Ep 143 The Pillars and Potential of Lifestyle Medicine with Dr. Mark Stephany

[00:00:00] Cynthia: You are listening to the Well Connected Twin Cities podcast. I'm your host, Cynthia Shockley, and I'm here to learn alongside you through meaningful conversations with health and wellness practitioners. This is your time to experience some mindset shifts, learn practical tips, and get excited about what is possible.

[00:00:22] We want you to own the power of choice in your personal well being journey. Let's discover what's possible right here in our Twin Cities community. 

[00:00:33] In today's conversation, I speak with Dr. Mark Stefani about the field of lifestyle medicine and how he was compelled to shift focus from hospital based medicine. He walks us through the pillars of lifestyle medicine and sheds light on how it's different from functional medicine as a holistic health and well being coach myself, everything Dr. Mark shared resonated with me so deeply. I also felt connected to his personal story, how avoidable health conditions can rock a family, but inspire the next generation to avoid the same fate. So much of our health is in our own hands and I'm so grateful that medical doctors like Dr Mark are taking a stand for the power of lifestyle as medicine.

[00:01:14] Dr. Mark Stefani is a board certified internal medicine physician and American College of Lifestyle Medicine certified diplomat who had practiced Who has practiced hospital based medicine for 12 years. The choice for Dr. Mark to lead a healthier life came down to two reasons. One, if he was going to tell us patients to eat better and exercise more, he'd better be practicing what he preached. And two, since he didn't have the best genetics when it came to cardiovascular disease, he did not want to put his family through what he saw his parents and grandparents deal with as it related to their health and happiness.

[00:01:48] He chose to practice lifestyle medicine because it gives him the opportunity to make a world of difference in other people's lives within the space of just a few sessions. Helping people in their time of need is a huge responsibility, but it comes with a lot of joy. Thank you to our sponsors, Human Powered Health, the Minnesota Institute of Ayurveda, and Harvest Health and Wellbeing for making this episode possible. I hope this conversation fills you with hope and inspiration.

[00:02:15] Here we are with Dr. Mark Stefani. Hello. Good to see you, Mark. 

[00:02:23] Dr. Mark: Thank you so much for having me on Cynthia. I'm glad to be here. 

[00:02:26] Cynthia: Yes. I'm really glad and excited to talk more about Lifestyle medicine, and it's something as a health coach that you know, I Understand lifestyle medicine as a lifestyle like habits ways that you can make small changes But I was really excited to find that There's a very specific field of lifestyle medicine and especially with your experience as a doctor, I think there's a lot that we can dig into today.

[00:02:53] So before we dive right in, I wanted to ask first, outside of your work, what has been bringing you joy lately? Oh, 

[00:03:05] Dr. Mark: there's two things. One, and first and foremost is my daughter. She turned six in December and seeing her and just seeing her get older and come into her own has been one of the greatest joys of my life.

[00:03:16] And so just seeing her activities and being silly is wonderful. And the other thing is just being active. I love biking. And so this unseasonally warm time that we have right now has been accommodating for that. So I'll probably get out for a bike ride later today and that's my happy place.

[00:03:33] And so that's how I stay centered and focused. 

[00:03:36] Cynthia: Yeah, I know this weather is bonkers but glad you can get your biking in and six is just such a fun age. My niece is six and we just have the most fascinating playtime conversations. So I totally understand that. Now within your work, cause I know there's a lot going on right now.

[00:03:57] What has been bringing you joy when you think about the work that you're doing it professionally? 

[00:04:04] Dr. Mark: Right now I'm still working full time as a hospital medicine physician as I hope to transition into full time lifestyle medicine, and, but the joys that I get out of it. Each specialty are very similar.

[00:04:19] It's never been really about the medicine and the physiology that brings me the most joy. It's the opportunities that, that I have to sit down with patients or clients and really talk through their needs, their hopes their questions about their body and their health, and really try to help them better understand those elements.

[00:04:41] And in a turn, I think ultimately what it comes down to is giving them hope and hope whether that's recovering from a severe illness that it may see in the hospital or giving them hope that they may be able, that they will achieve their health goals that they're setting for themselves.

[00:04:58] And so it's much more of that, that human level component that really drives me and is what I'm most passionate about. 

