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March 2, 2020

Your body in balance with Dr. Neal Barnard

In his new book, Your body in Balance, Dr. Neal Barnard shares how we can manage our hormones using food and movement to get and stay healthy.

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Allan (01:10):
Dr. Barnard, welcome to 40+ Fitness.

Dr. Barnard (01:13):
Thank you. Great to be with you today.

Allan (01:14):
You know, it's interesting. You have so many books out and, I guess it's a little bit embarrassing. I've been in this industry, doing this podcast for over four years and I don't know how I've missed you all these years. It's kind of interesting, but this book that we're going to talk about today, Your Body in Balance: The New Science of Food Hormones and Health is actually pretty good. I really enjoyed the read.

Dr. Barnard (01:37):
Pretty good? It's groundbreaking.

Allan (01:42):
Well it is, it is. There's a lot in there. It's a very deep book. And particularly what I like about the layout and I know you kind of said something at the beginning of the book of you can read it this way, but you probably still want to read it cover to cover. So I was a cover to cover guy. I will say, you know, there were sections of it that I thought, okay, this, this is cool and I understand this and I know that and okay, that makes sense. And then, Oh, I didn't know this. So it is a good book because it brought out a lot of things that I didn't know. And it related a lot of, I guess, basic illnesses we go through. Many of them kind of come from the same problem and it's the quality of our food.

Dr. Barnard (02:23):
That's right. And to be really specific, many people have all kinds of symptoms that they had no idea it related to their hormones being out of control and hormones are messengers. So the ovaries make estrogens and the estrogens go to the uterus and they get it ready for pregnancy or the testes make testosterone. And so that goes to your, to a man's brain and makes him want to run for president. Kidding. But, uh, the hormones affect our bodies in many, many ways. And if you are unaware, you may be unaware of it, but a young girl has menstrual cramps or endometriosis or a couple has infertility and he never realized that their hormones were out of balance. And more importantly, they didn't realize that their hormones were knocked out of balance by what they were eating for breakfast. And so the point of your body in balance is to say, here's how the hormones are working.

Dr. Barnard (03:12):
Here's the reason why you're depressed or why your blood sugar is high. Here are the hormones that relate. Here's how to pick foods to get you back into balance. And what you said is right that there are certain themes that come through over and over and over again. Cheese is terrible from the standpoint of your hormone balance. Uh, animal products in general are not good and plant products are better. And so we go through it, tell people to, to really get back into balance and to be able to reclaim your health as a just an amazing thing.

Allan (03:42):
Yeah, and I'm a huge proponent of, of people going out and saying, okay, let's, let's look at the science. Let's look at what's there and then let's listen to our bodies. If we're not healthy, what we've been doing isn't working and there's not really going to be a pill that the doctor can give us that's going to compensate for eating the wrong way for years and years and years.

Dr. Barnard (04:05):
Unfortunately, that's what medications are trying to do, but they don't do a particularly good job. Um, with regard to diabetes, which is now the hormone that's not working is insulin. Insulin is a hormone. It's made in the pancreas that goes to your cells and it acts like a key to try to let sugar get into the cell because sugar or glucose is the name of it. It's job is to give energy to your, to your muscles and, and to the rest of you. And insulin is a key that loves the sugar in the cell. But if it's, if it's not working, you end up with high blood sugar and diabetes. So our research team developed a better diet for diabetes that turned out to be 300% better than the best current diet. We were funded by the U S government to do it, and it works really very well, but it's a completely different view of diabetes.

Dr. Barnard (04:58):
We now understand that the reason that insulin isn't working is because fat has built up inside the cell. And as long as there's a lot of particles of just grease, fat, lipid inside your muscle cells, the insulin can't work well and you end up with diabetes. But the beauty of this is if you get that fat out of your diet, it tends to come out of your cells and diabetes improves. And in some cases diabetes just goes away, which is something that previously people thought was not possible. So our goal here, choose the foods, get the hormones in balance, and let your health recover.

