozen that are not organic, they’re not treated with a fungicide. There’s not a lot of residual pesticides on berries. It’s not the pesticide, it’s the fungicide that’s residual, people mix everything together. So berries are very highly treated. The environmental working group rates them as a food that can have a lot of residue, especially strawberries, but it’s not pesticide residue, it’s fungicide residue. There are chemicals that prevent fungus that extend shelf life. It’s why they treat them and then spray them. Or they put them in these rooms where they gas them to make them have a longer shelf life. Do you know what I’m saying? So when you buy frozen they don’t gas them. So frozen is healthier than fresh, and they’re usually frozen on the day they’re picked. So I think that frozen is a better choice, and that’s why I suggesting that we can get these – we can access to this all year round because we can eat – and I travel – I eat frozen broccoli and frozen artichoke hearts and frozen berries, and I even eat frozen jackfruit. I put it in my bag, I wrap it in a piece of paper towel or put it in a plastic bag, and I put when I’m traveling in my suitcase with carry-on on a plane. I’m eating a bag of frozen artichokes on the plane or something. Yes, so frozen, I think, is still a very healthy way to eat your fruits and vegetables.

Dr. Maya Novak:
This definitely will help so many people, because otherwise, it’s just so hard to afford everything, you know, in regards to berries. The question that I have, since you also have personal experience being a figure skater and you said that you were injured, you probably – you might also have some experience with people who are losing hope in regards to their healing. So what would you say, or advise someone who just doesn’t see any light at the end of the tunnel sort of thing?

Dr. Joel Fuhrman:
Well, we’re in a period of time during medical technology where we have a huge ability to help people get better. So there’s so much available to people today to get better. That’s good eating, all the therapies we talked about, we have electric therapies that can reduce pain with electric modulation as opposed to using opiates. We even have the advancement of stem cell therapy to help tissue regenerate today, that’s moved. The technology is growing and becoming more – in the future years will become better. So I’m saying that people never should be disheartened. They never should think they can’t get better. You just have to get those people to have hope, to work on getting well, and get them in touch with the right kind of people to get them to get the help they need.

Dr. Maya Novak:
We talked quite a lot about the regenerative muscular therapy. Is there any other therapy that you suggest to an injured person, or that you would suggest to someone who is injured right now?

Dr. Joel Fuhrman:
Well, no. The good nutrition, the right supplements, the regenerative therapy, and then the right physical therapy to develop the proprioception and the strength when they’re getting healing. If a person sprains their ankle we want to give them the massage, but we also want to do the proprioception, the movement, and those balance exercises in strengthening the tissues around there in the future. So it’s getting the right type of care that’s very conservative and very forward thinking in reestablishing blood flow and muscular integrity around the injured area healing and eating right too. And then, if there’s poor healing, if there’s some bad outcome due to surgery or due to a very severe bone injury, then we can talk about how to add other things to that if it’s necessary. But you basically start with the basics. The basics are always the good nutrition, the massage, and good physical therapy. And then we always want to use what’s most conservative first and then if there’s a problem then we could think about other treatments that might be required.

Dr. Maya Novak:
Great. I always ask the summit speakers three standard questions, and you have already answered one of them in regards to what you would say to someone who is losing their hope in regards to their healing. Then the other one is, what is your number one advice that you would give someone who is injured and is listening right now?

Dr. Joel Fuhrman:
Well, the number one advice is that I was on crutches for a year myself, and a lot of people are suffering with pain and injury. But this is a time to reflect and to reconsider doing everything you can to maximize your health and healing. This could be a starting point of having a new healthier you be reborn. So this could be you taking the initiative now to change your life in the right direction and healing the part of your body that’s been injured, could also heal the rest of your body, including your mind and your brain and be the starting point of you having a happier and healthier life. So wishing you all the best, to do all the right things to maximize your chance of healing, and that means taking care of the whole body both emotionally, psychologically, physically, nutritionally, and musculoskeletally. All these things will start to move towards having a healthier life and then things will work for you and your life will be better.