[00:05:09] Cynthia: Yeah clearly, especially as you try this, or as you navigate this transition into kind of more of that health coaching space and education space, I feel like that's really apparent that you want to make that human connection.

[00:05:23] You want to empower individuals. What initially drew you into the DO path? And for those who might not know, there, it's doctor of osteopathy versus a traditional MD. And I know I was also considering the DO path because there's just so much richness there where you learn everything an MD does plus some, and you learn a little more about just hands on manipulation.

[00:05:49] So I'm curious about your path and what drew you in. 

[00:05:53] Dr. Mark: Yeah, you summed it up. Well, that The doctor of osteopathic medicine, the medical school training is really the same that you're getting within a traditional medical school and MD degree, but there's an additional focus and training in musculoskeletal medicine.

[00:06:10] And so that's not only the additional anatomy and physiology of the musculoskeletal system, but also, as you mentioned the hands on manipulation and. That that's how the profession was founded back in the mid to late 19th century. And that's how it started. But as pharmacotherapy and surgery became more efficacious in the ensuing decades, there was this merging of fields where you had your traditional medical degree and then osteopaths who wanted to utilize medications in surgery.

[00:06:41] And so then thereafter, really. in essence became the same degree and practice. But I would agree with you that in, when you're in the training in medical school in those first couple of years, there is a bit more of an emphasis of how do all these systems fit together. It's not just thought of in isolation, this is the nervous system and then this is cardiovascular system.

[00:07:05] You're going to learn them separately. It's a bit more of an integration like that, and I hate to use the word holistic, but I guess it is a good descriptor in this sense. But I was really happy with my training and very pleased that we received a great deal of training and nutrition and that formed a foundation for later interests in my life.

[00:07:24] Yeah, 

[00:07:26] Cynthia: and I love the distinction to some people have been using when they say holistic, it's spelled W H O L, right? Like it's whole person, whole experience, how everything's connected. So it is nutrition. It is movement. It is all these lifestyle factors. To me, it makes total sense that lifestyle medicine was attractive to you as you, learned how everything is connected.

[00:07:52] But tell us a little more about your journey from being in more of that traditional medical space and then wanting to transition more into that lifestyle medicine and health coaching. 

[00:08:03] Dr. Mark: Absolutely. Starting out in your career, there's this sense that you're Of idealism that you're really going to be helping people and I do every day.

[00:08:15] But there's this, at least for me and my colleague who started lifestyle sound lifestyle medicine with me. There was this sense like you weren't able to do enough that you were putting band aids on. Individuals and they would come in with infections or heart attacks and we'd give them we would give them optimal medical therapy but you never address the root causes and you know You would see these individuals weeks months years later, you know with the same condition and it only got worse despite medical therapy and so it began the sense of Futility with what you were doing and I think I began to sense that probably midway through my career I've been practicing hospital medicine for 12 years now and It was incredibly disconcerting, frustrating.

[00:09:05] Like I can't imagine doing this for another 20 plus years until I retire. It just. I felt like I could do more. I wanted to do more and I wanted to address the root causes and, lifestyle medicine is built upon the understanding of what is called the social determinants of health.

[00:09:21] And so when you look at the bucket of what determines one's health, you have genetics, you have your environment that you live in, and then you have all these other elements what you eat, your activity level, do you smoke, how much do you drink, your stress levels, your relationships, all of those encompass outside of the medicine and the genetics or become your social determinants of health.

[00:09:46] And that's really the foundation by which lifestyle medicine is built is addressing those lifestyle determinants while not ignoring, while not disparaging. Traditional medical therapy and again, it all kind of forms this Venn diagram of health where you are in the center. And you have these other avenues by which to address optimal health and what that means for you.

[00:10:09] Cynthia: Yeah. And I think that it's perfect how you describe it's that Venn Diagram, right? Because there is a bit of that crossover or overlap where people could go to a traditional provider or they could go into lifestyle medicine for some similar support. But there are some things where, the Western medicine field is really good at some of the urgent care.

[00:10:33] Some of the things that are in the moment really needed medicine, but then when you think about things that could be prevented with lifestyle, that's where. You come in, that's where, sound lifestyle medicine comes in, where you can have some more focus on the things that you have control over in your personal life.

