Resilience, hope, and the profound power of holistic healing take center stage in this conversation. In this episode, we dive deep into a truly remarkable journey with Dr. Dawn Mussallem, a physician at Mayo Clinic, as she shares her powerful personal battles against stage four cancer, advanced heart failure, and a life-altering heart transplant, all while maintaining an unwavering zest for life and dedication to her patients; you’ll hear about her unique insights on nutrition, plant-based diets, and the often-overlooked role of emotional well-being in physical health, including her groundbreaking work in plant protein development and regenerative farming. Through her inspiring story, you’ll discover not only her medical expertise but also her profound belief in the human spirit’s capacity to overcome adversity, ultimately transitioning “hope to knowing” that everything will be alright.

The information presented in Fully Alive is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before making changes to your health regimen. Guests’ opinions are their own and do not necessarily reflect those of the podcast host, production team, or sponsors.

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Listen to the podcast here

 

The Heart Of A Survivor: A Journey Through Cancer And Living Life To The Fullest With Mayo Clinic’s Dr. Dawn Mussallem

Welcome back to Fully Alive, where we are unlocking the secrets to your healthier, happier, and longer life. I’m your host Zach Gurick, and I’m excited about this episode because it’s a powerful and deeply moving conversation with an amazing guest. We have Dr. Dawn Mussallem from the Mayo Clinic with us. She’s a board-certified integrative oncologist and lifestyle medicine specialist at the Mayo Clinic. What makes her story so compelling is that she’s not just a physician. She’s also a patient.

Dr. Mussallem is a stage-four cancer survivor and a heart transplant recipient. Through it all, she has become this radiant example of resilience, faith, and overall well-being and healing. In this episode, we’re going to dive into her extraordinary journey, and we’re going to explore this intersection of science and soul together in medicine. You’re going to hear how her personal health battles have transformed her approach to care, and what it means to just love life and to truly live fully alive, and the powerful role that mindset, lifestyle, and love can play in the healing process.

Whether you’re a healthcare professional, a patient, or just someone who’s seeking to live with greater purpose and vitality, this conversation is going to leave you encouraged, enlightened, and energized. Get ready for a dose of hope, healing, and inspiration. Here’s my conversation with Dr. Dawn Mussallem. Let’s dive in.

 

 

Dawn, thank you so much for being on the show. You are such an amazing human being. You’re radiant, joyful, and you love life. I’m excited for our audience to hear from you. Thank you so much for being here.

You’re marrying exactly how I feel. Thank you for your kind words. I’m excited to be here.

From Smucker’s Jar Dreams To Early Health Passions

You have this unbelievable story, and I’ve had the chance to hear it, but I would love for our audience to get to hear about your own personal journey with the way you tell it. I won’t give it away. Maybe you can start us off by telling us about your personal story and how that led to you finding your purpose and things like that.

I love that. Thank you for having me here. It is so fascinating that at a young age, I’m going to use the word obsessed, I was obsessed with healthy living, at the age of four. When people would stop to ask me, “What do you want to be when you grow up?” I would quickly, without pausing, be like, “I want to be in a Smucker’s jar.” I would also follow it up and say, “I want to be a doctor.” When I say, “I want to be in a Smucker’s jar,” they would look at my parents and think, “What is your child talking about?”

It was Willard Scott of the Today show, and they would celebrate the 100th birthday of these individuals who are living these thriving lifestyles, and they would have joy. Their pictures always have these smiles, and I set out at a young age to live a healthy lifestyle myself. In junior high, I clearly remember going on field trips, and I would always pack healthy snacks if I went to school. I would often read health magazines, health and fitness, or I would love to read Life Extensions. That’s an old-time book on anti-aging back in the 1970s and 80s.

It is a part of my upbringing, and I participated in a whole food diet at a young age. My family was very healthy. I was certainly born into the right family. When I went to undergraduate training to support my ongoing desire to be healthy, I studied nutrition, exercise, and physiology at The Ohio State University, then I went on to do research at The Cooper Institute. My first research project was setting centenarians who were still running marathons, so 100-year-olds, still running marathons, and were still healthy. They were not necessarily running a full marathon. They were still setting out with these impressive exercise goals.

I did research at The Cooper Institute. I was new at that time. I was ready to go to medical school. I was a little bit, not turned off, but I wasn’t just excited about traditional medical school. I first went to naturopathic school. In naturopathic school, I realized I wanted more science training, more traditional medical training to match and blend both together. That’s when I researched all the medical schools in the country, and I found one medical school that upheld nutrition. That’s the only medical school I applied to. I had friends saying, “Don’t do that. You need to apply to more than one medical school.” I said, “Not really. This is the one that’s a good fit for me, and I will only apply there.” That’s what I did, and I got accepted.

Battling Stage Four Cancer And Initial Heart Failure Diagnosis

I went to medical school. In a few weeks in medical school, I started feeling well. I didn’t understand why. It was the first time I hadn’t felt good in my entire life. I was very fit. I always ate healthy. In medical school, I would climb Camelback Mountain twice a day sometimes, as I started medical training. That’s a mountain in Arizona where I went to medical school. All of a sudden, I couldn’t do that anymore. I got to the point where I couldn’t even go up a flight of stairs. I saw a doctor and they said it was asthma. They gave me an inhaler, but the symptoms didn’t get better.

I saw a second doctor. This doctor said to use it more, but I still wasn’t getting better. I got to the point where I couldn’t walk 10 feet. A third doctor said it was in my head. It was shortly thereafter that I collapsed. I was taken to the hospital, and they found a 16-centimeter mass in my chest. I was taken to urgent surgery because I was in cardiogenic shock. The tumor was pulling at the great vessels in my neck and not letting appropriate blood flow circulate. They took me to surgery to pull pieces of the tumor off those major vessels, a little bit off the heart, because the tumor was wrapped around the heart, so that the heart could work properly.

