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Category Archives for "guest/interview"

January 20, 2020

Medical tourism with Janet Bristeir

More and more people are traveling abroad to get treatments and surgeries that are much cheaper. Is medical tourism right for you? On episode 417 of the 40+ Fitness Podcast, we meet Janet Bristeir and discuss her book, Medical Tourism: Surgery for Sale.

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Allan: 00:59 Janet, welcome to 40+ Fitness.

Janet: 01:01 Hi Allan. Thank you very much for inviting me on your show.

New Speaker: 01:04 Now your book Medical Tourism is something that's been kind of top of mind for me lately because I get a lot of questions about why I moved to Panama. But before I get into that, I have to get into the subtitle, which is Surgery For Sale, How to have surgery abroad without it costing you your life. That was brilliant. It opened some eyes and I like that because we moved to Panama to save money in healthcare. And a lot of people ask why and how that works and if they have to move to a country to get those same benefits. And my short answer is no. But there's a lot of things to consider before you just decided to get on an airplane and go get some surgery.

Janet: 01:46 Definitely. And basically medical tourism is when people are thinking about traveling internationally to purchase medical care. And we're usually talking about surgery. So, and the thing with that subtitle of my book is that most information people see about medical tourism is the headline. A person comes back from surgery abroad and dies of something. So that's that information there.

Allan: 02:15 I remember reading about this decades ago when it was, I guess South Africa was kind of marketing themselves as the plastic surgery capital of the world and people were flying into South Africa. They would get their plastic surgery done and granted they needed about a week or so for recovery. So they're out doing African safaris as far as any of their friends or family or maybe even doctor knew, they basically just went on a Safari and came back two weeks later looking a lot happier, tanner and maybe with a smaller this or a bigger that. Yeah.

Allan: 02:56 So let's talk about medical tourism. Cause I'm really what I would call a medical tourist. I'm a medical resident, not a medical resident in the state of actually working at a hospital. But we traveled to Panama, we were looking at our, our health insurance, me being self employed and just the overall cost structure of what was going on with the rates, everything going up every single year, double digits in the United States. And you know, I was saying, well before I'm eligible for Medicare or any assistance whatsoever, I'm going to get costed out of this model and there's just no way I can afford medical insurance itself. Not to mention medical costs under my new profile of living. And so we looked around and Panama was one of those locations where medical care is high quality, it's low cost. And I can, I can tell some anecdotal stories both that we've experienced and others have experienced here that really are kind of our model now for healthcare. But when we're talking about medical tourism, we're actually talking about traveling to another country for the purpose of having a medical procedure done. Like you said, usually surgery and then heading back home typically to finish out the recovery there.

Janet: 04:06 Very true. Yeah. And it's usually because people are frustrated with the wait times for surgery in their own country. You know, it's like, and the wait times, they have serious consequences. You've got the increased pain, suffering, mental anguish, and sometimes poor medical outcomes because the longer you wait for something, there's the potential of that disease or illness turning into something that's irreversible and you've got a permanent disability.

Allan: 04:33 I had a colleague that was working with me and he was having shoulder issues and he was like, he was in a lot of pain and they gave him some pain pills and they helped with the pain, but he couldn't drive his vehicle and he couldn't focus on work. And so he went back to his doctor and his doctor's like, well, it's a six month wait for this surgery. And he was just at wit's end and he's like, I can't not work for six months. And while I don't know about the medical leave and how that actually works in Canada, in the United States, it's 12 weeks. And so he, you know, if he said he had to be off work on a doctor's note, so he can't work for 12 weeks, that's fine. If he has the time off and can afford to be away from the office that long, most people can't.

Allan: 05:20 So he was at wit's end of, fortunately being in Canada, he was able to fly from Calgary to Toronto to find a doctor that could do the in a place that could, they could do the surgery sooner. So we didn't have to leave. He was actually looking outside of Canada to have that procedure done because he just knew there was no way he could bear the pain and there was no way that he could do the pain meds and keep his job. And that was unfortunate. But it is just kind of a reality of healthcare today.

Janet: 05:49 Well that's true. I mean, and that's the thing, you know, people have to lose their wages while they're waiting for the treatment. And so the economic cost just adds to that stress and it's terrible. And just for some data in 2018 Canadians expected to wait four weeks for a CT scan or 10 weeks for an MRI or maybe four weeks for an ultrasound. And in that same data set in 2018, they were talking about 30% of patients who required hip or knee surgery or cataract surgery didn't have the procedure done within the recommended wait times. And so what you find is that people that have the time and the financial resources, they don't want to wait. They want to get ahead of the game and they want to go and they, that's why they're looking internationally for these things.

Allan: 06:38 And then in the United States, I think the base story is that well we have the affordable care act and I don't want to get into the whole politics of, of that. Healthcare is not really affordable. We paid much more for the same procedures, for the same medicines than we would elsewhere. So the opportunities for us to save money by traveling is pretty significant.

Janet: 07:01 Yeah, it can be very much. And the other thing, you know, what we find here in Canada, you know, it's a very diverse population and sometimes people would incorporate going back to their home country and staying with relatives to have surgery or procedures. So they, they will travel abroad, they'll, they know that that country, they could get their hip surgery or cardiac surgery or whatever much more timely and they've got the family support there that they need for recovery.

Allan: 07:31 And I think that's key. That's what some of the things that you brought up in the book because it was not a direction my thought process went naturally being a resident and having access to lower-cost healthcare, it wasn't something that I thought about, but obviously one I would not take my wife or myself to a clinic that I didn't feel was capable of taking care of us. And this, one of the things I can say is in doing research on this some of the things I found is like here in Panama, if you're concerned about the quality of care, one of the hospitals that I took my wife to here to have some work done is basically a Cleveland clinic. And people from the United States might not know that name, but it's basically one of the top medical establishments in the entire United States. They have an outlet in Panama. The doctors there are the same caliber. In fact, our doctor had worked in the United States including the U S military for over 31 years. And so the quality is there. Obviously, you know, our, our hospital here on our little Island, not necessarily all of that, but if we need something, we know where to go and it's not that difficult or time crunch for us to get to high quality care. And that's going to be the case in a lot of countries, particularly the countries that are really investing in medical tourism.

Janet: 08:48 Yeah. And when you're looking at the different facilities, you know, one of the things that we're concerned about is that if someone is considering being a medical tourist, is that they actually get informed consent about the medical procedures that they're going to receive abroad. Because what you find with most of these sources of information is that it's a marketing focus and they don't actually provide enough insights into the risks involved, not just with the surgery but with the travel and things. And so that's another factor to consider when you're looking at locations and doctors and things like that.

Allan: 09:26 And I want to go down that line because you, you mentioned a lot of really important things in the book. The like I said, kind of being a resident didn't really, they didn't initially think about was what if you have a doctrine in United States and that doctor says, okay, I'm willing to do the surgery in six weeks. That's when my next availability is and you find that you can go to say Mexico and enjoy a week there and have the surgery done come back. Is your doctor actually going to want to do post-care on a surgery he or she didn't do.

Janet: 09:59 Usually, no. You have to have a very good relationship with your doctor, whether it's your GP or your specialist before you go away and there's various reasons people are told they can't have surgery as well. So it might just not be a factor to do with the wait lists. Sometimes people are told that they're not considered for surgery because they have other, what we call co-morbidities, wherever other health concerns where a surgery wouldn't be good for them at that particular time. And so it's not necessarily just the doctor said you can't have this, it's you can't have this because it would affect this, this and this and this. So then if someone jumps and goes abroad for surgery and has surgery when they come back, these things that have been a concern in this country before they go, you know, might be exacerbated. So that's the other thing to consider. But definitely having that followup care arranged before you go, whether it's with your doctor, with a specialist, a physiotherapist, you might need ongoing counseling. So you're gone for bariatric surgery. You definitely need a lot of support when you come home from like a dietician or a forum, some kind of chat group where you will get that support because it's a huge lifestyle change.

Allan: 11:22 Yeah, I think a lot of people, if you're going in for something fairly simple, which most of the time that's not where you're going to get your bang for the buck. That's worth buying an airline ticket. Most of these are going to be surgeries and in many cases a pretty major surgeries like bariatric surgery or hip or knee replacement, something like that. Maybe even some plastic surgery, but usually again, something probably a little bit bigger. The recovery is something that's really, really important to think about. And are you going to have the family support to get you through that?

Janet: 11:52 Well, that's right because if you haven't got that psychological support, especially if we're talking about bariatric surgery, you know, if you go and have the surgery and you come back and you've got these extreme changes in diet that you have to comply with, but you've got someone in the family that's always saying, well, I've made this for you, eat this, or why don't you try that? It's defeating the object. They'll just wear you down and then it won't be successful. But if you've got people at home that are supporting you and encouraging you with the diet, with the exercise, with looking after yourself, when you come back you'll have a much better recovery and a much better outcome.

Allan: 12:30 Yeah, and another thing I got into you got into is a little bit about talking about your employer and obviously you're going to have to take time and potentially a good bit of time away from work because you've got to mix in the travel time along with the recovery time along with the surgery time. And I got to thinking we would, we would let someone off of work if they had a doctor's note and say, okay, I'm going to be out for three weeks for this surgery, but is your employer going to accept the doctor's note from a doctor in Thailand or do they think you're taking three weeks to vacation on, on FMLA, you know, and I'm on medical leave.

Janet: 13:04 Well and also do you want your work to know about it? If it is a plastic surgery or something, do you want work to know? So that's the other thing is it might be something that's very important to you, but you might not want everyone talking about it around the water jug. And the other thing is if you might have already been off work with whatever's causing you to have the surgery and then the surgery, you've had the surgery, but during your recovery you might need some kind of accommodation, reduced hours or working back into the system. And is your workplace going to be able to accommodate that?

