HOW TO LIVE YOUR BEST LIFE?

HOW TO LIVE
YOUR BEST
LIFE?
LEARN THE LATEST EVIDENCE-BASED HEALTH, NUTRITION,
AND WELLNESS RESEARCH
One of the few physicians who is also a trained chef, Linda Shiue has
dedicated her life’s work to bridging the gap between the medical, nutrition,
and culinary worlds. She is the founder and director of Thrive Kitchen, a
teaching kitchen at a large national healthcare system, where she educates
patients on cooking craveably delicious, healthy meals. A practicing
internist for more than a decade, Dr. Shiue made the journey from the clinic
into the kitchen to more effectively support the many patients she saw
struggling with lifestyle-related medical issues, despite taking medications.
Noticing the gap in conventional Western medical training to address
nutrition (only a quarter of medical schools in the U.S. offer a nutrition

class), Dr. Shiue formalized her own culinary education, attending San
Francisco Cooking School, before staging in the kitchen of Michelin-starred
restaurant Mourad in San Francisco and obtaining a certificate in
Plant-Based Nutrition from Cornell University.
I sit down with Dr. Shiue to talk about her book, her thoughts on food as
medicine and some of her delicious recipes.
Transcript
Sean Hashmi, MD
I am delighted to have an amazing guest with us today. Who is a friend is a
colleague. I’ve known her for years now. And not only have I known her, but
I’ve also had a chance to see her grow and develop and have all sorts of
amazing things done. So today, I’m excited to introduce Dr. Linda Shiue.
Linda Shiue, MD
Thanks so much, Sean.
Sean Hashmi, MD
Absolutely. So for people who don’t know who you are. Start by telling us a
bit of who you are, what sort of got you excited about food? And if you had to
pick, give me one food that you like.
Linda Shiue, MD

All right. So I’ll answer that after I introduce myself a little bit. So, as you
said, I’m Linda Shiue. I’m an internist practicing primary care, and I love
food. Long before I went to medical school and long before my medical
training, I cooked, always. I took my first cooking class when I was seven,
and I have cooked since then. And you know what got me into becoming
someone who could write a cookbook? My cookbook, Spicebox Kitchen, was
realizing that food could not just be a source of personal pleasure and joy
but that it could be a new tool for me to help my patients improve their
health and improve their wellness. So that’s the short story for how I got
where I am.
And I believe so much in this idea that food is medicine and that
conveniently translating that for patients was key to their health that I took
a year off my medical practice. Now that was in 2016. Several years ago, five
years ago, I went to culinary school and really kind of learn everything that I
needed to know so that I could teach patients how to cook and how to enjoy
food and improve their health.
Sean Hashmi, MD

That is fantastic. So I can only imagine how hard it is to leave your practice
for a year. How was that?
Linda Shiue, MD
So it ended up that I left that practice and joined a new one. So I came over
to the same place that we worked together because it made more sense. It
was it’s an organization that emphasizes prevention and has farmer
markets. And interestingly, in all the years that I worked in my previous
practice, I would hear ads for our organization all the time on the radio, see
them on busses and billboards for farmers’ markets, for various other
health, education, and prevention campaigns.
And that was what gave my idea that you know, if this place already has a
farmers’ market, they’ll buy into my idea that they should have cooking
classes, too. And so that’s sort of how that happened. First, I want to teach
cooking, and I’ve been doing it already kind of casually for a few years
before I decided to go to culinary school. But then I had the end goal of
going to start this program.
Sean Hashmi, MD
Wow. So let me ask you, you know, for somebody like me who doesn’t know
how to cook that well, I’ll tell you, I know how to do the basic things. And I
find that even knowing how to do these things is so important. A lot of
people complain about it there isn’t enough time to cook. Like the number
one thing we hear. So how do you respond to something like that?
Linda Shiue, MD
So I don’t want to say practice makes perfect because I don’t want people to
think there needs to be perfect in your cooking. But practice makes your

cooking faster, more efficient, and more enjoyable. And so not just to start.
Simple is how to do it, not to feel like you have to do these complex recipes
that take, you know, an hour or two to make. People aren’t going to do that
daily. So my first tip is to get some good knife skills, whether taking an
actual knife skills class.
I always start with a brief knife skills lesson in the classes that I teach in the
beginning or watching a video or whatever it is. Learning how to make cuts
properly, safely, and efficiently will make you a better cook, a safer cook,
and you’ll enjoy it more. So that’s first thing get some basic, fundamental
skills. Then set your goals on just learning how to do one and then two and
maybe five different recipes. And from those five recipes, you can make
variations.
Once you get more comfortable with the technique, then you can very you
make a swap. You may realize that you can swap this green vegetable with
that green vegetable. Oh, I don’t have this spice. Well, I like this spice better.
Anyway, I’ll use this. You learn to cook more intuitively, but you have to. But
I do recommend that people start with recipes if they truly don’t know how
to cook.
You can’t just throw things at yourself. You need to understand, you know,
the purpose of heat, different heat settings, when to add moisture, why not
to add moisture? These things are part of the nuts and bolts of cooking,
which you don’t need to study kind of beforehand. You can learn through
trying different recipes.
Sean Hashmi, MD
That’s amazing. You know you used a very important word, “intuitively.”
There’s this concept of intuitive eating, which is this idea of getting back to
understanding how your bodies respond.