The next day, I found out I had stage-four cancer. It’s a Diffuse Large B-cell Lymphoma. They had given me 3 months to live without treatment and 21, to live with treatment. This was the Thanksgiving weekend of 2000. It was the on-call team. In the hospital setting was an on-call Thanksgiving. Everyone wants to be with their family. I don’t blame the doctors. You’re dealing with his young girl who is kind of feisty, like, “I want to live to be the healthiest person in the world, and you told me something bad.” They followed that up with saying, “You need to drop out of medical school, and you’re never going to be able to have children.” They’re like, “Boom, boom, Bye.” I was like, “Whoa, wait a minute. How are we going to do this?”

I remember feeling like the word hope was unappealing to me. That’s so interesting. To me, hope had this almost duality. If someone is hopeful, what’s on the other end of hopeful? It was almost like there was a little bit of a negative undertone. I just took my belief to knowing everything was going to be okay. I share that with my patients. “I’m going to take you from hope to knowing that you’re going to be okay.” Those are very powerful words. That was my mantra, if you may, “I know I’m going to be okay.” We started chemotherapy right away. I don’t ever remember being sick during chemotherapy. I kept my schedule the same. I still woke up at 4:00 AM. I studied for my medical school training. I finished chemotherapy after several months.

Because the cancer was so advanced, I had to do a bone marrow transplant. This was over twenty years ago. Back then, you were admitted to the hospital, and you’re back in like the girl in the bubble. I remember the hospital room. This is the City of Hope, amazing care. I had the best care with the City of Hope. My oncologist is Dr. Schriber. They had a bicycle in my room and one by the nurse’s station. They said, “We know you’re going to wake up at 4:00 AM and study every day,” which I did. “You can sneak out of your room. You can ride the bike and watch the sunrise.”

That’s what I did. I would wake up at 4:00 during my bone marrow transplant. I go ride on my bike, go back to my room, and study. They had a bike in my room if I wanted to ride the bike in my room during the day as well. I remember every morning, when I get up at 4:00 and tiptoe out to go do the bike, looking out and seeing everyone else in their hospital rooms’ glass doors. You can see them sick. They were dying enough to be alive. I remember attaining my vet holiday without pause.

Also, in every interview, it was so specific to how I felt. I felt so empowered to have that knowledge, to have autonomy over my disease, to know how to show up for myself, and how to take care of myself, because it made a massive difference. I finished my bone marrow transplant, and the stage-four cancer was cured. Powerful.

Instead of 3 months or 20 months.

Yeah, 25 years later, I’m here. That’s amazing. What was super cool is this. About two and a half years later, my husband and I found out the miracle growing in our family. I was pregnant. They were wrong about that, too. I had my daughter Sophia, a total miracle. A few weeks after she was born, I started feeling unwell. This was different, though, because the narrative was totally different now. When I had cancer at the time of my diagnosis, it was just me. I was at a medical school, young. I felt so resilient, knowing I was going to be okay. I could be selfish with my time, but now I had a family, and if something happened to me, it meant they were going to have to suffer and have that pain of my loss.

It was so much more challenging to go through what I was going through in my head, and I don’t want to tell anyone. I kept it to myself for quite some time until my symptoms got so bad. It was again exactly how it was in those last few days before I ended up in the hospital with my cancer, where I couldn’t walk 10 feet. In my mind, I thought for sure the cancer was back. I had to go to the emergency room. Only this time, I was again in cardiogenic shock for a different reason. They found out that my heart was only beating at 8%.

The cancer treatment many years ago was so different from that nowadays. We have a whole field of cancer care centered on this. It’s called cardio oncology. We know that some cancer treatments have the possibility of hurting and damaging the heart. In my case, the tumor was wrapped around my heart, so the radiation I had had to go right to my heart. It saved my life from stage-four cancer. I have no regrets doing the treatment I did, but there was, unfortunately, some collateral damage along this journey.

I had advanced heart failure, and this is why I became a patient at the Mayo Clinic myself. They gave me back the knowing that I was going to be okay. They shared with me that when the medicines don’t work, we may have to start doing procedures. When the procedures don’t work, I may eventually need a heart transplant. The first thing they signed me up for was cardiac rehab. I was like, “I can do this. This is great.” I was able to get stronger. I went back to residency, and I was a resident at the Mayo Clinic.

How heart failure works is you do good and then you use all your reserve and you dip. That was 2003 when I was diagnosed with heart failure, to 2007. In 2007, I had a big dip. I couldn’t keep up with the demands of residency hospital training, so I had to take some time off. This is when the hardest part of my journey happened. My husband died of sudden cardiac death during this time, unexpectedly. That part was so difficult. I was born, as I would describe it, as probably the most joyful human who ever walked the planet. That’s how I was born. I still have that in me.

You still do.

I’m in love with life. I love it, always have. It’s such a blessing to be alive and to experience it through that lens, but when my husband died, I remember finding him and knowing that I couldn’t help, knowing that I wouldn’t be able to resuscitate him. I remember that vital existence free-falling like the ride you would see at an amusement park, that free-falls. I never remember feeling depressed. I was never in a negative mood, but I couldn’t elevate my mood. It was hard for me to be around any sensory experience. Even music was too much. It would be hard for me to handle anything that would stimulate me.

I knew I had to be strong for my daughter. I’ve always had faith in my life and belief in God. This connected me to the concept of heaven, and knowing that, in order for me to get through this, I had to rely on God to bring me through, and He did. This was when I was off from work because I was having my own health problems when this happened. I was able, over that year, after my husband died, to get stronger and go back to residency. It was so miraculous, I got very strong. During that time in 2007, when I was off from work, they did a procedure. That procedure started to strengthen my heart.

I went back and finished residency for the fellowship in hospital medicine. I became a hospital doctor at Mayo with one of the toughest schedules ever. Even though my heart still had heart failure, I was functioning at a high level, walking every day, and eating right. I did great. I did so well, and then, until about 2015 is when I had to reassess what I was doing as a hospital doctor. This is when I started the integrative medicine and breast health program at the Mayo Clinic, where I can transition to the outpatient setting. That’s what I’ve been doing ever since. In 2015, I started that program. I’m going to pause it and see if you have any questions, because I unpacked a whole lot.

At what point, then, did you have the heart transplant?

