As we at MamaSezz well know, changing to a plant-based diet can change your life in ways you never expected. In this series, we talk with some of the world’s most soulful, dedicated, smart (and often funny) leaders in the plant-based world. We get to hear their stories of suffering, transformation, and service — and we learn how food is an essential part of their journey.
Dr. Aggarwal is a board certified cardiologist, author, athlete, and mother of three in Florida. Driven and brilliant, she pushed hard for many, many years to achieve at the highest possible level in every aspect of her life.
But taking care of herself? Using diet and nutrition to support greater health? Neither was a priority, until her body said otherwise. (Or screamed otherwise, as you’ll see!)
Over time, this health crisis transformed Dr. Aggarwal’s health, her medical practice, and her research in diet and nutrition. Today she is the Director of Integrative Cardiology and Prevention at the University of Florida. Based on her experience and her research, she is a strong advocate for plant-based nutrition and its benefits in both treating and helping reverse chronic illness.
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How did the pressure to be perfect impact your life and health?
After I finished my 10 or 15 years of studying and training and became a full-fledged doctor, I remember feeling like, Whoa, I'm old now. I am a cardiologist, great, and I've got this career, but I’ve got to build up this career and people want— expect — me to work full time and do all this stuff and take all the calls and do all this stuff. But oh, by the way, my maternal clock is ticking and I would like to have some babies here!
That imbalance happens that we as women endure — believing we have to be 100% as a woman and 100% as a physician, and then also rear babies and then still look fabulous after you deliver the baby.
We believe, Oh, I got my figure back immediately! and Oh, I fed my kids and made them sweet potatoes and I ground everything! I nursed them for 10 years and they're amazing!
I had all of these expectations. I had all of those sorts of female/mother kind of expectations. And then I also...had to also be a highly functioning cardiologist. And so I sacrificed, as a result. And of everything besides those two things, what else is there to sacrifice?
Well, I sacrificed my sleep. I was stressed all of the time. I exercised, but in this very dysfunctional way at four o'clock, five o'clock in the morning, I would exercise and then I would nurse and pump and run all of the time.
I always describe the first five years of my children's life as feeling like I was always running. There's that Hamilton line, I always think about, why he was writing. "Write like you're running out of time"-- I was just running all the time, running, and like I was running out of time.
And I think that balance is so difficult as a woman, we put so much expectation on ourselves to be a super mother, super at our jobs and super with our spouse. And look fabulous too. And so I went through a lot of that.
Remember I had three kids in four years because I had this feeling that I had to have all these kids because I need to have them early. Because I didn't want to be advanced maternal age because that's not what you're supposed to do. I loved it, but it took a toll. And so after I had my third child, I remember I always described this as a situation where I had, one I'd be carrying, one was on the breast and one was usually hanging onto my leg.
When did you realize something in your life had to give?
About four months after the third baby was born, I started manifesting all these joint pains. I had gone back to work six weeks after the delivery, because that was the expectation. I was sleeping about four or five hours a night, if that, because I would wake up for the baby at night cause I was nursing. I didn't see any reason for my husband to wake up. And so I would take that burden.
So I was sleeping for about four hours a night. I was trying to run and I was trying to make baby food and to pump all day and all this crazy stuff that a woman does.
I remember there are two moments that were most impressive to me. First, I couldn't snap the baby clothes. I remember those little snaps on the clothes, and I remember thinking, you know, they need to change the clothes! The second moment was when
I felt like there was ice cutting my feet. You literally get out of bed...and it really feels like somebody has a knife and they're slicing your foot as you're walking. I thought my shoes were the problem and I got a new pair... three times I changed my shoes, just not appreciating that I could actually have a real problem here.
The moment of crisis… and diagnosis… and painful treatment
It was at four in the morning. I set the alarm for 4 a.m. because I had to pump, and usually nurse. Usually, I had to make baby food. I had to feed the dog. And then I'd make my own lunch, usually in the morning. And I usually took about two hours and so maybe two and a half. And then I'd wake everybody up too. So, I used to wake up at four, I remember hobbling down the stairs to go start making lunches and letting the dog out.
Then the baby cried. I thought, Oh no, the baby is crying, and I didn't want him to wake up my two- and four-year-olds who are still sleeping and its four o'clock in the morning.
My husband found me at the bottom of the crib crying because I couldn't lift the baby out of the crib. That was the moment when I was like, Really, I'm in big trouble here. Something is not happening.
I diagnosed myself with Lyme disease because of I right because I felt like because of my migratory joint pain. And I'm a physician and I am a hiker.... I must've gotten Lyme disease somewhere along the way. It made the most sense. So I started treating myself for Lyme disease and I didn't get better.