One of the lectures I’m about to give is on food addiction. And essentially,
what most people don’t realize is a lot of people, when they end up getting
food addiction, it has to do with, you know if you look at what makes a drug
so addictive. Well, the characteristics of a drug that makes them so addictive
are how fast it can get into your bloodstream? How quickly can it give you
that high? Such certain things like the more processing we do.
So if you’re taking talking about, let’s say, you know, oatmeal versus a
donut that has tons of sugar and all the stuff on that sugar gets in your
blood so fast. That in rats’ studies, when they go ahead and look at the data,
rats will go for sugary food. And even if you shock them, they would rather
have the shock and get the sugar at the sugar. So when you deal with
patients, how do you help them understand this idea of food as medicine
and healthy eating?
And what are the steps you do to get them started on this journey?
Linda Shiue, MD
That’s a great intro to this concept. And the most important question, right?
How do we talk to people? How do we partner with them to help themselves
along the street? And so there’s no one size fits all. I know some people say,
is there one perfect diet? Is there one best diet? And I say no, actually, except
if you want to consider it, primarily plants. Right? So that’s my philosophy.

Everybody will do better with the more vegetables and fruits that they
consume.
Within that, there could be a spectrum of do you eat fish, do you eat meat,
do you eat other things? But that’s very individual. And I think that’s
important for people to understand. I think it’s also important to ask
open-ended. What you eat right now? And try not to be judgmental about it
and work with exactly what they told you they like to eat and think of
slightly better choices. For example, when I first started teaching cooking
classes back in 2012. In addition to the classes, I began to write recipes on
prescription pads.
Remember those paper prescription pads? Now they’re my electronic
medical record ready to go. My first two recipes that I prescribed to patients
were for the people who are either salty snackers or sweet snackers. And so
for the salty snacker, this is someone who’s like some sort of chip,
something crunchy and salty. So I’m sure kale chips pretty straightforward,
but also somewhat radical to write this on a prescription pad. But that was
one of the first things that I did.
It had that added shock value of something unexpected and the authority.
This is written on a prescription and it signed by my doctor. I need to do
this. So that was very successful. And then my sweet snack for the person
who eats ice cream while they’re watching TV at night is just for the banana
ice cream. You make the soft serve by using overripe bananas to freeze and
then put in the food processor or a high-speed blender with whatever
healthy mix.
And so that’s not butter, fruit, spices, maybe even some shaved chocolate.
These are very powerful prescriptions, and I have to say. Because I think
with these examples, what I did, what I’m doing with the patients that I give

them to, and I’m telling you’re not wrong to have that taste preference. You
know, people have these days preferences. But if you’re looking to improve
your health, let’s just try. And you don’t have to say you like it the first time.
Let’s just try something similar but gives you so much more nutritional
benefit, you know. So it helps if you’re going to get fiber instead of not fiber
that you’re having with your chips, you’re going to get less salt and less oil
because you’re making yourself at home. You’re going to get all the
vitamins and minerals present in kale and not in whatever you’re just made
of, you know. So it’s like you get added benefit and just try it.
I think you’ll like it because it’s similar to what you already like. And the
same thing with the banana ice cream. I tell most people maybe you
shouldn’t have ice cream every night if you have it once a week. But if you
feel like having it every night, perhaps the other night of the week, have
this. If you can eat a banana, you can have it at ice cream. And this is pretty
successful people like this approach. So it’s the idea of finding out what they
like and giving them just a nudge and some suggestions, very concrete
suggestions.
I think that’s the key. Right. That’s different from many things that we do
when we give people incomplete information, like a list, that doesn’t work.
People don’t want a plan. Oh, yeah, I know that spinach is good for me. I
know banana is good for me, whatever it is they need. I think people need
the recipes or very, very specific suggestions.
Sometimes, they want to tell me what to eat, breakfast, lunch, or dinner.
That sort of concrete meal plan is what some people might wish for people
who don’t want that; then I scale back. You know, I to you need to see what
they want and what they’re ready.