Allan (05:34):
Yeah. And it's following, you're following a similar vein that I've, I've had with many doctors that I've had on the show and we talk about, okay, you've got to eliminate some foods because they're just not doing your body well. And so when I look at the vegan diet, and from my perspective, again, I'm not vegan, but I look at it and say, you do need to, a lot of your diet has to be somewhat plant-based. You shouldn't go completely carnivore. And vegan is an approach. It's, to me, it's an elimination diet and it's an approach to where you can actually learn what your body performs very well with. And so I just, you know, as we go through, when we talk about elimination diets, in either case, I think it's very important for you to understand the nutritional basis behind what you're doing. And so, uh, I'm not going to be the person that throws a stone and says you can't get your protein if you're a vegan. Cause that's a false statement. You can't get proper protein. But there are some things you have to be aware of that you're not going to get initially out of a vegan diet. And you have to work around that.

Dr. Barnard (06:40):
That's right. You won't get ecoli. You won't get salmonella. You're not gonna get any cholesterol. I'm teasing a little bit, but the animal products are really unhealthy for us in so many ways. They provide a lot of things we don't want. I mentioned infectious bacteria and parasites and all that kind of stuff, but they have cholesterol, they have a lot of saturated fat. Dairy products have estrogens in them that came from a cow. You have absolutely no need for any of that stuff. And a plant based diet is dramatically healthier than animal based diet. But what you said is true. You want to plan it. Do you want to make sure that it's the best it can be?

Allan (07:17):
And so for someone that's going to go pure vegan, uh, they're going to have to recognize that B12 is an element of that diet that isn't there? They're going to have to supplement for that.

Dr. Barnard (07:27):
Easy to do.

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Dr. Barnard (07:28):
And the same thing with a carnivore, when they go out and decide they want to do carnivore as an elimination style, I would just get completely opposite spectrum of what you're talking about. But they're, they're going to need fiber. They're not necessarily getting the fiber they need properly. So on either side of these, there's just a little bit of thought that I think has to go to any kind of elimination diet.

Dr. Barnard (07:48):
Well, there's, there's much more to it. If a person's on a carnivore diet, they need to consider the fact that they're at high risk for colorectal cancer. They're at high risk for cardiovascular disease. They're probably at higher risk for Alzheimer's but the jury is still a little bit out there. We are not designed physiologically to be eating, uh, animal products and we, and we don't do well when we, when we make them the center of our plate.

Allan (08:13):
Okay. I do want to ask that question because that was something that's in my mind trying to figure this out because you know, it's funny, there's this meme going around the internet right now that says, you know, we used to think that people were idiots because of a lack of access to knowledge. And now with the internet we have access to all knowledge and it really hasn't solved the problem. That's kind of the joke of it. You can have complete access to information and still not know the answers to things. There's so much information out there, so much conflicting information that's often difficult to parse it out. And so we typically like to put paradigms together, you know, like calories in, calories out. It's just an easy little way of thinking about food and energy expenditure. But another one that's out there that's pretty common, and I actually kind of believe a little bit of it's true, is the ancestral eating.

Allan (09:02):
And granted that, I know my ancestors did eat plant matter as a part of their regular diet. But if you live in Northern Europe, you can't, you can't survive as a vegan year-round because the is just not going to be there.

Dr. Barnard (09:17):
You mean today or you mean?

Allan (09:19):
Well, I mean, yeah, I don't mean today. Today, I've got you know, Safeway or what are they? I forget what they call their grocery stores over there. Sansbury's or whatever. So yeah, there's grocery stores everywhere and so you just get your groceries and they're shipped in from Mexico or Chile or Spain or wherever. But in the general sense of our evolution of us coming through, um, there were periods of time when we would not have access to plant matter at all.

Dr. Barnard (09:46):
Okay. So your, your, uh, your, uh, ancestors were in Europe. What was specifically where,

Allan (09:52):
uh, it would have been in, uh, Ireland, up into Norway, all the way over to, uh, what would be I guess Western Russia area? All of them. Yeah. Almost nothing. Almost nothing South of that. If, if 23 and Me, uh, it was actually right about that. Uh, there's almost nothing else. Yeah.

Dr. Barnard (10:12):
Okay. Um, go back in time. Where did they come from? Where did, where did they migrate from to get there?

Allan (10:18):
Uh, most of them migrated up from closer to the equator.