So then I talked to one of my girlfriends who was an internist, and I said, “I think I've got something going on here. Why don't you check some labs?”
She did, and she said, “Why don't we just check a few inflammatory markers? A few of this and a few of that.”
I said, “I don't think we need to check all that. I think it’s Lyme, why don't you just check for Lyme.” She insisted, “Let me just check it.”
So she checked all this stuff — and it came back through the roof. All my inflammatory markers were very high. My Lyme was negative. And she said, “I think you've got rheumatoid arthritis.”
I went to the best rheumatologists in town and he said, Yes, you have advanced rheumatoid arthritis you. It's very debilitating. Your numbers are very high. You need to get on medication this week… If I didn't start immediately, then I would be in trouble.
I did everything they said. Yes, it was horrible. I remember the days of the baby crying and I had to walk away because I couldn't nurse her. I stopped nursing. It was a horrible, horrible time for me. I took everything they told me to take. I took it and the joints stopped bothering me, and the sharp pains in my feet went away.But I was left with side effects of nausea. I was nauseous all the time. People would say, “Oh you lost all your baby weight so fast!” And I was like, what happens when you don't want to eat? Right? So, yes, I was nauseated, I had a metallic taste in my mouth all the time.
My hair fell out. And so you're better, but you're worse. You’re worse or you are better. I don't know. I'm not sure.
How did you discover plant-based eating?
At around 16 years old, I became a vegetarian. And then, I was vegetarian until about seven years ago, when I became a hundred-percent plant based. The short version is that I met a woman who wanted to participate in one of my heart health fairs.
I said something along the lines of, We don't really have a role for someone like you. I already I know a lot about nutrition. I've got this. I was probably obnoxious! Later, she said, “Well, I know you don't have space for me, but how about this? Why don't you just let me do your profile, your nutrition profile?” I, quote unquote, humored her.
..And she went on save my life. She started asking me questions I hadn't asked before about the diet-stress-illness connection. This started me on a path towards my own research. I went to programs at Harvard. I spent time with different researchers who are working on the gut biome.
Sadly I found that there was very little research out there. And so, some of this was a leap of faith, and some of it was research-based.But once I changed my lifestyle...and I didn't just change my diet, I changed everything.. I got better.
I got better. And I haven't been on medication in seven years.
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How did your health transformation impact your medical practice?
From the moment I became an internal medicine doctor, it was where I was meant to be. I loved working with patients. And going into cardiology was natural as well, because I like taking care of patients in a way, in a part of the body that’s at the core of the person, and being able to sort of adjust and change things and help people in that way. It was fabulous. I loved it.
And I've always had a leaning towards integrated medicine. I did most of a fellowship in alternative medicine with Dr Andy Weil over in Arizona, and so I'd always been interested how to use other lifestyle tools to make your body heal. But I hadn't really become serious about it, because I didn't really know if I believe that they could be combined.
I've changed everything. I have a prevention clinic where we have one hour long visits and people spend time with us focused on nutrition and lifestyle. I don't take medicine away unless it's appropriate.
I don't say that I won't give people medicine, because I'm guideline driven and I believe in the data, but I give them complementary tools and often in many cases, we pull away medicines all the time.
As part of my approach, I tell patients that I'm not there to judge them. I'm only there to move them forward in this agenda towards improving their life and health.
One of the first questions I ask is, what would you like from this appointment? What are you looking for? And then I asked them what, what do you think I can help you with and what is it that makes you feel happy, what gives you joy?
These are some of the first questions I asked because for me, giving people joy and giving them back the love of life and there's so much more important than figuring out the sort of details of whether they ate mushrooms cooked or uncooked.
What's neat about patients is, I have patients lose a hundred pounds. I don't care about that. I will tell them, I don't really care how much weight you gain or lose. But I do care about what's happening to your body. And what happens is they would come off their blood pressure medicines and no longer be diabetic or angina goes away. They never need a heart stent again. And so these are the results I'm getting.
What drives you to research a plant-based diet?
I also wanted to publish these results. We're taking all the data and we're writing up papers so we can show people what we're doing. And so my biggest goal is to educate through the research now.
We're working on the research so we can answer the question of why this approach works.
I want to know that what happened to me was not a fluke. I want to understand exactly why, if it's the gut biome, if it’s genetics affecting the gut biome, if it’s stress, how stress affects that, that biome.
These big questions need to be answered because people would say that they'd think that the Keto diet is a good diet, and they're wrong. They're wrong. That I know. That was discovered in 2018 in the Lancet, a study showing that low carb diets don't work, and they have increased mortality.
But I think there's also the question of the Mediterranean versus plant-based, is one better than the other? These are the questions that I want to answer. I know what I believe, but I want to show it through scientific trial.