Sean Hashmi, MD
Well, I love this philosophy of yours, because I’ll tell you, you know, I do a
lot of research, and I read a ton of studies.
And what I learned is the easiest way to make somebody crave something is
to tell them you can’t have it. That’s it. It doesn’t matter what it is. It could
be a bowl of rocks, and you can’t have it.
I love this approach of yours in what was fascinating about what you just
said with this concept of kale chips, and people have certain flavors and
individual taste and specific habits. You know, for me, growing up, certain
foods addicted. So, you know, hiding something crunchy, for example. It’s
fantastic. I never thought of it. So on that topic, give me some ideas for
breakfast. What are some easy to do?
Healthy breakfast ideas. Our viewers could take in that kind of, you know,
follow the same example that you just gave on switching from something
unhealthy to going down that spectrum.
Linda Shiue, MD
I think for breakfast, there are savory breakfast eaters, and there are sweet
breakfast eaters. And unfortunately, most sweet breakfasts are things like
danishes and donuts, where we really can’t say this is an excellent breakfast
to start. Right. It’s a sugar high first thing in the morning, leading to a crash
shortly after that. So, you know, I think that’s not the best idea for most
people. However, if they like sweet, then you want to give us that sweet.
Something that is not with added refined sugar but has sweetness mainly
from fruit, for example. And so my favorite go-to breakfast for people who
like sweet things is overnight oats.
Sean Hashmi, MD

OK, my steel-cut oats from Trader Joe’s. That’s what I ended up using. And
you microwave it. I’m horrible at it. So it’s water in the microwave for a long
time to eatable, and I eat it.
Linda Shiue, MD
OK, so let’s talk about this. Steel-cut oats are great, but they do take time to
cook and taste good. And if you prefer steel-cut oats like that, you know, a
hot bowl of oatmeal, maybe another way to do that is to make a big batch of
it in either an instant pot or a slow cooker and then have it, and microwave
is already cooked oats that taste a lot better. But overnight, it meant to be
eaten cold.
But like what I just told you, with batch cooking, you’re still cut oats, and
you can also heat up overnight. So they’re usually in the cold. You can make
a big batch of these. It’s, you know, whole grain oats, but not steel-cuts. So
rolled oats. You know, there are many great brands out there, and it is a
whole grain. And then, you use the absorption method to soak them in.
A combination of it can be milk and yogurt. And add a little bit of tang, and it
can be plant-based versions of each of those. And then, you can stir in some
chia seeds for some added nutrition, more omega 3s, and texture. And it’s
pretty much half and half liquid, you know, the milk type stuff, plus your
oats. And then just sprinkle in a couple of tablespoons of chia seeds. Stir it
all together, and you cover it, put it in the refrigerator, and then in the
morning, you can add whatever fresh fruit or even frozen fruit can work
well with this, like frozen berries.
I also like to add some nuts for texture, like crunchy and some nuts. Touch
your nutrition yet again. And then if you if, people want a little more
sweetness because they’re used to it. One suggestion I’d like to give first for
people who have a sweet tooth is just try some sweet spices because you can

add a lot of sweetness with ground cinnamon and cardamom like they’re
very intensely sweet. I sometimes find cinnamon too sweet.
Stir that in and start with that, and taste it. And then see if you still need a
little bit more sweetness. Maybe a bit of sugar, a sprinkle of garnish sugar
on top, honey, or maple syrup. This is one of the easiest recipes to make
because you can make this in advance of a large batch.
You can package it individually in little jars. So it’s ready to go, and you
bring it with you to eat on your desk at work if that’s what happens. So
that’s my go-to sweet breakfast for the busy person who wants to improve
their nutrition.
Sean Hashmi, MD
OK, since we got breakfast out of the way.
How about something for lunch and let’s pick somebody who’s busy at work
and what can they do? Because many people, what they end up doing is they
think they’re eating like healthy foods or whatever the option, maybe. I’ll
tell you, one of my favorites is there’s a Mexican restaurant very close to us
where I go there a lot, and I get their tofu burrito. It’s all we need is brown
rice, but it has so much sodium in it.
For the life of me, I can’t imagine. And what’s crazy about is I tell all my
patients, please don’t get that burrito. Like, why do you get it? Because, you