Dr. Barnard (10:21):
Uh, which Continent?

Allan (10:22):
uh, Africa. From what I understand.

Dr. Barnard (10:25):
Okay. Uh, what can you eat in anF in Ecuadorian Africa?

Allan (10:28):
Oh, tons. There's the equitorial region would have been flush with fruits and vegetables.

Dr. Barnard (10:34):
So a natural diet for you would be lots of fruits and vegetables and plant based foods.

Allan (10:41):
I don't know. I mean potentially, yes.

Dr. Barnard (10:44):
And your ancestors had the same bad judgment that my ancestors had, which is to leave that wonderful, uh, equatorial environment and to go to a Northern climate. Mine ended up in North Dakota. Um, and so, uh, our healthy a healthy diet for us, if we look at it, we are in the biological group of great apes, which is chimpanzees and gorillas and orangutans and Bonobos. And they are mostly or exclusively a herbivorous and, and that's the diet they were still good, good with. And, and it's amazing what happens when you kind of take a lesson from that and use it. Um, the thing that actually caused me to write this book, Your Body and Balance was that a phone call from a young woman who was eating all the wrong things. She had terrible mess, Joel cramps. And who would think that menstrual cramps would have anything to do with, with what you ate?

Dr. Barnard (11:34):
Um, she called me up and she just said, I can't get out of bed. This happens to be every month for about one day. I've got a business trip tomorrow. What do I do? I said, let me give you some painkillers to get you through today and tomorrow. But then I suggested to her a diet change that I don't think any doctor would ever have suggested for cramps. I said, how about this? No animal products for you at all the next month and keep oils really, really low. And it absolutely cured her, her cramps. She thought, what is, you know, how could this be? So I did a randomized clinical trial of that same prescription in a large group of women who had had cramps. And it, it works. It's very effective. What she didn't know was that your body has a system for eliminating excess estrogens.

Dr. Barnard (12:20):
And it depends on fiber. And if you have lots of fiber in your diet, which comes only from plants, you eliminate the excess estrogens. If you don't eliminate them, they cause the uterus to go through more vial changes every month. And you feel terrible if you eat a lot of fatty foods, meat, dairy products and so forth, you get too much estrogen in your body as well, not from those foods, but your body's response to the fat by making estrogen apparently. And if you eat cheese, cheese has estrogen in it that came from the cow. Nobody explained this to her. Her own doctor never told her this. But my point is that we in nature we would have had a very high fiber, very low fat diet, uh, with no ice cream in it. So we wouldn't be getting estrogens from a cow and it returned to a more healthful diet is, um, is amazing what it will do in balancing the body.

Allan (13:11):
Yeah. And I do agree with you there. Um, wholeheartedly. I think the, uh, the emphasis we have on our, um, food in the Western diet of milk and cheese is really kind of off the reservation there. We're, um, we're a milk and cheese eating nation for one reason or another.

Dr. Barnard (13:30):
Yeah. And it's, and it's bad in every way. I have an now by point of disclaimer. Um, I grew up in Fargo, North Dakota. Uh, I come from my extended family raised cattle. They're all good, decent people, but I have to say to raise cattle for dairy or for me, this is obviously the cattle don't enjoy it. It ends up being a fatal experience for them. Um, and the environment doesn't enjoy it because they're belching methane all day long and your coronary arteries aren't too cool about it either. Um, so it's, it's a good idea to break away from that even though that's, that's the way most all of us were raised initially, unfortunately.

Allan (14:05):
Now, do you think that there's significant difference, um, because one of the things you said in the book was, you know, obviously for, for giving them the hormones and they're getting pregnant every cycle that they're eligible to be pregnant because they want to maximize the, you know, the yield, uh, off of their cows. And so that's, that's part of the problem. Do you think there are more sustainable ways that you know you could raise cattle that would not cause as much problem or is it just inherent in any access to any food that's a milk or cheese regardless of whether it's a properly raised animal or not?