The Near-Death Experience: A Magical And Peaceful Journey

In 2015, when I started the integrative medicine and breast health program at the Mayo Clinic, I transitioned to the outpatient setting, and I wasn’t feeling good then. It was hard for me. If I were driving, I would have episodes of feeling like I was going to pass out. Examining patients in 2015, I remember looking down at my hands, and they would be almost blue. I’d have to lean up against the table. I was so weak.

In 2016, I was presenting to our leadership team at the Mayo Clinic about the success of this integrative program in the breast cancer center, with the encouragement that we grow this program institution-wide. I actually had a near-death experience during that presentation. My heart went into what’s called fine ventricular fibrillation to asystole, which was so fascinating because I had a defibrillator. I kept on shocking myself for four minutes, but it wasn’t able to resuscitate me because there was no heart rhythm for that defibrillator to capture to shock the rhythm back to life. It was an unshockable rhythm during that period of time.

It’s not every day you meet someone who has had a near-death experience. Would you be willing to share a little bit about what that experience was like?

It was magical. It was so amazing. I remember going down for the presentation, knowing something was off. I wasn’t feeling right. I felt so weak going down the stairs as I was approaching the border. I couldn’t even open the boardroom door, but I knew I had to keep my act. This is an important talk, and so I sat at the head of the table, and I remember grabbing the mouse and trying to control the efforts of the mouse with the cursor at the far end of the screen. As I’m doing that, I wanted to shake the mouse. I felt like the battery wasn’t working in the mouse. I was starting to have arrhythmias during this time. I just didn’t feel it because the heart was so weak. I didn’t feel my heart pumping in my body, so I didn’t know what was going on.

The cursor on the far end of the screen was getting more faded and more faded. That was my last conscious memory. What I remember in this moment, how I would describe it, was an arrival at this place that was completely unknown to me. My acceptance of this place was a total acceptance of this complete unknowing. It was like I was meant to be here. It was so peaceful. It was so still. I felt as if the hands of God were holding me. It was like embodied love. It was this sense of such love and stillness that one is never in a hurry to escape or leave. I had no need or desire to go back to wherever I came from. I could have stayed there forever.

That’s how I would describe it. Complete peacefulness, content, harmony with self and with the large presence, which was God for me. I felt that presence. It almost felt like my body was floating, but I remember one element of sensory perception that was still aware. I remember there was one single strand of hair that I felt was stuck in my lipstick. It is so weird that you would remember that. I remember there was still this slight awareness of what was happening in this moment, but it was truly beautiful. Even to this day, when I run, or if I need to take a moment like a mindful meditation, I will subtly dip back into exactly how that moment felt.

You can go back there.

I can go right back to that space of total stillness any moment I need to. It’s such a gift to have experienced that because once you know what that feeling is like, you are encouraged to want to go back and revisit that often. That embodied love is something that I live with every day, and my love for humanity and others. I love people and that human experience. I would never exchange one aspect of anything I’ve gone through in life. It’s been such a gift.

It’s palpable being around you. You radiate that love to others. Thank you. I would imagine that experience probably helped with your husband’s passing as well, giving peace and comfort.

You’re right. It did. It is even helpful when I talk to patients who are worried they’re dying from their cancer, or who are dying from their cancer, or their spouses, just to have this discussion. I’ve had that experience. Ninety-nine percent of my patients are women because I’m in the breast cancer center. When it comes to, on occasion, the time when cancer has progressed, which is not very often nowadays, we’ve had so many advances in breast cancer, I don’t have these conversations as much.

A breast cancer diagnosis does bring up this conversation of mortality. Even though I don’t feel my patients are going to die, I let them know about this beautiful experience. That’s nothing to be fearful of. I think when it comes to death, we’re more scared about leaving our loved ones behind than grieving our loss. I don’t think many of us are probably too scared about dying ourselves, but for me, I certainly I’m not scared of dying myself as I would not want to leave my daughter behind. I hate to do that to her.

After that near-death experience, he did one more procedure to try to fix the ability for the blood that’s supposed to go forward to go forward because it was all going backwards. My valve at that point was completely wide open, and so all the blood that was meant to go forward was going the opposite direction. They tried to cinch that. That procedure led to a stroke in the left eye. I lost vision in my left eye. That’s when they listed me for a heart transplant. I was listed for transplant in 2019. I was on the transplant list for fourteen months. For a very long time, there was no match.

The Long Wait For A Heart Transplant: A Second Chance At Life

In January 2021, my symptoms had gotten so severe. At that point, they had to admit me to the hospital for supportive care, and I waited the rest of the time in the hospital for an organ. On February 5th, 2021, they found a matching heart. That’s fascinating after eighteen years of living in heart with heart failure. Heart failure is so hard. It’s like your life is a life with total resistance, especially for a young woman. I was 29 when I was diagnosed with heart failure and had lived with heart failure up until I was 46. That is tough to go through your whole middle age with a disease that has substantial limitations.

I didn’t think of it that way when I had the disease. I never victimized myself. Now, my life is so effortless. It’s so easy. Life is so easy. I don’t want to sleep. I just want to be alive so I can keep doing it because there’s so much to do. It’s such an exciting time. I think the interesting thing is when they tell you, “You have a heart. You have an organ. We’re going to save your life.” You would think you would be like, “Oh my gosh, finally,” but you don’t. Everything paused. It was like, “Whoa, wait a minute. That means the memory of my beautiful childhood, my daughter growing up, and my husband, who passed away, would all disappear.”

I had a colleague who said, “Do you even want this heart transplant?” It was several months before I was transplanted. He was a psychiatrist friend, a good friend. He said these very powerful words to me, and it stuck. It’s that messaging that our words are so powerful. When we say something, we always want to think about how those words are going to be perceived by another person. It was very hurtful in a way, because when I heard that I had the new heart, the doctor followed it up with saying that it was the heart of an IV drug user with hepatitis C.