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[00:12:15] Cynthia: And so I know with lifestyle medicine, there are these pillars that is discussed it, are those pillars, the social or the lifestyle determinants of health that you just mentioned? 

[00:12:27] Dr. Mark: Yes, exactly, and I should back up for a moment, and the reason that this is so important is that these elements are the primary drivers of your health.

[00:12:37] It's not just a component of, but rather 60 to 70 percent of your health is defined by these lifestyle factors. It's not what I do as a physician. It's not your genetics. And we're generally speaking, obviously there are genetic conditions That have a much greater influence, but generally speaking, when we look at things like diabetes, high blood pressure obesity, heart disease, those are primarily driven by these lifestyle elements.

[00:13:03] Genetics makes up about 15 to 20%. What I do as a physician, is about 10 to 15 percent of what determines your health. And so that's really empowering for individuals to know that a lot of control over their health comes from things that they can do. 

[00:13:18] Cynthia: Yeah, and it's such a paradigm shift because I feel like it's this social norm that, Oh, you're sick.

[00:13:26] You go to the doctor and the doctor will fix you. The doctor will heal you versus recognizing that you have, you 60 to 70 percent of what you can control is actually what can heal you. And so to make that shift in mindset is huge. And I know. As a coach, it's your job to remind people or to educate people on the power that they have, the choices that they could be making.

[00:13:56] How was it for you going from doctor who, tells people, this is what you need to do versus a coach who might more open the space and ask for their own wisdom and their own understanding, how is that transition in your training? 

[00:14:13] Dr. Mark: That's a great question. And I always felt like I should be treating my patients in the hospital as their coach.

[00:14:23] And so it wasn't a challenging transition for me. That's how I wanted to practice. And it was a big impetus for me to, to again, make this transition to a different form of medical care of practice. So I completely agree with you that in generally speaking, there is this more paternalistic element within traditional medicine of, this is what you're going to do.

[00:14:45] This is what I recommend it, take it or leave it. And I think For many physicians, that's how you were trained and that's how you were expected to practice. And so there has been shifts over the years with regard to, shared decision making processes and training in that. But on a day to day practice, that's, it's not emphasized, it's not implemented.

[00:15:07] There's no, for lack of, to be quite honest, to practice that way. But for me, I, once I was, A few years into my career and I was comfortable with what I was doing. And I was less concerned with patients questions and perhaps sometimes push back with recommendations.

[00:15:27] And so began opening it up more to that shared decision making process where this is what we know, this is what we don't know. And how do you feel about that? Would you like my opinion? And unfortunately, the way medicine has progressed over the decades. Again, it's very much that paternalistic element of this is what's best for you, but there was never that acknowledgement of how the vast gulf of gray area within.

[00:15:57] Medicine, Medicine has painted this picture of binary outcomes in black and white and there's an answer to everything There's a solution to everything. There's a cure for everything And that is just simply not the case And so you have people come in expecting that type of straightforward answer when you paint this More challenging picture.

[00:16:18] It's incredibly overwhelming for people and you really have to step back and acknowledge the uncertainty, acknowledge the gray area and find out what's most important to them and what their goals are, what, with their health rather than just paint, painting broad strokes for each patient.

[00:16:37] They're, each person is not defined by their pathology. And we refer to patients in the hospital oh, there's that stroke patient in 4317 and the heart failure patient down in 2316, but they're people. And they have their own wishes. And desires and families and circumstances, and you really, in my opinion, should tailor recommendations to those individual needs and not treat you, but everybody as cookie cutter.

[00:17:07] Cynthia: Yeah. It sounds like you've been able to So really listen to your patients and be reflective about what they need to make the progress that you hope for them. And just taking that coaching approach was like an intuitive choice to be more curious, to be a partner in the process. And lifestyle medicine, when you learned about this as a field what is it that kind of sparked your interest that you were like, yes, this is what I want to do moving forward.

[00:17:42] Dr. Mark: Yeah so lifestyle medicine, is a area of practice and it's a, there's a governing body, the American College of Lifestyle Medicine, and there's training for physicians and other providers. And so that's, a full process that I went through well over a year and extensive examination.