Dr. Barnard (14:42):
Well, if you want to get cheese just to state the obvious, cows aren't going to give you any cheese or milk or anything. Well, they don't give it. People take it. The way this has done is you take your left hand and put a big glove on it, up to your shoulder and insert it into the cows rectum. This is what happens on every glass of milk came from this source through the rectal wall. You can feel the uterus and you hold it steady in your left hand grip. You then take your right hand and load up a very long syringes looks like a knitting needle and you jam it through the cervix and you impregnate the animal. The reason that this is done is that if the animal has not been pregnant, she's not gonna make milk.

Dr. Barnard (15:18):
Her pregnancy is about nine months. Uh, at the end of that time, she will give birth. The male calf is slaughtered, uh, for veal. The female calf is taken away because you don't want her to drink the milk because if you did, you would, you wouldn't have anything for you. So you, you're, you're now just taking that milk that is supposed to be for her baby. And so now you're asking me, well, how do I do this humanely? How do you artificially inseminate a cow humanely? How do you take away their calves humanely? How do you kill her humanely when she's not productive anymore? These are fantasies that we have. And for me as a doctor, I'm not an ethicist, I'm a doctor. What I see is all of the things that come as a result of that, which is the estrogens in the milk are affecting your body. The lactose sugar in the milk breaks down to produce galactose, which is toxic to the ovaries. There's no good side to it apart from the fact that culturally we've come to accept it as normal.

Allan (16:14):
Okay. All right. We don't want to know how the sausage is made. I guess is the answer. Yeah.

Dr. Barnard (16:19):
Well you know and I wouldn't say this if I hadn't been on the other side for half my life. I mean I have personally driven cattle to slaughter. As a child, I had a 20 gauge shotgun and I went out with my dad and we killed all the, anything that moved out of Canada into North Dakota. So I understand all that, but there comes a time when you understand what it does to your body, what you're doing to the planet, what you're doing to animals. We used to have the idea that animals were resources. I think that's a mistake. I think we need to think of them as people are not people, but they're beings who are sharing this planet with us. And to the extent that we can leave them alone, I think that's a good thing.

Allan (16:55):
Okay. Um, now you had a very interesting perspective on fish oil and I remember that that part of the book, I was just, it was, I was a fascinating read to kind of go through it. Do you mind taking some time to talk about why fish oil and fish might not be a good idea?

Dr. Barnard (17:11):
Well, I have to say science is still marching forward on this, but you might be referring to the connections with prostate cancer. This was totally unexpected. You know, people have tried to make money by selling fish oil supplements. They don't work particularly well for or at all for protecting the heart. And that was kind of what had been hoped for. But in these studies, it turned out that men consuming the fish oil capsules would have a higher risk of prostate cancer. And at first that was thought to just be a statistical fluke.

Dr. Barnard (17:44):
But it shows up over and over and over again, including researchers who are trying to disprove. So we still don't know the mechanism for it, but we just see this. So the question is, should, should people avoid it? And I think the answer is yes. Now with that said, Let's say a person wants to boost their omega-3 content and um, they, what you can do if you wish is you can, you can get a blood test. Um, there are companies, there's one called Omega quant. As in quantifying your Omega three Omega quant will send you a card. It costs maybe $50, $60 and you put a drop of blood on it, you send it back, they'll tell you if you're low in Omega three or not. And if you're not, you can maybe stop worrying about it. Perhaps if you are, you can decide if you want to take the risk of supplementing with Omega three. If you do, there are, luckily there are vegan Omega threes available. They're there. They're exactly DHA and EPA just like a fish, although they don't smell like a fish, they don't have mercury in them or whatever. And they're okay, but the safety of them is still uncertain, uh, because of the prostate cancer risk.

Allan (18:52):
Okay. Now I hear about this more and more as you know, obviously now I'm in my fifties and so, you know, I've got friends in my fifties and sixties and so the conversation around a bioidentical hormone replacement seems to be kind of a regular recurring conversation amongst my friends and kind of out in the industry. I think it's becoming much, much more mainstream than it ever was. And a lot more people are looking to it to either help them deal with menopause or as, as men just kind of feel a little bit more viral and, and you know, in many cases to try to address other problems like ED, you don't think that's such a good idea though.

