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Do you know the six pillars of lifestyle medicine and how you can apply them to your daily life? Anthony Gallegos, MD from WellMed at Grissom, explains how providers help patients change lifestyle behaviors and improve their quality of life.
Aug. 26, 2024
Podcast transcript
INTROWelcome to Docs in a Pod, presented by WellMed. Over the next half-hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Tamika Perry and award-winning veteran broadcaster Ron Aaron will share information to improve your health and well-being. And now, here are Ron Aaron and Dr. Tamika Perry.
RON AARON
Well, welcome to Docs in a Pod. I'm Ron Aaron. We are delighted to have you on board with us. Our co-host, Dr. Audrey Baria is on special assignment today, and we have a delightful opportunity to talk with Dr. Anthony Gallegos. Dr. Gallegos is someone who loves primary care. In fact, in his bio, he says he treats his patients like family and listens to them. Thats a really good thing. He explains in a way that is clear and easy to understand, and he emphasizes lifestyle changes, some of what we'll be talking about today, like diet and exercise. Dr. Gallegos graduated from the University of Vermont College of Medicine, completed his residency through the Christos Santa Rosa Family Practice residency program. He's board certified by the American Board of Family Medicine. He was born and raised in California and then emigrated to the great state of Texas where he now claims his home. He enjoys playing sports, watching documentaries, or listening to podcasts in his free time. Dr. Gallegos spends quality time with his wife and his two young children. Youll find him at the WellMed at Grissom Clinic if you happen to be in San Antonio, Texas. Dr. Gallegos, thanks for joining us on Docs in a Pod.
DR. ANTHONY GALLEGOS
Yes, thank you so much for having me. It's a pleasure to be here.
RON AARON
What led you to the practice of medicine?
DR. ANTHONY GALLEGOS
Well, I, as a child, I unfortunately had to endure several surgeries on my ear. I was found to have an ear tumor that continued to grow back after being surgically removed a few times. So, I spent a lot of time around doctors and, and in hospitals. I looked up to them and, you know, I felt like as a child looking up to superheroes like Spider Man, I had doctors right up there with Spider Man. I was amazed by what they did. And so, from a young age, I always knew I wanted to practice medicine
RON AARON
And did you end up with a hearing deficit or did they fix it?
DR. ANTHONY GALLEGOS
Yeah, no, unfortunately it's never been fixed, so I am deaf in one ear. Yeah, that's something I've always had to deal with, but I forget about it sometimes because I've just learned to adapt, and this is my new normal.
RON AARON
Now one of the things you wanted to talk about is the six pillars of lifestyle medicine. What do you mean by that?
DR. ANTHONY GALLEGOS
Yes. So, in general, lifestyle medicine, it's, it's a medical specialty where doctors will focus on changing certain lifestyle behaviors as a way of treating, preventing, and sometimes even worsening your chronic health condition. Conditions that are super common that we see every day in clinic, like high blood pressure, diabetes, cholesterol, obesity. You can focus on those certain lifestyle changes and there are six pillars of a healthy lifestyle that we try to focus on when we are, you know, taking care of those chronic conditions that I listed.
RON AARON
And I'm assuming one of those has to be quit smoking if you smoke.
DR. ANTHONY GALLEGOS
Yes. One of the pillars is, is avoiding risky substances. Risky substances could be smoking, the use of alcohol, recreational drugs. So of course, you know, avoiding those and talking to your doctor. I mean, one of the most important things that I want to emphasize on this topic is just being honest and open with your PCP about this. It sometimes is a topic that can cause people some shame, but your doctor is there to help you. So, I want everybody to hear this, that, be honest even if you're not sure if it's a problem for you or not, about any substances that you may be using, because your doctor can help you through these things.
RON AARON
Every smoker lies. I used to be a smoker, and when the doc would say So, Ron how much do you smoke? Well, maybe five or six cigarettes a day. I was smoking three packs!
DR. ANTHONY GALLEGOS
Oh, wow.
RON AARON
Three packs. And the same goes with drinking. Although I don't drink, are you drinking maybe a beer once in a while? How do you, as a family practitioner, pierce that veil?