Allan: 13:39 Yeah. Well under I know under us law there's a, there's a thing called family medical leave act, FMLA, and it specifically kind of puts the parameters of how an employer treats an employee relative to their medical care to include. Then there's HIPAA. So if you have a medical issue, you should be able to go to your HR or whoever that is that would be handling that for you and your company. Give them the basic information that they need to know along with communication with your doctor and that's supposed to be a very protected area. That information is not supposed to be circulated. So it's not water cooler stuff, but just recognizing that the law is pretty specific about, you know, coming back to your job, how long they have to hold your job open, what kind of accommodations are they required to do and which ones are they not. So working carefully with HR to understand what your rights and responsibilities are, I think is a huge consideration as you go into this.

Allan: 14:39 So someone decides, okay, I definitely want to have this procedure done. My knee is bothering me, my doctor says we're not going to do this surgery until you're 63 and that means for like, if it were me, it's like that's 10 years of constant pain in this knee. If that were the case, I don't, I don't have any problems with my knees, touch wood. But if I did and the doctor says I'm not willing to do this surgery until you're 63 and then I find a doctor or find a physio and say, okay, I'll do the followup. If you go get the surgery in Panama or Thailand or wherever, Mexico, how do I decide, because again, I just listed three countries. There's different costs, structures to those. Obviously different doctor facilities available. There's just a lot of information to kind of pour through. How, how do you decide what doctor, what location and when, how do you, how do you do that?

Janet: 15:32 Well, that's what I say. I'm think one of the first things we need to touch on here is that does someone want to organize this themselves or not? Because if someone can organize their vacation really well and they always have great places to stay and stuff like that, that's great, but if you're someone that every time you book a vacation, the hotel you get is half built when you get there and there's no taxi, you have to really consider are you going to do this yourself or are you going to get something what they call a medical tourism facilitator to organize this for you. And that we can talk about afterwards as well. There's, there's a whole other problem associated with that, but things that you want to look at is how far away is the facility and will the travel to the facility you're thinking of determined, you know, it'd be detrimental to your condition before and after surgery.

Janet: 16:22 Because if you are going to be on a flight for six, seven, eight hours, just in normal fly in, there's the chance of deep vein thrombosis, which is a clot you can get in your leg and that can cause all sorts of problems. Now if you're already having problems with joints and things like that, that long flight is going to be a problem to start with. And a long flight before you're going for surgery is definitely gonna be a problem. And then after the surgery, depending on what surgery you're having, you can't fly straight after surgery. Like if you've had gastric surgery, you can't fly within a few days because the gas that they put into your abdomen for the part of the surgery has to be completely dispersed because otherwise the pressure in the airplane can create problems. So there's things like that. How far is the facility you're looking at to travel to. And also if you're going to another country, do you speak the language?

Janet: 17:22 So if you don't speak the language, how are you gonna communicate with the staff? If they have limited English is your first language. If they have limited English, how are you going to communicate them, especially when you're stressed and you're in pain. So it's things like that. And then again looking at the facility, are the surgeon and the staff licensed to be practiced in in the country that they're practicing in? If they've got the right credentials. And is the condition and the related surgery a familiar position, or procedure for them or is it something that they are just doing for a few months just to make a bit of extra cash. And then do you have contact with the surgeon pre and post op. So it's really nice to know who's doing your surgery and lots of facilities, whether you're doing it yourself or through a medical tourism facilitator.

Janet: 18:17 You're quite often have like a Skype call or at least a phone call with your surgeon before the surgery so you can get some kind of feel for, you've got some rapport with them. And then when you're looking at the facility, you want a facility that's accredited by an international certification agencies, something like joint board, international, Canadian international standards because you want that facility to be run to the highest level as far as cleanliness, staff certification and follow up like that. And then when you've had your surgery, will you be given reports of your surgery in a language you can understand to bring back home because that is going to be really crucial to your followup care. If you go to Mexico and you have a surgery and they give you your surgical report and it's in Spanish, you know, and no one can read it. Or if it's handwritten and no one can read it, you can't get your full out care done until that's been translated and transcribed. So it's things like that that you have to consider.

Allan: 19:25 Yeah, and so it's not just location. It's cool. You can say, I want to go to South Africa and have this cosmetic procedure done and then after the recovery or during the recovery time, I'll still be able to do this safari and I'll be able to go and see the beaches and then I'll travel home with a little bit of a tan and, and the surgery done. But if your recovery is going to be much more difficult than that, you have to consider that in the whole math of all of this because it's not just a pick a doctor and go, you've got to kind of do your homework.

Janet: 19:56 I think as well, you have to dispel the fact that it is a holiday. It's not a holiday, the phrase is medical tourism. This is not a holiday. This is not a vacation. You shouldn't even plan to be looking at the country and doing it. Because I think as we touched on briefly when we were talking, if you start doing trips tourist type trips before your surgery, there's a potential for you to get some kind of acquired effect infection while you're wandering around. You might eat the local food, drink the water, you might get some kind of infection or illness and that will delay your surgery. And you also got to consider most people take a caregiver with them, a companion. And what happens if your companion goes off and does touristy things and they get sick while you're away. And that's a whole nother level of stress.

Allan: 20:48 You took me on this great trip to Panama and then you got sick and I had to look after you. I basically get to sit in a hotel room and hang out with you. I don't get to actually see anything. So yeah, I totally get that as like, Hey, come down to Panama with me. It's like, Oh no, I don't want to just sit in a hotel room with you. I could do that anywhere.

Janet: 21:11 Well, and also you have to be very careful about who you choose as your companion because this is a medical procedure. You're going to be talking about some very personal things and do you want your golfing buddy, which is great to play golf and sit in the bar afterwards and yak up a storm, but you want that person in when you're being asked about your bowel movements or things like that.

Janet: 21:34 And also do you know this person will actually function in a medical facility because there's lots of people that they're the good guy, the good woman or whatever, and they walk into a medical facility and they just close up. They are totally overwhelmed with it. They don't deal with it. And so you really need to be sure who's going with you that they can be your advocate, that they can speak up for you when you can't because we'll beyond the facility.

Allan: 22:01 We've talked about this before we got on the call and it's true. Most Americans have no desire or ever will travel outside the United States. They don't even own a passport. And so you take someone who's never been outside the country, doesn't speak the local language, and while you might be able to speak the language fluently and you gave them a medical power of attorney, when the doctor comes out there and starts speaking to them and trying to explain to them what extra thing needs to happen, are they going to be able to handle the stress of being in another country having to deal with, even if it's not a language barrier, just a pronunciation issue that's asking a lot.

Allan: 22:40 So this has to be someone that you really trust, someone you know that's going to be comfortable in not just the medical perspective, but just being out of their element. Because traveling outside the United States, if it's your first time is already pretty stressful.

Janet: 22:53 Very true.

Allan: 22:55 So you talked briefly about medical tourism facilitator, and this is a little bit more than just a travel agent. Obviously they'll do a little bit of that for you too. But their job is to kind of make this process of the looking and doing the research and understanding what's going to happen and how it's all supposed to work, that they'll do a lot of that work for you.

Janet: 23:17 Definitely. And again there's all ends of the spectrum involved in this. What you want is a well established medical facilitation company and so ideally someone that's not just linked to one facility because you want someone that's got your best interest at heart that it's not that they're just sending you somewhere cause they're on commission for it. So you want someone that when you go to them and say, look, I'm looking for knee surgery. I've been thinking about going to Panama. What can you suggest? They need to discuss with you? Well, why are you thinking of Panama is an eight-hour flight away, whereas this is other hospital that's four hours away from you. Where are we could get something similar. It's someone that's got your best interests at heart, so they're looking for the best deal and the best surgery and your best outcome. Not, okay, I'm going to put you into this hospital because I get the commission from this and from the airline, from the hospital or from the taxis, whatever.

Allan: 24:17 Yeah. And so understanding who you're working with, and one, how are they getting paid, who are they loyal to? Those are all really, really important. And again, like you said, they're experienced in doing this.

Janet: 24:30 I mean, because someone, someone can be a travel agent but they can't arrange the surgery and someone can work for the surgical facility, but they can't arrange the travel. So you want someone that's got that qualification where they can put both of these together. And there are lots of really good companies where you have the initial conversation with you, they set you up, you decide what facility you're going through and from the choices they give you, you have the conversations with the surgeon. They have, sometimes companies have someone that will go with you. So instead of you find it a companion to go, they have someone that will travel with you and be with you through the procedure and come back with you and they take care of making sure that you have all the documentation to bring back with you and that it's translated and they sometimes do followup for like six months so that they check in with you afterwards to make sure you're getting that follow up.

Allan: 25:26 Not to even mention visas and everything else because that's a whole other animal as you're traveling internationally is making sure that your, when you land, they actually let you stay. Now we talked briefly, you're in Canada, so you're under a program there with your national government, in the United States we have national, when you get to the age of 63 or 65 or 67 I forget where the age is right now that you'd be eligible for Medicare, but because it just seems like 10 years, 15 years from now, I don't even know. But one of the main reasons I came down here was because when I got my insurance quotes, it was $1,600 a month and I'm going to count it by trade. And there's a rule of 72 which basically says that if something's going up a certain amount, you can expect it to double based on multiplying that by 72 so at a 10% increase, which was conservative, I was looking at my insurance doubling every 7.2 years.

