Transcription of Dr. Herzog for the show Sports Medicine, #92
Dr. Lisa When you think about orthopedic surgery, and vegan and vegetarian eating, there’s really only one doctor in the area whose name comes up. That is our very own Dr. John Herzog of Orthopedic Specialists, right here in the Portland area. He’s coming in to talk us today about sports medicine, and vegetarian and vegan eating. Thanks for coming in.
Dr. Herzog: You’re very welcome. It’s always a pleasure to be here.
Dr. Lisa: You’ve been an orthopedic surgeon for almost 30 years.
Dr. Herzog: Hard to believe, but yes.
Dr. Lisa: So you’ve seen a lot of sports injuries and you’ve seen a lot of people who aren’t injured but just want to maintain good health?
Dr. Herzog: Yes, I have seen the whole gamut from the horrific crash to the little child with an ankle sprain.
Dr. Lisa: What part does vegan eating or even just vegetarian eating, minimizing meat, what part does that have in maintaining an active, healthy lifestyle and even excelling in sports?
Dr. Herzog: I think it all comes down to when you consider food is the fuel that fuels our bodies, we would like to put in the best highest-octane fuel you can get. I believe truly that the plant-based diet gives us that. It’s a higher quality of food because it’s easier for us to absorb it.
When we have a good, clean running system we don’t produce a lot of residue. Just like a car with good gasoline, there’s not a lot of soot building up in the tailpipe and there’s not a lot of cavitating. That would be akin to having good circulation. If you have good circulation, that helps your muscles grow bigger, get stronger, have more endurance, and when they get hurt you repair them much faster. That’s the whole basis to the whole eating thing in my opinion.
Dr. Lisa: Does it also help people to stay leaner?
Dr. Herzog: Definitely helps you to stay leaner. Eating a complex carbohydrate, which is in the plant world very commonly, when you eat that food your intestines have to break that down. It takes energy to break down the food that you’re eating, and that in turn burns calories, which you can in fact lose a little weight while you are eating. It doesn’t make sense, but that’s how it works.
Dr. Lisa: Let’s talk about protein. This is something that comes up a lot whenever we discuss vegetarianism, veganism. We’ve had people on the show, we bring this question up a lot because this seems to be the primary concern: If I’m going to be a vegetarian or a vegan I won’t get enough protein and I won’t get enough iron. Is that true?
Dr. Herzog: I don’t believe that to be true at all. I think that there is more of a bent on people being concerned about protein than there is an actual protein shortage in the food world. You should not eat a high protein diet. It slows down your athletic performance, it creates more of an acidity in your body not an alkaline environment, which is good for metabolism, by eating high protein. I stick with the 10-10-80 rule: 10% protein of your calories, 10% fat and 80% carbohydrates, which are mostly complex carbohydrates. Protein shortage is not an issue.
Dr. Lisa: As you’re doing this 10-10-80 rule, how are you getting protein into your diet if you are just doing this from plants?
Dr. Herzog: As it would happen, plants are designed that way. They’re about 10% protein and 10% fat, and the rest are complex carbohydrates. So it’s very easy. You don’t have to concoct all kinds of potions, and pills, and oils, and incense and crystals or whatever, to have a good diet. You can basically eat 10 different plants and you get all you need except maybe a little vitamin B12, which is always the big question. I’m sure that’s coming.
Dr. Lisa: Let’s talk about vitamin B12. You’ve set up the question nicely, so go ahead.
Dr. Herzog: Vitamin B12 is really high in meats that have a lot of blood, because blood has a lot of vitamin B12 in it. You do need to supplement a little bit of vitamin B12, which you can do in a pill. But most of the vegetarian foods that are fortified, let’s say like cereal, yogurt, soy milk, they’re full of vitamin B12. You really don’t need to get it by eating a piece of cow liver.
Dr. Lisa: You yourself are vegetarian, you’ve been vegan. Are you still vegan?
Dr. Herzog: I’m vegan, but I will admit and I can’t march the party line 100%; something about squid I really like, and it would be considered non-vegan to eat that. So I say I’m mostly vegan.
Dr. Lisa: We’ll call you a squid-eating vegan.
Dr. Herzog: A squiditarian.
Dr. Lisa: A squiditarian, all right. It’s actually funny because I know people who are also bacon vegetarians. They eat all vegetables and they eat bacon. It’s a thing that people crave. I think this is a very normal part of being human, is you crave things. Sometimes you crave them because maybe you need the nutrients that are actually in them.
Dr. Herzog: It could be, but that crunchy sweetness of that fresh squid, I’ll tell you.
Dr. Lisa: Okay, so it’s also a texture thing, it’s a sensory thing. How do you yourself, because you also … you are a cyclist and you’re very active in your own life. Describe to me what your diet looks like.
Dr. Herzog: My diet is a very simple diet. I eat the same breakfast every morning. I have a bowl of granola with fresh fruit and either rice milk, soy milk or almond milk, because I can put it in a bowl and get out of the door in about five minutes. It’s very efficient for me. I don’t do any cooking in the morning.