DR. ANTHONY GALLEGOS
Yeah, so, I mean, you start by just creating a warm and welcoming environment. You kind of pick up on the cues on what is somebody seems nervous or like they may be skirting around a certain subject or being intentionally vague. So, I try to emphasize to people when I ask them about smoking or, or substance use, alcohol, things like that that I'm here to help. I'm not here to judge. So, I, I do just need to know the exact amount so that we can then figure out, is it a problem. So, I'll ask, also ask certain questions like does this substance get in the way of you performing your daily activities or doing what's expected of you on a day-to-day basis? Asking things like do you need to wake up in the morning and have that substance just to start your day? Do you ever feel guilty or out of control when using xyz? So those are all different ways that we can kind of piece together. Okay, how serious of an issue is this? Is, are there any red flags and how to go from there in terms of treatment and monitoring?
RON AARON
We're going to pick up that in just a moment, but first I want to let folks know who may have just joined us. You're listening to Docs in a Pod, the award-winning podcast and radio show. We're available in a number of markets in Texas and Florida on the radio and the award-winning podcast available wherever you download and listen to your podcasts. I'm Ron Aaron, our special guest today, Dr. Anthony Gallegos. He's at the WellMed at Grissom Clinic in San Antonio. But the advice and comments we're sharing with you apply to anybody, wherever you live throughout the world, or even the universe. We're talking about lifestyle medicine. I want to come back to what you were talking about. Dr. Gallegos, well, I obviously jumped to what may be the middle of your list of what we're talking about, substances that people may use. When I was a kid growing up, smoking was everywhere. The Surgeon General's report that came out in 1964 warning about the dangers hadn't come out yet. Smokers smoked at their office, in their automobile. They smoked in elevators, didn't matter. And then slowly that's changed. And I guess, Dr. Gallegos, I'm personally amazed that there are people who will start smoking. It is so addictive. What gets them to start?
DR. ANTHONY GALLEGOS
Oh, I mean, usually it's a stressor, some sort of life situation. Maybe it's a loss of a job, loss of a loved one. Or it could also just be that they're, they're in the environment where that's the norm. You know, you go to casinos, and you smell cigarette smoke everywhere. Naturally if you're around people that are smoking and you, you link that smell and that taste to something that you are enjoying at the time, like if someone enjoys the casinos and they may pick up a new habit just from being in proximity to it.
RON AARON
And of course, in casinos, and I haven't been in one in, in quite a while, I'm not a gambler or a drinker or a smoker, but in casinos, alcohol flows three freely as well.
DR. ANTHONY GALLEGOS
Yeah, exactly. They go hand in hand. I mean, I hear a lot of my patients when I'm asking them about substances that they're using alcohol and smoking at the same time when they go to bars and that's just a part of that particular habit and that lifestyle that they live.
RON AARON
And in the substance category, what other substances are you finding that some of your patients may be exposed to, may be using?
DR. ANTHONY GALLEGOS
Well, the obvious ones would be the, the harder drugs, you know, like amphetamines, heroin, cocaine, things like that less obvious, but still serious would-be marijuana, you know, it's super, super common nowadays. People are using all types of CBD types of products and vaping and e-cigarettes as well, some with nicotine, some with CBD. So, it's important to note that those are also considered risky substances and should be discussed with your doctor.
RON AARON
And they're very addictive, are they not?
DR. ANTHONY GALLEGOS
Yes. Yes, they can be. Absolutely.
RON AARON
What about you mentioned amphetamines? What about Oxycontin?
DR. ANTHONY GALLEGOS
Oh, yes, that's a good point. Even prescription medication. Can be considered risky substances as well. We need to be monitoring very closely when we're prescribing those medications. Like Oxycontin is a very powerful opioid painkiller. Even lower levels of painkillers like Norco is very common or Tramadol you may have heard of. Those are also considered risky substances even if they're prescribed by a doctor
RON AARON
And the rules have changed on running prescriptions now. You know, have they not for these painkillers?
DR. ANTHONY GALLEGOS
Yes. Absolutely. We have to be monitoring peoples use of other substances by doing routine drug testing when they come into the clinic. We have restrictions on how many pills we can prescribe at a time, how often we need to be seeing them. We of course need to be following up with them regularly, oftentimes even once every month for certain medications.
RON AARON
All right. We knocked off one of your six pillars of lifestyle medicine. Anything you want to add on substance before we move on?
DR. ANTHONY GALLEGOS
I think we covered the main points.
RON AARON
What's next on your list?
DR. ANTHONY GALLEGOS
I would say nutrition. I really want to hit that one because that's one of the biggest ones.
RON AARON
And by nutrition, you mean what we eat and what we don't eat.