know, I am tired and this. So I’m always looking for stuff. For somebody
like me, who’s busy. What could I do for lunch or make the night before?
Whatever.
Linda Shiue, MD
The first big tip I have is making extra dinner so that you have leftovers. And
that lunch can be leftovers. Maybe it’s not the one dish you have
supplemented with greens, for example. For example, let’s say I had salmon
for dinner then, and there’s not much left. There’s a tiny little bit left or
something. A delicious lunch the next day could be some cooked whole
grain. So whether that’s brown rice or farro, one of my favorites, or quinoa,
you know, I’ll have it around precooked in the fridge already.
Again, batch cooking, things that take time, so they’re ready to go, is a
perfect idea. And then I can assemble Grain-bowl out of that. So I might
have a grain base, a tiny bit of protein that little bit is enough for one
person’s lunch, and a lot of greens. So on that note, I eat greens about three
times a day. I try to eat them at every meal. One of the other go-to
breakfasts that I didn’t mention is a green smoothie.
I end up making it easy to have greens is one of my favorite tips for patients
because greens help everybody in terms of fiber and many other nutrients.
Right. Is to buy those triple-washed, pre-bagged baby greens. Whether the
arugula, baby spinach, baby kale. All of those, you don’t even have to wash it
is what I tell people, but you certainly can. They benefit from another rinse.
They’re ready to go.
You can eat them raw. And because the greens are so tender, they blend up
easily and blended into a smoothie. You’ve eaten raw lots of them in a salad.
But if you’re if you want them cooked, they wilt within minutes. With this
grain-bowl, I’m assembling with my leftover salmon, a little bit of

wholegrain at the base, and I just put in tons, maybe two big handfuls of
greens. And then you need some flavor. So some sort of sauce. You know,
that if they’re sauce from cooking the salmon that might go with it. Maybe
some tahini-based sauce, perhaps some other sort of vinaigrette or
dressing, whatever it is. Something to add some flavor and bring it all
together.
Your approach, you could also cook beans. So you would you like a rice and
beans and greens thing. And depending on what kind of grain you have, you
know, if it’s something that doesn’t need to be hot, like quinoa, you’re
ready to go. There’s your grain-bowl, and you just kind of stir it all together
the next day. And it’s, and you’ve basically both put away your leftovers at
the same time and made your lunch. Right.
So this is like two one. You’re right. Your lunch is ready to go there. And if
you wanted it to be hot or if it was like leftover rice and it needs to be heated,
then you could put that whole thing in the microwave, and your greens will
be cooked. So that’s my simplest method for people. Use leftovers, assemble
many components to make either green salad or a grain bowl and a green.
You know, for people, again, there’s no one size fits all.
People are avoiding grains and other carbohydrates like that. You could do
this with cauliflower rice also. But I think that’s a really simple idea for
many people as a vegetable-packed lunch.
Sean Hashmi, MD
Wow. I love it. So I see behind you there is a book.
So I’ve had a chance to look through the book. I’m just so blown away. It’s
beautiful. You know, and I get to see a lot of books.
Linda Shiue, MD

Can I show you up close a little bit more? I’m the photographer. I’m going to
try to page through it a little bit here. I’m very proud of my food stylist and
photography team for these images because I think they captured the
reverse camera here. They captured my goal of bringing life to this food and
bringing joy.
Sean Hashmi, MD
What inspired you to write this book?
Linda Shiue, MD
So in 2016, I founded a cooking class series for patients at the medical
center. And these cooking classes are so much fun. You bring together a
group of strangers by the end of the two hours of cooking together. We have
one big shared meal together, and it’s an enjoyable community. And we talk
about the food we eat. You know, everyone’s kind of friendly by then, and
we talk about any nutrition questions that they have.
Not everybody can come to my classes, right? So I’m in San Francisco, and
everybody’s in San Francisco. And even if you’re in San Francisco, there are
small classes by intention just so that they can be interactive. And so I
thought, how can I bring that experience actually to the home cook? I
genuinely believe that any food you cook at home, on average, will be
healthier than takeout or eating out most of the time, no matter how you
eat.
So that was goal number one, get people to cook more at home. I also
wanted to change people’s conception of healthy food or healthy food from
kind of punishment pleasure, honestly. So, you know, many people have
this idea that healthy food doesn’t taste good, has no flavor, has no texture.

And that has been true for a lot of people in terms of what they’re presented.
So who would follow that kind of dietary change?
Who would do that? We’re humans. We like to eat food. We need
good-tasting food. We need food that is interesting and has texture. And if it
doesn’t, we’re not going to stick with it no matter how good it is for us. So
that was my next goal. Make people understand that healthy food can be
delicious food and should be. And then finally, I thought, how do you make
this appeal to a broad range of diners, of home cooks?
You know, if I started you, I’ve been talking about kale, quinoa. I think a big
problem that we have in our modern Western wellness culture because
there’s almost only one way, one monoculture of eating one flavor profile.
And that won’t resonate with everybody. Right. We live in a very
multicultural society. Living in California, we benefit from this. Right. So we
get exposure to so many different kinds of foods. Yet, I think many people
have this misguided conception that none of that food is healthy food.
I deliberately included foods of many, many cultures in this book because
that’s how I eat. And also, I was inspired by my love of travel. And in doing
so, I could incorporate a lot of spices into my recipes. And so spices are kind
of underrated. You don’t use that many in general in this country and
America and cooking, yet they add flavor without sodium. They make your