Lunchtime varies. I eat a lot of hummus. I love hummus. I love pasta, I love fresh breads and I love pestos, I like nuts and have all kinds of little creative recipes where I can put those things together. I tend to bake in large batches or cook in large batches, and I’ll have some kind of a bean casserole or rice already in the refrigerator. I’ll just plop it all on a plate and put it in the oven. Lots of beans and rice and pasta, tomato sauce, breads. I get my 80% carb diet, that’s for sure.
Dr. Lisa: It sounds like one of the things that you do is to cook things in large batches, which is sort of an old-fashioned notion. We’re very much into, “take something out of the freezer, put it in the microwave, small portions”. But this is something that you are able to use as a tool to keep yourself eating healthy.
Dr. Herzog: Yes, and it keeps it simple. I love to cook, it’s a passion of mine, but why not cook enough that you could have another five meals and use your freezer? Growing up in a family where there was 10 of us in the family, we always cooked in large batches anyway. Economically, when you go to the store, a 10 lb. bag of potatoes is sometimes $3 or $4. Why not cook them all up and put some curry spice and onions and mushrooms and whatever you like, put it out in little portions and eat on that one energy-filled pot for the next five weeks. Stuff freezes really well.
Dr. Lisa: What are some of your favorite vegetarian or vegan foods, besides hummus?
Dr. Herzog: I like to make my own vegetarian pizzas. I already mentioned pesto. I’ve got a passion for pesto because I grow a bunch of basil in the summer and I freeze it, and it’s good all year. So I have pesto a lot.
I also like to cheat and go out to the local restaurants in town, like the Green Elephant, and eat their Tikka Marsala. I like Thai food. I always ask them to keep the egg out of the Thai, but Pad Thai. Although that would have a little bit of fish sauce in it, it wouldn’t be a pure vegan food, but it’s pretty close. Basically any type of stir-fry, Mexican bean burritos with rice and salsas and jalapeno, whatever. I’m not at lack of not having something to eat.
Dr. Lisa: How did you learn how to cook for yourself?
Dr. Herzog: It was kind of a family thing. My dad was a foodie and he travelled a lot to Europe. He knew all about the latest, what was going on in the fields. He’d go to pick the grapes to help … He was into winery, oenology and whatever the Europeans were making in their casolets or how they made their bread or their bagels, or what region had this and that food.
He’d bring that home to us. As children we had a huge more or less industrial kitchen with an eight-burner stove and four ovens. We were always cooking as part of keeping the family together, and had huge gardens. It was always considered like a sacrament, food. It was a blessing to have and fun to prepare.
Dr. Lisa: For people who don’t have that sort of background and that isn’t part of the family culture, or they don’t garden, who come to see you as patients and you’re trying to encourage them, “Maybe you should eat more vegetarian foods,” what types of resources do you offer them or where do you send them to learn how to do this?
Dr. Herzog: There’s a couple of those popular magazines, The Vegetarian Times or Veg News. I have a favorite cookbook called “The Veganomicon” by Chandra Isadora … I’m going to mess her last name up, but it’s a beautiful book and it’s written with humor. It tells you how to start a kitchen. What kind of strainer to buy, what kind of garlic press works the best, what kind of spices to put in your pantry, how you sautee, how you braise, how you fry, how to not be a heavy vegan, because vegans can get very heavy. Those little cookies and cupcakes we know how to make can get quite fattening.
But it goes through the whole process with a little tongue in cheek, more or less trying to fool people that, “Hey, they didn’t realize this was really good for them and they didn’t pick up any animal products when they ate it.”
Dr. Lisa: What about people who are specifically interested in being athletes? Are there things that you tell them to do as far as eating ahead of time, eating after, how to structure their diet over the long term?
Dr. Herzog: Before you have a long endurance run you want to have a lot of fuel built up in your liver called glycogen. You want to carbohydrate load generally 6-12 hours before you compete. If you’re an ultra athlete you have to consume products while you’re on the run, if you’re doing one of those 100-mile races. The average person can just load up on a nice high fiber, high carbohydrate, the 10% protein and with some oils in their diet. There’s no real specific magic formula that I have. I know there’s all the powders out there at Whole Foods. I’ve met Brendan Brazier, he has his own line of special stuff. I bought it and tried it, I just didn’t like the taste of it. I’m a soy and potato guy.
Dr. Lisa: Brendan Brazier is the author of “Thrive” I think.
Dr. Herzog: Right.
Dr. Lisa: Yeah, so he is himself an endurance athlete who has embraced veganism.
Dr. Herzog: Yes, he has. He has his own protein powders. He believes in the smoothies and … which there’s nothing wrong with that, I just don’t have one of those machines so I haven’t gotten into it yet. Perhaps I will one day.
