Heart Healthy, Plant-Based Eating with Dr. Jenneffer Pulapaka [Ep. #1021]
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This Weekâs Episode Special Guest: Dr, Jenneffer Pulapaka
Summary:
In this episode, Kimberly and Dr. Jenneffer Pulapaka discuss the importance of heart health and the role of a plant-based diet in achieving it. She shares her journey into lifestyle medicine, emphasizing the need for a holistic approach to health that includes diet, exercise, and sleep. The discussion covers common misconceptions about protein intake, the impact of inflammation on health, and the benefits of cooking with whole foods. Dr. Pulapaka also highlights the affordability of healthy eating and the significance of understanding the nutritional value of everyday foods.
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About Dr, Jenneffer Pulapaka
JENNEFFER PULAPAKA, DPM, is a Board-Certified Podiatric Physician Diplomate from the American College of Lifestyle Medicine. A trained podiatric surgeon who specializes in diabetic limb salvage, she is the founder of DeLand Foot and Leg Center. She focuses on Peripheral Vascular Disease, holds a Plant-Based Nutrition Certificate, and is a Culinary Health Education Fundamentals (CHEF) Coach. A Certified Sommelier, she also has 15+ years of experience in menu planning and event design in the restaurant industry and has been a featured sommelier at the James Beard Foundation House. Along with her professional chef husband Hari Pulapaka, she founded Cress Restaurant and they both live in DeLand, FL. They are the co-authors of The Heart Healthy Plant-Based Cookbook.
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Guest Resources:
Website: www.delandpodiatry.com
Book: The Heart Healthy Plant-Based Cookbook
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Episode Chapters
00:00 Introduction to Heart Health and Plant-Based Diets
02:56 The Confusion Around Dietary Trends
05:58 Understanding Protein and Kidney Health
09:10 The Role of Inflammation in Heart Disease
11:55 Personal Journey to Plant-Based Living
14:47 Cooking with Whole Foods and Spices
17:51 The Importance of Fiber and Gut Health
20:58 Exploring Nutritional Benefits of Everyday Foods
23:51 The Impact of Sleep on Health
26:59 Affordable Healthy Eating
29:48 Final Thoughts on Heart Health and Lifestyle
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KIMBERLYâS BOOKS
- Chilla Gorilla & Lanky Lemur Journey to the Heart
- The Beauty Detox Solution
- Beauty Detox Foods
- Beauty Detox Power
- Radical Beauty
- Recipes For Your Perfectly Imperfect Life
- You Are More Than You Think You Are
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Transcript:
Solluna By Kimberly Snyder (00:01.494)
Hi Jennifer, thank you so much for coming on our show today.
Jenneffer Pulapaka (00:06.162)
Thank you for having me, Kimberly.
Solluna By Kimberly Snyder (00:09.282)
You know, when your book came across my desk and once again, everyoneâs called the Heart Healthy Plant-Based Cookbook, it really caught my eye because Iâve been so interested, especially in the heart lately, the heart, the physical heart, you know, from a health perspective, from a dietary perspective, also from an energetic perspective, a spiritual perspective, how the heart is mentioned in all these different traditions around the world. But I wonderedâŚ
And you tell a little bit about this in the beginning of your book, but if you could share with us why your focus has really honed in on heart health in particular.
Jenneffer Pulapaka (00:46.888)
Well, for me, so I am the pioneer of podiatric lifestyle medicine. And a majority of the patients that I see have lower extremity vascular disease with cardiac complications. So thatâs the over, the broad overreaching patient population that I treat. And when dealing with patients, I was a typical physician that
would treat patients with conventional medicine, was, you want surgery or do you want a pill? And lifestyle medicine allowed me to handle patients more broader with treatments, such as using diet, using sleep, reducing stress, exercise.
reducing substance abuse, things like that, that I started to be able to include pillars in their healthcare and see a better outcome in patients. So for me, thatâs why it was important. Just because I think I was getting burned out with just, it was the same thing all the time, pills or surgery, pills or surgery, referral, cardiovascular, interventional, cardiologists, what are we doing? And we were not getting off the wheel. Youâre just kind of stuck in that cycle.
