Dr. Reshma Shah, NOURISH

Dr. Reshma Shah, NOURISH

Zibby Owens: Welcome, Reshma. Thank you so much for coming on “Moms Don’t Have Time to Read Books.”

Reshma Shah: Thank you so much for having me.

Zibby: Nourish, your book, The Definitive Plant-Based Nutrition Guide for Families, you open this book and say, why should there be another book? Don’t we know everything about nutrition? What is your big answer to this question? Why take all the time for this plant-based nutritional handbook of sorts? Tell me about it.

Reshma: I think that we’re at a really interesting time right now. People are really becoming open and so much more aware of issues that face us as a community in terms of everything that’s been happening with COVID and with all the social justice movements. I think that people are really willing to look at the impact of their food choices. The reason that we wrote this book is because — it’s not a call for everyone to be vegan or for everyone to be perfect or for everyone to eat a perfectly clean diet, whatever that means. It’s just really an invitation to look at our food choices and what the consequences of those might be. The reason that we focus on a plant-centered or plant-based approach to feeding our families is because research overwhelmingly supports a plant-centered diet as a foundation for promoting health. The first section of the book is all about the big why.

When you look at the added benefits of the impact that our food choices have on our environment and climate change and what we do with factory farming, in our opinion — I cowrote the book with Brenda Davis who’s a phenomenal plant-based dietician. In our opinion, a plant-based approach to feeding our families checks off all the boxes. It supports our health and the health of our family and our communities. It supports the health of our planet. We think of it of as a radical act of compassion when you think about the suffering that we inflict upon factory-farmed animals. Whatever we can do to address those issues is a win. Yes, there have been a lot of books on nutrition. Our perspective is really focused on families. It’s focused on all these larger issues, but it’s very much intimately connected to our dinner tables because it has to be practical, reasonable, and doable. I’ve got two kids. I know what it’s like to have a busy household. It can’t be just an academic discussion.

Zibby: How old are your kids?

Reshma: I’ve got a fifteen-year-old and an eighteen-year-old. Actually, soon to be sixteen. It’s hard to believe how they grow.

Zibby: Oh, my gosh. How did you convince them to adopt this? Have they adopted this? Has it been from day one? How did you do it?

Reshma: It’s kind of been a full-circle experience for me. I’m Indian. I grew up in a vegetarian household. I grew up eating lots of lentils and beans and all these things, but I was a typical American kid. I definitely ate my share of hot dogs and hamburgers and all those things. All through medical school and residency training, I actually didn’t really connect health and nutrition very much because, I’m sure many people can relate to this, doctors don’t get a lot of training when it comes to nutrition. When I had kids of my own, that’s when I really became interested nutrition and the role it played in our health because all of a sudden, I was responsible for these two young beings. I wanted to make well-informed food choices. The more I started learning about what sort of dietary approaches support health, I kept coming back to this plant-centered, plant-focused idea. One of the reasons I felt like I was very qualified to write this book is because I’ve made all the mistakes. I was a short-order cook. I did all the things at the dinner table that we ask parents not to do.

My family, in the beginning, I was super aggressive. It didn’t really work very well. When you try and force things on people that you love and care about, they don’t really enjoy that so much. My family was keen on letting me know. There was a period where I was super forceful. When I realized that it wasn’t working, I kind of backed off. The single best thing I did to get my family on board was to — I just kept cooking really good food. I didn’t really focus on talking to them about, this is good for you. You should eat it. This is good for our environment. I just, over and over again, kept cooking good meals. Gradually, they sort of came on board. My daughter who’s eighteen, she was vegetarian before any of us were. She was fully on board very quickly. My son and my husband came along much more slowly. Now I would say our household is ninety-five percent plant-based vegan. In the house, that’s how I cook. Then we’re out and if they want a pizza or an ice cream or something, I don’t sweat too much about it.

Zibby: Wow. You’re obviously a really good cook. The recipes that are in the back, are these your own? Where did these come from? Which one would you recommend? If I’m going to try to convince my kids to give away their chicken nuggets, I’m feeling like, I don’t know, are they going to go for lemony chickpea pasta with mushrooms and broccoli? I don’t know if my kids are going to do that. Molasses tahini energy balls, I would. I would do it.