What went through my mind was, “Am I going to develop any of these personality traits?” That was the immediate judgment. I learned a lot from that. Why would I judge? I had to think about it. Am I willing to accept the heart of an IV drug user? What does this mean? What could it mean? Within a few hours, I knew that that was the right heart for me. I also learned a lot about judgment. It’s probably the biggest lesson I learned from this transplant. Why would I judge another person’s life? That person had this beautiful willingness to give their heart, give their organs to other people, and it saved my life.

We live in such harmony together in a way that I even wonder if my existence is elevated because of her heart. She may have lived a very different life than I lived. I lived a beautiful life, my whole life has been a gift. She may not have had that, and so her heart to be a part of my experiences of a fruitful, blessed life is a total bliss. I live in it and it gives me chills. I get this burst of chills, but it’s this true awe-inspired life that I get to experience every single day, so I’m grateful for her heart.

That’s amazing. Thank you for sharing that story.

You’re welcome.

Living With Love & Nutrition: Fueling The Body And Soul

You’ve had all of these things happening in your life. How do you attribute it to your health now? You’ve done extensive work and research around nutrition, diet, exercise, and all of those things. Maybe we can shift gears, and I’d love to hear a little bit about it.

This is my favorite part to talk about. I never like to talk about myself too much, although now life has been saved by the gift of another. Shout-out to organ donation, for sure. If you’re not an organ donor, please sign up to be one because I wouldn’t be here today. The magic and the miracle behind me being here today, having this level of vitality, directly comes from my lifestyle. The number one most important thing is what we talked about momentarily, which is the love, love of self, love of others, without judging self so harshly, without judging others always, but living life through the lens of love is a priority. Nothing else matters if you don’t do that.

Beyond that, let’s say we all master that. I would attribute my flourishing to my nutrition. I know that sounds extreme, but over my lifetime, ever since I was a little girl, I have paid close attention to nutrition. People may say, “Wait a minute, you’re not the poster child for nutrition if you had cancer and then heart failure and a heart transplant.” Had I not taken care of myself, I know that I would not be alive today. We have cancer research that shows us that. People who live a healthy lifestyle, God forbid, they get cancer for whatever reason. We know they live longer than people who didn’t live a healthy lifestyle.

If you correct your lifestyle after the diagnosis, you still improve your outcomes. It’s never too late to change. We know it’s never too late to change. I shared that study here that even at the age of 80, if you decide to start living healthier with a healthier diet, at the age of 80, you can add 3.4 years to your life expectancy. If we go back to 20, and if you start living healthy young, this is a shout-out to moms. I see women every single day who say, “I want to eat healthier, but my husband and kids are not going to want to do this.” The whole family should participate. This is about making the whole family healthy, not just yourself. We know that if you implement these lifestyle changes of eating healthy at 20, you can add 10 to 13 years to your life expectancy. It really matters.

Correcting your lifestyle post-diagnosis still improves your outcomes; it's never too late for change. Share on X

That’s from a study over 30 years of a longitudinal study.

It was a study to show the impact of healthy living on life expectancy, and how many years you can add on to that expected projection of life if you were to make those lifestyle changes. My biggest message for people when it comes to healthy living is that it doesn’t have to be perfect. This is about progress, not perfection. Karen Collins is an amazing nutritionist from the American Institute for Cancer Research. That was the messaging that she started years back. I thought it was so important that this doesn’t have to be perfect.

 

In the Blue Zones, these are the areas of the world where we don’t necessarily have to apply rigorous research to the Blue Zones. We can step back and say, “Wait a minute, these are areas of the world where people live to be over 100 with low levels of chronic disease.” One thing they share in common is community, love, connection, and faith. Those are priorities, but beyond that, they have this Plant Slant diet where over 90% of their diet is traditionally plant-based. Less than 1% is coming from animal proteins and eggs, and those sorts of things. You don’t need to be vegan, and I don’t even like that word vegan. We talked about that. A whole food plant predominant diet or a Plant Slant diet is a direction you want to go.

After my transplant, I wanted to put it to the test. I thought, “What could I do to prove that nutrition makes that much of a difference?” In addition to exercise, getting adequate sleep, avoiding toxic exposures, and such, I eat a whole food plant-based diet, which is what I have eaten for my whole life. I was able to run a full marathon after my transplant. No one else had ever done that.

Starting healthy habits young, by eating well at 20, can add 10 to 13 years to your life expectancy. It really, really matters. Share on X

Tell us that story. Within one year, right?

From Deconditioned To Marathoner: The Power Of Plant-Based Recovery

After my transplant, my gastric, my calf muscles were indented. I was so deconditioned. They had to walk me after my transplant with two people assisting me and a walker. It was very deconditioned.

From that to a marathon in one year.

After by transplant, when I first started taking those first steps, I thought, “I never should have said this. This is possibly not going to happen.” It was so hard to take steps that I stayed committed in the hospital. Every hour, I would ask the poor nurse to unhook me from the wall so I could go for a walk. I just walked and walked. Within a few weeks, I asked if I could start taking a little bit of trot. My surgeon was amazing at the Mayo Clinic. He worked with me to say, “I have you sewn up fine. You could start to do little trots.”

I started running, and within about three months of my transplant, I was running 5Ks. Four months after my transplant, I climbed Camelback Mountain again for the first time, which was powerful. I felt one with the heart. I felt that powerful beat of that new heart. That was so glorious. We have an exercise specialist who is a cardiologist at the Mayo Clinic. They were worried, but they wanted to make sure that this was safe, and I wanted to make sure this was saved, too.

I guess it was about eight months after the transplant, he had run a 10-mile race with me just to keep his eye on me. I had already run longer miles, but he wanted to see how I looked. They gave me the green light at that point. I continued to train. Jeff Galloway trained me. He’s an amazing former Olympian with that run-walk. He wanted to be careful. My heart rate would get a little bit too high, and that was one of the methods we would use to keep my heart rate controlled.

About eleven months after my transplant, I ran a full marathon as a practice run. Actually, I ran one at eleven months, but who’s counting? No, I’m kidding. I had this competitive trait, so then, 365 days after my transplant, I ran a full marathon. It was the DONNA Breast Cancer Marathon in Jacksonville, Florida. I ran in honor of my patients, and it was such an honor. I had such love and support and that effort. I’m so grateful.