Dr. Barnard (19:31):
Yeah, I have to say I'm concerned about, and the reasons and actually it's, it's not that there's anything unusual about the bioidentical hormones. They, uh, or, or I should say that if they're formulated correctly, they might be an exact match for yours. What I'm concerned about is that yours are dangerous. Um, where we see this very clearly as in women, a woman has estrodiol, which is a hormone in her bloodstream that diminishes at menopause and she may have hot flashes or whatever. And she goes to the doctor who says, let me, let me give you a prescription for Premarin. And she goes online and discovers that Premarin comes from a horse and it's a mixture of, of estrogen, some of which aren't, aren't human estrogens at all. And, and she learns that Premarin, the name comes from pregnant mare's urine and that all seems gross.

Dr. Barnard (20:20):
So she goes back to the doctor and says, what do you got? And there are hormones that are actually not horse derived, not animal derived at all. And they are a match for your own hormones. But then you discover that your own hormones, if they're in too high of a quantity, will increase your risk of breast cancer. Uh, so for post-menopausal breast cancer is directly related to the amount of estrogen in a womans blood. And so she's supplementing her natural hormones with extra hormones, her risk of various cancers likely to be higher. So that's where we are. And, um, my concern is, is that even if they are identical to yours they're still problematic.

Allan (20:59):
Okay. And I think one of the other concepts that was in the book that I thought was really important because it's, I think it's missed more times than it should, is if, if a man suffering with ED, that's a big red flag that something bigger is going on in his body.

Dr. Barnard (21:13):
Oh my goodness. Um, this is, I'm glad you asked that. And just about every primary care clinic and in America and everywhere else, um, guys go into the doctor's office and they say, you know, I'm having trouble and the doctor writes amount of prescription for Viagra and I would, he goes, if this is a smart doctor, he will drop his pen, race out the door and grab the patient before he is gone down the elevator and say, I forgot to tell you something and escort the patient back in the office and give him a short speech. Which is the reason that you have erectile dysfunction is that you've got narrowed arteries. Uh, the reason for erectile dysfunction in the vast majority of older men is atherosclerosis. The arteries are narrowed by a lifetime of eating animal products.

Dr. Barnard (22:04):
Fatty foods may be ,smoking, might contribute, diabetes can contribute, and the erectile dysfunction occurs because a man's private parts are a hydraulic system that needs good blood supply to work. And if he doesn't get good blood flow, uh, he's nothing's going to happen. So, um, as his arteries are narrowing from his meaty cheesy, greasy diet, the blood supply to his private parts is shut off. But what the doctor was concerned about is that he has the same atherosclerosis in his heart and the same probably in the arteries to his brain. And he has to explain to him that within the next five years, you are at high risk for a heart attack or stroke men with erectile dysfunction, it is now viewed pretty universally by cardiologists. Erectile dysfunction is the Canary in the coal mine. It's a sign that you've got artery narrowings that ultimately are likely to kill you. So take your viagra if you want to, but start a healthy completely vegan diet and your arteries will open up again and uh, in to a degree in the vast majority of people. And that may mean that your artery or your a heart attack never happens and your stroke never happens. And your erectile dysfunction can go away as well too, which we see all the time.

Allan (23:21):
Yeah, and I think that's really important is, uh, a lot of general practitioners might, might just miss that signal. Uh, pull out the scripts, let you leave for the blue pill and, and think we're all good. But this is, this is a big warning flag for you to keep on the, on the mass to know, okay, there's something bigger going on here and then I've got to make some changes to make sure I'm still around to enjoy those little blue pills. If, if I continue to need them.

Dr. Barnard (23:46):
Well and you may not continue to need them. For a doctor to write a Viagra prescription for a man with an erectile dysfunction, without talking with him about his atherosclerosis and without referring him to a dietician to give him a healthy vegan diet. That's the equivalent of seeing a smoker in your clinic and prescribing some laws and just to help him with his cough. You have to say at some point the smoking is going to kill you. And unfortunately, the doctors still haven't really quite gotten that message. And uh, many of them have cardiologists really understand this, but primary care docs are in some cases they're there, they're not there yet and they really need to be.

Allan (24:23):
Now, one other thing obviously is a personal trainer. This is near and dear to my heart. That continued to come up was the need for exercise that it helps us in so many different ways. Can you, could you give us a little bit of insight into exercise? Why it's helping with so many of these issues, and exactly what's going on in our body that is helping us heal.