Allan: 26:25 So if my insurance doubled every 7.2 years before I was eligible for Medicare, it would quadruple. It would double and then double again or even more. And so I was looking at healthcare costs well in excess of $5,000 a month. And that's, that's not even the medical procedures, copays, percentages, anything. That's deductibles, that's just for the insurance. And I was like okay, that's, that's not sustainable. I can't just keep staying in this rat race. That's part of what I was getting out of it for. And I don't want to make my wife have to do the rat race cause she doesn't want to either. We want to live simpler lives and that was part of the choice to come to Panama.

Allan: 27:06 We were talking to a realtor here and one of the cool things he said was he broke his ankle. Not cool thing, but he went over to the mainland. It's about a 30 minute boat ride from here. He went into the clinic there, they x-rayed it, they set his ankle, he went back for two follow up visits. So he did have to ride, drive his boat over there and back a few times. I'm not difficult. Like I said, half an hour, easy boat ride. He did that and his total costs for the entire procedure, including the X rays and everything was $250. My wife had x-rays for x-rays of her knees and total costs with x-rays was $130 and now she's still having problems with the knees and she wants to go in for an MRI. The MRI is $400 so out of pocket is sustainable here. Which is part of what we love about it now, we did buy these international insurance plans. Basically it works everywhere, including United States. So if I went into the United States and had a medical procedure, I've got a $5,000 deductible, so I hope I wouldn't hit that. But if I did, I know I've got insurance for something catastrophic. So I'm buying this catastrophic plan that I wouldn't be able to by living in the United States.

Janet: 28:16 Right. And I think one, one of the things about people that are looking for surgery abroad, one of my big concerns has been is what insurance they get to cover them when they're abroad. And for six years I've tried to find places that would cover them, all the big companies and that and no one would touch it. And just a couple of weeks ago I found a company here that actually has medical tourism coverage and benefits and it's really interesting because when you talk to people, as we said earlier, most people think, Oh, I'll just get travel insurance and that's it. But that's not going to cover it. You really need something where you're saying you're going for a surgical procedure and that insurance is actually going to cover anything that might go wrong where you need to come back, whether it's you or whether it's your companion and not just flying you back but covering you for maybe six months afterwards because something could happen that you get a complication, you know, a few weeks, a few months afterwards and does that insurance still kick in and this, this coverage actually seem to do that.

Allan: 29:21 And so I think that's one of the cool things is that as medical tourism is kind of growing, these insurance programs are coming about when folks do hit Medicare age. One of the programs we can buy into here is basically medical evacuation. So if we have a heart issue or something significant and just don't want to go to Panama city for it and we want to go back to the United States and utilize Medicare for example, we can have a policy that basically says in the event I have a problem, heart attack or stroke or whatever, I can be medivaced and my spouse with me to the United States and they'll take me to Houston or Miami, whichever is the most cost effective, and then I can be admitted there and they can deal with the issues. So there are these opportunities, they're forced to use the insurance.

Allan: 30:08 And I think it's something that you do have to think about because you may say, I've got the $7,000 in the bank to go down. I got my airfare, hotel, lodging, everything covered, food and the surgery. But if you end up having an infection or a complication during the surgery and you're going to spend an extra five to seven, 10 weeks, whatever, in the hospital there, do you have that? And so insurance is something to consider as you get into this because your insurance from the United States, and probably from Canada may not cover those costs and you're out of pocket on all of those.

Janet: 30:42 Very true. Yeah.

Allan: 30:44 So if someone's thinking about this and considering this, what are some of the most critical points that they should consider as they really get into it, cause we've talked a lot about talking to your doctor, making sure your family is engaged, having someone there with you, understanding the true cost of what this is. Because it's not just how much is the procedure, but what would you say if they're going to do this, what's the most critical aspects that they should just have top of mind throughout the whole process?

Janet: 31:10 I think I would say safety and that insurance coverage I think is a very good blanket too to wrap themselves. But also that checkout the facility, talk to people that have been there if you can and people that have been there recently, not someone that was there five years ago, someone that was a last week, last month, and find out what their experience was because staff change, things change. Find out about the travel arrangements, where you're going to travel. Are you going to be staying in a hotel before your procedure? Then you're going to be in hospital. Then you're going to be in a hotel for a few days afterwards. When you're in the hotel, is there someone going to be coming to check your dressing? Are you going to have drains associated with your surgery? Someone coming to check them and take them out? Will you see the surgeon the day of the next day after your surgery? Who will be telling you when you can travel home? What physiotherapy do you need? What changes of diet? These are all the things that you have to take into consideration.

Allan: 32:10 Yeah. And, and one of the cool things, like I said, in the community here in Panama, there's these open forums, these forum groups. And so you can get out there and I'm pretty certain on Facebook and otherwise there's forums of people that are doing exactly what you're trying to do, exactly where you're trying to do it. And there are a wealth of information. The same questions get asked over and over sometimes on these forums, but we put up with it and we answer the questions. But you can search these forums. Facebook's made that a lot easier to do these days. So take some time, do that base research, get to know some people. Because what I've found is internationally people just really want to help each other out. If they've experienced something that they want to share that information and help others. So reach out. You'll find folks that have gone through exactly what you're trying to do and they'll be able to give you some really good information, really good tips and steer you away from some potential problems.

Janet: 33:00 Yeah. And I think it's also very crucial that people make sure they've got followup when they get home. That they've arranged that there is a doctor that's going to see them when they come home or a surgeon, you know that someone is going to check their dressings if they've still got them, they're going to get the physio therapy cause it's usually takes a while to get into these appointments. They need to book their physiotherapy for the followup when they come home, if they've had kind of joint things happening and they have things in place. I mean and it's the day to day things as well. If you're coming home from surgery, is there going to be someone there? Is someone going to help you with the shopping, the cooking, the laundry, the cleaning. You're going to need to go to medical appointments. Who's going to take you there while you're away? Who's going to look after your home? If you've got pets, they look after who's going to water the plants. It's all of these things because you don't expect anything to go wrong, but if there is a problem, you want to know that everything's taken care of at home while you're away and also that you're taken care of when you get back. You have to line all these things up. It might be as simple as if you know that when you come back, you're not going to be able to reach the top cupboards of the kitchen. You move stuff down in the kitchen so that you can work on the top surface or the lower cupboards. Basic problems like that that people don't ever consider.

Allan: 34:18 Well and they need to. I think that's what we're really kind of coming out here is there's like a huge opportunity, opportunity to save time to get things done sooner, opportunities to save money. But you do have to do the homework. You do have to think through these and be really logical and get really deep on understanding what your process could and may look like because it's not necessarily going to go to plan. So are you in position where you can actually manage through all that? So it was a lot more considerations than I actually had originally thought this conversation was going to have before I read your book. But I really appreciate that you took the time to really go through that in detail. And so the book is called Medical Tourism and I do encourage anyone that's considering it to check out that book. But I have one last question for you, Janet. I define wellness as being the healthiest fittest and happiest you can be. What are three strategies or tactics to get and stay well?

Janet: 35:15 I think we have to be easy on ourselves. I think all of us can improve our health in some way or another. And I think it took us a while to get to the state we're in where we think we need to improve our health. So we need to be easy on ourselves and take small steps towards changing lifestyle and eating habits. Because if you do things drastically, you're not going to do it. If you're going to cut out everything to make these huge changes, you're going to resist it. You're not going to do it. And I think that you need to be working every day towards that health goal. So if you're thinking about increasing your exercise, you know, you might be thinking about walking, so park your car a couple of blocks further than where you're going and increase the distance you walk and increase that distance every day, every week or every month. Use the stairs instead of the elevator. Take it gradually so that if you're on the 15th floor, you don't try and do 15 floors in one day, but go up a few flights at a time, you know, then take the elevator, just work up to it. And that mindfulness, I think we all need to have some quiet time. We need to take some time each day to be away from electronic gadgets if possible to do maybe 15 minutes of meditation. And that just kind of resets us and of course really important to get enough sleep.

Allan: 36:29 If someone wanted to learn more about you, more about your book, Medical Tourism: Surgery For Sale, where would you like for me to send them?

Janet: 36:37 I have a website, so it's www.areusafe.ca and that's got information about my books on there. There's also, if you go on there, you can register and download a free checklist of questions that you should be asking for a facility and there's information about the medical tourism company that I mentioned so that that's on that site as well.

Allan: 37:09 Okay. Go to 40plusfitnesspodcast.com/417 and I'll be sure to have the links there. Janet, thank you so much for being a part of 40+ Fitness. Thank you very much. Good to talk to you.

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Another episode you may enjoy

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The new keto-friendly south beach diet with Dr Arthur Agatston

Dr. Arthur Agatston inventer of the South Beach Diet, has added a new twist to the wildly successful diet making it even better. His keto-friendly version should help you drop the weight for good. We discuss his new book, The New Keto-Friendly South Beach Diet on this episode.

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Allan: 01:00 Dr. Agatston, welcome to 40+ Fitness.

Dr. Agatston: 01:03 Great to be with you Allan.

Allan: 01:04 Your new book. It's called The New Keto-Friendly South Beach Diet and I want to say, okay. I knew about the South beach diet, but it came out at a time in my life when I didn't really have to think about what I was eating or what I was doing, so I was familiar with it being, you know, kind of a more of a whole food protein style diet. Not dissimilar from some of the other stuff that was out there like Atkins and whatnot, but still very effective. A lot of people that I knew that did the South beach Diet really got good effect.

Dr. Agatston: 01:33 Yes, and I must say you weren't that interested the I was not that interested in diet. I was always thin until I realized I was, well I didn't realize it then, but I was addicted to sugar and I was pre what I call pre pre-diabetic even though my blood sugar is, everything appeared normal. But I, once I got off the bad, carbohydrates and sugar, I lost weight and it was I guess in my early fourth reason. I know, I love your show that 40 plus fitness because things change as we age, we get more fat, less lean body mass, less muscle and bone and exercise. The proper diet becomes more and more important as we age. Although our youth today are in big trouble with their diets. So it starts early, but it is tougher, is tougher as as as we age.