[00:18:01] And the reason that I chose that as opposed to, getting a degree in nutrition or diet headaches or exercise physiology or something like that is because I wanted to be able to address all of those pillars, much like being an internal medicine hospital physician. I am good at a lot of things, but I'm not an expert in any one of them.

[00:18:24] That's why I consult a cardiologist. That's why I consult a neurologist, etc. I think each one of those fields of lifestyle medicine has their own certainly experts within it. But I wanted to be able to provide my clients with a great understanding of each. And one thing that you learn as a medical physician is when there are patients that are above your pay grade, right?

[00:18:49] And they're complex enough that you need to get those experts involved. that has allowed me to, you learn how to research then, what do I need to do next? But then also, when do I need to refer? When do I need to get somebody else involved to help this person out? And, having that kind of humility, I think pays dividends for patient care and client interactions.

[00:19:14] Cynthia: Yeah, when you can remove the ego and just really be honest about what is in your scope versus what isn't and just to really think about the client's needs first, I think is huge. That's amazing that, you've been able to really finesse what this, the scope is for you.

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[00:20:37] Cynthia: And I know that we have discussed in previous conversations how sometimes functional medicine and lifestyle medicine might get jumbled up together and there is a distinction. So for those who might be relating in their mind Oh, this is functional medicine. Do you mind sharing what that differentiation is between lifestyle versus functional medicine?

[00:20:59] Dr. Mark: Sure. And I'm not a functional medicine practitioner. I've not received any formal training. And so certainly would appreciate anybody's specific feedback. If I, if they feel how I describe this as inaccurate, but I know from reading and interacting with practitioners that there is a strong emphasis on looking granular level of somebody's, Physiology and hormone imbalances micronutrient imbalances, things like that.

[00:21:24] And so there's, that in turn emphasizes a lot of the laboratory evaluation up front. And I think there, and correct me if I'm wrong there, but there may be more of a emphasis on the activity movement and nutrition side of things, and not as all encompassing as the pillars of lifestyle medicine.

[00:21:45] And so it's. The reason that I chose not to pursue functional medicine is because again, I wanted a broader scope of understanding of all those pillars, but also the laboratory evaluation felt very eerily similar to what I was already doing in the hospital. And I don't want to be just treating numbers, right?

[00:22:06] Somebody is not eating well or sleeping well, I don't need a CRP to tell me that. And that doesn't mean that I can't order labs. It doesn't mean that I don't think that's appropriate. It's just not, doesn't paint the whole picture for me. And I don't want my clients to have to fork over hundreds, thousands of dollars for labs at it.

[00:22:25] In my opinion, may not be needed. That's my understanding of some of the differences. 

[00:22:30] Cynthia: Yeah. What strikes me about you just as we've been talking, Dr. Mark, is just that You, it seems you've been very intentional and thoughtful about the choices you've made in your career and how you treat your patients, your clients.

[00:22:48] And so I'd imagine that same thoughtfulness and intentionality goes into, the programs that you've been creating, that you have, executed in the past. I know right now, Sound Lifestyle Medicine does have a couple of programs. Do you mind sharing what those programs are and what people might expect out of them?

[00:23:12] Dr. Mark: Absolutely. I think it's important to back up and I'd love to describe the evolution of what we were wanting to do a sound lifestyle medicine. Both my colleague and I, Dr. Jim Kosowitz we didn't want to have a brick and mortar clinic and we didn't want to take insurance.

[00:23:26] We didn't want to be in the same exact system that we were wanting to leave. And it was our hope to be able to provide these services on a broad scale. We want to, we eventually want to be offering our services nationwide. And so in order to do that logistically, it's very challenging to get patients even locally into a brick and mortar, let alone, that kind of scope.

[00:23:47] And so starting out just with, grassroots and trying to get, clients on board was obviously challenging and we felt like we needed to offer additional services to that were more accessible to our clients than just working straight away one on one. And so the two things that we currently Have that are one on one is our intensive Program called the better you program where we go through all of the lifestyle pillars It's 10 45 minute sessions that we work with individuals on their goals defining what they are why They want those as their goals and then executing on them.

[00:24:28] And for the, for most people, it comes to down to, nutrition and activity as a primary focus. But then we, as those kind of get streamlined, we move into sleep. We move into distress and the other pillars. And that's our bread and butter package. And then we also offer a consultation service, which is called a sound hour.