I think what helped me with that recovery is plant-based nutrition, where I don’t consume any processed foods whatsoever. I should say ultra-processed foods. I don’t do things with chemicals. I do food as close to nature as possible, and I always make sure that 50% of what I eat, whenever I eat, is coming from a vegetable or fruit. There’s good research on making sure you get at least five servings of vegetables and fruits a day. Who wants to count? It’s easier to say whenever you eat, make sure 50% of that plate is coming from vegetables and fruits. You’ll be fine. You’ll get that five, probably more.

You’re a living, breathing proof of this type of lifestyle and nutrition. Maybe you can share a story or two about other patients you’ve treated through nutrition, and maybe some success stories.

It’s such a gift to sit in that space with my patients every single day. When it comes to the whole food plant-based nutrition, when it comes to nutrition period, we know that nutrition is the biggest contributor to body composition. Body composition weight management does matter, too, when it comes to overall, how can we live to be on Earth for as long as possible and be healthy? It’s this whole concept of health span more than life span.

We don’t want to be 100 years old and drooling, and not enjoying life. That’s so fine. We want to extend our health span.

 

 

There was a study a few months ago that looked exactly at that. Increasing our health span by 8 to 10 years comes from getting more plants. We know that more of a plant-dominant diet can improve the health span by an average of about 46% to up to 80% more likely to a healthy aging. We want to focus on that plant. What things do they stay away from? Again, those trans fats, the ultra-processed food, the red meats, the processed meats, those are the things that you want to minimize, but it’s that emphasis on trying to get more plant foods and plant proteins. I would say my favorite study, next to that one, is the one showing that even at 80, you can add 3.4 years. Awesome.

It’s never too late.

My other favorite study is out of the Nurses’ Health Study, which was published over the last year. They followed 48,000 individuals over 30 years. Every four years, they did a reanalysis of the nutritional pattern. The question they asked was the most important question we should ask in the science of healthcare. It was, “What is the path to healthy aging physically, cognitively, and emotionally?” That path to healthy aging was plant protein. It outperformed dairy and animal protein otherwise. It showed an increase in healthy aging by 46%.

That is a big difference.

Massive number, right? You want to do more plant proteins, like beans, lentils, split peas, and soy. We should probably talk about soy and the biggest myth that exists.

I have avoided soy because I’ve heard the myths. Tell us about that.

Debunking Soy Myths: Truths And Benefits For Health & Longevity

Soy is so interesting. Several decades ago, there was a lab study. First of all, any study in the lab that is either showing harm or good doesn’t mean that it is going to happen to humans. This is a lot in the supplement industry. There are a lot of things that happened in the lab that look like the Holy Grail to longevity medicine, but applying that to humans may be a lot different. Just because it’s a lab study doesn’t mean it translates to humans. You want to read science and make sure that you’re not just relying on lab data. This is where this myth about soy came from.

There was a mouse model study, and the mice that were eating lots of soy developed tumors in their mammary tissue or their breast tissue. Every media post grabbed onto that soy causes tumors in breast tissue. Scientists said, “Wait a minute. Humans do not metabolize soy the same way. This study needs to be rejected.” We know that in humans, the soy binds to estrogen receptor beta predominantly in the breast tissue. That is the anti-proliferative area. It turns off, or the tumor growth would be turned on. It’s doing a very favorable thing. If we step back and look at Asian countries where they consume a lot of soy, they have low levels of breast cancer.

We’ve known this for a long time, so much to say that, from a common sense standpoint, this study makes no sense. We don’t see this pattern in humans. We know that soy consumption, especially at an early age for young women, can reduce the risk of breast cancer. We know that soy consumption throughout a lifetime, God forbid, a woman ever gets breast cancer, reduces the risk of dying from breast cancer. We know soy reduces the risk of prostate cancer. We have some early studies suggesting that soy is even helpful for looking at different aspects of lung cancer. That one is fascinating to me.

Soy is amazing for the gut microbiome. The gut microbiome harnesses our immune regulation, which right there in and of itself would mean that it’s going to be favorable for cancer control of all cancers, and any chronic diseases when it comes to that. That would be infection-mediated. When it comes to breast cancer survivors, there has been a lot of attention in this space. The 2022 American Cancer Society update on exercise and nutrition dedicated three paragraphs to soy.

There was a wonderful review of the data by scientists about an 8,000, almost 9,000-person study. What it showed us is that breast cancer survivors who had more soy versus less had a 25% reduced risk of breast cancer returning. It’s even safe among breast cancer survivors, and beyond safe, actually helpful. This was emphasized among that group of estrogen receptor-negative patients. Women with estrogen receptor-positive breast cancer still got that benefit.

Soy is safe for everyone. It’s safe for little boys. We got that great question earlier. What about almond milk versus soy milk? I would say go for the soy milk because you’ll get protein, and it makes sense. Always look at the labels of plant milks. Some of them have added sugar. They have added additives, so get as close to nature as possible. With soy, there’s a lot of genetic modification. Try to steer clear of that. Make sure it’s non-GMO. You may want to try to get an organic one if you can. Shout out for soy. Don’t overconsume it. You still want a variety of food, but 1 to 3 servings of soy a day is 100% safe.

Edamame, soy milk, tofu, and things like that.

Tempe, but I love that you said edamame first. It’s the whole food source. We know that it is a complete protein and it’s going to par right along the same grams that would chicken and other things. Toss that on your salad.

It also reduces hot flashes in women.

I love that you’re listening so good.

Maybe 88%, you said?

Yes. That is from the whey study by Dr. Neal Barnard. Shout out to him. He did the study twice. It showed that half a cup of edamame a day reduced moderate to severe hot flashes by 88%. The woman’s mood felt better, her libido was better, and over a twelve-week study, they lost 8 pounds. That’s pretty powerful.

Just by eating edamame.

Yes. I see this in my patients when a woman comes in with hot flashes, which is the majority of my patients. Seventy-five percent of breast cancers are driven by estrogen, which means when we’re treating that breast cancer, we have to target that estrogen, which is going to typically cause some of those menopausal symptoms to upregulate. Hot flashes are a major thing that I’m managing in my practice. That’s the top thing I turned to. I want you to get one serving of soy a day. One to three is where we need to start, unless they have an allergy or something. I want them to lean on it, and sure enough, these hot flashes are gone. It’s amazing.