Allan: 02:35 Yeah. And I definitely want to get into some of the warning flags and things that we can look to before we get there. Because again, yeah, the doctors are going to say, Oh, you're a A1C is fine. Keep eating the way you're eating. That's not necessarily the answer. Because historically, I mean if we look back and you think about it and you, you talked about bears hibernating, but you know, in a, in a sense, human beings, we went through feast and famine ourselves, you know, and we would get into that. We get into that same season when when the bears fattening himself up and we're finding the berries and the nuts and we're, we're just gorging on that stuff. So our, our bodies were kind of pre-wired to put us into, for lack of a better word, what you call it. You were doing it like bingeing like you would eat a part of a blueberry pie and then you'd go back and eat the rest of it. I think that's just natural for us to do.

Dr. Agatston: 03:28 Yes, I love the, I do love the grizzly bear analogy. We're always either storing food for either an overnight fast when we're going to sleep or you know, in our history it was more often for times of famine and it's all mammals, but it's really almost all living. Ever since we became multicell cellular organisms, we had a, have a way of storing energy to use when there was no energy available from the environment. And so the fat storage mode where when we eat, whether carbohydrates, sugar turns into fat, other than what we're burning for our immediate needs and it's stored as fat and to some degree has starch or glycogen in our liver and our muscle. And usually we needed that not only when we slept and more eating, but we never had the luxury of three meals a day.

In most of our history. We were in a sense doing intermittent fasting, which gave us time for our insulin levels to go down when we ate our insulin levels go up, we store, we store storage in fat, and when it goes down, we burn it for energy. And that important survival mechanism has been totally upside down. When we have only the feast, we don't have famine. And so we're storing fat indefinitely and really creating physiologic problems that we never had in our natural existence. And it's most recently it's the abuse of sugar, high fructose corn syrup, which is, has been important because when it was introduced, it was ubiquitous really in everything and often a hidden killer in a sense. And our intake of sugar went up tremendously, really starting in the 1980s at the beginning of our obesity epidemic.

And people didn't realize they were consuming all the sugar and it was turning into fat being stored for a famine that never comes. And that's what really messed up our physiology, caused all the modern diseases. Yeah. We think of obesity. We think of diabetes, we think of heart disease, but it's cancer, it's depression, it's Alzheimer's. And every time we bring our standard American diet called the sad diet to another country, whether it's Dubai, Mumbai, Beijing, Tokyo, they get all the Western diseases, not just diabetes and obesity, but increased rates of cancer, again in Alzheimer's, autoimmune disease, all our chronic diseases. And when, what we often see now is when people came from more traditional diets like Asians, the Japanese had been studied carefully when they moved from Tokyo to Hawaii, to San Francisco. The rest of the United States, they, we've known for years, they get increased heart attacks, but they also get increased cancer, particularly breast cancer has been very well studied in Japanese women from Tokyo to the to the Midwestern United States. And so the cancer goes up as well as the obesity, the diabetes, and the heart disease.

Allan: 07:25 Yeah, so one of the things that you got into in the book is, okay, so you had, you know, we had the South beach diet and for a lot of people that was very useful because they went through a phase where they kind of allowed their body to change its insulin mode and effectively. Then after that short phase, they could go on and start reintroducing some of the food, say before until they kind of found that balance of a whole food diet that was basically much more nutritious for them. But you've adapted that so that the new South beach, new keto friendly South beach diet is just a little different. Can you kind of compare and contrast those and and why you use the term keto friendly versus just making it a keto diet?

Dr. Agatston: 08:05 Yes. I'm one of the first things that in the original South beach by the first phase, which was the low almost Keto phase only went for two weeks and what we know now, once it did get rid of cravings, the other thing that happens when you're low, you're low carb, low sugar, low processed foods is when you run out of your starch, your glycogen stores in your, in your liver and your muscle. You then have to get fat adapted, which means you really turn on the hormones, the enzymes that break down fat and make it useful. One of the best examples is the traditional marathon lovers who get hydrate loading on the night before the marathon and the idea was to fill their livers in their muscle with as much starch glycogen, that's the storage form of sugar if they could, because within two to three hours running the marathon, they would run out of the sugar glycogen stores and they had to burn fat and they weren't good at it, so that was called hitting the wall and they ran out of energy.

Now long-distance runners have learned to be fat-adapted and that takes one to many months and it continues. And I've had that experience myself. So instead of just the first phase being two weeks, we'd go for one to many months of low processed carb, low sugar so that we can learn to use our fat for energy. And the first fat that goes is the belly fat. And today it's interesting the long endurance runners, the people doing triathlons and even more than marathons are going low carb and they don't hit the wall, they burn their fat very well. Now for the rest of us, you know, it takes 12 hours to a day. It's individual where you, you deplete your Icogenics stores and you begin to burn more, more fat and become fat adapted and allowing for that is very important.

When I first became really strict and good, it's when I realized I, I was truly addicted to sugar and I went cold Turkey once. Once, by the way, I understood that I was truly addicted to sugar, that when I cheated, it wasn't a lack of self-discipline. And what would happen to me is I could lose my cravings on the first phase of the South Beach Diet. But when I went to the second phase, I would invariably have a fruit or maybe even a whole grain bread, but I would, or a dessert and I wouldn't sop and now we know it's not a lack of self-discipline. It's truly and addiction and many Americans, especially overweight Americans are addicted. But once I got off that addiction and stayed on sort of the traditional phase one the South beach diet, I did my first, I was, I started the diet while on vacation and I came back and I returned to my, to my boxing, which I did regularly. And I still, I recall vividly, it was a Tuesday morning in late September, hot in south Florida. And normally I would take a round or two off when I did my boxing and all of a sudden I didn't have to take around off. I went continuously for eight rounds and now I can 12 rounds, three minute rounds with a minute and a half rest.

Allan: 12:12 I do have to say this, if you haven't done boxing as a workout, three minutes is an eternity. I have some clients I do some boxing with and you know, we'll go for a minute. I've gotten one, I'm up to about a minute and a half and they're, they're done. You know, like I need a break. And so going, just even going a three minute round is saying something. But for you to have the endurance to be able to, you know, go round after round with what about a minute rest between rounds. That's, that's pretty impressive.

Dr. Agatston: 12:40 For my tender young age, I take an answer 30 seconds in between rounds.

Allan: 12:45 No, but still three, three minutes is a lot of time to keep moving.

Dr. Agatston: 12:49 Yes. And I couldn't in hot, difficult conditions, I would always take rounds off and since I'm fat adapted, I don't, I feel better physically and mentally and that much more than the cosmetics of losing my belly. And then remember I was a diet doctor. My wife used to say, Author, no more TV for you only radio. You get rid of that little belly and so, but it's much more the way I feel and since we've been, we've been more flexible with our patients. The results we see are incredible and besides the fat adption, the longer sort of phase one, the other idea is you don't have to be in full ketosis. Actually, when we're in the fat burning mode, we're often in ketosis. It's the levels we can't measure easily by current methods, but you can, you can lose the belly.

You get all the benefits without actually being in ketosis. The big advantage of ketosis, particularly for people who are diabetic, who really want to jump into something strict, is you can measure your ketosis and you can document compliance and that's, that's good for us often and our patients. But to make the diet a lifestyle, there still has to be more flexibility. We also encourage either time-restricted feeding or intermittent fasting. And we do suggest that with full keto, with fasting that you do it with a nutritionist, to health coach or your physician, your physician so that you can avoid problems such as what's called the keto flu. But so we are flexible in our approach depending on our patient, the needs, the desires and you can even be a vegetarian low carb as long as you're having whole foods and not having other process carbs. It's tougher but you can do it. And of course traditional societies that like the Asians with rice and not the Okinawans with with sweet potatoes, they were some of the, well particularly the Okinawans were some of the longest lived populations in the world, but they didn't eat snacks all day frequently. And now to the degree that sugar has shown its ugly face in all these societies, they are becoming overweight, diabetic and all the Western diseases that had been in the United States for decades.

Allan: 15:48 When you put this together, I mean cause like one of the things you said and I think that's really important is, well a couple of different things, but one that I thinks is really important is that we all are gonna have different needs. We're all going to be slightly different from a biology perspective of how we want to apply this. So there's, there is a lot of flexibility to this to say, I know, okay if I need to lose 30 pounds or I am diabetic, I'm probably gonna stay in phase one and be a little bit more strict and probably get to a point where I am in ketosis if not completely, at least most of the time I'm eating at that low of a low carb. But you have 12 rules for what you call keto friendly eating. Could you just kind of go through those rules with us? Cause I think that'll make a lot more sense to folks when they see, okay. It is really kind of flexible. It 12 rules sounds like a lot, but they're just the basics of if you're eating this way, you're going to be much more healthy.

Yes. And by the way, yeah, you got it exactly because the flexibility is we all come with different degrees of we call the thrifty gene and the tendency towards becoming diabetic ultimately. And so the rules are first minimize sugars is number one. And we might say no sugars, but you know, our parents and grandparents who had the sugar cube in their coffee was a lot different with the amount of sugar we're getting today. And so you can burn some sugar without having stored it. It's the volume that is totally off the charts today. And refined carbohydrates are absorbed more rapidly than whole grain or high fiber carbohydrates. And by being absorbed more rapidly, they, it's called the incorrect in effect, but they increase our insulin levels out of proportion to just the increase in blood sugar, blood sugar alone.