Reshma: One of the things I always say is that this is a guidebook. We’re providing you with the resources, but you are the expert of your family and your children. You’re going to know what they like best. The recipes are mine and my coauthors. We have slightly different approaches. She’s a grandmother. Her kids are out of the house. The way she cooks is going to be slightly different than what I cook because I’ve got two teenagers who are athletes. Our approach is going to be slightly different. Know your kids. One of the things I recommend is, start with the things that you think are going to be easy and approachable for your kids. Don’t start with the hardest things first. If you’ve got kids that are really into chicken nuggets and that’s a thing, you could try a tofu nugget. If you’ve got kids that are skeptical of tofu and it seems sort of strange, you might start with some of the veggie meats that might be a little bit more approachable. I also think that kids require repeated exposure. Even if they don’t like it today doesn’t mean they won’t like it tomorrow. The more that we can use an approach, inviting them, including them, instead of sort of forcing it upon them, I think the easier it goes. For kids that are really, really picky, it might just be, instead of trying to take things away, that you’re just adding things in. Serve whatever you normally serve, and then maybe you’ll have a huge kale salad or maybe the lemony chickpea pasta as a side just so that they don’t feel like you’re forcing this on them.

Zibby: I know. I feel like we do that, and then — my husband is actually the cook in our family. I can cook, but I have to follow recipes. Then if I deviate, something goes wrong. He’ll just throw things together, and it tastes great. I feel like sometimes he’ll spend all this time making it, and then none of the kids touch it. He’s like, why bother? Why is he going to make the same thing again the next night? I’m like, fine, just give them whatever. It’s so easy to be discouraged as the person cooking.

Reshma: Yeah, because you spend a lot of time. You spend a lot of energy. You don’t want the food to go to waste. One of the things that I did early on that helped us at the dinner table tremendously is — my shopping day is usually Sunday. That’s when I go to the market. That’s when I do most of my menu planning. Before I would do all that work, I would ask them, what are your wishes for the week? I would get them involved in the menu planning. If they said, I don’t really care, I don’t have any wishes, the rule in our house is that I will try to honor your wishes, but once we’re at the dinner table, you’re not allowed to complain about the food.

Zibby: That’s good.

Reshma: I spend a lot of time making it. The other is, always try to have something at the table that you know your child is going to like. If you’re trying a new vegetable, maybe pair it with their favorite pasta so that there’s always something that they’re going to enjoy at the table. That’s not the time that you want to be arguing, bickering. The average American family spends seventeen minutes at the dinner table. Make those seventeen minutes count. That’s a time for connection, enjoying one another’s company. It’s not the time to be battling about food.

Zibby: I feel like seventeen might be generous. I don’t know if we make it seventeen minutes.

Reshma: That’s the average time. Some families are going to be a little shorter. That’s the average time.

Zibby: Take me back a little to you and your career up until this point and your becoming a doctor and where you chose to specialize. I heard how this became another interest, but where did you start out?

Reshma: It’s kind of a windy path for me a little bit. I, early on, knew I wanted to go to medical school. I can’t tell how much of that is — I definitely wanted to be in a helping profession. Growing up in an Indian community, becoming a doctor was definitely the path to success. I think that was kind of engrained in me. After medical school, I actually started out in obstetrics and gynecology. I did a year training in that and decided very quickly it didn’t feel like the right fit. For me, when I don’t know what to do in life, I always go back to school. I went back to school and got my master’s in public health and then made a shift in pediatrics. It definitely felt like a much better fit for me. For quite a lot time, I’d say for the first fifteen years, I did general pediatrics. I worked in the emergency room. I had my own patients. I’ve worked with residents and students at Case Western and Rainbow Babies & Children’s Hospital in Cleveland. Then we moved to California about seven years ago. I decided I wanted to make a little bit of shift. I had done primary care for a long time. I’ve been working in the urgent care. It’s a large medical facility that Stanford residents and medical students rotate through. I have been doing some teaching. Really, for the last six months or so with COVID, life has been so different. I’ve been focusing on finishing up the manuscript and getting the book out. For me, I really enjoyed teaching and working with the residents and students, but writing has become a passion I didn’t even know I had.

