Beth Motley MD, FACLM

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Beth Motley MD, FACLM Family Medicine/Lifestyle Medicine MD
Plant-based diets & deprescribing
Longevity & chronic disease prevention
Wife & mother of 5 Health & Wellness Website

🧬 “I have the APOE4 gene… does that mean I’ll get dementia?”This is one of the most common fears I hear from patients. B...
24/07/2025

🧬 “I have the APOE4 gene… does that mean I’ll get dementia?”

This is one of the most common fears I hear from patients. But let’s clear something up:

👉 Having APOE4 is not a death sentence.

Yes, it’s a genetic risk factor, not a guarantee.
Here’s what the science says:
• 1 copy of APOE4: ~2–3x increased risk of Alzheimer’s
• 2 copies (one from each parent): up to ~10–12x increased risk
• But: many people with APOE4 never develop dementia, and many with Alzheimer’s don’t have it at all

So what actually causes dementia?

🧠 Only 1–2% of cases are due to rare inherited mutations that guarantee early-onset disease.
The other 98% are multifactorial, influenced by:
✔️ Vascular health (blood pressure, cholesterol, stroke history)
✔️ Blood sugar regulation (diabetes, insulin resistance)
✔️ Chronic inflammation
✔️ Poor sleep
✔️ Lack of movement
✔️ Social isolation
✔️ Nutrition

This is where Lifestyle Medicine becomes your greatest tool.

🌿 A whole-food, plant-predominant diet
🏃‍♀️ Regular movement
🛌 Prioritizing sleep
🧘 Stress management
🤝 Staying connected
🧠 Challenging your brain

These pillars directly impact the same pathways that APOE4 influences, and they offer a powerful counterbalance.

🩺 Genetics load the gun. Lifestyle pulls the trigger… or keeps the safety on.

- Dr. Beth

Do you have dementia in your family history? What are you doing about it?

📣 Let’s talk about statins and cholesterol.Too often, it’s framed as lifestyle or medication… but that’s a false choice....
23/07/2025

📣 Let’s talk about statins and cholesterol.

Too often, it’s framed as lifestyle or medication… but that’s a false choice.
The smartest approach is lifestyle first, and medication used strategically if needed.

Statins block an enzyme in the liver called HMG-CoA reductase, which is needed to make cholesterol. By doing this, statins reduce LDL production.

🥗 Lifestyle changes can lower cholesterol dramatically, especially with a plant-predominant diet.
💊 Statins are well studied and save lives, especially for those with known heart disease.
⚖️ Side effects are often overstated, and most people tolerate statins well.
🌿 Medications don’t replace lifestyle… they complement it.

We don’t have to be anti-medication or anti-lifestyle.
The answer is usually somewhere in the middle.

➡️ Use lifestyle as the foundation.
➡️ Use medication when it’s needed.
➡️ And most importantly, stay informed. If you don’t understand why a medication may be recommended, always ask for more information!

Early morning meal prep!This is my favorite way to use peaches. It’s the easiest summer salad. ☀️Equal parts:CornCucumbe...
22/07/2025

Early morning meal prep!

This is my favorite way to use peaches. It’s the easiest summer salad. ☀️

Equal parts:
Corn
Cucumbers
Tomatoes
Peppers
Black beans
White beans
Red onion (omitted here)
Peaches

Add a squeeze of lemon and some finely chopped cilantro. Salt and pepper to taste.

So easy to make. Even the worst chef can pull this one off!

Any other ingredients I should be adding here? 😋

🎈Your stomach doesn’t count calories; it measures stretch.You have built-in stretch receptors in your stomach that help ...
21/07/2025

🎈Your stomach doesn’t count calories; it measures stretch.

You have built-in stretch receptors in your stomach that help tell your brain when you’re full. But here’s the thing… they respond to volume, not calories.

That means:
🍟 A serving of fries? Calorie-dense, but barely registers.
🍲 Rice, beans, and veggies? Fewer calories, but takes up more space, and tells your brain, “I’m full!”

This is why you can feel stuffed on 400 calories of beans and veggies… or still hungry after 800 calories of chips and cheese.

🧠 Want to feel full while eating less?
Try these volume-based tips:
- Start meals with a broth-based soup or big salad.
- Load your plate with high-fiber, water-rich foods (think fruits, veggies, beans).
- Drink water with meals.
- Minimize high-fat foods and oils (for me this is peanut butter!).

The goal isn’t to eat less… it’s to eat smarter.

- Dr. Beth

What’s one high-volume, low-calorie food you rely on to feel full?

Willpower is great, until cookies show up.We love to think it’s all about willpower. But the truth is, our environment m...
20/07/2025

Willpower is great, until cookies show up.

We love to think it’s all about willpower. But the truth is, our environment makes more decisions for us than we realize.

You could have the strongest intentions… eat better, move more, sleep earlier… but if your home is full of ultra-processed snacks, your phone is buzzing all night, and your friends roll their eyes at your rice and beans… it’s going to be an uphill battle.