Solluna By Kimberly Snyder (02:00.536)
Great.
Jenneffer Pulapaka (02:10.875)
and you werenât regaining ground, you werenât regaining your health, nothing positive was coming out of it except for trying to prevent a catastrophic event. So thatâs why a heart healthy cookbook is really key to a majority of my patients.
Solluna By Kimberly Snyder (02:21.974)
Right.
Solluna By Kimberly Snyder (02:31.84)
Right. And I want to get into that in a moment. Thereâs such great information here, but one of the things you said is that weâre on the wheel. Many people are on the wheel. And one of the reasons I think people are on the wheel is because theyâre confused. And thereâs so much information out there, Jennifer, as you know. And it feels like to me, you know, there is decades of
And sort of this general idea that we should limit red meat in particular and these foods that have high cholesterol, foods that feel clogging and common sense as these are really dense foods. But now weâre in a time in culture where thereâs, itâs sort of swung, feels like back when I started writing books 11 years ago, I was always talking about this protein question that would come up being plant-based myself. How do you end up protein? And now thereâs this
such an over emphasis on protein. And what I see, Jennifer, is confusion. People are eating tons of red meat and theyâre like, well, I saw such and such and they say that can eat as much red meat as I want or I should sit down and have six eggs. Can you talk to us a little bit about this confusion about cholesterol, foods that are elevating blood pressure, all the research for many decades that donât correlate necessarily with these health trends or I donât say health trends.
Jenneffer Pulapaka (03:52.72)
I mean, thatâs great. That is what they are, okay? Bell bottoms, theyâre not in fashion right now. They have been in fashion. They went out of fashion. They came back in briefly and theyâre out. Thatâs kind of what we cycle when we deal with food trends. Different diets will keep on coming up historically. But unfortunately, thereâs not enough peer-reviewed literature to be behind them.
Solluna By Kimberly Snyder (03:53.954)
dietary trends.
Solluna By Kimberly Snyder (04:06.082)
Yes.
Jenneffer Pulapaka (04:22.331)
We donât have a big enough population to evaluate certain diets that are out there and nor is there research behind it. So those for me are always risky when it comes to patients. So weâd like to stay when Iâm looking at or evaluating diets with patients. I always tell my patients when they were talking about plant-based, theyâre like, well, can I add chicken? Iâm like, well, youâve been adding chicken in it and weâre here right now.
Iâm the thing thatâs gotta cause a bump. Why donât we learn how to not add chicken and not use butter and use a substitute to make it a more healthy option for you? Because what youâve been doing hasnât been working. Thatâs kind of where we are. I only use peer-reviewed literature for the most part.
Solluna By Kimberly Snyder (05:05.11)
Right.
Jenneffer Pulapaka (05:16.677)
And itâs for me, itâs very hard because right now I do see a trend of patients who come in, they think theyâre on a ketogenic diet. Theyâre not on a ketogenic diet. Theyâre never in ketoacidosis. Theyâre never reducing their amount of carbs to get to that state. And most of my patients are complicated patients, meaning that they have diabetes, vascular disease. Chances are they have chronic kidney disease.
When weâre dealing with a lot of comorbidities with patients, we have to be very cognizant when theyâre taking high protein diets. One of my biggest concerns is my kidney patients. High protein diets does not bode well for kidney function long term. And Kidego, which Kidney Disease International, when they put out guidelines, the last several years, the primary treatment for
Solluna By Kimberly Snyder (05:58.625)
Right.
Jenneffer Pulapaka (06:15.719)
chronic kidney disease in patients was diet and lifestyle. So it was nice that we saw a really good bump or a really good change in how weâre addressing patients with chronic disease. So now that we had a patient with chronic disease, maybe they donât even know theyâre stage three chronic kidney disease. And now theyâre just loading up on all these proteins, which kidneys have to strip off nitrogen and it really taxes the kidneys.
