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8. Preventive and Lifestyle Medicine for Women with Dr. Zenobia Tayeb
110 Plays1 year ago
What is preventive medicine?
Join Dr. Rachel Pope in this enlightening episode of "Our Womanity" as she sits down with Dr. Zenobia Tayeb, an accomplished preventive and lifestyle medicine physician. Dr. Tayeb, a Cincinnati native, has an impressive academic and professional journey that spans biological sciences, science education, and extensive work in the pharmaceutical and biotech industries.
With a passion for humanitarian work, Dr. Tayeb's medical missions to aid Syrian refugees sparked her desire to pursue a career in medicine. Currently, Dr. Tayeb is in her third and final year of training in Public Health and Preventive Medicine at Case Western Reserve University School of Medicine, where she also serves as chief resident. She is simultaneously completing a second residency in Lifestyle Medicine and a master’s degree in public health, focusing on health promotion and disease prevention.
In this episode, Dr. Tayeb shares her insights on the importance of preventive and lifestyle medicine, particularly for women. She discusses:
Featured in this episode:
- Pillars of Preventative Health
- Unique approach to healthcare that emphasizes disease prevention
- Healthy living as the foundations for long-term wellness
- Vitamin D, Calcium and Magnesium supplements for optimal health
- Necessary Screenings
Types of Magnesium and Magnesium Fact Sheet for Health Professionals.
Submit your questions on anything and everything women's health-related and we will answer them in one of our episodes.
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Transcript
Introduction to Dr. Zenobia Tayeb's Journey
00:00:00
Speaker
Hello everybody and welcome back to Our Role Manatee. I am very pleased to introduce you to Dr. Zenobia Tayeb. She is originally from Cincinnati, Ohio and studied biology and did her master's degree in science education and actually started to volunteer helping Syrian refugees, which really gave her this inspiration to go into medicine.
00:00:22
Speaker
So, she went into medicine and found herself doing residency and really found a passion for preventive medicine and then lifestyle medicine. I'm going to let her tell you all about that, but she is an amazing individual. I'm so excited to have her here with us today to talk about preventive medicine and lifestyle medicine in women's health.
What is Preventive Medicine?
00:00:44
Speaker
Welcome, Dr. Tayab. Thank you for being here today. So maybe we could just start. Can you tell us what is preventive medicine? Sure. So I think whoever you ask will have a different definition for preventive medicine. But to me specifically, again, it's very broad. And I think some people who go into preventive medicine would stay maybe on research side of things on how do we prevent
00:01:09
Speaker
diseases, how do we keep everyone healthy at a big population level as opposed to one on one patient care and then.
00:01:17
Speaker
When you think about it, one-on-one patient care preventive medicine then also means, you know, when you come to see me as a patient, what can I do to prevent illness? What can I do to prevent you from going down a path where you're traveling? Let's do a vaccine. Every year we want you to get the flu vaccine to prevent any sort of illness in that regard. So preventive medicine
00:01:41
Speaker
so broad. So it can mean one on one care, but it also can mean looking at the population as a whole and how do we keep our community safe and healthy. Oh, right. Cause you also are in public health. So that brings in the population side of things.
Exploring Lifestyle Medicine
00:01:56
Speaker
Okay. And then what is lifestyle medicine and how is that different?
00:01:59
Speaker
go back and talk a little bit of a history of lifestyle medicine. It's always been around, but never was called lifestyle medicine. And then finally in 2004, physicians came together and said, we really need to talk about this with our patients all the time. And what they did is they came up with six pillars and said,
00:02:18
Speaker
how are we going to use lifestyle to reverse chronic illness and keep people healthy? So those six pillars then became nutrition, physical activity, sleep, keeping chronic stress levels low, substance use, mainly focusing on tobacco and alcohol, and then your social connections as well, because we have found that people who are isolated tend to have more chronic illness. So lifestyle medicine really focuses on these six pillars,
00:02:47
Speaker
to keep people healthy and to prevent illness. And if you've already maybe gone down that path of illness, how can we now reverse this illness potentially or improve your illness? You're making me think of the blue zones. I watched this Netflix documentary about the blue zones and I feel like those were the aspects that they were looking at in these communities.