Want to change your habits?
Start by changing your environment.

- Clear the counter.
- Keep nourishing foods visible and convenient.
- Make your bedroom a haven, not a second office.
- Find a community of exercise buddies.
- Spend time with people who support the version of you that you’re becoming.

Willpower is finite. But the environment you build is supporting you every day, even when you’re not thinking about it.

- Dr. Beth

What have you done to change your environment? How has this had an impact on your health?

Anxiety. Brain fog. Low mood.Could it be your gut talking?Your gut and brain are constantly messaging each other via the...
18/07/2025

Anxiety. Brain fog. Low mood.
Could it be your gut talking?

Your gut and brain are constantly messaging each other via the vagus nerve. In fact, around 95% of your body’s serotonin is produced in the gut, not the brain (Yano et al., Cell, 2015; Gershon, Gastroenterology, 1999). What you eat truly affects how you feel.

Want to feel better?
→ Feed your fiber-loving gut bugs (fiber is only found in PLANTS!)
→ Add fermented foods to your meals
→ Ditch the processed junk

Nourish your gut. Soothe your brain.
- Dr. Beth

Health coaches are undervalued.In the clinic, I see it all the time: people want to make health changes. They’re motivat...
16/07/2025

Health coaches are undervalued.

In the clinic, I see it all the time: people want to make health changes. They’re motivated, they’ve read the books, they have the apps. But somewhere between knowing what to do and actually doing it… they get stuck.

That’s where a health coach comes in.

✨ A good coach provides:
• Guidance tailored to your life
• Support when it gets tough
• Accountability to keep you moving forward

Yet many people hesitate to work with one, especially when they’re used to insurance covering everything. I get it. But lifestyle change takes more than good intention. Deep work requires time and attention.

I regularly refer to health coaches because I’ve seen how much of a difference it makes for some.

If you’ve been trying to go it alone and feel stuck… a coach might be the missing piece.

💬 Have you ever worked with a health coach? What was your experience like?

He came in to talk about erectile dysfunction 🍆 .But for me, it opened the door to a bigger conversation: his heart.Erec...
14/07/2025

He came in to talk about erectile dysfunction 🍆 .
But for me, it opened the door to a bigger conversation: his heart.

Erectile dysfunction is often the first warning sign of blood vessel disease, a red flag 🚩 that the arteries aren’t working as well as they should, including the ones that feed the heart.

His elevated cholesterol and borderline high blood pressure are further clues.

That’s why, in cases like this, we shouldn’t just treat the symptom.
I order a coronary artery calcium (CAC) score to assess his true cardiovascular risk ❤️ .

👉 More often than not, it comes back elevated.
This presents an opportunity. Instead of just starting another pill, we talk about long-term goals, including heart health and vitality, and how a plant-based diet can support all of them.

ED may be the reason he came in. But the opportunity to have a conversation about heart disease may be the bigger win.

Once the CAC score comes back, I often point to “The Game Changers” documentary as a starting point. Have you seen this and if so, what did you take away?

📢 Truth bomb: “Protein quality” sounds scientific, but in real life, it rarely matters.To start let’s dispel a common my...
14/07/2025

📢 Truth bomb: “Protein quality” sounds scientific, but in real life, it rarely matters.

To start let’s dispel a common myth… ALL foods contain ALL 9 essential amino acids. Plant foods are not “missing” any essential amino acids.

A “quality” protein is one that has amino acids acids in the ideal ratio for human needs and is easily digested and absorbed by the body.

But for most people, this isn’t something to worry about.

Here’s why it doesn’t translate into better outcomes:

1. Protein quality matters most when intake is low.
If someone is undernourished or severely restricting their diet, quality matters more. But that’s not most people.

2. Plant-based diets provide ALL of the essential amino acids.
Your body doesn’t need them all in one bite. Eat a variety of plant foods during the day and you’re covered.

3. “Quality” animal protein doesn’t mean better outcomes.
No strong evidence shows animal protein leads to better health or performance.
🚫 In fact, high intake is linked to higher risk of chronic disease.

4. Plant-based proteins support muscle growth and repair
As long as you’re eating enough total protein, plant-based athletes build and maintain muscle just fine.
🌱 As a bonus, plant-based diets reduce inflammation and improve muscle repair, making them a great choice for athletes and active people.

Bottom line:
🌱 Eat a variety of plants
🥣 Get enough total calories
💪 Fuel your body with whole foods

If the amino acid profile is all that matters, then technically… human flesh is the highest “quality” protein. So unless you’re into cannibalism, maybe stop obsessing and just eat your beans.

It’s not fat shaming. It’s physiology.I’m catching up on emails this morning. This one needs to be shared!Excess body fa...
11/07/2025

It’s not fat shaming. It’s physiology.

I’m catching up on emails this morning. This one needs to be shared!

Excess body fat, especially visceral fat, drives inflammation in the body. And chronic inflammation is a known risk factor for cancer, along with heart disease, diabetes, and more.

