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Alicia Morgans: Hi, I'm so excited to be here with Dr. Gary Deng, who is the medical director of the Integrative Medicine Service at Memorial Sloan Kettering Cancer Center in New York. Thank you so much for being here with me today, Dr. Deng.

Gary Deng: Thank you. Good to be here.

Alicia Morgans: Well, it is great to be here talking with you because you have put together recently a beautiful book. I would call it a cookbook, but I think of it more as a wellness guide, that I think is such a wonderful contribution to the field. As we think about helping cancer patients live better and live well as they're going through that journey, during or after a cancer diagnosis. I'd love to hear your thoughts. The book of course is entitled, The Wellness Principles.

Gary Deng: Well, the book is inspired by my patients. In my daily clinical practice I see a lot of cancer patients, especially GU cancer patients, lot of prostate cancer patients. They not only are getting therapeutic treatment, they also want to optimize their own lifestyle. We know from research, a healthy diet, regular exercise, stress management, good sleep, all these make patients stronger, and make their quality life better, more energy, and maybe even change the trajectory of cancer development. Especially for those low risk, lesion six cancer.

So when we discuss these lifestyle changes, especially dietary changes, they want specific advice. They want recipes. I look at the books available on the market, some are very extreme, like a totally vegan diet, or raw diet, promoting a healthy diet, or ketogenic diet. I don't think they are sustainable. They're very hard to do, very... People just not going to take it for long.

If you don't like a diet, you don't eat it every day, you're not going to get any benefit, no matter how healthy it is. So I try to make a book with recipes here. There are a hundred recipes. They are healthy and they're tasty, and they're quick to make. I think those three are key factors or key characteristics of this book, because I am a home cook. I cook three meals for my whole family and almost every day. We rarely dine out, we rarely order takeout. So I have a lot of experience.

I also know it's important to make things quick because I'm also very busy. So I try to put all my experience in the book. I also have a PhD in immunology and in my PhD work, I do a lot of molecular biology biochemical work. So I know the nutritional science and also how to generate good taste. The flavor and taste for food. So I incorporate some of that knowledge into the recipes and also the principles of healthy diet as well. So that's where the cookbook's coming from and it's really written for my patients.

Alicia Morgans: Well, I love that your guiding principles are really the health, the flavor, but also the speed, because I can't imagine making three meals a day as a busy physician, the medical director of your group. I mean, these are time consuming activities that you partake in, and yet you're able to cook in a way that lets you show your family certainly how much you care about them, keep them well. And you're also getting all of that done within a 24 hour day.

I'd love to hear what are some of your favorite recipes, some of the favorite things that your family likes you to make, and how do they connect in terms of helping support the immune health or the overall wellbeing of our patients who are living with or after cancer?

Gary Deng: Yeah. So you are exactly right. There is a way to cook quickly and actually at the end of the book, there's a two weeks menu. So you can see the two weeks menu and we use a lot of leftover. Like you cook dinner, you cook more and the leftover can be used for lunch, right? So that saves you a lot of time. My favorite dish would be, I call it "full spectrum salad". I don't think it's called written anywhere else. The idea is people always say, "Oh, I want super food. I want blueberries, super food, broccoli, super food." I always tell my patients, there's something I call super duper food. It's even better than super food, which is variety. Because the body, our body, needs hundreds if not thousands of nutrients, no super food, no matter how healthy they are to provide that.

So you want to eat all kinds of food together. So the "full spectrum salad" is basically a salad made of leafy vegetables or vegetable roots or fruits like tomato, cucumber, and so on. And because of that, it's easy to mix and match. So you can basically eat the same salad without repetition for a week, and super quick to mix as long as you get fresh ingredients. So it's very important. That's another principle emphasizing the focus to get high quality, fresh ingredients. They don't have to be expensive, but the fresher the better. Then you just chop them up, mix them together, and in the recipe, there are different way to flavor this dish. So you can have the European flavor or the Asian flavor or the middle Eastern flavor just by adding different spices in. So that would be my favorite recipe because it's easy to mix, it provides all the micronutrients we need, and also you mentioned immune system. It's very high in fiber and we know the microbiome. Now we know more and more in the last five, 10 years, the microbiome influenced our health in many ways, right?

For example, cancer patient on immunotherapy, if they eat a lot of fiber, the high fiber diet, immunotherapy works better. They have a healthier microbiome. There even studies show because the healthy bacteria in our guts metabolize our food, there's some link between depression or mental health because if we eat the bad food, they can generate harmful materials and even dementia. If we eat healthy food, they generate better nutrients for our neurons. So this salad give us all a variety of the fiber that cultivates a very diverse and healthy microbiome. So I think that's also a very healthy part of this food, this particular dish.