00:03:06
Speaker
to find out what gave them good quality of health and also like good quality of life for longevity, which I found fascinating. And I thought, okay, how can we make Cleveland a blue zone? Yeah, absolutely. We only have one blue zone in the US that's like low Melinda. Yeah. Yeah. Oh my goodness.
Why is Lifestyle Medicine Crucial for Women's Health?
00:03:25
Speaker
Okay. So let's talk about women and preventive medicine and lifestyle medicine for women. What is it that women need to be aware of and to know what would you want women to know?
00:03:35
Speaker
Absolutely. So women, unfortunately, as we start to hit mid 30s, we're hitting that 40 mark, it's almost like magic. Let me tell you, we hit that age and then you're like, Oh my God, why did this happen? Or why did my labs change? Or how can I have this ache or this or that? But we can sort of prevent that.
00:03:54
Speaker
when we are focusing in on lifestyle. And that's really how I've taken my focus of preventive medicine and sort of incorporated lifestyle medicine in there. And I look at those six pillars and why those six pillars, they're always important from the time you're born, the end of time, they're always important. But especially as we're aging, they become all the more important. So I would say if you're just looking at nutrition and let's take cardiovascular health, for example,
00:04:23
Speaker
So cardiovascular disease is the number one killer for women and for men. So women don't realize that, right? People are really worried about breast cancer, rightly so, but so many other things, but honestly, cardiovascular health is super, super important. It takes more lives, right? It does. It does. And so when you look at the six pillars of lifestyle medicine, it helps us with cardiovascular health, and then it goes all the way and spreads into other aspects of your health as well, right?
00:04:52
Speaker
So if I'm seeing one of my patients, it's very easy to say, well, just eat more fruits and vegetables. And so, you know, really that benefit of that lifestyle medicine visit is I get to spend so much time with them and we really get to talk about, well, what is so beneficial about each of these things that you're doing? And so, for example, we'll start talking about the fruits and we'll talk about the antioxidants and we'll talk about, well, how does this prevent plaque buildup in your arteries? So I think that kind of opens their eyes.
00:05:19
Speaker
Oh my gosh. Yeah. I really should be eating my berries, not just I should eat this because it's good for me, but this is literally what's happening in my body when I start to eat this. And so we go through and talk about, well, what did the veggies do? What are these specific vegetables? How are they affecting my health and how are they actually helping to keep my blood vessels open and to keep the blood flowing to my heart and to my brain?
00:05:44
Speaker
So we go through all of that on a nutritional level. And then if you sort of move over into that next pillar of physical activity, then we start to talk about, okay, how does physical activity affect the different parts of my body? And one of the things that I focus on a lot is just walking because
00:06:04
Speaker
I think sometimes people come in and us as women, we're hard on ourselves. And we think, oh, maybe we should be running like 5Ks and 10Ks and marathons, and we should be going to the gym six times a week and lifting weights. And those are all good things. And you can eventually maybe work to that. But I just say, hey, let's just focus on one of the best exercises that you could ever do for your health as you're getting
The Benefits of Walking for Women's Health
00:06:29
Speaker
older. And that's walking.
00:06:30
Speaker
And again, that's great for your cardiovascular health, makes your heart stronger, again, keeps your blood pumping, gets blood to your brain. And then even when you think about as you're aging your bones, you know, your bone density starts to decrease.
00:06:46
Speaker
And so with bone density, then it's a weight bearing exercise and it helps to keep your bones healthy as well. So I, I really park on the walking with my patients. Do you mind talking a little bit more about the weight bearing exercise? I find myself having to explain this a lot with my patients, especially as they age, their favorite exercise is swimming, which is great. It's great. I don't want them to stop swimming, but can you explain why that's not
00:07:11
Speaker
So with swimming, there's that whole idea of buoyancy. And so your bones are not getting any quote unquote weight. So when you walk, you bear down on the bone and you bear down and it's helping to build muscle. I'm sure the professional swimmers who are doing this at a very, very high elite level, and they're also weight training, by the way. So they're probably questioning too, right? Exactly.