That sounds amazing. Walk us through a normal day in your life. What does your practice look like as far as all of the things that we’ve talked about with your faith, your exercise, and your diet? Maybe we can talk a little bit too in there about your thoughts on time-restricted eating, fasting, intermittent fasting, and all of those things, because I know those are questions that people have, too.

Dr. Dawn’s Daily Routine: Exercise, Plant Power & Time-Restricted Eating

That’s great. Thank you. These are such good questions. I still wake up every morning at 4:00 AM. I love doing it at 4:00 AM. I want to get my day started. I wake up at 4:00 AM and I start working. It’s such a peaceful time for me and so I go over patient charts. I do some reviews. I do a lot of different talks and so on. I’ll work on some of the research or writing papers. I like to go for my morning run as soon as the sun rises. That is my favorite time to run if I can fit it in. I typically try to go for a 60-minute run.

You’re right there by the beach, and the sun is coming up. That’s nice. How long do you run for?

On the weekends, I go for longer runs. By the weekdays, I try to do 60 minutes. I do try to prioritize resistance training. Resistance training is so important. We need to give our bones and muscles a reason to stay strong. After 30, our muscle mass wants to dwindle. We’ve got to lift weights. I don’t enjoy that as much.

I hear that from everyone now, every expert I get to interview. Resistance training is so important. I think it has been overlooked for a while.

It has. This is a shout-out to moms, kids, teens, and adolescents. I was fortunate that I was so fascinated with wellness that I started lifting weights at a very young age. That muscle memory has served me beneficial. We know bone health and muscle health start young. Parents, show it for yourself to be role models for your kids. Engage your kids in these healthy activities to get them off their iPads, away from the TV, and be active and fit as a family. I show up for myself in my own life, like I want my patients to run. I try to role model that behavior in. In the days when I could always get that run, I’m so energized for the rest of my day. If I miss a run in the morning, I’m a little more, not sleepy, but I don’t have as much energy. I go like, “I should have run.”

You definitely ran today. I can tell.

Yeah, I always do. I always try to get some exercise in the morning, so it makes me feel great. I love my plant-based nutrition, and I spend time. I’m very busy. I have a full schedule, but I never miss the opportunity to get healthy food. When I travel, I’ll pack something with me or grab something. I don’t make a big deal out of it. This morning, I had some dried soy nuts and a banana. It was quick, but it was great, and coffee. I have a little pack of organic coffee that I bring with me. We can talk about coffee, too.

Ordinarily, during the week, if I’m running behind, I’ll just do a smoothie. I load my smoothie up a soy milk. Sometimes I put some chickpeas in there. I try to do whole food as possible without even using protein powder. If I feel like I don’t have time to add chickpeas or something, then I’ll go ahead and put a scoop of protein powder. I always do two huge mixed green leafy vegetables and a bunch of berries. I do organic berries unless I’m doing wild berries. I’ll just do the wild. They don’t need to be organic in most cases.

I do a little matcha in that, some flaxseed in that. Sometimes I’ll do some hemp seed for some added protein. I do blue spirulina, this gorgeous color, this beautiful pigment. That’s what I typically do for breakfast. I put a high-powered multivitamin in there a lot of times as well. That’s what I do for my breakfast, and some creatine. I’m a big believer in creatine for muscle, bone, as well as brain health. I’ll do 3 to 5 grams because I’m a smaller-stature woman.

Just on the creatine for a second, I hear that all the time, too. That’s so helpful. Most men seemed more likely to take it, but it’s important for women as well.

Itis. This is the most studied supplement. It’s harmless. A lot of people say, “My creatinine increased.” That’s different. If someone pushes their creatine too high, they could maybe see a little bit of an increase, but it’s not harmful. Creatine is important for everyone. We know it’s safe for kids, too. We’ve even seen some recent research that it may even help the mood for some individuals. The coolest research with it is if you’ve had a sleep-deprived night and you need to be on, doing 10 grams of creatine punch can help that brain rejuvenate a little bit.

That’s good for your brain as well.

It is. The brain research is exciting, too. Right now, it’s a hot topic. I don’t want to say it’s the fad, but it shouldn’t be a fad. It should be around to stay forever. It’s been something I’ve studied ever since my exercise physiology years, since 1992. This is nothing new, but it’s something that everyone should consider. It’s super cheap. You don’t need to spend a lot of money on this.

You do 3 to 5 grams in your smoothie. How long has it been since you’ve eaten then, by the time you have your smoothie?

Pre-Run Rituals And Fasting Perspectives

That’s usually the first thing I do for my breakfast. When I wake up, I am one of those people who feel better if I eat a little something before I run. I usually have a few walnuts and 1 or 2 dates before I run. That’s usually what I have, just a little snack. It fuels my run. I can’t run fasting. Stacy Sims has great research in this space. I do believe in fasting. Fasting is great. If you can try to get twelve hours, stop eating by 5:00 or 6:00 if you can, and start back eating at 6:00 if you can’t. A twelve-hour fast would be great. I’ll be honest, it’s hard for me to do that sometimes in life. You show up the best you can. For me, fasting is hard at times. I wish I could be better.

A lot of times, what I do is I will do a five-day fasting mimicking diet. I’ll do that one time every 3 to 4 months. I use Prolon. I love Prolon. Valter Longo has done amazing research in this space. It’s a very tested and trusted company. I love that option, and you’re still getting food during it. I like that, and then I start seeing patients at lunchtime. I never skip a meal, so I’ll usually break away to get a little bit of lunch. I usually do a grain bowl with a lot of green leafy vegetables.

I try to batch cook. On the weekends, I’ll cook up some quinoa with some chickpeas in it. I’ll put that in the bowl and I’m a big advocate for the purple sweet potatoes, the Stokes sweet potatoes. I put those in there, and I usually pop some edamame on top, too, to give me a little extra protein. That’s my salad, with some vinegar. I think it’s delightful. I put some hemp seeds in for some added protein. I love my food. My palate is so primed to natural food.