Zibby: Wow. How did you learn how to write?

Reshma: I don’t really know how I learned how to write. I never thought of myself as a writer. I think at the core of writing is really teaching. Teaching is something that I’ve always done in some capacity, whether it’s working with medical students or residents. I’ve had the fortunate of doing some talks at Stanford. I think at the core of writing is really teaching. There’s something that you feel you want to convey to people that can help them in their daily lives. That’s been a long passion of mine. It just overflowed in writing. I was really lucky to have a writing partner. I cowrote this book. There was a lot of collaboration and sharing of drafts and back-and-forth and things like that.

Zibby: Amazing. How did you do that? I always wonder how collaborators collaborate. What system did you use? How did you assign the workload and everything?

Reshma: It’s a really interesting story. My coauthor, Brenda Davis, this is actually her twelfth book. She’s written many, many books before. When we decided to write this book together, I really drafted out the outline of it. We had certain sections that we were each going to work on. The first section is mine. The second section is her. The third is mine. Then the fourth was a combination. The way that we did it is, we would write a chapter at a time. I would send it to her. She would give me her feedback. It just kept going back and forth like that until we had it the way we wanted. It was really wonderful because I think we each have our own strengths and set of experiences. It was a really beautiful marriage of both our backgrounds, our experiences. We also had a very similar work ethic. I think a writing partner is kind of like a marriage. You don’t exactly know what the relationship’s going to be like. It ends up being a beautiful collaboration. She has become a true friend through the whole process.

Zibby: That’s great. Put your pediatrician hat back on, if you will. Pretend you’re talking to kids, my kids, my friends’ kids, about the advantages of a plant-based diet for their health, not the environment and not about the animals, which both I think are easy for me explain and which they would get pretty simply, but in terms of what it actually does for you. Why should they give up these other things that they’ve come to like? What are the benefits?

Reshma: When we have these conversations with our children, I think it’s really important to be careful and tender because you don’t want to be alarming. Especially in pediatrics, this whole conversation around pediatric obesity has become — I feel like it’s present in every exam room and every conversation. At the end of the day, I always try to focus on health and healthy habits instead of things like weight because that can be a really tricky conversation. One of the things I would say is, for kids, when you look at the longest-lived populations in the world, there are these areas called the blue zones. The blue zones are these geographical pockets throughout the world where they have the highest concentration of centenarians, so people that are living to age a hundred and beyond in fairly good health. They’re still working in their garden. They’re still part of their communities. All of these communities follow plant-centered diets as the foundation for their diet.

Following a plant-based diet can help you to reduce your risk of developing a lot of chronic diseases like heart disease, type two diabetes, certain cancers, even neurocognitive diseases like Alzheimer’s and things like that. I think with those kids, though, those long-term effects can feel so far away. Kids who eat plant-based diets tend to have higher overall nutritional quality. They tend to consumer definitely way more fiber because plant foods are full of fiber. Animal foods contain no fiber. Also, a lot of protective phytonutrients. It gives them all the energy, the nutrients. Appropriately planned plant-based diets are safe for children during all stages of the life cycle. In terms of the specific benefits, there have been fewer studies done on children than there have adults. For instance, some of the health outcomes that we measure in adults in terms of hypertension and diabetes, we just don’t see those as often in kids.

One of the culprits in kids’ health that we’ve seen a lot is dairy. Dairy has been linked to increased incidents of colic in babies, constipation in children for sure, acne, and a whole host of other conditions of eczema and asthma and other atopic illnesses as well. Dairy is definitely something to consider. The way I approach it with children is I never say you have to eliminate these things. Let’s say, for instance, your child has a lot of acne or has been really suffering with eczema or asthma. One approach could be, let’s see how things go if we just eliminate it for two weeks. We don’t have to do it forever. Let’s just try for two weeks. Sometimes if they see enough of an improvement in their constipation or their asthma or their allergies, they will likely say, oh, yeah, there’s so many alternatives, I will gladly forgo the dairy. I don’t know if that answers what you were looking for with kids.