How is your research reshaping your medical practice and training?
I work with the medical students: I wrote a nutrition curriculum for the University of Florida medical school.. This is unheard of in the states, and actually in the world — very few people are giving education on nutrition in medical school. I was asked to do four hours as a nutrition curriculum, which is huge. That was fabulous. I gave all the first year medical students four hours on nutrition curriculum. That was awesome.
I also work with the residents and I worked with the fellows. I put together a whole prevention conference for them. We have the prevention clinic, and even our patients in the hospital, they get a hundred percent plant-based menu. They walk in the door, they come in with a chest pain syndrome and there is a plant-based menu.How do you practice value-based care in a money-driven health care system?
I think once we start moving and shifting towards value-based care, which is the way the future has to be, is that we focus on the value of care rather than the cost of care, the paradigm will shift. And that's going to take time. But a bunch of people moving this agenda forward is going to be the key, and patients demanding that they want value based care.
Yes, it's not easy. The financials are complicated, and I have to balance everything in my week based on making sure that I’m positive that the hospital feels that I am successful and I making enough for the hospital.
But the thing that gets me the most joy is giving people that purpose and desire to change. And so, I, I'm okay with that.
Can diet alone heal illness?
I think it would be naive to say we just need nutrition. There are multiple things. You have a genetic predisposition. I have a genetic predisposition for rheumatoid arthritis for unclear reasons [as it] doesn’t run in my family. And then something caused an imbalance in my system which triggers inflammation.
Was it only nutrition? I doubt it. I think it was probably a whole lot of stress. Remember, poor diet is a significant stress on the body, but lack of sleep, high levels of emotional stress, all those things are stressors on a body. And I think all contribute to why a person gets sick.
I do have patients that are a hundred percent plant based who can't understand why they're not better. The way I make them better, so much of the time, is by working on the other aspects. I work on their lack of self-love, which is a real problem, or their stress levels and the fact that they don't sleep.
You have to come to each person individually and see what is stressing their body.
Now, is nutrition and diet a significant part of stress? Yes. But is it the only thing? I don't think so.
How do you maintain balance in a very full life ?
It changes every day! I don't know the answer to that, and then yet I do. I guess what I would say is that what I've learned along this journey is that you have to take time for yourself. And what that means is different for other people.
So, finding balance for me was learning to love who I am at this moment. I always tell people I had to learn to do this. This is what I tell patients in clinic: See exactly what your body has to give, and then push it further.
Accept who you are and don't feel bad about things you can't do or that your body won't allow you to do. Then take that information and say, okay, maybe not today but going to try again tomorrow.
And that's how I've always done everything with my own health and has really helped me. I do a lot of yoga and so some days I can't do as much as I'd like to do. So I always have to remind myself that I've to accept what my body has to give. And so I think that that's the key.
Tell us why you say, women need to stop being responsible for everything?
For women it's so much more complicated than for men, sadly. Or for the primary household provider. It's always more complex. We as women put so much on ourselves and we should allow ourselves the time to be a mom and the time to focus on self and self-love.
We don't have to do everything. I think that that was probably my biggest lesson, and one that I continue to learn today. Because when we try to be everything, we fail, or at least I did. I certainly did.
I think that remembering that it’s okay not to be perfect is really important.
Something that I have to say almost every day is that it's okay. I am not perfect.
I didn't make my food perfectly or that I didn't sleep as well as I should have or I didn't. I wasn't as stimulating to my children as I usually am or that I didn't go running today and that it is okay to rest.
Saying those things yourself and reminding yourself of those things, I think sometimes it's the key because, for me at least, was how I was able to achieve some balance in my life. I was able to say, okay, well maybe I won't exercise five days a week for an hour and then sleep four hours a night!
Maybe I'll sleep seven hours and I'll only exercise two or three days a week, some weeks, months. That's okay. And there's so much judgment in this community of nutrition and lifestyle. I think that that's unfortunate. And I think that we should accept people for what they're able to do. I look at some of these websites and people said, no, you can't do this. Or no you're not allowed.
What does that even mean? I want people to remember every day you just try to do a little bit better. And I think that that's how you achieve balance more than anything.
BONUS QUESTION
What is a motto you would put on a t-shirt?
Eat mostly plants if not all plants!
Accept what you have to give and then push it further.
I am good. I am strong. I am loved.
And I always tell people that my hashtag is
#bringbackthejoy.
Dr. Aggarwal is a leader in revolutionizing medicine toward value-based care and prevention
Learn more: www.drmonicaaggarwal.com
Read more: Body on Fire: How Inflammation Triggers Chronic Illness and the Tools We Have to Fight It
by Monica Aggarwal, MD and Jyothi Rao, MD