Solluna By Kimberly Snyder (06:39.467)
Right.
Jenneffer Pulapaka (06:46.853)
And unfortunately, it usually puts them in a downward spiral towards stage four. And at stage three, we have some really good studies that look at, can we get an improvement in kidney function if we decrease the amount of unused proteins? For the most part, my patients are not active. I am usually negotiating, can I get three days a week? Just three days a week, can you do 30 minutes three days a week? And the standard of care is exercise is
five days a week, 30 minutes, moderate intensity. So when my patients tell me I need the protein, Iâm like, no, not to walk the Pomeranian, a half a block, thatâs not really exercise. Iâm glad weâre doing range of motion and Iâm glad youâre not doing sedentary, but youâre not really in an exercise state to be getting a lot of benefit. I donât need to worry about protein issues with you.
Now, when I deal with wound care patients, I deal with them. Or if I deal with dialysis patients, when I have a nutritionist, registered dietician thatâs on board, then weâre looking at protein loss, but weâre not talking about a majority of patients that are on that. Weâre talking about they got a, they went on Pinterest and they got some keto balls, which are hugely high in fat and protein. And nothing about that is gonna help with inflammation, their heart, their blood flow, or their weight.
Solluna By Kimberly Snyder (07:58.806)
Yeah.
Jenneffer Pulapaka (08:13.201)
Right?
Solluna By Kimberly Snyder (08:14.752)
Yeah. Well, you what you say makes sense and it makes sense to me. And then thereâs Dan Buettner, whoâs been on our podcast several times. Heâs coming back on in December, whoâs saying, Hey, look at these human populations, which are eating really fiber rich diets. Theyâre not hyper fixating on protein. And yet their longevity numbers are the best in the world. Then you have Dr. Michael, Dr. Michael Greger, who also came on with all his thousands of studies. Heâs referencing saying, Hey,
Look at the research. So why do you think Dr. Jennifer, from your perspective as a physician, you know, itâs like people are going on Pinterest, but Iâm also seeing some doctors being like, you know, double the amount of grams that youâre hearing, you know, the recommended doses, one gram per body weight. Where is this coming from? How can, in our culture, we can have such differing views of the research.
Jenneffer Pulapaka (08:45.532)
Yeah.
Solluna By Kimberly Snyder (09:12.308)
And to me, common sense, if you want to open up your blood flow, you donât want to eat clogging foods and really fatty, dense animal foods all day. But how is this even happening in your opinion? Because itâs mind boggling to me.
Jenneffer Pulapaka (09:25.489)
Well, we have different specialists that are out there and everyone has a different way of treating patients. For example, okay, for a good example, I have a lot of patients who will come in for lower extremity arthritis and tendonitis and everyone will keep missing kind of the, I donât wanna say the elephant in the room, but the fact that a lot of my patients have
obesity class two, class three, and no oneâs even discussed about an oral medication for them at that point in time.
Solluna By Kimberly Snyder (10:00.962)
Wait.
Jenneffer Pulapaka (10:04.165)
Some physicians only want to treat with lifestyle medicine or diet or conservative options. So maybe thatâs where these practitioners are trying to maybe cause a bump, but I still prefer to stay with evidence-based. I still want lifestyle medicine on my patients. I still talk about diet, but Iâm also an advocate for GLP-1, GIPs, phenamine and topramate.
Iâm an advocate for that. And Iâm also very realistic with them that usually when you get on a semi-glutide, you will have to stay on that for life. And then they get upset. And then I just remind them youâre not upset that youâre on lisinopril for life. So now can you look at the benefits of being on a medication long-term, how weâre going to reduce our comorbidities? Maybe youâre going to
Solluna By Kimberly Snyder (10:44.887)
Yeah.