I’m not in the business of scolding anyone about their weight. I don’t even bring up BMI unless my patients ask. Because saying “you need to lose weight” isn’t helpful.

What is helpful?
Focusing on the daily habits that reduce inflammation and support long-term health—
🥦 Eating more plants
🚶 Moving your body
😴 Prioritizing sleep
💆‍♀️ Managing stress
🫶 Staying connected
🚭 Avoiding toxins

These are the pillars we build on. The weight often takes care of itself when we stop trying to “fix the number” and instead support the whole person.

Obesity isn’t a moral failing. But ignoring its impact on health isn’t kindness either.

👉 Do you think the conversation around weight and health has become too polarized?

— Dr. Beth

Physicians Committee for Responsible Medicine physicianscommittee

We fall for it all the time:💸 If it costs more, it must be better.I had a patient recently who was about to drop thousan...
10/07/2025

We fall for it all the time:
💸 If it costs more, it must be better.

I had a patient recently who was about to drop thousands on a brain health program. He’s sharp, but getting older. He asked for my input.

I’m still learning the art of respectfully telling a patient that they are falling for snake oil.

But that’s exactly what it was in his case.

Meanwhile, he also had prediabetes, high blood pressure, and clearly some work to do on his diet.

It’s called the price–value bias, the assumption that higher cost means higher quality. I see this in my office constantly:
👉 People spending hundreds on specialty labs, expensive supplements, and “biohacking” services…
…while skipping over the simple, proven, affordable foundations of health:
🌱 Food
🏃 Movement
😴 Sleep
💞 Relationships
🧘 Stress
🚫 Avoiding toxins

I get it. We’re drawn to what feels premium, cutting-edge, exclusive.
But the real magic is in the boring, obvious stuff.

It’s like my haircut:
Sure, I could pay $100 for a fancy salon.
But I go to Great Clips. $15.
I’m not sure spending more money will get me a better result.

Health doesn’t have to come in a shiny package.
Start with the basics. Master the boring stuff.
Then see what you still need. (And if you still want to spend money, Venmo me.)

What’s the most expensive thing you’ve tried for your health… and was it worth it?

Stop obsessing over protein. Or electrolytes. Or carbs. Or fat.We live in a reductionist nutrition culture, one that zoo...
09/07/2025

Stop obsessing over protein. Or electrolytes. Or carbs. Or fat.

We live in a reductionist nutrition culture, one that zooms in on single nutrients while ignoring the whole package of a food.

The truth is… you don’t eat nutrients. You eat food.

And the whole food package matters.

🌱 Whole plant foods come with protein plus fiber, antioxidants, and zero cholesterol — things you just won’t get from meat.
🥩 Meat gives you protein, but it lacks fiber, antioxidants, and phytonutrients, and it comes with cholesterol your body doesn’t need.

Let’s stop cherry-picking nutrients and start thinking big picture. 🌎 Your heart, gut, and long-term health will thank you.

What’s one whole plant food you’ve added to your routine lately?

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ABOUT

I am a Family Medicine/Lifestyle Medicine physician with Greenville Health System in Greenville, SC. Originally from Acton, MA, I was a figure skater growing up, and became interested in nutrition as a means of optimizing performance. I then moved on to study biomedical engineering at University of Virginia. It wasn’t until my medical training that I made nutrition my main focus, and dedicated my elective time to working with various Lifestyle Medicine doctors around the U.S., including John McDougall MD, Neal Barnard MD, Ron Weiss MD, and Caldwell Esselstyn MD. After these experiences, I had no doubt that Lifestyle Medicine is the key to addressing our chronic disease. I thought I was giving up engineering when I switched to medicine, but in fact, Lifestyle Medicine is engineering. We are reframing the question. Rather than asking “how do we treat the symptoms?”, we must ask why the disease state developed in the first place, our root cause analysis. I am a clinical assistant professor at USC School of Medicine Greenville, a leader of the Lifestyle Medicine Education Collaborative, and an active member of the American College of Lifestyle Medicine.

WHAT IS LIFESTYLE MEDICINE? Lifestyle Medicine is the medical subspecialty focused on using lifestyle modalities to prevent and reverse chronic disease. Why, today, is healthcare so focused on "controlling" disease and treating symptoms, rather than addressing the root cause of disease, and reversing the process entirely? Heart disease, diabetes, and cancer are all prime examples. Lifestyle changes - in particular, a move to a more plant-based diet - are far more powerful than any pharmacotherapy for managing chronic disease and ensuring long term health. We don't "need more research"; we need to start applying what we already know to our communities.

WHAT IS A WHOLE FOODS PLANT-BASED DIET? “Whole foods” means unprocessed or minimally processed foods, as they exist in nature, i.e. single-ingredient foods. Strict individuals will avoid added salt, sugar, and oil as well.

“Plant-based” in its broadest interpretation means >95% of calories coming from plant-based foods: fruits, vegetables, whole grains, and legumes. However, most individuals who follow a plant-based diet aim for 100% in order to maximize potential health benefits.