So if you give blood sugar a certain amount intravenously through the vein, the blood sugar goes up a little bit and the insulin goes up a little bit. But when you consume it, then you stimulate hormones. It's something called GIP, which causes an exaggerated increase in insulin. And that's, that's the problem with frequent feeding. And snacking, which we used to say, like everybody said, when you went to the South Beach Diet, have frequent snacks to stabilize your blood sugar, your insulin levels. That was just plain wrong. So the third rule is, is limit snacking. You want to give time for your insulin levels to drop and that's where having very low glycemic foods, whole foods or nothing for breakfast and lunch, that allows your insulin levels to go down. And that's when you can start burning fat. When your insulin levels are high, you block the burning of your fat stores.

So you can be once the, insulin levels stay high and you can't access your fat stores, you can be starving and you run to the fast-food restaurant or you have a coke that doesn't even suppress, doesn't even, doesn't even fill you up. So you want to give time for your insulin levels to drop by not snacking, having fewer larger meals, which is the next in the 12 rules or having foods that are absorbed further down in the intestine and don't increase your blood sugar and your insulin levels. We say maximize the healthy fats and one of the things is while some people I know don't like dairy cause they're sensitive to it, well saturated fat in meat, in dairy, we now know raises your large LDL bad cholesterol particles and they do not cause heart disease.

This is relatively recent knowledge but it's done. It's been repeated in several large studies. It's the small LDL particles that cause heart disease and they come from sugar and bad carbohydrates. And one other point that out the bad carbohydrates is again, it's volume. Because when you have a bad carbohydrate, you either burn it or if it's glucose, not sugar, you can store it as glycogen, as starch, but only so much about 700 calories. Then you then it turns into fat.

Allan: 20:50 Yeah. But that's part of the problem is these processed carbohydrates are process to basically make us eat more. That's what the food manufacturers are doing. If you don't eat, let's just say you're not going to eat one Pringle. You could eat one Pringle and maybe you'd love the taste of it and that would be all you needed. Your body could absorb that and you'd be fine, but invariably it's a long sleeve and you're not just going to eat one.

Yes, absolutely. And one of my favorite books by Dr. Robert Lustig from UC San Francisco, the Hacking of the American Mind, and he talks about how the food companies make us addicted. And yeah, I mean sugar. I seen another friend, Dr. David Ludwig, did a study where they gave Cokes to teenagers before they ran into a fast-food restaurant and they ate more, not less because fructose, the sugar in the cokes does not suppressed. There's not suppress your appetite. It actually increases. And again, those processed carbohydrates including sugar are absorbed at the beginning of your small intestine or you get that bad incretin effect where your insulin goes way up, and sugar is not turned into starch or glycogen in your liver. It's either burned or it's turned into fat right away. So a high sugar diet is a high-fat diet. And then we say, you know, limit the Omega six vegetable oils.

Of course, the original vegetable oils, and they're not made from vegetables. They're made from, from seeds. The first were made from cotton seeds now soybean and many other types. And they originally they were hydrogenated for shell finding and that was shown not to be healthy, to be very unhealthy. They were outlawed. But instead of going to just traditional saturated fats such as lard, butter, coconut oils or olive oils there going into nonhydrogenated vegetable oils. And Americans were never, humans, in general, were never exposed to naturally. We need small amounts of these or else they're called on your Omega six oils, which today are the vegetable oils and small amounts are fine, but when you process them and create the salad dressings, the cooking oils, we were never meant to have that many oils and it throws out our Omega six inflammatory measures to Omega three oils which are anti-inflammatory.

So where our ratio of omega six to omega three should be from one to four to five to one in most Americans its greater than 10 to one. And so you should be avoiding all vegetable oils as far as I'm concerned, it's proinflammatory but your vegetables and you know the nonstarchy vegetables, asparagus and brocolli, Brussels sprouts and green leafy vegetables, the spinach, those are all good. Yet when the problem is when we always talk about fruits and vegetables because a lot of fruits have a lot of fructose, particularly the tropical fruits, so fruits have anti oxidants that could be good for us when it's a whole fruit in the form of a Berry, but a lot of people think they're being healthy cause they're having a lot of fruits and they can overdo it because of the sugar and the fructose that makes the fruit sweet so we shouldn't be always loving vegetables and fruits and fruits together and then a wide variety of needs, poultry, seafood all very nutrient-rich and eat primarily whole foods.

The best example of this I think is the field cut truly whole grain oats versus instant oatmeal and with actually the same amount of fiber when you have the steel-cut oatmeal, the sugar or the or the starch core of the oat is surrounded by fiber. It takes a while to digest and releases the starch, the sugar into the blood stream slowly and you stimulate the enzymes further down the intestine that are good when you have processed instant oat meal. Even if you have the same amount of fiber, it's not surrounding the starch core and so it's absorbed much more rapidly. The enzymes, the hormones have direct access to the starch, it turns to sugar instantaneously and that increases your insulin levels rapidly and you're much hungrier. The studies have been done, you're much hungrier sooner than if you have the steel cut true oatmeal.

So, and that's true of eating whole foods and that means whole foods adding the fiber in separately. There's just a lot less evidence that that's helpful. And flexibility. It's more important not to be snacking and not to be eating frequently often than sometimes what you eat if you're eating in a relatively small window or during intermittent fasting. I hate to say, you can get away with more because you do increase your starch stores and your insulin, but then you have a long period of time to burn off that starch and the fat that's been consumed. So we prefer whole good foods all the time. But if you're going to be, if you're going to cheat, cheating in a short window is much better than if you're grazing and eating all day. That's disaster. There were snacking very well documented where we're eating many more times per day than we were in the 1970s and it's cause we're walking around hungry all day because our blood sugars are swinging around and our insulin levels are high and we don't have access to that big store of fat in our bellies.

Allan: 27:38 Well, and I think flexibility is important, but this is not, we're not talking about a license to just say, okay, I'm going to allow myself to have a piece of cake every night because I can, I'm only having, you know, two big meals a day and therefore I know I can have, and that's great. But if you're wanting weight loss, if you're diabetic or prediabetic or as we're going to get into in a minute pre pre-diabetic, then you have to understand, or you no you're addicted to sugar. You really have to think hard about how you can approach this and use this diet as a tool to get yourself healthy, to get yourself off that addiction because it's possible. But if you're going to start the game cheating, you probably not going to get there very fast.

And by the way, I mean that is the mistake that I frequently made without knowing. But even now, I mean, in the holiday season, if I'm acting in a fair, and this has happened and I, you know, and I eat the wrong food, the addiction comes back so quickly. And other than that, knowledge of I I can't do this or I can't keep doing this and I can get back on the wagon pretty quickly. But you're, you're, you're absolutely right. This is not a license to be cheating every night. I mean, the good thing if it's once a month or you know, somebody loves their pasta meal and there's a good amount of protein with it. And that's, that's again, depending on the individual, some people will immediately fall off the wagon and get into big trouble. Others, I always have patients who don't have the sweet tooth I have and they can have a bite or something and have a bite, you know. In Miami we have, we have Joe's stone crab and their key line pie. And I generally can that have just one bite. So I don't have it at all. And others can, including my wife. So that's knowing how each of us are as individuals.

Allan: 29:44 And that's one of the things I liked about your book was it took that into account and said, you know, because now you've dealt with thousands of patients and yourself and it's like we're all going to have to approach this slightly differently and we're going to figure out what works for us and we're just going to have to be self aware that you know, if we have this addiction, if we have this issue. One of the things you had in the book, which I thought was really, really important because by the time you go to the doctor and your A1C is over six and they're going to start now diagnosing you with diabetes, you're way down the road and you talk about some tests, some things we can look at before we even get to that point. And so these are tests I'm actually kind of interested in having done because my A1C is great. My blood sugar is great, but that doesn't mean I'm out of the woods. It just might mean that right now my body's creating a ton of insulin and it's able to shuttle all of that blood sugar away so I don't stay in a high blood sugar state. So one of them you call was, it was basically the insulin resistance test or you know, insulin. And then the other one was called the Atkinson calcium score.

Yes. The first, as far the points you've made about insulin are so, so important. So in fact, if we take in America healthy young, 20-year-olds, not overweight today versus the 1970s their hemoglobin A1C, maybe five are they're very normal. They're fasting. Blood sugars are absolutely, absolutely normal. They give a glucose tolerance test where you take a drink of 75 grams of sugar, glucose and wait two hours, their blood sugar comes down. But if you measure the insulin levels, it's taking four times normal insulin levels to keep their blood sugar normal. And that's already hacking fat into their liver, if you anybody, even teenagers, if you see a belly on anybody, a little protrusion, it means they have high insulin levels and they have excess fat in their liver. That's where it all, it all starts. So the test that we do, we call it the insulin secretion test, your insulin-resistant test.

It was actually developed by Dr. Joseph Kraft in the 1970s he died recently at age 94 and unfortunately, he did great work. Unfortunately, it was not recognized by the nutrition establishment, including the American diet. I thinks its an association. Partly, you can only measure insulin levels. In the 1960s the developers undercut the Nobel prize and hasn't been measured clinically until very recently. But he did the measurements when it was very expensive, but on 15,000 patients and he found that he called it diabetes insight too. I call it, it's kind of a medical term, I call it pre prediabetes because anybody with high insulin levels is having problems already, whether they know it or not. Including depression. There is an epidemic of colon cancer in young people, breast cancer, which are related to high levels of insulin. And so the real tests you need, which I'd like to give Kraft credit, called the Kraft test, is you take the insulin, the glucose drink, which was given in the traditional oral glucose tolerance test.