Dr. Barnard (24:44):
Yeah. Exercise is, is um, it's a funny thing. Um, and even I think it's been a bit misunderstood. Um, early on in your body and balance. I talk about fertility and there have been say, distance runners, women who are no longer opulate, um, because they're running so much and so people started to think, Oh, don't run so much if you want to be fertile, take it easy, dah, dah, dah. But then other research has shown that the more vigorously women exercise, the higher their fertility. And the way we put it together is that there's nothing wrong with the exercise. Having your muscles move is a good thing where people run into trouble is if they're not keeping up with themselves with their diet and they're losing so much body fat that they are now out of hormone balance in the other direction. That's when the infertility comes in. Um, so exercise is fine. In fact, the more vigorous exercise, a woman who has the higher fertility, as long as she doesn't lose body fat and exercise of course plays a role in, in many, many other things. It's good for brain health. It appears to reverse brain shrinkage. Um, it helps with weight loss a little bit, not, not nearly as much as the diet changes will, but it's part of a healthy diet. I'm part of a healthy lifestyle. I mean.

Allan (26:00):
Yeah. And I think that's cool. The cool thing about it, you know, you referenced Ornish's study, uh, where he had not just eating a vegan diet, but other lifestyle changes like quitting smoking and exercising and the Australian study that you reference also talked about the fact that they, they got them into exercising and that helped with the weight loss. Uh, cause it's just kinda like, just little kick in the butt, right past of what you're doing with your food, uh, that can help you reach that weight loss goal a bit faster. And with the weight loss, a lot of these conditions that you talk about in the book, you know, like diabetes, like infertility and some of those other things, those, those tend to ferret themselves out. If we're forgiving our body what it needs.

Dr. Barnard (26:44):
They really can. No, I do want to say a word for people who are unable to exercise, let's say their joints aren't really shot or they have say retinal problems that are extremely fragile at the moment or they've got massive obesity and they're really having trouble. You could still benefit enormously from the diet changes alone even without a lot of exercise. And the reason we know that is in our research studies, if we're trying to test diets, we ask people not to modify their exercise regimens cause that would be a confounder. Um, so we know that the diet alone works well, but, but adding exercise to it is a really good thing. Plus I have to say, um, if you're out, uh, running a 5K, you can't eat a bowl of ice cream while you're doing it. So it's got lots of other benefits.

Allan (27:30):
Yeah. But they'll figure out a way to drink it. Little goo packets or something. I define wellness as being the healthiest fittest and happiest you can be. What are three strategies or tactics to get and stay well?

Dr. Barnard (27:45):
Well, I'm going to suggest, first of all, you want to follow a healthy diet, which I'm going to say is a low fat, completely plant based diet. It is a good thing to get an a good activity and sleep cycle. So that means do get, give your muscles, have a reason to live, exercise them, but don't forget to stop and sleep at night. So to give yourself the ability to rest so your bed, your best the next day. But the third thing I think is the most important and that's to share what you know with other people because they are at risk for all kinds of problems because they don't have the knowledge that you have. And if you understand how foods and exercise can protect your health, share that information with other people, share it with your loved ones in turn because you are now their role model. They'll keep you on the straight and narrow the next time you have some kind of temptation. So that'll help everybody.

Allan (28:36):
Yeah. And this book has a lot of that information. It's well-researched, it's well supported. Um, so Dr. Bernard thank you so much. If someone wanted to learn more about you, learn more about the book, your Body in Balance, where would you like for me to send them?

Dr. Barnard (28:50):
Oh well thank you for asking. Our website is PCRM.org that stands for Physicians Committee for Responsible Medicine (pcrm.org) and you'll see me, Neal Barnard to all of our social media and our organization that the Physicians Committee for Responsible Medicine is there too.

Allan (29:07):
Okay, well you can go to 40plusfitness podcast.com/423 and I'll be sure to have that link there. So Dr. Bernard, thank you so much for being a part of 40+ Fitness.

Dr. Barnard (29:17):
Nice talking to you today. Thank you.

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