[00:24:49] It's an hour long consultation with individuals. And that. Are the people who generally want to do that are usually already involved in some lifestyle changes and they may have specific questions about how to dial in their nutrition or what they can do if they've reached a plateau with weight loss or if they've got a specific medical condition like diabetes and in what they may do.

[00:25:14] Want to do from a a dietary standpoint, so it's a bit more focused and, we've had people come back a few times with questions and then we've had people transition from the consultation service into the better you program and it's been a, an ideal set up in that sense, but additionally with our hope to be able to reach a broader audience, we are excited to be releasing, a course that goes through all of these pillars.

[00:25:41] And in essence is a condensed version of our better you program itself guided. And that should hopefully be out within a month where people can sign up for it again and work through all these pillars individually and we're incredibly proud of it. It's been a lot of work, but we hope it's helpful and beneficial for people and gets our name out so that more people can benefit from lifestyle medicine.

[00:26:06] Cynthia: I love, again, that thoughtfulness of what's going to be less barriers for people. Do they need a one off? Do they need more intensive work? Or is it something that they would rather do on their own and just follow a course? So it sounds like there's just options. for people who want to make these lifestyle changes, who recognize that they're not in the best place and there's room for optimization.

[00:26:31] And so we do have the link to the the website, if you would like to look at the sound lifestyle medicine website. And also I know Dr. Mark, you guys also have podcast. What are some things going on at the podcast? 

[00:26:48] Dr. Mark: Yeah, we've really enjoyed doing that. Doing the podcast and the hope with it was not to recreate some of the other podcasts that are out there from, functional medicine experts and other nutrition, nutritionists who really do a great job of getting into the granular technical weeds of nutrition and exercise, we wanted to be able to really hit high level.

[00:27:14] Notes for some of these topics and provide information that's, that filters out a lot of the noise that you're gonna hear in, more maybe traditional media outlets and articles and blogs and so forth. And they give people actionable steps that they can take to implement some of these lifestyle changes.

[00:27:34] I, I think I certainly get overwhelmed with all the information out there. And so I can't imagine, somebody without a science or medical background trying to tease through it all. It's just overwhelming. It's confusing. And you look at podcast episodes that have got like 500 plus episodes and you're thinking, how am I going to get through all this information?

[00:27:55] How are there 500 plus different things that I need to do in my life to implement in order to get optimal health. And so we're really trying to hit these high level things and provide what you need to know to make to get moving and to help people who are more generally just starting out.

[00:28:15] With their changes, I think there's a spectrum of people and we're not trying to hit them all. The people who are already made lifestyle changes and are feeling comfortable with things. Yeah. Tune into the more the podcasts that are go like into detail and you're already at the 95 plus percent of optimization and you just want to dial in those.

[00:28:34] The remaining percent, but we know for a fact that the majority of Americans are still sitting over here and haven't done anything. And if we're going to make a change in this world, if we're going to make a change in the trajectory of chronic disease, we really need to be able to provide that that population with more digestible food.

[00:28:55] Information that's actionable as well. 

[00:28:57] Cynthia: Yeah. Because you have been in this space and, doing this podcast, what would you say is even one simple step that you find is really beneficial to a broad range of people to just start to take some kind of action in their well being? 

[00:29:19] Dr. Mark: I like to have people back up and ask themselves, why do I want to make these changes in the first place?

[00:29:24] I really feel like that's a missing piece in a lot of lifestyle changes, because what are people wanting to do 30 day challenges and two week retreats or what have you, and feel great during that time. And you're, you've made great improvements, but then.

[00:29:43] Things slowly revert back to the way they were right on day 31 after your challenge, you're going straight to the. Punch pizza or wherever to congratulate yourself for what you've done. And that's not what we want to see. We want to see you make sustainable changes over time. It doesn't mean that you're not going to make mistakes.

[00:30:05] It doesn't mean that you're not going to go on vacation and splurge. No, what you're looking for is sustainable habits over time. And the only way to really. Do that is to have an underlying reason why you want to make these changes in the first place. Why do I want to lose weight? Why do I want to look better, feel better?