00:07:34
Speaker
But swimming on its own is not applying any pressure to your bones. So that's why it's not weight-bearing. And it's not the best exercise then for someone who is trying to build up their bone density or someone maybe who already has osteoporosis or osteopenia. Like you said, I wouldn't stop them from doing that. I would just say add in the walking if you can. And I will add to that. A lot of people shy away from it. They say, well, I'm swimming because I have arthritis and I have achine.
00:08:04
Speaker
And so we have this mentality, the more I walk, the more I'm damaging my knees or my arthritic joints, but actually that's not true. The walking is actually beneficial even for those with arthritis. Wow. And a lot of them with arthritis, unfortunately in the US, we have an issue with obesity and obesity makes arthritis worse, right? And so then they're not walking because of the pain and then they're gaining more weight because they're not walking. So you get this vicious cycle. Yeah.
00:08:31
Speaker
So trying to do something, I mean walking seems like at least the bare minimum. Right. And if you want to think about a guideline, what you are aiming towards is that 30 minutes or that they say the 150 minutes, right? So 30 minutes a day. And I think that works out to like five days a week or six days a week, 150 to 180 minutes. And you want to work up to two days of strength training. Okay. Well, I'm definitely not doing that. I need to increase my
00:09:00
Speaker
It's the amount of time that I'm doing this. But the one thing I add, like caveat I put to that is we see the guideline and we think, oh my God, I got to go out and start doing this. And that's the fastest way I say that you'll get an injury if you have been exercised naive. Or if you exercised a lot in the past and haven't done it for quite some time, then put little milestones in for yourself. Like I'm going to walk 10 minutes after every meal.
00:09:28
Speaker
or if that's not even doable, I'm going to walk 20 minutes, three times a week. And then it makes it so much more bearable and doable. And then as you meet that goal, and as you start to build your cardiovascular reserve and feel better, then you increase it. Yeah. Oh, that's smart.
00:09:44
Speaker
Okay, so I get a lot of questions on my website about screenings that women need to be aware of and also supplements like what do women need to be taking, especially as they're getting into their midlife and beyond.
00:09:59
Speaker
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00:10:27
Speaker
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00:10:43
Speaker
What do you recommend?
Essential Health Screenings for Women
00:10:45
Speaker
Yeah, if we start with like cardiovascular health, when you're seeing your physician, they should always be doing blood pressure screenings. That's not a specific age related screening that Oh, this only starts when you're 40 years old. When you go in for your visit, you should always have your blood pressure checked. That's one of those, you know, it's a silent disease, you don't necessarily feel bad when your blood pressure is high.
00:11:08
Speaker
So you definitely want to have your blood pressure checked every time you go. And if they're not checking it, you should ask to have it checked. Can you please check my blood pressure? And I think since COVID, they've removed the blood pressure machines that used to sit in front of pharmacies. Yeah. Yeah, they're gone because of COVID. So I used to love those. The back post screening is so important as well. And obviously, if you're smoking, you probably are not going to ask your physician to do that. So I will just say that that's
00:11:36
Speaker
important in and of itself that patients look into that. And you may ask your physician, what is, or your provider, what is available for me to help me quit smoking? But as providers, they should be doing those on a regular basis, heart to heart health.
00:11:52
Speaker
And I sort of plug into brain health, the depression screenings, right? That's important too. And not necessarily that you as a patient or you as a woman are going to go ask for those things. That's nonetheless something that whatever provider is listening, make sure that you're doing that. And then something interesting about that.