DR. ANTHONY GALLEGOS
Yes, exactly. So, the way I like to think of nutrition is it's the fuel for your body. If your body is a vehicle transporting your soul around this universe, you know, we, we have a body that needs to be taken care of. It needs routine maintenance, and it needs the right fuel. So, nutrition is exactly that. Food is fuel. So, I like to think of it in that way.
RON AARON
But many of us growing up didn't necessarily have the best examples of food choice. I grew up in a Jewish family, and if you didn't have meat, potatoes, and bread on the table, that wasn't a meal.
DR. ANTHONY GALLEGOS
Yeah, exactly. And yet now with, with research in the past couple of decades, we're seeing a lot more evidence that certain diets like a Mediterranean diet or a plant-based diet can lead to so many health benefits. And I mean, when we talk about lifestyle in general, we can't help but talk about the blue zones, which has been brought up on some past episodes of Docs in a Pod, but the blue zones are areas in the world where they have the most people live to 100 years old or more. And we're seeing that many of those people that live in the blue zones have a more plant based or a more Mediterranean diet. So that plays a huge role in longevity.
RON AARON
In order to understand how to eat that way, however we need guidance, and we need help.
DR. ANTHONY GALLEGOS
Yeah. So first, the Mediterranean diet. That's been highly recommended by many different medical societies. And it's, it is considered a way to treat and prevent some chronic conditions like the ones that I had mentioned like high blood pressure, diabetes, high cholesterol. And a Mediterranean diet focuses mostly on fresh fruits and vegetables as the main base of the pyramid. So, think of the food pyramid, if you've ever seen that diagram. The base is all fresh fruits and vegetables. Then you've got lean meat poultry and fish.
So white meat, chicken, turkey. Those are good. And fish, all wide variety of fish. Now it's important to note on that subject that a lot of times it's fried. And so of course, we want to avoid the fried fish. And I've had patients tell me, Oh yeah, I eat a lot of chicken. I'm like, Oh great. Okay. And then we get into more detail and talk about their cholesterol, and they say, Oh, well it's mostly raising canes. It's mostly fried chicken.
RON AARON
Hold that thought, were going to come back to you. Thats pretty funny. Yeah, I eat a lot of chicken but its mostly deep fried. You're listening to docs in a pod, the award-winning podcast and radio show. I'm Ron Aaron. Our special guest today is Dr. Anthony Gallegos. He's at the WellMed at Grissom Clinic in San Antonio, and we're giving advice and suggestions on a wide variety of topics that deal with lifestyle, health and wellness. You're listening to docs in a pod.
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RON AARON
We are so pleased you're sticking with us today on the award-winning Docs in a Pod. Our podcast available wherever you get your podcast. We're on the radio as well in a number of cities in Texas and Florida. I'm Ron Aaron. Our special guest today is Dr. Anthony Gallegos. Dr. Gallegos is trained in family medicine. He's at the WellMed at Grissom Clinic in San Antonio, Texas. And we're talking about health, wellness, nutrition, and more. Six pillars of lifestyle medicine. Dr. Gallegos, I was a vegan for a day. And that was it. I couldn't continue. And what I hear you saying is that plant-based approach, not necessarily strict vegan, is beneficial.
DR. ANTHONY GALLEGOS
Yes, absolutely. And I do want to give a quick plug to a recent Docs in a Pod episode with Dr. Snyder talking about the plant-based diet. It has so many health benefits, and it can actually taste good. You know, he was talking about getting a high-powered blender and making your own nut butters. And I was like, wow, that sounds delicious. And he found a way to make a plant-based diet more simple and more enjoyable. So, I definitely want to defer listeners to go back to previous episodes and, and go ahead and listen to that. That's, that's a great way of looking at a plant-based diet.
RON AARON
Now did you run out and buy a high-powered blender?
DR. ANTHONY GALLEGOS
I actually did look into it. I haven't bought one yet, but it's on my to do list.
RON AARON
Now, when you think about, and I mentioned that we really need help and guidance if we're going to change the way we eat. A lot of folks worry that if we're on a plant-based diet, they don't get enough protein. How do you deal with those concerns?
DR. ANTHONY GALLEGOS
Well, yeah, mostly just education. Teaching them that vegetables do have a good amount of protein. You could get plenty of protein from broccoli, zucchini these common vegetables that you find. It doesn't have to be some magic secret cure or a ton of additional supplements. No, you can get a good amount of protein from a plant-based diet. Just make sure you talk to your doctor about it and help to figure out, you know, some people do have certain deficiencies when they do their blood work. And so, it's important to, to always use your doctor as your guide as well.