All pregnant women today get the oral glucose tolerance test, and instead of just measuring blood sugar, you measure insulin levels. And so, so many people who have bellies and some, are what do you call it? TOFI. There's thin on the outside and fat on the inside. If you look with a CT scan, cat scan of their belly, they have belly fat. Even though from the outside you would never realize it. And so you can really only tell, you could do it if you do a special MRI of the liver, but that's too expensive and not practical. The Kraft insulin secretion test, it's not expensive. The main thing is it's done over two hours. You do a fasting in some level, then you drink the glucose and then you repeat it at 30 minutes, 60 minutes, 90 minutes and two hours. And so we see patients who already have plaque in their coronary arteries, they have all kinds of chronic illness and their A1C is normal.

And so the fact is it takes years to develop. The fat is not only in your liver, it's also in your pancreas, and it's not till your pancreatic beta cells that make insulin, that synthesize insulin, become injured by the fat in the pancreas and you can't make enough insulin to keep your blood sugar normal. That's when your A1C, your fasting blood sugar goes up. And that's when we diagnose you have a problem pre diabetes or diabetes. But in fact, 10- 20 years before you can measure high insulin levels and people are suffering from again, skin problems to having cancer to heart disease when they're told your blood sugar is normal, don't worry about it. So that's, it's so important to understand. If you have a belly, you have high insulin levels, you're at risk of having heart disease, diabetes and cancer and Alzheimer's. Even though your doctor say your blood sugar is normal. So it's very important to get that word out right.

Allan: 35:43 And then the calcium score is basically going to tell us how much plaque is built up already.

Dr. Agatston: 35:50 So yeah, the calcium score I developed with my colleague Warren Janowitz. And if you're heading for a heart attack, if say you're 40 years old and you're heading for a heart attack when you're 50, 55, 60, you already have plaque in your coronary artery. And with the calcium score, it's inexpensive. In Miami, it's $99. At Johns Hopkins, it's $75 to have the test. You can,uand it's essentially no radiation. It's a cat scan that has some radiation, but you get more radiation when you, when you fly in distance. So the radiation is not an issue for cost is really not an issue. And even though your cholesterol might be normal, things can look normal.

But again, if you have a lot of small LDL particles and other problems that are hidden, you may be developing plaque and you can't tell with a cholesterol test, LDL test or any other tests. Here you're looking directly in the coronaries with a safe, inexpensive test and that tells you what your risk is of a future heart attack. But it also, it predicts all cause mortality because it indicates how the various risk factors for chronic disease are mixing in you as an individual. So the one thing that we see now is we see people whose hemoglobin A1C, their blood sugars are normal, but they have high insulin levels. They may have some other genetic markers that we look for cause you're my practices is cardiac prevention. But those tests are not so difficult to get either. But the main thing is that with the high insulin levels, the sugar and bad carbs they're consuming is turning into fat in the liver and they're overloading the liver with fat.

That causes a lot of problems. But one thing it does is it turns the normal LDL in to small dense LDL, small LDL particles that are not cleared by the, in the bloodstream easily. They don't fit into the usual receptors. They become oxidized and the oxidized LDL sticks to the vessel wall. It gets underneath the vessel wall, builds up the plaque and we again can see with the calcium score, you can see the build up of that plaque and the result of the high insulin levels years before you get chest pain or a heart attack and you can monitor it and then can prevent it.

Allan: 38:36 And I think that's huge. You know, so many of the tests and the things that we get diagnosed with, we're already sick and this is an opportunity for you to catch it much, much earlier, even if the other tests are coming out relatively clean these are really cool. I, I really appreciate this cause I was having, I mean I remember interviewing Dr. Fung and his, his book about the Obesity Code, and back then and he's like, you know, it didn't make any sense to measure insulin because you're doing it fast and you're doing it one time. But you know, here's some advancement where we're saying, well let's, let's go ahead and test the other side of this. The sugar is glucose equation. Basically using the same test, just looking at the actual insulin response, which I again, I think that's just brilliant.

Dr. Agatston: 39:17 And I yeah, I admire Dr. Fung a lot. And but you can't just measure the fasting insulin. We have people with normal fasting insulins and I'm particularly young people are at at 30 minutes after the glucose load their, I mean their insulin levels are in the hundreds, whereas their fasting glucose is normal. In older patients, you get more and more of the delay in the insulin, which indicates dysfunction of the beta cells in the pancreas that are making insulin. And that's because fat, we know that you get a fatty liver years again before you're diabetic or, or even pre-diabetic. And the fat is also going into your pancreas and interfering with the beta cells. And so you get a delay in the insulin secretion. So we can see both the degree of insulin resistance and the degree of what we call beta cell dysfunction, the pancreatic dysfunction that eventually is going to lead to the high blood sugars when you can no longer make enough insulin to keep the blood sugar normal.

And the other thing with this delay in the production of insulin is the insulin peeks hours after a meal and it stays high and that's that high insulin level that is locking in the fat after a meal. So when people get up in the middle of the night starving, even though they have all these fat stores in their belly, in their liver, in their muscle, the problem is they have sustained high insulin levels that blocks the enzymes that breaks down the fat and gives you the energy in the hibernating bear late in the fall. The bear is, they're eating the fruit that's become ripe. That's why fruit is seasonal and they are ravenous, depleting the forest of blueberries and other berries, even though the bear has already put on 400, 600 pounds of fat, but they don't have access to the fat because their insulin levels high. So they can continue to put on the fat for the winter hibernation.

Once they're hibernating and they're not consuming that fruit and the fructose in the fruit, then their insulin levels drop. Now they have access to the fat and that's how they hibernate the whole winter without eating because its that fat that is helping their brain, their kidneys, their heart to continue to function while they're asleep. So normally when we sleep every night we're not eating, so we're accessing our storage starch and fat. But what our insulin levels are high, we can't. So the blood sugar falls and we may wake up in the middle of the night starving and go to the refrigerator and have whatever sugar and carbs are there to bring our blood sugar back up. So it becomes a really vicious cycle.

Allan: 42:36 Yes it does. And so I think this is, you know, we're, we're into January here and I think, so this is kind of a great time to look at something like the Keto Friendly South Beach Diet because it's going to help you regulate your insulin. It's going to help you kind of go through a good period now where you can be thinking in terms of the bear or humans and what we would and wouldn't be eating. The rules are pretty simple. You do have meal plans in there and recipes so it's all put together very well. So again, I think this is an excellent opportunity to take something that worked. The South beach diet definitely was one of those things that people, when they follow it, it worked and you've improved it, which I think again is just wonderful.

Dr. Agatston: 43:16 Well thank you. Thank you so much. And Allan, I mean you obviously you really got it. And it's part of the book is certainly understanding the principles because even for me, who was the cardiologist diet doctor telling, putting my patients on diets for years, but I didn't understand the addiction aspect. Once I did it made such a difference for me and it is, it is for my patients. So this was not necessary eating differently. I mean it was the understanding that made me stick to principles that I already knew. So understanding the role of insulin and how it's different for all of us and understanding flexibility, understanding that America is not overweight because we all of a sudden lost our discipline or for that matter have stopped exercising. Exercise is very, very important. But what causes, what's caused the obesity and chronic disease epidemic is mainly, it's mainly the way we're eating.

Allan: 44:22 I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and sta well?

Dr. Agatston: 44:32 I would say understand insulin, keep it down, don't snack between meals, try some intermittent fasting and others is getting a good night's sleep and this enters in. Of course, if you're overweight and have sleep apnea, you may not be able to sleep proper, but we know a lack of sleep. Again, it stimulates enzymes and hormones that lead to high insulin levels and the other is regular exercise. And exercise is not going to be a solution from the calorie burning aspects. They prove that on the Biggest Loser for your, for your brain, for insulin sensitivity, for keeping up lean body mass. And you know I, you know, I love your podcast and the and being well over 40 plus that we have to keep our muscle and our bone. And you know, when we weigh ourselves, it's the weight, the BMI doesn't really mean anything because that includes, muscle, bone and fat under our skin, when we call the subcutaneous fat, it's only the fat in and around or origins.

That's the dangerous fat that we have that we have to worry about. And regular exercise, it improves our brain function, improves our sensitivity to insulin. So it decreases insulin resistance and it helps us age. We sustain lean body mass and on balance and so many things that's part of healthy aging. And I agree with you. Wellness, we use the term optimal health and it's, it's your vitality. And again, what's kept me on the changes in the diet that I made is I vitality, my ability to exercise, my ability to concentrate, get rid of the brain fog. And it's all those things. My belly was often hidden, people couldn't see it where I was wearing clothes but I knew it was there, but it's because I feel so much better with this and this type of lifestyle. So sleeping right, my exercising right and eating right.

And as you age you have to be more and more concerned about each of these elements. And so I really applaud for what you do with 40 plus as we age, we do become more insulin resistant and it becomes tougher and tougher and you have to get enough sleep, enough exercise and eat the right foods and not eat too often.

Allan: 47:18 Great. Thank you for that. So Dr. Agatston, if someone wanted to learn more about you or learn more about the book, The New Keto-Friendly South Beach Diet, where would you like for me to send them?

Dr. Agatston: 47:30 South beach diet website changed recently.

Allan: 47:36 Okay. That's good. Yeah. Just send me the link and I'll make the show notes so you can go to…

Dr. Agatston: 47:41 Agatstoncenter.Com is our office, our website. It has all of information too.

Allan: 47:48 Cool. Well you can go to 40plusfitnesspodcast.com/416 and I'll be sure to have those links there. So Doctor, thank you so much for being a part of 40+ Fitness.

Dr. Agatston: 47:58 Thank you Allan so much. It was really enjoyable.