food a lot more exciting, and many of them have health properties. They
were our first medicines, after all.
Sean Hashmi, MD
Give me some examples from the people listing of some of your favorite
spices, and you know how they kind of complement some of the stuff you’re
referring to.
Linda Shiue, MD
Eggplants, actually.
Sean Hashmi, MD
Wow. Yeah. That’s actually what my wife likes.
Linda Shiue, MD
Oh, really? So do you like eggplant?
Sean Hashmi, MD
No!
Linda Shiue, MD
Suppose you want an example of how I do this. I will ask you next, how have
you had eggplant prepared and what do you like about it?
Sean Hashmi, MD
I didn’t like the texture. I don’t know how it was prepared. I didn’t like the
texture.
Linda Shiue, MD
OK, and what about the texture? Did you not like it?

Sean Hashmi, MD
Is it good? You know, I don’t. To be honest, I don’t remember. I kind of gave
up on eggplant for a long time now. You see, it’s interesting. For me, I grew
up. When I was growing up, we were very poor, and we had every day, had
two choices either had okra or we had lentils. And this was in Pakistan. And
at that time, you know, okra was dirt cheap, and lentils were dirt cheap.
So that’s what we had. And I can’t stand okra. I love lentils to this day. But it
was just because every single day we had the same food. My wife always
makes fun of me because she says, what, you eat the same food every day. It
was part of it if you came out of like a survival mechanism because that’s all
we had.
Sean Hashmi, MD
I never really ventured out. And that’s why when I saw your book, I was so
excited because I told my wife there are so many things that I can do. It
sounds crazy, but I see recipes in there. I’m like, wow, I can do this.
Linda Shiue, MD
Yes, you can.
This is the whole idea. These recipes, actually, the way I like to describe
them. They taste sophisticated, and the techniques that complicate it are
not. These are meant to be cooked. You know you do have to stock your
pantry. And I have a whole section on what I recommend for stocking your
pantry. There is an okra recipe in it, which I would like you to try on that
note, Sean. The okra, this is what people don’t like. For you, that
association may be different, but because of texture, right. People think it’s
slimy. This recipe, which is with okra and tomatoes. Very simple cook with
garlic, cumin seed, and a little bit of coconut oil. There are two techniques

for reducing that slime factor, which I like about okra. One is high heat, and
the other is cooking with something acidic so that the tomato comes in.
So like it’s a straightforward recipe. And yet, I thought of these principles to
make the okra convert the okra hater. I have the same thing with the recipe
for Brussel sprouts. So I love vegetables, but I think a lot of people say they
don’t like them. You don’t like eggplant. I think it has to do with cooking
techniques, maybe not even so much flavor. It’s cooking techniques. So that
was a big goal here.
There might be one best way to cook a particular vegetable, and that’s what
I try to highlight in these recipes.
Sean Hashmi, MD
Tell me about some of your favorite spices.
Linda Shiue, MD
Well, first, I think I’ll start with the one that I think most people have heard
has a lot of health properties because, again, I want to emphasize that spices
will benefit your health more than just the flavor part of it. And that would
be turmeric. Turmeric is a potent antiinflammatory. It’s very similar to the
nonsteroidal, antiinflammatory people down every day for pain and related
conditions. And you can have this in your food.
Another fascinating tidbit about turmeric is that the bioavailability, the
ability of your body to use it, absorb it, is greatly enhanced when you have it
at the same time with ground black pepper. And that’s fascinating, right?
Because this is like this that people cook. These flavors always go together,
but there’s science behind it. Whether or not that was articulated to most
home cooks who cook this way, probably not. It benefits people’s health.

And I think there are so many examples like that are fascinating. So
turmeric is a great spice for everyone to have for anything that, you know,
they want for savory food. Another favorite is cumin, which I use either in
whole form or grounds and many types of food. And in terms of its health
properties, it is a source of iron and helps with digestion. So, you know,
every spice you kind of research, it’s fascinating.
I love you. A lot is known for a long time, and people are trying to get more
evidence for exactly laboratory conditions. What does this do? But
anecdotally and through the years, all of them have properties like this.
Ginger is another excellent example that I love both for the flavor. You
know, it’s used a lot in East Asian cooking and Asian cooking in general, and
it’s used a lot for GI symptoms, nausea when people have morning sickness
and don’t want to take any medication. And so, you know, I’m a doctor who
can write any prescription. I, I always delay the prescription until I can say
maybe you can try this food first. Ginger, what I’ll recommend to somebody
was mild nausea, and it helps with just kind of bloating and other things like
that, too. And I love the flavor.
If you add sweet things, add in many savory dishes. So that’s a perfect one. I
often use powdered Ginger on my coffee in the morning. So a mix of
cardamom and powdered Ginger, which I love. From Eritrean friends of
ours, that’s a very common combination with coffee.