Dr. Lisa: You’ve got an interest in a lot of different areas, and that’s what’s fascinating. As a physician you could have decided early on, “I’m just going to deal with this specific segment of medicine. I’m going to be an orthopedic surgeon, I’m going to do this.” You’ve decided to branch out.
Not only have you branched out into vegan foods and vegan or vegetarian eating, and feeding people in other parts of the world, but you’re also doing a lot of work with stem cells and you’re doing different things in your practice. Actually it’s been so successful you’re expanding your practice, or talking about expanding your practice into New Hampshire.
Dr. Herzog: Correct. Yeah, I’ve been onboard with trying to keep things efficient in orthopedics, and more or less in this region pioneered the use of an ultrasound machine instead of using MRIs and X-rays. You can have that machine in your office and show patients their rotator cuff, their Achilles tendonitis, where the break is. You can look at it, and that really helps lighten people up. They say, “Wow! That’s what it looks like.”
Also, having that technology where you can see in real time, that means while we’re both looking at it, I can numb something up and put a very small needle in it and we can inject it with a standard cortisone if need be or we can spin down. That would be taking some of your own blood out, putting it in a centrifuge and concentrating the stem cells and the platelets, and injecting it into an area that gets very poor blood supply, and cause it to grow new tissue like new muscle and tendons, like for plantar fasciitis, et cetera, type problems.
It’s like tilling the garden a little bit with a teeny needle, putting in some seeds and then a little fertilizer. As opposed to doing what I would normally have done with a knife, a chisel and a mallet, if I can do it with a little needle in my office it makes great sense. It’s may be 5% the cost of surgery and it works very well. Gaining that up a notch, I’m in negotiations right now to open a stem cell clinic in New Hampshire, which is going to be a bit more potent than the PRP I just spoke of, the centrifuge the blood. We actually use bone marrow and some belly fat with stem cells in it to inject. Here again, a real long answer.
Dr. Lisa: This is used for tendonitis and…?
Dr. Herzog: Tearing in rotator cuffs.
Dr. Lisa: Rotator cuffs.
Dr. Herzog: Tendonitis, muscle ruptures, of course the problems in the joint where people’s joints are wearing out. With stem cells and the appropriate environment injected into your joints, you can prevent arthritis of the knee. If you have the fear of having a total joint, hip, knee, ankle … I do, because I have quite an amount of arthritis in my body. You can prevent it by feeding your cartilage, just like you feed your skin and your muscles with PRP and stem cell injections. It prevents arthritis. That’s going to be the new rage.
Dr. Lisa: You’ve always been on the forefront. You were a vegan before anybody else was a vegan, and you were one of the first doctors to be really be doing that in this area. You’ve been networking with doctors nationally and internationally who have been espousing the idea of veganism and plant-based eating. I have every faith in that, that what you’re saying is so, that stem cells and PRP is the forefront of medicine.
Dr. Herzog: Right. Noninvasive and it is actually fun to do for me, so it keeps me technically in the game doing interesting things. I’m a blessed man.
Dr. Lisa: That’s good to know that, that you really enjoy doing what you’re doing because it’s important that people go to see a doctor who really wants to help them heal because he’s enjoying his own life.
Dr. Herzog: Right. Coming out of that, just to expound, sitting around the doctors lounge in between surgeries, it’s hard these days to see anybody with a smile on their face. There are always … 25% of everybody is happy, just no matter what. You can make them stay awake for three days and they still would be smiling. A lot of us get us burned out, and I see that in our profession quite a bit. It takes a toll on the doctor personally and patient care too, to a minor degree.
Dr. Lisa: Since we know that you’re a very fulfilled doctor and you offer all of these therapies for things physical, things emotional, how can people find out about you Dr. John Herzog and your practice?
Dr. Herzog: The best way would be to go to my website, which is orthocareme, like M-E like for the state of Maine. I think it’s www.orthocareme.com. Or they could look in the phone book under Dr. John P. Herzog, and pick the guy in Maine. There’s another one in New York and one in Michigan with the same name.
Dr. Lisa: We appreciate you coming in and talking to us today. As we are finishing up I think it’s interesting for people who are listening that you not only are an orthopedic surgeon, you are an Eagle Boy Scout. You’ve performed over 10,000 surgeries, seen over 150,000 patient visits, treated over 5,000 fractures, you’re a professor at the University of New England College of Osteopathic Medicine, you’ve performed more than 3,000 musculoskeletal ultrasounds, and you’re the first orthopedic surgeon to use ultrasound-guided PRP treatment on the East Coast, in addition to being a proponent of vegan eating and part of Little Lad’s Bakery and sending food across the ocean. Thank you so much for doing all that you do, and for having done all that you’ve done.
Dr. Herzog: Thank you very much. I sure hope I get a copy of this to my mother, she’ll be so proud.
Dr. Lisa: We’ve been talking with Dr. John Herzog of Orthopedic Specialists right here in the Portland area. We appreciate you coming in.
Dr. Herzog: Oh thank you, it’s always a pleasure.