It's that time of year. It's the time of year when everybody is thinking about health and fitness. Maybe you've set some resolutions, maybe this is the year that you want to get healthy and fit and if it is and you need a little bit of help, check it out at 40plusfitnesspodcast.com/coach you can come on as a group client and I can help you lose weight, get stronger and make 2020 something special. Go to 40plusfitnesspodcast.com/coach.

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Another episode you may enjoy

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January 6, 2020

Carnivore cooking with Craig Emmerich

As more people adopt different ways of eating, the carnivore diet is gaining rabid followers. Today we bring back Craig Emmerich to talk about the carnivore way of eating and the cookbook he and his wife, Maria wrote called The Carnivore Cookbook

Allan: 01:29 Craig, welcome to 40+ Fitness.

Craig: 01:32 Thank you for having me on.

Allan: 01:34 You know your cookbooks now. You're working directly with Maria to do the cookbooks and those cookbooks have been some of my favorites across, including Keto Comfort Foods, which made my list of favorite books that I've read because of the recipes that she has in there. Her etouffee is just unbelievable There's also Keto Restaurant Foods. You recently sent me one on air fryers, which I'm just now diving into. We don't have an oven in our apartment here we didn't realize that until we moved in. It's like we have a stove top and no oven. I'm like, huh. Air fryer. That might do it. A very small place. I'm going to be diving into that big, big time.

Allan: 02:13 And then your book now The Carnivore Cookbook. When I first started hearing people moving to carnivore, because the conversation went paleo, keto started kind of gaining momentum, and now carnivore. It was almost reminiscent of the vegan approach to eating. It's such a huge elimination diet that I was like, I don't know that I would ever try that, but I'm glad you sent me this cookbook. I'm glad we have this opportunity to have this conversation because I learned so much from this book.

Craig: 02:51 Thanks, Yeah, we tried to put a lot of, you know, it's much more than just a cookbook. You know, it's got over a hundred pages of content of why. You know, just the general question of why carnivore and I think the book covers that pretty well.

Allan: 03:07 Yeah. I would get on these Facebook groups and everyone's like, Oh no, you don't, you don't need that. You can just eat rib eyes all day every day. Or bacon. That's the same thing with Kito. I'm like, get off the bacon please. We need a little more than that. And I was really appreciative. I figured there was no way that you and Maria would put out a book without at least giving us some basis in science and some, some general howtos before we ever even try something like this.

Craig: 03:32 Yeah. That's what Maria and I, we've been doing this for over, Maria for over 20 years and we've always based everything we do on science and the, things we read and we're constantly learning and we're always looking for the latest information to, you know understand and, and understand this lifestyle and what the science is saying about it and our biology and all of that. And we incorporate that into, you know, our books and what we do with clients. And so, you know, things have evolved over the years. We used to recommend flax and we no longer recommend it. Probably eight or 10 years ago, we read more on the estrogenic compounds and what they you know do to people. And if they're with estrogen balance and so we'd no longer recommend it. So, we always try to keep up and learn and educate ourselves.

Allan: 04:25 And I appreciate that. That is part of what this podcast is all about. I'm generally agnostic until someone gets militant about their way of eating which is happening on all sides of this. I think a lot of us went through the evolution of the paleo, keto. And now people are looking at carnivore and other kind of spinoffs of keto. I've even seen some vegan keto that's out there and we've covered that on the podcast. And so I encourage people to explore these.

Allan: 04:56 Now with the carnivore diet, it's, the way I'm reading it, we have gone through this is it's basically an elimination diet. And a lot of people will get into it predominantly for weight loss. Maybe they stalled on keto and they're not losing any more weight. And they're like, well, what do I do? And seems like, well, you know, I went on the carnivore diet, I lost an additional five pounds in a week. And they're like, Oh, okay. And so people are experimenting with it. So it's important for them to understand what this diet means. But at the same time, it's there's, there's a reason we're going to do it besides weight loss for a lot of people. Including yourself.

Craig: 05:37 Yeah. So, you know we took the book when we started talking about applying this diet we took it in two parts and we said, okay, what are your goals? Why are you doing this? And if the goal is weight loss, then great, here's kind of how you do it and how to get success doing it for weight loss. And then we took the other angle of, are you doing it for healing? Because that can be a little bit different when it comes to, you know, healing from auto-immune disorders or bipolar or Lyme disease. Like I have those things require a little different protocol to kind of weed out what you can handle and what your body reactsto or not. And so that was, we coined, we called it the carnival auto immune protocol and it's basically, you know, just like an autoimmune protocol or it's an elimination diet, but it's a total elimination diet.

Craig: 06:36 And you start out just eating beef and salt and a take it back to the basics and allow your body to adjust to that and then slowly add things back in. And this is a way to find where your tolerance level is. And it's so important because people like me with Lyme disease that I've struggled with now for seven, eight years with, you know, chronic pain, especially the, the hardest thing is the migrating pain that I get where, you know, you wake up in the morning and it feels like you sprained your knee, you didn't do anything, you just wake up with this knee pain. Next morning you wake up, it's in the other knee or in your hip or your ankle. And it's very hard to function when you've got this because I mean it's just hard to even walk around with carnivore I was able to completely eliminate that migrating pain.

Craig: 07:27 And by eliminating certain plants and things that I eat used to eat when I was keto. And so it's a powerful thing. And there's even people in this community like Amber, our friend Amber O'Hearn, she's been carnivore for like, I don't know, 15 years and it's to help with her bipolar. With keto she saw improvements but not total stopping of the progression of the disease. With carnivore she did see a complete stopping of the progression. So, you know, this is not, I look at this as how we've always approached keto in that people come to keto and yeah, the weight loss is great, but they stay with it because of the healing effects and how much better they feel and a lot of the carnivore is in the same realm is that, you know, people especially with these, you know, chronic autoimmune or Lyme or these chronic pain conditions, they come to it and they see relief and that is the driving force behind it.

Allan: 08:34 And I think that's one of the cores here is that this is for some people this could just be a temporary, you know, I want to lose 20 pounds. I'll try carnivore and I do it for 28 to, you know, I don't know, six weeks, six months, whatever. You lose that weight and then you can start incorporating, you know, plant material back into your diet, and became basically keto from that point forward and feel pretty good about.

Craig: 08:59 Yeah, keto or low carb. And you can, you know, live that way for a long time and forever. And you know, Maria's been keto for, like you said, over 20 years and she's thriving and you know, she kind of goes back and forth herself. You know, she'll, there's days where she pretty much eats carnivore and then other days, you know, maybe like this weekend and we're going to family outings, you know, she'll incorporate salads and, you know, other things basically eating keto you know, myself, I'm still gonna stick to the meat because if I don't, I'm gonna be in rough shape that next day with the pain. So, you know, it really depends on your goals.

Allan: 09:39 Now you've mentioned in the healing part, you mentioned the Lyme disease, which is what you're familiar with particularly. And then of course the bipolar. Some of the other conditions you had in there included gout, which one of my clients suffers from. It's kind of hard. I can give him workouts and say, Hey, you know, go to this workout. But then, you know, he has a gout flare up and he's bedridden for a week. So that's not helping him. Is the state's going to help other things you had got listed, I believe. There's other items out there and exactly what do we think is happening in our bodies that's allowing this to be so effective? If you ask someone a doctor about gout, they'll say stay away from red meat.

Craig: 10:21 Yeah, I mean, that's a common myth, but you know, most of gout, lot of times it's related to fructose and as well as possibly oxalates. You know, there's some evidence that oxalates are one of the anti-nutrients that come with plants, plants, all plants have anti-nutrients. And this is something I would really want it to talk about in the book because I think this is one of the components that helps people like me is that you get rid of all these things your body doesn't really want. And when you're at a state like mine where lyme disease really chronically depresses your immune function and puts you in an inflammatory state. And so removing additional inflammatory components like anti-nutrients can help the body. And so all these anti-nutrients are basically compounds the body can't use and doesn't want. So it has to detox.

Craig: 11:16 There's tons of antioxidants, there's thousands of them in anti-nutrients in thousands of them in plants. Some of the most harmful are things like oxalates and phytates and glucosinolates and these compounds that are basically natural pesticides for the plants to kill off bugs or things that try to eat them. You know, a plant is, you think about it from an evolutionary perspective. Animals can defend themselves by growling, showing their teeth running away. A plant can't do any of those things. So it's the natural defenses that are basically natural pesticides. So a plant does not want you to eat the STAM, the roots or the leaves because that kills the plant. So it only wants you to eat the fruit. So the fruit, it makes sweet and tempting to animals. And then it has natural pesticides on its other parts that keep bugs and things from eating them.

Craig: 12:18 And there's actually toxicity levels for some of these anti-nutrients things like oxalates it's anywhere from three grams to maybe 30 grams of oxalates can kill you. It's a wide range because of immune function and metabolic state. So somebody has diabetes or Lyme disease or chronic issues or depressed immune function. They might be closer to three grams of oxalates that could actually kill you if you're very healthy. It might be more like 30, but a man did die eating too many oxalates in Europe and it's been documented. So, you know, this is something that we don't understand about plants. We've been taught our whole lives, that fruit and vegetables are unlimited. Eat as much as you want, but there are some negatives and especially if you've got a disease state, they can really hinder you.

Allan: 13:11 Yeah. You know, and they'll tell you, you know, when you go to lift weights you're, you're, you're doing some damage to the muscle. And then this process called hormesis is what's allowing the muscle to build back stronger and better. They used to tell us now, they would tell us with vegetables is that, you know, yes, they have these anti-nutrients, but your body under normal functioning can goes through hormesis there as well. So some of the advice I've heard before is a breakup your kale 10 minutes before you're ready to start cooking it so that it maximizes these anti-nutrients. And so, yeah, it, you know, I, I guess I, if you're, if you have a normally functioning immune system and everything's working out for you, you probably have that opportunity to improve from that stress. But if you're dealing with an auto-immune issue of any type, now you know, you're, you're in that situation of too much damage.