Jenneffer Pulapaka (11:03.105)
reduce your diabetes, youâre going to reduce your arthritis and your tendonitis and your like my diabetic patients who have a collapse of the midfoot and I have to deal with all the bone deformity and the ulcerations. So we have a lot of comorbidities that are around obesity as a diagnosis and we havenât allowed the patients yet flexibility to look at it as a disease and to be treated as such with
medication or with diet. So I just donât only do that. Iâm there with conventional medicine, but that may explain why some doctors, like one of my patients today, she was in obesity class three and her doctor was telling her about fiber. Great, wonderful. I am glad he had that discussion, but sheâs looking at one total knee on one side and now we have another total knee thatâs possibly starting on the other leg.
and I had all the tendonitis and tendinopathies in my ankle and in the foot. And heâs still trying to tell her to lose weight and she could lose about a good 75 pounds and then sheâll feel comfortable and then we may see start to see improvement. But he that was the way he wanted to approach it. So that may be the way some physicians want to approach it. Itâs not I like better peer reviewed research and
A lot of the high fat, high protein diets do not have large scale populations to be looking at. So we donât hear the nuances. And you know, and I love the Blue Zones. We just had a dinner the other evening that my husband hosted and it was about the Blue Zones. And it was, you know, reallyâŚ
they just the way they eat is healthy. Itâs not a planned thing. They donât make a concerted effort to be like, Iâm going to get my fiber in. Iâm going to get those things. They actually just eat a more healthy way than we do. And theyâll do conservative, like theyâll have an occasional glass of wine or theyâll eat, you know, fish twice a week or meat every so often. But itâs a more realistic diet.
Solluna By Kimberly Snyder (13:07.009)
Yeah, itâs
Solluna By Kimberly Snyder (13:19.746)
Well, itâs simple, I think, and itâs accessible when youâre cooking one-pot meals and youâre not hyper fixating on numbers. It starts to get really confusing when you start to get heady, I think, versus intuitive and more in your heart, what your bodyâs drawn to. Thereâs this section, Jennifer, in your book about inflammation. Thatâs also one of the things we know is a precursor to heart disease, to many different illnesses in the body.
Jenneffer Pulapaka (13:29.084)
Yeah.
Jenneffer Pulapaka (13:40.807)
Mm-hmm.
Solluna By Kimberly Snyder (13:47.53)
And when you are eating more fiber, itâs feeding those short chain fatty acids, which is helping to reduce inflammation. I, one of my, Iâm concerned when people are just focusing on overloading protein, Iâve noticed in people, itâs like protein no matter what. So more meat, more protein bars, more protein shakes. They naturally get less of these colorful fiber-filled anti-inflammatory foods. And so it starts to create this imbalance.
Jenneffer Pulapaka (13:51.74)
Mm-hmm.
Solluna By Kimberly Snyder (14:17.378)
when youâre focusing, your compass is set towards something very different.
Jenneffer Pulapaka (14:22.285)
find that most patients when theyâre focusing on proteins arenât actually really talking about a whole food. They like to do bars or smoothies or supplements. Theyâre not actually thinking about food or whole food, whether itâs grains or beans, lentils, seeds, nuts. Theyâre not really there. They will with their protein.
Solluna By Kimberly Snyder (14:29.461)
Right.
Jenneffer Pulapaka (14:52.045)
as in their meats, animal proteins, they will fixate on that. And some of that can be due to the fact that we live in a society that praises wealth and a sign of prosperity has been for a long time that if you eat meats, itâs a status symbol versus Iâm going to have a bowl of grains and lentils. there are sometimes we haveâŚ
Solluna By Kimberly Snyder (15:13.73)
Yeah.
Jenneffer Pulapaka (15:17.767)
food can be personal and there are barriers or boundaries that people have to get around when it comes to eating a more healthy way. Because sometimes those family recipes are not healthy. They havenât been there and thatâs why you have a family history of heart attacks, gout, kidney disease, diabetes. Itâs, know, the family cycle keeps on feeding you the wrong information.