00:12:13
Speaker
Just as a quick caveat. So, you know, since all of the weight loss medication craze has started in the last few years, I've had a lot of patients talk to me about their experience with it, ask for prescriptions, et cetera. And I have some patients who've been on the combined medications that have an antidepressant as part of them. And they say, you know, okay, I've lost the weight that I wanted. I'm doing great. I'm going to come off the medication, but I realize how much the antidepressant has been helping me.
00:12:41
Speaker
and I'd like to continue that. And it's incredible to see, I guess, how prevalent depression or mood disorders are and how much better people feel and how much healthier they can be if they're addressing their mood. She would never have asked for an antidepressant if she hadn't tried it through the weight loss medication. Absolutely, absolutely. I will add to that, just prior to my medical life when I was a clinical trial auditor,
00:13:07
Speaker
That was the first study that I was on. I won't mention the company or the drug, but you probably know what I'm talking about, but it was a combination weight loss medication, and it was typically something that's used for seizure or migraine and a weight loss.
00:13:24
Speaker
how it actually helped also stabilize their mood. So there's other screenings important for bone is your DEXA screenings, right? Like osteoporosis. So that's something that typically happens at 65, but there's other reasons why you may receive that or ask for it sooner, right? There's a risk factor. So women who are naturally very thin,
00:13:50
Speaker
and have maybe fragile or folks who are malnourished. I recently did a DEXA for a woman who wasn't 65, but she came over from war-torn country and was very malnourished. And she was like 5'9 rail thin. And I was like, we really need to get her a DEXA scan. And lo and behold, I came back that she was osteopenic.
00:14:11
Speaker
So it's just keeping an eye out on those things as well. And then I do want to mention, especially the breast cancer screening because that just changed in April and we've all been getting blasts about that. And originally I want to say that breast cancer screening back in the day used to start at 40 and then they changed it to 50 and now it's back again to 40 because we're seeing that, Hey, if we can save a couple more lives by screening sooner, that's important.
00:14:37
Speaker
breast cancer can be a devastating condition. And especially for women, that's one of the things that identifies us, right? That's so personal to us. So the screening for that is important. And I will also throw in there two more that aren't necessarily related to like bone health or cardiovascular, but cervical cancer screening
00:14:57
Speaker
is important for women. And I think sometimes that falls to the wayside as well as, and colorectal is important for both men and women, but we should also pay attention to that. And that screening actually recently, not as recent as breast cancer, but that also changed. And now they've lowered the age to 45 to start screening for colorectal at 45 because we're seeing people
00:15:20
Speaker
who are now getting colorectal cancer at an earlier age and we weren't seeing that 10 15 20 years ago but all of a sudden there's an increase in colorectal cancer so now that screening has started in general for most people at 45 there are some caveats to that based off of family history. That's what I was gonna say just in addition to knowing your family history not everybody knows their family history but if you do and you know
00:15:44
Speaker
that you have especially a direct relative, a parent, a sibling, then who's been affected by a cancer, then your screening may start earlier. And same with bone health too. I think it's like if your mother had a hip fracture, your screening with Adexa would be earlier as well.
Nutritional Needs for Women's Health
00:16:00
Speaker
Great. And then what about supplements? I get questions about, you know, what should people be taking? Do they need to take them? What else? You know, and I'm sure especially in lifestyle medicine, this is something that comes up for you.
00:16:09
Speaker
Yeah, it does. I get a lot of questions. Some of the ones that I get, I'm like, Oh my goodness, what is this supplement that you're telling me? But in general, what I will say is that the first one that I made a mention is vitamin D and that is to me one of so hugely important.
00:16:28
Speaker
And the reason I start with that is because a lot of times we're like, oh, you know, if you're out in the sun enough, you'll have enough vitamin D. But you know, the more and more that we're testing people and vitamin D, they're rowers out rowing, like multiple times a week, and they could be normal, but they're low normal, right? How could you be that low in your vitamin D?
00:16:50
Speaker
So number one, I recommend you should get this checked. I think that vitamin D is one of those things that you should check. And it is something good to supplement with, especially if you're low, your provider can tell you how much of it that you need. But in general, every day in a multivitamin, there's 600 to 800 IU of vitamin D. And that's good for everyone to take every day, even if your levels are normal.