RON AARON
But I think you'd agree, especially with the older docs, not a lot of attention in medical school to health and nutrition, diet, and the kinds of meal preparation you're talking about.
DR. ANTHONY GALLEGOS
Right. Exactly. It is difficult. There's, there's a lot of information online, some very useful and accurate and some not so accurate. So youve got to be very careful as well when, when you're looking for advice. I would not recommend using social media as a way of getting high quality, evidence based nutritional advice. A lot of times it's mostly, to be honest, clickbait. If they want to put something out there that's extremely shocking, some new fad that's going to get a lot of clicks and shares well, that, that may not be the most accurate. So, if you are looking for, for that advice, I would recommend talking to your doctor or consider looking into a nutritionist. Some would require a referral from your PCP. So those are things to look into and, and definite conversations to have with your doctor.
RON AARON
My dad used to say. If it's too good to be true, it's too good to be true.
DR. ANTHONY GALLEGOS
Exactly. Yeah. If there's some miracle fad out there that claims to melt away body fat overnight, it may be too good to be true.
RON AARON
Now let's move on. We've covered nutrition. We covered substances. What else is on your list of the, the pillars of lifestyle medicine?
DR. ANTHONY GALLEGOS
Yeah, so the next pillar I want to talk about is exercise. So, exercise, I mean, its widely known already that it's, it's extremely beneficial for so many different aspects of life when we're talking about health and wellness. One of which is it's, it's very good for anxiety and depression, something that many, many people are dealing with now, and more so now than ever before, it may be that people are more you know, into technology and devices. And you know, especially with the election coming up, there's political anxiety going on. There are a lot of sources of anxiety for people now. And it's, it's less of a shameful culture as well, which is a good thing. So, more people are open and talking about it. That's helping us to realize that. Depression and anxiety is a huge, I mean, epidemic going on, and exercise has been shown in some cases to be as beneficial or even more beneficial than antidepressant medications. So not to say that medications are, are wrong to use, I, I use them often but if you want to take a more natural approach to treating these mental health conditions exercise is a great place to start.
RON AARON
What do you recommend? So many minutes a week, so many a day. What is your guidance?
DR. ANTHONY GALLEGOS
Yeah, so the general principle to follow when you're looking at exercise as a way of preventing and treating health conditions is a goal of 150 minutes of moderate intensity exercise per week. So, what does that mean, right? Moderate intensity being enough to get your heart rate up. If you also are having trouble when you're doing that exercise with speaking in full sentences because you're huffing and puffing, okay, that's moderate intensity exercise. You shouldn't be able to have a full conversation on the phone without huffing and puffing if you're doing moderate intensity exercise. So think about how fast you can feel your heart beating. Is your heart You know, starting to pump a little bit. Are you starting to build up a little bit of a sweat? Are you starting to huff and puff a little? That's moderate intensity exercise. And like I said, 150 minutes a week, you could split that up however you'd like. You know, if you, if you are somebody that likes having a daily routine, you could do 20 something minutes a day twice a day. And, and you could hit it that way. I'm sorry. 20 minutes a day, once a day, for seven days a week would get you to 140 minutes. So, you're almost there just from a quick 20 minutes of exercise. Or if you split it up 10 minutes twice a day, that's another simple way to meet that, that number.
RON AARON
And in that mix, do you recommend not only cardio, but stress and weights as well.
DR. ANTHONY GALLEGOS
Yep, yep, weight bearing exercise has been shown to, to also be really helpful, like, for the, the prevention of osteoporosis, especially for our elderly folks that are, that are listening in. It's a huge problem. As you age, your bone density goes down. And so not only focusing on cardio, but on, on weight bearing exercises, strengthens your joints, strengthens your tendons and your muscles and your bones so that you won't have that fall or you won't have that fracture that can be so devastating.
RON AARON
In fact, falls are a great risk for people 65 and over.
DR. ANTHONY GALLEGOS
Yes, exactly. So, make sure you're talking to your doctor about bone density screening, and if weight bearing exercise is something that they would recommend. Of course, you need to be careful if you have chronic joint pain. You could have some arthritis going on or some other inflammatory condition. So, make sure if you're going to start exercise and you're not currently doing it, you talk to your doctor about what would be the most appropriate for you.