Dr. Maya Novak:
Yes, I love this advice because we are not just the ankle or just the shoulder or just the back, so going into healing through all the aspects of the body is so extremely important. Now for the third question, if you were injured right now – if you were stuck on a desert island with an injury right now and you could bring only one thing with you that would help you heal perfectly, what would you bring?

Dr. Joel Fuhrman:
Shoes. I can’t stand walking barefoot on bristles and like rocks and stuff. I could be naked and nude in a jungle and I’d have to have a knife – but I’d have to have some footwear because I can’t go barefoot. You see that on television when people are running around the jungle barefoot and totally new and you go oh, their feet must be killing them stepping on those rocks and on those thorns and everything. As long as my feet are okay I could run through the woods and I could climb trees and stuff. I could dig for insects and make – anyway, I always think at some point of my life of being – of purposely going to vacate on some tropical deserted uninhabited area where you’re just fending for food in the woods. It’s kind of like a fun vacation, but I’ve got to have footwear.

Dr. Maya Novak:
Well, I agree and especially after years or decades of wearing the shoes that we are wearing. Our feet are definitely not used to rough terrain.

Dr. Joel Fuhrman:
Yes, exactly.

Dr. Maya Novak:
Well, I extremely enjoyed this conversation. You mentioned your retreat earlier. Can you share a bit more about your retreat and how this can help injured people, and where they can find more information.

Dr. Joel Fuhrman:
Right, yes. I have an Eat to Live retreat. We gear it up so people can stay there for a long time. Like they make it - so I want people to stay four weeks, or eight weeks, or twelve weeks. So when people have diabetes, or heart disease, or auto-immune conditions or an injury, they can go for a long-term stay and help them recover. So we have a therapist there, we have great chefs there. They are under my direct medical care so I can adjust their medications and actually – I don’t mean adjust medications - it’s usually that I’m adjusting to take them off the medications little by little so they become nondiabetic, they don’t need blood pressure medication anymore, you can take them off their pain medication slowly and gradually. So I do have a retreat where people can get the right type of care. It’s in northern San Diego in a beautiful area where you can look out over, with a salt water pool. You can get exercise in the pool and we have a gym and I have therapists there, and I also have counselors, like psychologists there helping people emotionally. Especially some people who are food addicts who are overeating and got overweight because they’re addicted to food. They need the counselors there to help them as to their emotional issues that lead to their overeating behaviors too. So we have the professional staff that can help people make the recovery so when they leave the retreat after a few months they now can handle their life and they can stick on the plan. They can continue to eat healthily and they know how to make it taste great, and they learn the foods, and how to cook them. So yes, if a person is a candidate for considering this, they can look at drfuhrman.com. There’s a tab that says retreat and then they can click on the Eat to Live Retreat, or they can just go to drfuhrman.com/etlretreat – which is Eat to Live Retreat. But yeah, they can find it on my website, drfuhrman.com and the retreat tab.

Dr. Maya Novak:
And we’ll definitely put the link on this video page so that people can easily find this information and contact you in regards to the retreat. Dr. Fuhrman, thank you so much for being here. Thank you for sharing your knowledge and giving hope to so many injured people around the world.

Dr. Joel Fuhrman:
Thank you, it was such a pleasure, and thanks for the wonderful work you’re doing.

Dr. Maya Novak:
This wraps up today’s Mindful Injury Recovery Talk with Dr. Joel Fuhrman. If you haven’t done it yet, subscribe to the podcast on whatever platform you’re using to tune in, and share this episode with your loved ones – it really can change someone’s life. To access show notes, links, and transcript, of today’s talk go to mayanovak.com/podcast. To learn more about The Mindful Injury Recovery Method visit my website mayanovak.com and find my book Heal Beyond Expectations on Amazon. Until next time – keep evolving, blooming, and healing.

Love and gratitude xx
Dr. Maya

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