When people are first onboarding to this diet, the traditional food chain of ultra-processed food has hacked their palate. The palate is expecting this hyper palatability of food with salt, sugar, artificial flavors, and X, Y, and Z. It may take you some time to start tasting food again, but just savor it. Play with it. The feel, everything is so fun. The crunch, the color is so vibrant. It’s very exciting.

You have that for lunch, and then?

Finish my patients, and then for dinner, it depends on what I do for dinner. I may do tofu a certain way, or a healthy longevity soup with a mixture of beans in it. I am big in the space of novel food development for proteins. I’m excited about mycelium protein, or protein from mushrooms. There are some exciting products that are on the market, and more to come on the market in the space of meat alternatives. I don’t personally care for the meat alternatives that are ultra-processed with oils and all added into them.

I personally don’t consume oil in my diet. I do the whole food. I’d rather do the nut than do the oil, or do the seed than do the oil. I’d rather eat all of those and do the olive oil to access. I do think that there’s a health benefit of olive oil, so I don’t think people need to shy away from it. If they have a normal body composition, but 70% of Americans are overweight or obese. They don’t want to overdo the oils. That’s a very calorie-dense food.

For dinner, I have a lot of variety, and I take time to make my dinner. We’re all busy. I don’t watch TV, instead I’d rather make a beautiful dinner for myself, family, friends, or if my daughter is home. It’s so exciting to be able to do that, and then sit and enjoy it. Maybe be off your screen during that time and have a moment, some reflection, or whatever is special to you. That’s how I approach it. I don’t drink alcohol unless it’s a special occasion. I’m not alcohol-free either. If it’s a special celebration, I’ll enjoy a cocktail. We know that we want to avoid alcohol for cancer prevention.

People, for too many years, were given a message that alcohol is good for the heart. We know what’s good for the heart. Eating a low-fat plant-predominant diet and getting your exercise, that’s good for your heart. Alcohol isn’t going to give you that added heart benefit. We know that when it comes to alcohol, even in the Blue Zones, they had a little bit. If you’re having a little bit, it’s probably not going to hurt you if you’re doing everything else right. That research got so messed up because the non-drinkers turned out to have recovering alcoholics in that group. That’s why the original alcohol study showed that people who drink alcohol are healthier than non-drinkers. We later learned that the non-drinkers had some of the heaviest alcohol drinkers in their past in that subset.

It’s the past drinking that skewed the numbers.

Alcohol doesn’t give you a health benefit.

That seems pretty clear.

The special connection, the love does.

It sounds like an amazing day. You mentioned trying to have 30 different whole foods per week, at minimum, but even up to 50 to 70 different whole foods. You mentioned that even spices can count towards that and things like that. You can have this significant variety for your gut microbiome.

You are such a good listener. That is exactly right. The American Gut Project, ten or less different plant foods a week versus 30 or more. Thirty or more gives you a much more diverse, optimized gut microbiome. That’s great. If you want to get an A+ in the class, it was 50 to 70. That’s a lot, but it’s everything. It’s all the different vegetables and fruits. It’s a different whole grains, nuts, seeds, and beans, as well as spices. Not one spice. It’s usually four spices equals one different type of diversity.

Nonetheless, here is a shout-out to variety. When you go to the grocery store, let’s say you’re going to pick sweet potatoes, and you’ve never had a Japanese sweet potato, try a Japanese sweet potato, or maybe carrots. Rather than getting the orange carrots, get the purple carrots that have a little white ones in there too. Just get variety. Get cilantro and different parsley.

Think of sprouting. It’s such an inexpensive, easy thing to do. You can live in an apartment or condominium. You don’t need a yard for a garden, and you can sprout. It’s the point of the plant when it is the most nutrient-dense, and it’s very inexpensive to grow your own sprouts. I would caution buying them at the grocery store because of infections that can happen, or organisms, but the sprouting is a fun thing that I do encourage for my patients to do as well.

Yeah, if they’re growing their own. It sounds like you’re doing that with your own nutrition. It’s giving a wide variety. Your gut microbiome is probably healthy.

It’s very happy. It’s very smiling, and there’s even fun research to show that when you get more vegetables and fruits each day that you’re happier. You have less worry and less tension. You see that in people. You go to the medical conferences, where the doctors are specializing in lifestyle medicine, and it’s like a happy festival. Everyone is very happy and joyful because they’re taking good care of their bodies. We want to advocate for doing better. It doesn’t have to be perfect, but do better.

You mentioned a little bit about Dean Ornish‘s work. Some of the things that are now reversing Alzheimer’s or making a dent in MCI, mild cognitive impairments. Can you talk a little bit about that?

Reversing Cognitive Decline: Lifestyle Changes And Dr. Ornish’s Work

What a gentleman. He has informed us about the science of medicine and healthy living over the years. He has shown us so much with cardiac disease reversal and with early prostate cancer reversal. Now, he’s taking on whether we can reverse early mild cognitive impairment, mild Alzheimer’s, and dementia. He recently had the study published. He did amazing findings in this particular study. The application of lifestyle that he approached this with was a whole food plant-based diet. It was to exercise every single day. It was social connections at least three times a week, and it was an hour of meditation each day, reflective time, and prayer.

Some people say, “I’m not really into that.” Do you pray? There are many ways of trying to calm your mind in a non-judgmental way, where you can be at peace and have some elements of stillness. What he showed is that after this particular study, he was able to reverse this early cognitive impairment. It’s a very powerful study. A huge shout-out to this application of showing up for yourself. There were some interesting supplements that he used in the study as well. I think that’s an important talking point.

There are a lot of micronutrient deficiencies in food systems nowadays. I see in my patients a lot of vitamin D deficiency and B12 deficiency. I see zinc and selenium deficiencies in my patients often. If people are not eating fish, especially as we get older, even if you’re having flax seed, which is an omega-3 fatty acid, you’re not good at taking that Alpha-linolenic acid in the flaxseed, and making it into DHA to protect the brain. In my people who are whole food plant only, I do have them supplement with algae oil to make sure they’re getting that DHA. That was part of his study as well.