Sean Hashmi, MD
OK, so I have so many things to try tomorrow morning.
Linda Shiue, MD
You do. You’re going to be busy. I should mention I’ll mention this one more
spice. And I said many of my favorites, but this one is important for people
who like bacon but are trying to go more plant-based. Tall order smoked
paprika or pimiento gives you that smokiness and a little, you know, a little
bit of an I guess, like a savory undertone that, you know, it’s not quite
bacon, but that is what is missing.
A lot of people feel like when they eat entirely plant-based, something is
missing. And for people who like to eat a lot of meat, I feel like just put some
of that smoked paprika on it. I think it’ll enhance and give you that flavor
that you’re missing. And it works a lot of the time, especially things like
soups and stews.
Sean Hashmi, MD
Well, it’s funny when I started getting into tofu. I was not too fond of the
taste of tofu because it doesn’t taste like anything. And so my wife, you
know, she’s talking like crazy. Oh, no, I’m not into it. So then, you know,
what she does is she put some spices on there, and I was like wow, it tastes
so good. And what do you do differently? And she said, “Nothing. I just put
some spice in”. And I was like, wow. When I made it for her like, it tasted
bland and tasted horrible.
And she’s like, no, no, no, no, no, that didn’t taste good.
And she puts few spices. And I tell you what I’ve learned is spices are like the
eighth, ninth wonder of the world. It’s fascinating. And, you know, when we
talk about the food industry and we look at all of the ways people can get us

to eat processed food and junk food. We know about salt. We know about
sugar. We know about fat, but people forget that using flavorings and spices
into those combinations can make a lot of horrible stuff that is good.
So why can’t we make the good stuff taste even better?
Linda Shiue, MD
Yeah. And it’s fun. And I think especially in this past year when we’ve all
been, you know, at home all the time, pandemic, it’s a way to bring in the
rest of the world to where you are. I’m all about expanding my horizons.
I’m curious about other places, people, and cultures, and spices are one way
to do that because they evoke other places.
If it’s not something that you’re used to having every day, then it’s exciting.
And then, you know, it just gives you a whole other dimension to your food.
Sean Hashmi, MD
So OK, we’ve talked about breakfast, we talked about lunch. So how about
some ideas for dinner. And this is all me being selfish because as soon as we
finish this interview, it will be like dinner time. So I’m just selfish here.
Yeah.
Linda Shiue, MD
So do you want a plant-based option or some other option?
Sean Hashmi, MD
So, I mean, the plan we’ve gotten to a point now that we’re predominantly
plant-based. That’s been a journey of ours. So that would be fantastic.
Linda Shiue, MD

I have to share one recipe from the book, which I think is actually both
simple and incorporates a wide variety of colorful vegetables and uses some
very good for you plant-based proteins. It’s the Gado of Gado. And have you
had Gado Gado before? So Gado Gado is an Indonesian salad, which means it
translates loosely as “mix-mix,” It’s dressed in a peanut and coconut milk
paste and ginger-based dressing. And my version uses the rainbow of colors
of vegetables.
Usually, it has things like bean sprouts, string beans, green cabbage, and
then tofu or tempeh as a protein. I want to bring it out to show you the
picture and tell you why you should have this tonight because I think you’ll
enjoy it. It’s effortless to make. And it’s just one of my favorites here. So
give me one second here.
Sean Hashmi, MD
And I’m going to let everybody know how it ends up being. My kitchen has
been on fire, but you know, and Dr. Shieu said, “practice makes perfect” I’m
going to practice.
Life is all about practice. It’s all about the journey, not the destination.
Linda Shiue, MD
That’s correct. Well, I would say that you know, the worst thing that can
happen with any cooking experiment is that you could burn it. And then, in
that case, you have to get rid of it. But otherwise, you know, it’s a learning
experience, that’s all.
Sean Hashmi, MD
I’ll just be calling you. That’s how it goes.
Linda Shiue, MD