Alicia Morgans: I have to say, it's a beautiful salad too. I mean, to look at it and we've discussed that my cooking leaves a lot to be desired, but one nice thing about this too is that it's not really cooked, right? It's just, there's a lot of chopping and there's a lot of, but there's also a lot of color because of that variety. So it's enticing and beautiful to look at, which also, I think makes it so much more appealing when you have the opportunity to sit down and have it for lunch or as a main meal for your dinner. So just beautiful.

You did bring up at the end of the book, the really helpful guide in terms of menu options that can help you think through, "How do I use this meal now?" And then as you said, you could sometimes have the leftovers to support the next day. Why was it important for you to include those menus? Because as a person who doesn't cook well herself, that's so helpful for me in terms of planning and ensuring that I have what I need on hand to make the food.

Gary Deng: Because that planning will simplify the planning process for patients or for users or the readers of the book. Because another principle is the proportion of macro nutrients, right? Like carbohydrate, protein, and fiber. So when you look at your plate, half your plate should be vegetables. Vegetable is not a side dish. So when you go to the restaurant, your order side dish, no. Vegetables should be the main dish. The protein side dish is about a quarter of your plate and carbohydrate, a quarter of your plate as another side dish. So each menu or each dish, I actually mentioned, "this should pair with this and that to make a complete meal", which has the proper 2:1:1 ratio of the macronutrients. I take that principle also in the design of that two weeks menu. Because if you look at each meal and they have different dishes and they put together a conforming to that principle, so this just makes planning a lot easier.

I have to tell you, the secret in cooking efficiently is in grocery shopping. When you shop right, you just open your refrigerator, your pantry, you look at things and then you just say, "Oh, I can put these things together." You don't have to do a lot of planning. And the secret of grocery shopping is not to buy a lot of a few items, instead buy a little bit of a lot of items. So instead of just buy a bag of orange, a bag of apple, you buy two or three oranges, two or three apples, some pears, some strawberries, some grapes, some watermelons, some kiwi fruits. So this way, when you open your refrigerator, say, "Oh, I can pick one of these." So you never repeat your fruit collections, spending the same amount of money, but eat a lot healthier this way.

Alicia Morgans: I love that. Other things to really comment on though, in this book beyond your little tips on how to be practical and add in that variety, are the comments that you have integrated regarding stress management and thinking about physical exercise, essentially addressing those aspects of wellness. And it is called The Wellness Principle, that help put in addition to the food that you eat, make the rest of you a whole and healthy person. I'd love to hear your thoughts or comments there.

Gary Deng: Yeah. I call it "beyond the plate for healthy living," right? It's not just what's on the plate is also beyond, because as a human being, we are very complex. Our mind has a huge role to play on our health and our physical health. Without addressing those, I see... It's like a car with four wheels, right? Nutrition, exercise, stress management, good sleep. If one of the wheels is loose, like you eat well, you exercise, but you're under tremendous stress, this car is not going to go fast. Even in cancer, there are some animal studies showing stress makes the cancer grow faster, right? Because it adrenaline stimulates angiogenesis, and you can block that by beta blockers. So we do think to achieve optimal health, we need to address diet, but also other factors, not only for our physical health, but also for our mental health, for our energy level, for our enjoyment of life. So in the book, I talk a lot about that as well.

Alicia Morgans: Well, I think that's so important and I'm glad that you included it because to your point, there is so much around that, eating well to be actually a well person. I love your analogy of the car not being able to go fast. So if you had to sum up the book and what you hope that it brings to the patients or others who end up using it, what would that be?

Gary Deng: I would encourage people to try home cooking. If this book make home cooking easier for you, that's great. Your home cooking is healthier because you have control on the ingredients and cheaper. Now when I went to the restaurant, I found like double the price like a couple years ago. But if you do home cooking, it's a lot cheaper. Also, it's a good way to bring the family together because sitting around the table, eating home cooked food is a very satisfying and nurturing event for people's family quality of life. So the bottom line is, if people read this book and do more home cooking and make it easier for them to do home cooking, I'll be so happy.

Alicia Morgans: Well, I think they would be so happy as well, and they would probably feel better. Also of course, be actively doing something to make their bodies and their minds healthier, to really deal with the stress and the physical challenges that can come with dealing with a cancer diagnosis. Thank you so much for your expertise and your knowledge in this book and of course, in this conversation today. I appreciate your time.

Gary Deng: It's my pleasure. Thank you. Thank you again.