RON AARON
All right, we've knocked out three: substances, nutrition, exercise. What's next?
DR. ANTHONY GALLEGOS
Sleep. Sleep is huge. So, sleep, as we all know, I'm sure we've all had experiences. Maybe you have as well, Ron, where you get a poor night's sleep and the next day, I mean, how do you feel? Have you experienced that?
RON AARON
You know, knock wood. I'm one of the lucky ones who has no problem sleeping. Occasionally, Sunday nights are tough because the week's over, the weekend's over and you're getting ready to go to work and a lot's going on in your brain. But for the most part, I'm able to shut down and go to sleep.
DR. ANTHONY GALLEGOS
Oh, you are a lucky one. That's great! I mean, for me personally,
RON AARON
Im sure you hear from a lot of patients. What about you?
DR. ANTHONY GALLEGOS
Yeah, from patients and from myself, I'll use myself as an example. If I'm not getting a good night's sleep, I mean, I'm groggy the next day, I might wake up with a headache, just trouble focusing trouble completing tasks that I normally am, am just fine completing just lower efficiency overall. I mean, it's, it's wildly important and you can see the very next day, if you didn't get a good night's sleep, just how badly your body is affected by that.
RON AARON
Now, is there a rule of thumb for folks? How much sleep do you need? Eight hours? Nine hours?
DR. ANTHONY GALLEGOS
Yeah, so the general rule is seven to nine hours. Most people need around eight. Some people are okay with getting a little less than seven. Just kind of kind of listen to your body and pick up on your own performance and your own symptoms, you know, the headaches, the fatigue, the inattention. So, if you're not getting enough sleep. Those are things you might feel, but in general try to shoot for eight hours a night. That's a good a good rule of thumb.
RON AARON
And talk to your PCP if you've got problems sleeping.
DR. ANTHONY GALLEGOS
Exactly. So, there are a lot of things we can do to try to help you with that.
RON AARON
Weve got about a couple minutes left. I don't mean to rush you, but number five on your list.
DR. ANTHONY GALLEGOS
Yes. Number five would be stress reduction.
RON AARON
Wow.
DR. ANTHONY GALLEGOS
Yeah, stress is a huge part, a huge contributor to just so many different health conditions, insomnia, anxiety, depression, obesity, heart disease. I mean, the list goes on and on.
RON AARON
And again, there are ways to deal with it. Necessarily a medicine or try mindfulness, try breathing exercises, right?
DR. ANTHONY GALLEGOS
Yes, exactly. Those are nice free ways that you can release your stress without needing medications or equipment or anything costly.
RON AARON
And number six on your list.
DR. ANTHONY GALLEGOS
Number six, the last one. It's actually social connection. This is a big one. It ties. A lot into stress reduction as well we should have a sense of community. It actually leads to more longevity. I talked about the blue zones. They tend to have a very strong tight-knit community. So, I recommend getting involved with a church or with a group that does a certain activity that you enjoy. Maybe it's an exercise group or just getting together with coworkers or neighbors.
RON AARON
And there's a lot of research that shows lack of social contact can shorten one's life.
DR. ANTHONY GALLEGOS
Right, exactly. And even the Surgeon General just put out a few years ago a big statement saying that loneliness is considered an epidemic. So definitely reach out to friends, reach out to family members, even social connection could even be considered your spouse. Somebody that you see all the time, try to work on building and strengthening those relationships and you can actually see significant health benefits from it.
RON AARON
Wow, Dr. Anthony Gallegos, this has been great. The six pillars of lifestyle medicine: substance, nutrition, exercise, sleep, stress reduction, and social connections. I really thank you so much for joining us today on Docs in a Pod
DR. ANTHONY GALLEGOS
Thank you so much. It's been such a good time.
RON AARON
Well, you're at risk of being invited back. You do a wonderful job! We thank you very much! Dr. Anthony Gallegos. Hes at the WellMed at Grissom Clinic in San Antonio, Texas. Thanks for joining us today on the award-winning Docs in a Pod. I'm Ron Aaron. We'll talk with you soon.
OUTRO
Executive Producers for Docs in a Pod are Dan Calderon and Lia Medrano. Associate Producers Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. We welcome your emails with suggestions and comments on this program at radio@wellmed.net. And be sure to listen next week to Docs in a Pod presented by WellMed.
DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.
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