Solluna By Kimberly Snyder (15:39.053)
Yeah.
Solluna By Kimberly Snyder (15:44.076)
Well, Dr. Jennifer, when did you become plant-based? And I know a lot of this was informed from research. And now, you your husband is, you know, a partner in ways. You guys host a lot of things together. Heâs been honored by the James Beer Foundation as a featured chef, working with all these amazing foods. When did you come into this path exactly?
Jenneffer Pulapaka (16:05.741)
So I first took my turn at 21. I became vegetarian. I decided if I was going to eat meat, I needed to go to a slaughterhouse and appreciate or accept the way the animal was being brought to my table. So after I had that experience, I became a vegetarian. I was not comfortable with
Solluna By Kimberly Snyder (16:18.413)
Hmm?
Solluna By Kimberly Snyder (16:29.208)
Yeah.
Jenneffer Pulapaka (16:31.463)
I was not comfortable and I could not do it and I wouldnât do it. So I decided at that point in time to become a vegetarian. And that was a pretty rapid change for me. I gave up red meat first. gave up chicken was the last thing. And then I think I finally had like a steak as one last hurrah. And I couldnât get through eating the steak that I wanted to because I knew it was gonna be great. I couldnât do it knowing that I went to, it was aâŚ
It was a cattle slaughterhouse. I just was like, I canât. So Iâve been a vegetarian since I was 21. Iâm 55. So itâs been a few years. Vegan, I say as much as possible. In my house, Iâm vegan. When I go out in public, it is always a battle with how much egg is going to be utilized, dairy.
Solluna By Kimberly Snyder (17:24.6)
Yeah.
Jenneffer Pulapaka (17:29.453)
in some instances. Iâm always able to get vegan vegetarian options, but vegan is a little bit difficult. And if Iâm going to get it out in public, itâs usually pretty pretty bad, I say. I usually get pasta primavera.
Solluna By Kimberly Snyder (17:36.471)
Yeah.
Solluna By Kimberly Snyder (17:44.716)
Well, thatâs why Dr. Jennifer, I donât need out very much because I feel like at home thereâs, and you can eat these beautiful recipes in your cookbook. It does make it much easier when the more home meals you do eat.
Jenneffer Pulapaka (17:56.008)
Yeah, you get pasta primavera, plate of sides, youâll get a salad, or now I can get like a black bean burger. Thatâs like the, thatâs the standard that I get when I eat out. So for me, itâs hard because yes, I do have my husband who is like, you know, a super creative chef when it comes to that. And he was vegetarian until he was 21. After he came to the United States, he was here a few years and then
He tried meat. in his professional career as being a chef, heâs been very broad. He cooks a lot of seafood. Heâs notoriously known for producing fantastic fish dishes. But I think it was his upbringing that taught him about spice and seasoning and flavor that makes him so good about making plant-based cooking.
Solluna By Kimberly Snyder (18:55.786)
Right, he grew up in India.
Jenneffer Pulapaka (18:55.973)
because it was second nature to him, correct. He grew up in India and he came here when he was young. And a lot of us, like I said, we do not have contact with food anymore. And when I do culinary and coaching classes with my patients, we do small group exams. I bring them in foods and we talk about things like that. Like I have an example.
Solluna By Kimberly Snyder (19:20.617)
Well, and while youâre getting that, I want to mention thereâs some call-outs in the book and I want to get into some of the specific information, which is really interesting. But even to educate people, thereâs a spice section in the book, you know, and itâs, this is something that everyone in India might know, for example, but here itâs saying, you know, spices are using any part of the plant, but the leaves, if youâre using the leaves, youâre, then itâs considered an herb. And if youâre not using the leaves, itâs a spice.
Jenneffer Pulapaka (19:30.961)
Yeah.
Jenneffer Pulapaka (19:46.737)
Mm-hmm.