[00:30:27] And for most people that comes down to. A value system, an idea, as well as family, right? And so I've chosen to make these changes personally, because I come from a line of bad cardiovascular disease and my father, Watched his dad die in front of him from heart attack, when he was just a young boy.

[00:30:51] I saw my father have quintuple bypass surgery at the age of 62 and I was in my early 20s. I don't want to put my daughter through That trauma. I want her to not have to worry about me and my health. And I want to be the best dad that I can be. I want to be able to show up every day. And the only way I can do that effectively is to make sure that I'm committed to improving my health.

[00:31:20] So I'm not eating the way that I do. I'm not going out for a bike ride later today, solely because I eat a plant based diet and that's who I am, or because I'm a cyclist and who I am. No, I'm doing those things So that I can be a better father, right? So there's that why behind all of the underlying actions.

[00:31:41] And so it's my firm belief that your health is the foundation by which everything else is built. It's going to be the thing that restricts everything else that you want to do in life and to optimize it as much as you can within the context of what you believe that to be for you and your needs. I think it's one of the most important decisions that you can make in your life.

[00:32:06] And so it's not going to buy more kale. It's not going to buy a new supplement. It's really taking a step back and being honest with yourself with, why do I want to make these changes in the first place? And keep asking yourself why, until you get to that point when it hits you in the gut and you think, yeah That's it.

[00:32:23] That's why I want to do this. That's what's going to get me up in the morning to make these changes, even when it's hard. That's what's going to get me back up on the horse when I fall off and that's okay. So that's what I would recommend for people. 

[00:32:36] Cynthia: That is powerful. And I thank you so much for sharing your motivation.

[00:32:42] I think that's a really And I think it's a really important reminder that we do need that anchor to the motivation. We need something that tethers us to the why, so that if you fall off track, you're not going to just give up, right? You're going to come back into alignment because, being there for your daughter, being there to be your healthiest self is that important to you?

[00:33:06] And thank you so much for listening. Just to that step, I think that's huge. And so if there was, gosh, even just one other takeaway that listeners left this conversation with, what would you hope it would be? 

[00:33:21] Dr. Mark: That you're not alone, that these changes that you want to make while they feel overwhelming are not insurmountable and that more people than you know that you recognize are going through it.

[00:33:36] And I see that on the hospital every day. People believe that they're alone in their condition, in their disease state, but you're not. And I really wish that we would be more comfortable with each other to share our struggles and desires and goals and our hopes because you need that support network.

[00:33:57] You need that understanding that people are going through the same struggles, but also want the same good. They also want the same. wholeness in their life. And that not only allows for more inspiration for each other, but there's this degree of accountability for each other and support.

[00:34:16] And so I always tell people to, find the few individuals in their life whom they love, whom they really connect with and tell them that one and then two, Tell them their goals that they want to have in their life, that they want to try to achieve and say, I need your help with this.

[00:34:38] Please support me in this. And Not only does that happen, but oftentimes it snowballs and they want to make those changes too. And despite what social media shows you, despite what TikTok shows you, you're not making these changes in a vacuum. You're not making these changes alone, and you're not making these changes solely for yourself, right?

[00:35:00] There's a higher cause, higher purpose to why you're making them and recognize that and you're gonna, you're gonna be fine. 

[00:35:08] Cynthia: Dr. Mark Stefani, thank you so much for sharing your light, sharing your wisdom and, just putting your passion into this work. I'm really excited that we got to have this conversation and I'm looking forward to just seeing how your program continues to support and make this world a better place.

[00:35:32] So really appreciate everything that you're doing. 

[00:35:36] Dr. Mark: Thank you, Cynthia. It's been an honor. I really appreciate what you're doing with Well Connected. I think it's a fantastic platform and I'm really excited for everything that lies ahead for you.

[00:35:47] Cynthia: Thank you so much for listening to the Well Connected Twin Cities podcast. Did you learn something new? Did you feel that spark of hope and excitement for what is possible? Because so much is possible. Tell us about it in a review on Apple podcast. Not only would we absolutely love hearing from you, but these reviews help our ratings and help other curious minds like you find this resource.

[00:36:12] We are always better together. Thank you again, and see you next time. 

[00:36:18]