Zibby: It totally answered it. Yes, that’s great. I feel like when I was little, I didn’t quite realize that by shifting all the different levers of what pieces of nutrition I could adjust some of the things with my own body and my own health. I feel like now the focus is so much more in the weeds, not really weeds obviously. I could eat more avocado. I could eat more omega-3s in salmon. That will help my brain. This might help my hair. I just feel like it’s important to convey all that. There are these little magic ingredients in every food. Maybe somehow making it seem like a treasure hunt for what your body needs or something like that.

Reshma: I think kids are definitely fascinated by that. If you have a child that’s really inquisitive and really curious, I think those conversations can be a lot of fun. You just have to be careful because for some kids, it can cause more anxiety around food. Our whole goal as parents is to make it a joyful, inviting experience. Sometimes overcomplicating the message for children can create anxiety. You just have to know your kid. If your kid is really interested in these conversations, then go deep, as deeply as they want to go. The main focus should be on including a variety of foods. Eat the rainbow in terms of fruits and vegetables. Make sure that the food is really satisfying and tasty. Anyone can do something for a week. If you’re in it for the long haul, it has to be enjoyable for kids and families and for adults too.

Zibby: Totally. Yes. Now that you’ve tapped into your love of writing as a form of teaching, what are you going to write about next?

Reshma: I have no idea. As a first-time writer — I’m sure you’ve experienced this with other conversations you’ve had. You begin to wonder, this might be the only thing I actually have to say. I haven’t really let this book fully percolate. We’ll see. I would love to do more writing, whether it’s as a book or even in other formats. I think it’s a really wonderful way to be able to teach. I think it’s a really powerful teaching method. This book has been — it was two years in the making in terms of all the research. It’s very evidenced based. We have tons of references at the end. I don’t exactly know what I would want to write next, but I would love to continue to write.

Zibby: Maybe you should do a children’s book version of it.

Reshma: That’s actually a wonderful idea.

Zibby: Even all the colors on your cover, I’m looking, if you had it illustrated and you still called it Nourish. Maybe you have to find this leaf on every page. Make it like a little game. I don’t know.

Reshma: That’s actually a fantastic idea. I’d never even thought about it.

Zibby: There you go. Get right on that. Do you have any advice for aspiring authors?

Reshma: I would say, for me, having a vision of what I wanted this book to be really helped. Our publisher was very open to a lot of our ideas. For instance, the cover of the book that they proposed, it just didn’t fit my vision. I was fairly aggressive in saying, “I don’t think this will work.” I had to think outside the box. I found my own photographer. I said, “This is what I imagine. Do you think you can do this?” Once I presented the full photograph and everything to the publisher, they’re like, “Oh, yes, this is beautiful. This works.” I think having a vision of what you want the book to be and just being persistent but also collaborative.

Zibby: Totally. Great strategies. Awesome. I love whatever you did. I know I’m being ridiculous, but you should sell prints of just the photo. You could personalize. It’s just such a great picture.

Reshma: I can share with you what the original cover was. You’ll see why. I’ll send you a copy of the original cover. Again, it goes back to having a vision of what you wanted the book to be. For me, more than anything, I wanted this book to be an invitation for families, not a, this is how you must do it. It’s not meant to be prescriptive. It’s really meant to be an invitation. I wanted the cover to reflect that.

Zibby: Love it. It is very inviting. Congratulations. Congrats on this book. Thanks for trying to help so many people live healthier, better lives, and the planet as a whole. It’s a big mission that you’ve taken on. It’s great. Thank you.

Reshma: Thank you. Thank you for the idea for the children’s book. Now my brain is buzzing with all kinds of thoughts. It was such a pleasure chatting with you. Maybe I’ll be back on once the children’s book is done.

Zibby: I would love it. Take care. Have a great day.

Reshma: Buh-bye. You too.

Zibby: Buh-bye.

Dr. Reshma Shah, NOURISH