00:17:13
Speaker
So that's the first one I will say. And then thinking specifically about bone health, I would say a lot of times you get the calcium and the vitamin D together. And really because in order for that calcium to absorb, you need the vitamin D with it. So the two for ones are great. And I think especially for us as women and like you said,
00:17:33
Speaker
is so important. Even if you knew like your mother or someone in your maternal side of the family had a fracture of known diagnosis of osteoporosis or osteopenia, important to supplement with calcium vitamin D. The other one that I actually have just started reading a lot about in the last two years, but never was on my radar screen ever prior to med school in med school. They didn't talk about it, but magnesium.
00:18:01
Speaker
I was going to ask you about that. Magnesium is huge. And it's responsible for over 300 processes in our body. And it affects everything. It affects your heart health. It affects your brain health. It affects your bone health. It is affecting everything in your body. It's affecting whether you're constipated or not. And that's why we see a lot of times you see patients who are taking some sort of magnesium supplement to help with their
00:18:30
Speaker
constipation, but it helps relax your body and helps you sleep. And the important thing to learn about magnesium is there's different kinds of magnesium. And so we could link that in the notes and say, these are the different kinds of magnesium. And this is what they're used for. And this is, you know, an ideal amount. But in general, I don't know the kind of magnesium they put in a multivide. I have to look that up.
00:18:54
Speaker
But women under fifty it's like a hundred fifty to three hundred and fifteen or twenty milligrams and then women should maybe start taking that three hundred and fifteen to three hundred and twenty milligrams of magnesium.
00:19:07
Speaker
But it's so helpful. People who are actually having trouble falling asleep are now using a certain kind of magnesium to help calm them, relax them, and sleep better. And your sleep health is so important for every other kind of health that you have, whether it's heart health, whether it's bone health, your sleep time, your body is resting, and also your repair processes are going on when you sleep.
00:19:29
Speaker
That's a really good point. Yeah. I just learned about magnesium a few years ago as well. You know, we use it in obstetrics for preeclampsia. We use it in surgery during postoperative recovery, which is so interesting. You know, we would give it IV and then to find out that actually it's great for sleep. It's great for constipation for people who are not necessarily patients. It just makes sense. I think it's great that it's being, you know, looked at a little bit more closely and studied now and people are in
00:19:59
Speaker
incorporating that where appropriate the other one I will sort of say which is huge and maybe with you being in women's health Maybe this is something you talk a lot about too But I am huge and sometimes it's characterized as a supplement But I still characterize it as food and fiber is like the flax Chia and hemp and I just think that's so important especially for women's health and we we have pretty good research studies that talk about how it helps with balancing estrogen and your hormones and
00:20:26
Speaker
we know as we're aging the fluctuations in our estrogen and progesterone and for women it's important we forget that we also have testosterone, of course not as much as men, but all of those fluctuations and those hormones and we have very good data and research studies on how their omega-3 fatty acids that are contained in there, they have so much fiber in them and they're so helpful in general.
00:20:51
Speaker
And those are the things that I tell people, you know, it's best to get things from your diet, but most of us are not eating enough Omega-3 fatty acids in our diet, especially in this part of the world, and especially definitely not Chia or flax or anything like that. But sometimes I put it in a smoothie or I put it on a cereal, but otherwise, you know, it's hard to get those in your meal. Absolutely.
00:21:13
Speaker
Well, this has been very, very helpful, very educational. And I know there's lots of people who ask me about this all the time. I get email questions about this and submissions on our website about it. So I think a lot of people will be very appreciative for you answering these questions. And just as a reminder to everybody listening, go to ourwomanity.com and submit questions if you have questions about women's health. And we'll find an expert like Dr. Chayeb to come and answer them. So thank you so much for your time and really, really appreciate it. And hope that will help you back
00:21:42
Speaker
for another topic sometime. Thanks for having me.