Yeah, I think so. I’d be happy to answer your questions on the call. Alright, I
found a page. OK, so look at this, right. So I said that many times. People
think that eating healthily is deprivation is not deprivation, even with a
glare from my light. Their product that they don’t see the glass. That’s very
beautiful here. I’ve played it on a banana leaf. Just because you have to make
things look nice and you can use a regular plate. You’re OK with this.
But as you see, it’s pre-tossing it. But you could you as a composed salad
like this and you can say use all the colors. So red tomatoes, orange carrots.
We have eggs here but couldn’t leave those out for days we have been
sprouts versus yellowish. And then I have some purple cabbage, some green
beans or longlines, some shredded green cabbage. And this is some tempeh
that’s just been pan-fried and dried.
I had no oil added at all. It’s up really nicely. And tempeh for those of you
and some cucumbers, it’s all sizzle with this dressing. So it’s very flexible.
You can use whatever vegetables you have on hand. Try to use some of those
that are raw so that you get some crunch. Try to use some that you steam.
You know some might be blanched, some spinach. So a mixture of cooked
and raw in various ways. Get a lot of variety there.
So I think it’s a great choice, though, because it gives you a chance to get a
wide variety. That’s a straightforward nutrition tip that I always share. You
don’t have to know what does a tomato contains versus a carrot versus kale.
It’s great if you want to learn that, but as long as you eat all the colors of the
rainbow, you’re going to cover your essential nutrition.
Sean Hashmi, MD
I love that. So simple and so practical, and it’s doable. So I’m on board. OK, I
lead.

I will follow Dr. Shiue’s prescription. I will let you guys know how it goes. So
bringing all of this home or for the audience, it’s out there. You see, we have
many people who have struggled in the past and all sorts of different places.
And my message around the SELFprinciple, which is exercise, love, and
food. On the food portion, what I see is food is culture. You know, I always
said food is medicine to my medical colleagues.
But I also started saying food is culture because what I found was that even
among doctors, it was this huge tendency for us to have everything in black
and white. And there was a lot of shading going on that if you do something
one hundred percent. And I told people and said, you know, some of my
fondest memories were I remember my father, you know, we had one
Mango and six of us and make little teeny tiny slices.
And it was some of the greatest moments that we had sitting at that table,
even though it was a broken table. No food was such an important part of
our memories. And the food is such an important part of who we are in our
culture. So people who are getting started and checking out your work and
your book will say what you would say are critical for them to walk away
from this today to start on their journey?
Linda Shiue, MD

Great. That was very nice. It’s a pleasant memory of the mango. Isn’t that
true, though? Food memories are some of the strongest memories, good or
bad, that stick with us.
And so, yes. So I think the key points are that no matter how you’re eating
today, it doesn’t have to be the same tomorrow. And any change that you
make in the positive direction that goes more towards being plant-based
will benefit your health. You know, science has shown it’s very much a
continuum in this book. I focus on vegetarian and pescatarian recipes, and I
think that covers many bases for people. And, you know, but wherever you
are with your eating, eat a little bit better every day, whatever.
I also like to say you like you know that again, that’s why I give such a wide
variety of different flavors from different cultures around the world, find
what makes sense to you or also try something new, expand your horizons.
And make sure that you get to have some fun experimenting with spices and
find out what you like, you know because you won’t know until you try it. I
love that. So, Dr. Shiue, where can people follow you on social media and so
forth? How can they reach you?
So you can follow me on Instagram and Twitter at SpiceboxTravels and on
Facebook at TheDoctorsSpicebox. And I also have a blog, SpiceboxTravels.
Sean Hashmi, MD
Fantastic! Well, I want to tell you, thank you. This has been amazing. And
you know, it’s such a delight because this is a topic that I’m personally very
weak at and having such an expert like yourself come on and give me some
tips and so forth.
Linda Shiue, MD

Thank you so much. And I would love to see you make all those things we
talked about today.
hat makes food addictive, and what are the most important things you need
to do right now to lower your risk of developing an addiction to certain types
of foods?
We all know obesity is an epidemic, but one thing that’s really concerning is
the projections. By 2030, 85 percent of adults are projected to be overweight
or obese. That is a staggering number. Despite all of the diets, fitness
gadgets, supplements, we have not been able to make a dent in this crisis.
In 2008, obesity-related health care costs were approximately $147 billion.
Over the next 15 years, these costs are projected to increase by 15 percent.
When it comes to causes of obesity, only 20 to 30 percent is genetic. The rest
of it is based on environmental factors such as food access, portion sizes,
physical food, and the increasing prevalence of highly processed foods.
These highly processed foods have led to a concept called food addiction.
Essentially, the definition for it is this loss of control over eating. This is
despite having negative consequences such as diabetes, heart disease, heart
attacks, strokes, cancers, and more.