I thought that the supplements that he used in the study were very exciting to see. When it comes to supplements, you have to be careful where you’re buying them from. You don’t want to get counterfeits, so be cautious of that. A good, high-quality multivitamin is important for people. One thing that I think is an important message. Many multivitamins have folic acid, and 44% of people have this gene mutation. Their body doesn’t know how to metabolize folic acid. It’ll build up as a metabolite that’s harmful, so look for methyl folate on your multivitamin. Make sure it’s a methyl folate. I think it’s a much safer way, because we’re not going to test everyone for that little bit of a gene mutation, just to be on the safe side. It’s important.

Men, you don’t need iron in your multivitamins, ever. In women, if you’re postmenopausal, you don’t need iron either. If you are post menopausal, if you’re a man, and you have iron deficiency, you should talk to your doctor and ask the question why, and get the answer why. No one should have an iron deficiency unless they’re women of childbearing age, still having a menstrual cycle, or losing that blood each month. Iron is an oxidative source. It’s part of why we cut out animal protein, so you get less iron.

This is all so fascinating. One quick question about vitamin B12. Sometimes you hear, “On a plant-based diet, you don’t get enough vitamin B12.” What do you do with your own diet?

I use that multivitamin. The same thing with that methyl folate, I use that methyl B12. I also use a lot of nutritional yeast. Nutritional yeast is a fun substance. You can add it to your food. It’s very rich in protein. A lot of people describe it like it has a cheesy flavor. It’s a very distinct flavor. First, it may turn people off, but after you’ve had it a few times, the palate adjusts to it. I think it has a very beautiful flavor. Most of those have B12 in that, but I don’t rely on that. I usually go ahead and do the B12 supplement. I’m making sure it’s a methyl B12, and I do have those levels checked. You generally want to have that checked with an MMA level. You can have your B12 check, but you would want to get an MMA level to confirm that you have proper tissue absorption of that. It’s very important.

That’s pretty easy to supplement, then.

It’s very easy, and the vitamin D, too. We see so many vitamin D deficiencies. Vitamin D supplements likely don’t prevent cancer. If you’re a cancer survivor, getting your vitamin D level up to the 55 range or even higher has been shown to improve outcomes. In colon cancer patients, it may even be higher, as high as 75. All patients should have B12 and D3 checked at least once or twice a year to make sure they’re okay.

One last question. What are you most excited about in terms of what’s on the horizon as you look at the medical landscape? What are you most excited about? Are there any breakthroughs that are coming or are close, or here even that you’re most excited about?

I love that question. Thank you. I’m most excited about this work that I’m doing in the novel food development space, including a plant protein development that I’m working on. That is very exciting for me, though I don’t want people to rely on plant proteins. Sometimes we’re in a hurry, and sometimes we have to have it. It would be nice to have a safe alternative out there that is healthy for the body.

In terms of this mycelium protein, I’m very intrigued by that. Being active in that space to help guide that industry with novel protein development that would not be an animal source is something I’m excited to be a part of. Also, my work with regenerative farming at the Mayo Clinic. It’s looking at how we can prepare food in a way that we can restore that nutrient density that we don’t see this depletion of the vitamins and minerals. Is there even a way with some technologies that we’re looking at or in partnership with to even augment some of the phytonutrient concentrations? Applying food as medicine like we’ve seen it, but trying to bring our food system back to where it used to be, so we just rely on the food. It’s an exciting time to be in this space.

Food is medicine. We've seen it, and we're trying to bring our food system back to what it used to be. Share on X

A lot of amazing things are happening there. Where can people find out more about you, or find you, or connect with Mayo Clinic?

I’m a physician at the Mayo Clinic. I do a lot of conferences and webinars at the Mayo Clinic. I’m on Instagram. I’ve been asked to have more of a social media presence, so I’m trying to do that. I’m learning. It’s very hard to do both, but social media is so fun because you get to have a wide footprint globally to try to help to inspire others.

I love that ability to inspire others, and I get beautiful messages from people every day, whether they’re going through cancer or their caregiver for someone with cancer or heart disease, or whatever disease it may be, here to inspire moving you beyond hope to knowing that you too can flourish amid the healthcare adversity that you have and beyond.

If you haven’t had health care problems, let’s show up for yourself now so you never have to. It doesn’t mean that if you have a healthcare problem, you did something wrong. There are a lot of environmental things, and sometimes life just happens. It’s the art of acceptance and then knowing how to show up for yourself so that you don’t have to necessarily perceive those symptoms in the way that people a lot of times are subject to otherwise.

This has been so fun, so fascinating, and I’m excited that our audience is getting to hear this from you. Thank you so much for being with us and sharing all your wisdom and expertise, and your amazing journey.

Thank you so much. I enjoyed being here with you. I wish you health, and for all the audience, optimal health. Hopefully, we can connect in the future.

Thank you so much.

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What an amazing conversation with Dr. Dawn Mussallem from the Mayo Clinic. She truly embodies someone who is living their life fully alive. She has experienced every part of life already, from having stage-four cancer to losing a spouse, to having a near-death experience, to having a heart transplant. She emulates joy and love. Dawn, thank you for sharing your story and your journey with us. I know that I learned a lot.

There were several myths that I have bought into that have been dispelled for me, like the whole thing around soy. I’m going to be having more edamame and soy milk in our house, and looking at how we can diversify our diet and get as many different plant-based foods each week. She said at least 30 is good, even upwards of 50 to 70 for our gut microbiome, for our overall vitality. I hope that you learned something new and are inspired by Dawn’s journey and her work. Thanks so much for tuning in. Until next time, we’ll see you back here on Fully Alive. Have a great day.

 

Important Links

• Dawn Mussallem on the Mayo Clinic
• Dawn Mussallem on LinkedIn
• @DrDawnMussallem on Instagram
• Mayo Clinic
• Karen Collins’s website
• Jeff Galloway’s website
• Stacy Sims’s website
• Prolon
• Dean Ornish on LinkedIn