Solluna By Kimberly Snyder (19:49.006)
So I think this appreciation and sort of deeper understanding when weâre looking at any sort of plant and the parts that weâre using starts to create a deeper connection when youâre working with herbs, when youâre working with spices, when youâre cooking. It can be really simple, but it starts to get more, it feels really connected.
Jenneffer Pulapaka (19:52.807)
Thank
Jenneffer Pulapaka (20:08.871)
He does a good job. think common spice substitutions like that. was originally we did this in one of the first books that we had. You know what? Thatâs great. I donât know how many itâs on page 27. I donât know how many times my patients will ask. Well, if I donât have fennel and they get scared about cooking recipes and like, you know, if you donât have fennel.
you know, use a substitute, you know. And if you donât have it, just donât use it. Move on. Find something else. Do you like gilding? You know, move forward with something, you know, but they get nervous about substitutions. And I think as you start to cook more and do more and be more hands on, then youâll realize, you know, I donât have lemongrass, but yeah, I just use, I just had lemon zest and I use lemon zest and I felt good enough.
Solluna By Kimberly Snyder (20:40.926)
Right. You said that you-
Isnât that funny?
Jenneffer Pulapaka (21:05.957)
And then I wanted a little bit more herbaceousness, so I put some basil in it and that was my lemongrass. Perfect. Great substitute. Did you like the food you ate? Yes. Then it was perfect, right?
Solluna By Kimberly Snyder (21:16.142)
Yeah, exactly. Again, less rigid, less heady and confused and more in flow, you know, the energetic part of being living a heart led life. And what I really liked too about the recipes, and I made a bunch of notes if you guys are watching this on her YouTube channel, Iâm holding them up. Thereâs really great information worked into the recipes, which I appreciate. So for example, on page 42, where you talk about kale,
Jenneffer Pulapaka (21:23.686)
Mm-hmm.
Solluna By Kimberly Snyder (21:45.164)
And one of the things that you mentioned is nitrate and nitric oxide and how it helps to open up the blood vessels contributes to the, itâs a vasoactive effector. And then it says, eat it, donât juice it. And Iâve always been more into smoothies and kale salad instead of juice. Yeah. If you could talk a little bit about that.
Jenneffer Pulapaka (21:45.799)
it.
Jenneffer Pulapaka (21:57.896)
Yeah, I love that.
Jenneffer Pulapaka (22:06.311)
So, and I lecture on this one all the time when Iâm talking because you have that nitrate, nitrite, nitric oxide pathway. And nitrates start in the mouth. You start to break it down by chewing. You need mastication with the saliva in order for that enzyme to start as itâs breaking down to your end result is nitric oxide. So it starts in the mouth. So therefore thatâs why Iâm like, you canât do it.
interesting there was a study that recently came out that was looking at toothpaste and mouthwash. So they were theyâre looking into the fact that sometimes when we have this 24-hour toothpaste, well sometimes the bacteria or the enzymes that are in your mouth have a purpose and sometimes those things you know can interfere with that.
Solluna By Kimberly Snyder (22:35.192)
Hmm.
Solluna By Kimberly Snyder (22:42.966)
yes, I read that in here.
Solluna By Kimberly Snyder (22:49.134)
you
Jenneffer Pulapaka (23:02.915)
It wasnât a robust enough study, not a big enough population, but itâs an interesting point to see how is that going to play out down the line? You know, are they going to be looking more into that? Because we know you talked about inflammation, gut biome. You know, they do poo samples all the time on people who eat vegetarian, vegan, and meat, you know, and theyâre looking to see which ones had the healthiest. And out of all of them, when people
Solluna By Kimberly Snyder (23:02.957)
Right.
Solluna By Kimberly Snyder (23:24.483)
Right?
Jenneffer Pulapaka (23:30.213)
have really aggressive disease states that they have to kill off a lot of their bacteria and restart. Theyâve had surgeries, really complicated patients, and then theyâre inocula
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