Food addiction is very similar to drug addiction. In both cases, there is brain
overstimulation. This leads to neural adaptation that reduces reward
pathways, resulting in the reduction of dopamine receptors.
Food addiction is very powerful. In animal studies, rats are first fed highly
addictive foods rich in refined carbohydrates and fat. Then the foods are
paired with an electric shock to discourage eating. Despite getting shocks,
the rats will keep going for this food.
Once the rats are used to this highly processed food, the researchers remove
it and replace it with their traditional chow. However, the rats actually
refuse to eat and end up starving themselves. And this is the same concept
in humans, is we are so addicted to this food that we keep going after it.
To measure food addiction, researchers use the Yale Food Addiction Scale.
It’s a 25 item questionnaire using the Diagnostic and Statistical Manual of
Mental Disorders (DSM-IV) criteria for substance abuse. It helps quantify
addictive eating symptoms.
When it comes to addictive foods, there are certain characteristics they have
in common. First, the foods are rarely in their natural state. Think of
grapes, which are not addictive, versus wine, which is processed. Other
examples are fruits that have sugar or nuts that have fat. Neither is addictive
in itself. But you take processed foods like cake, pizza, and chocolate rich in
carbohydrates and fat, and they are highly addictive.
The key to remember is how easy your access to junk foods is. If you have
junk food in your home, you’re going to eat it. This is something that Chef
AJ talks about a lot. Shhe tells her clients you can’t have these highly
processed foods in the home. I completely agree with that philosophy.

Glycemic Index and Glycemic
Load
When we talk about addictive foods, one way to think about them is through
the glycemic index. A glycemic index is very simply a rating on how slowly
or quickly foods cause an increase in your blood sugar. Low glycemic foods
have a rating of 55 or less; medium glycemic foods have a rating of 56 to 69;
high glycemic foods have a rating of 70 or more. Some classic examples of
high glycemic index foods include white rice, white bread, and potatoes.
But the glycemic index has a flaw in that it doesn’t take into account serving
size. This is where the glycemic load comes in. It uses the glycemic index
and the typical serving size to calculate a value for the glycemic load. Low
glycemic load values are less than 10, medium values range between 11-19,
and high values are greater than 20. Some examples of high glycemic load
foods include 1 cup of cornflakes (GL 21), ten large jelly beans (GL 22), or
one snickers candy bar (GL 22.1).

Research
Let’s dive into the research. In a study by Schulte and colleagues, the
authors proposed that highly processed foods are similar to drugs of abuse
in that the ingredients are concentrated and cause rapid absorption. In the
case of foods, their highly processed nature and high amount of fat and
refined carbohydrates are what the authors implicate in causing
addictive-like behavior.

The study had two parts. In the first part, the authors looked at 120
undergrads, ages 18 to 21, 72.5% Caucasians, with a mean BMI of 23. The
participants answered twenty-five questions on the Yale food addiction
scale, essentially asking how often they have problems with certain foods?
And what they found was that the most problematic foods are the ones that
are the same that we’ve been talking about.
The authors found that the most problematic foods had the highest-level
processing, highest amount of fat, and refined carbohydrates. These foods
included chocolate, ice cream, french fries, pizza, and cookies. On the flip
side, the least problematic foods were beans, broccoli, cucumbers, water,
and brown rice. All of which were closest in their natural state.
In the second part of the study, the authors looked at 389 participants, ages
18 to 65, 76.8% Caucasians with a mean BMI of 26.95. This time
participants were asked to rate on a Likert scale how likely were they to
experience problems with each of the 35 foods presented—one being not
problematic to seven being the most problematic. Once again, the most
problematic foods were highly processed and contained large amounts of
added fat and refined carbohydrates. These included pizza, chocolate,
chips, cookies, and ice cream.
Bottom Line
So, what is the take-home message? The first is, even though food addiction
is not an official diagnosis in the DSM V, food addiction is a significant
problem that needs to be addressed. The highly processed nature of foods
with large quantities of fat and refined carbohydrates allow for
concentrated dosing and rapid absorption. These qualities make foods
similar to drugs of abuse.

One of the best ways to reduce your risk of food addiction is by cleaning your
environment. Don’t keep junk foods in your house. Create barriers to
getting junk foods. Dr. Columbus Batiste talked about the idea that if you
want junk food, wait 30 minutes. In that 30 minutes, eat something healthy
like an apple. If you still want the junk food at the end of the 30 minutes,
then go for it. Chances are, this simple act of waiting 30 minutes will curb
your cravings.
Finally, remember that a Whole Food plant-based diet is ideal because it’s
naturally low in fat and low in refined carbohydrates. It is calorie-poor and
nutrient-dense; it’s good for the planet; it’s good for your overall health;
it’s good for the health of our children.
Written By Sean Hashmi M.D.
Sean Hashmi, MD, MS, FASN, is a practicing Nephrologist and Obesity Medicine
specialist in southern California. He is a sought-after speaker on topics ranging from
health, nutrition, fitness, and wellness. Currently, Dr. Hashmi serves as the Regional
Director for Clinical Nutrition and Weight Management at Southern California, Kaiser
Permanente. Driven by his lifelong commitment to be of service to others, Dr.
Hashmi provides evidence-based health, nutrition, and wellness research through
his 501c(3) nonprofit, SELF Principle. In addition, SELF Principle also supports
children’s education efforts worldwide through scholarships, books, and supplies.

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