Craig: 14:06 Yeah. Additional stress is not good in those situations. And so yeah, I think the mechanisms for all these different conditions where you can see improvements with carnivore are a couple fold. Number one is that that aspect, the anti-nutrients you don't have to deal with anymore and additional stress on the body. The other aspect I think is nutrient density and bioavailability of those nutrients. If you think about healing the body, what do you need? You need lots of vitamins and minerals to help the body you know, very nutrient dense foods to help the body recover and repair itself. Well, what is the most nutrient dense food when you, especially when you consider, well, that's going to be animal proteins. We put a lot of charts in the book to kind of explain this, but the very important aspect of it as well is the bio-availability of those nutrients because there's a lot of these anti-nutrients that can leach these nutrients from the body. So what I mean by that is we give the, there's a study that was done that took oysters, which are great for zinc. They're very high in zinc and they might've..

Allan: 15:20 And my favorite food by the way.

Craig: 15:21 Yeah, me as well. When I can get them, we can't, don't get them a lot in the Midwest.

Allan: 15:26 We don't, we don't get them down here in Panama. So when I travel back up to Louisiana, Florida, I'm hitting the oyster bars for sure.

Craig: 15:33 Yes I did. Or you know, high in DHA. So they're really good food for you. But what they did is they tested postprandial glucose, blood zinc levels. So basically the amount of zinc that's getting into the blood from eating the oysters. And when they did it with just oysters, you get this nice increase in zinc in the blood. So you're getting all this zinc into the body. When you eat, when they had the participants eat the oysters with black beans, like a third of the zinc gets into the body. And then when they had them eat them with corn tortilla chips, none of the zinc gets into the body. And this is, I believe is because those anti-nutrients like oxalates that latch on to minerals. And then when they're detox, they go right through the body. So the body is basically robbed of these nutrients. And so going the carnivore eliminates any of that from happening. And you get this huge dose of vitamins into the body that your body hadn't been getting. And, and that helps with healing.

Allan: 16:38 So let, let's get into that a little bit because you know, some of them say you can just sit down and it's just eat meat. You're, obviously, well, maybe not so obviously not getting all the vitamins and minerals that you could get from vegetables and fruits, but what you're saying is all of the necessary vitamins and minerals are available in animal products and they may be even more bio available to us as in, in addition to that.

Craig: 17:10 Yeah. And you know, the charts that I put in the book, I tried to kind of show that we have I think about 15 vitamins and minerals, a list of in these charts and they compare the content of, you know, beef, beef, liver, kale, you know, broccoli, all of these foods. And what you see is that beef by itself stacks up really well against those other foods. I think in the one chart I did have just beef, like a steak versus kale, blueberries and an Apple. Beef is number one in the vitamins and minerals in 13 out of the 15 vitamins and minerals and number two in one other one. So it's either one or two and all but one. And I think the only one it wasn't was vitamin C, which vitamin C is your requirement for vitamin C in the body is, is directly proportional to the amount of carbohydrates you eat. The less carbs you eat, the less vitamin C you need. So it's my position that especially if you eat a nose to tail type of carnivore diet where you incorporate things like beef liver and you know, bone marrow and these kinds of things. You're getting all the nutrients your body needs and it's in a more bioavailable form than you get from the plants.

Allan: 18:33 And, and like I said, I, I trust you and Maria so much that I knew when I started flipping through the recipes, you were going to be giving us some advice on how to get liver and bone marrow into our diet on a regular basis. Even for those who have difficulty with it. Can you tell us your trick, your trick for getting liver into, into your meals? Even when you don't necessarily like the texture, flavor of liver?

Craig: 18:57 Yeah, there's a few things that we do. Even if you're not carnival or if you're looking at a keto diet, a lifestyle, even in keto, it's great to incorporate some liver cause there's probably nothing on the planet that's more nutrient dense than beef liver. I mean that is like nature's multivitamin. So we try to incorporate it wherever we can. One of the great things that you can do is mix it into hamburger at like a five to one ratio. So for every five pounds of hamburger you put a pound of ground liver into it and you mix it all up and it makes amazing burgers. Or you can make, take that and make it into things like Maria's protein noodle lasagna or her chili recipe if you really averse to the taste. Chili is a great one because the more spice there is, the more you kind of cover that taste and you and usually in our chili recipe, you don't even notice that it's, if you don't tell somebody, they won't know that. It's not that there's beef liver in there.

Allan: 19:53 I wouldn't advise that because when you tell them afterwards, they're going to be pretty angry with you.

Craig: 20:00 Maybe with your kids,

Allan: 20:02 Just get them to try and say, Hey, try this, try this meatloaf. It just, just to taste. You might not like it, but just try it. And if you like, it's from Maria's cookbook, I know it's going to be good, but here try this. And if you don't like it, then I understand. But yeah, don't, don't sit down to dinner and then tell your whole family what you did later.

Craig: 20:21 Well, actually we like to let our kids pallets do the talking. You know, one of the things that Maria gets annoyed by is like, her mother will sometimes say to the, Oh, Omray you might not like this. This is Maria's healthy pancakes. Well now the kids are going to hate it. Yeah. Just let them try it. And if they like it, great. You know, they don't need to know that. That's the healthy one.

Allan: 20:45 Yeah. I get it with kids, I get it. With your spouse, you might want to say I'm going to try this experiment. I want you to try it with me. Are you game? If not, I'll eat all of it. I promise I'll eat every bit of it. I just want to share this, this healthy meal with you.

Craig: 21:02 Uh but that's, that's probably the best way to incorporate it if you're averse to it. Uh some people just like, you know, they soak it in some cream and, and then grill it with some onions. Some, you know, there's a lot of people I like it just like that. Another way to get it in, if you're really averse to the taste is to do, you basically cut it into little cubes and then you freeze it and then you just pop them, like swallow them like a multivitamin. And that's a way to get past the taste if you're really averse.

Allan: 21:36 Cool. Cool. I like that. So we don't necessarily need vitamins and veggies for our vitamins or minerals. We can get all that we need from a mixture of beef liver and some other meats. We can kind of put that together to build out the nutrition that we need. But as far as fiber, because you know, we're told we're going to struggle if we don't get fiber in our diet, our guts gonna hate us. Um we're never going to poop again. Explain a little bit about that. Cause I do see some posts like I just started this carnivore diet and I, you know, I'm struggling. I haven't pooped in three days. I'm like,

Craig: 22:12 Well we see it go both ways. Sometimes people will get a little constipated, some people will get diarrhea. A lot of that just transitioning, you know the body has to adapt and adjust to any big change in your diet. And that's what we talked in the book. One thing that can really help is adding digestive enzymes after your meal and a little HCL hydrochloric acid with your first bites of food and do that in the first few days or a week just to help your body adjust to eating more meat. And that usually helps with any diarrhea issues or digestive issues. But back to the fiber thing, you know, that's a common myth that you need this thing. Your body cannot digest, fiber to bulk up your stills and shove it through the GI track. And to me that just seems weird. You know, first of all, there's studies that have shown, there was a study in Japan that showed that the lower the fiber when you lowered fiber, it actually made constipation better. And there are another study that showed that symptoms of diverticulitis, they had less issues with the less fiber they ate. Zero fiber was the best scenario with almost all their symptoms going away. So having this fiber can actually bulk up the stools and elongate the intestines and irritate them so it's actually can be a negative in that way. And another example is when people say you get, you got to have fiber to go number two, well I always ask them, you know, does a baby that's being breastfed typically have any issue going Number two, I mean know they have no issues with zero fiber in there from the breast milk.

Allan: 23:58 So, you know, I think back to a cat, you know, cat as a pure carnivore and sadly enough, some people try to turn their cats into vegans and that doesn't work out very well. But so you end up with this carnivore and I, I've watched it. A cat will go out in the yard and we'll start eating some grass and it typically just eats that grass at moments where it is already having digestive issues. So is there a case for some fiber in our diet or not really?

Craig: 24:28 Well I don't know if that's, you know, like our dog would do that and would he would gag and throw up. It's like he's trying to purge himself when he would eat the grass. So I'm not sure if there's a connection.

Allan: 24:41 I just figured there was a nutrition, I mean not a nutrition problem, but maybe I digest an issue that the animal is dealing with. It's, it's trying to put something in a system that isn't really in its, in its opinion food.

Craig: 24:53 Yeah. Our, our dog always threw up after he ate the grass. So I dunno if that's why he was doing it.

Allan: 24:58 Now if someone's coming directly from the standard American diet and going into carnivore this is a fairly drastic move. Someone going from keto to carnival or it's actually seems to be a pretty natural transition. I think the core for both is just there isn't additional requirement for electrolytes.

Craig: 25:21 Well, at least a focus on it. You know, I think it's much less of an issue if you're coming from keto, depending on your level of keto to carnivore. Um you're already focusing on electrolytes and making sure you're getting them. So it's probably not as big of an issue there, but it's still important. As important as it is with Kito. You know, carbohydrates are water retaining. So when you eat, the more carbohydrates you eat, the more water you retain. And then when you eliminate the carbohydrates your body flushes out this retained water, which is a good thing. You don't want to be retaining water and bloated. And but what that water go electrolytes that are associated with it. So you need to replenish your electrolytes. And especially when you're eating a whole foods keto or carnivore type of diet because you're not getting sodium in the food where, you know, standard American diet, there's sodium in everything. You know, a milkshake at McDonald's has more sodium than their French fries. So you're getting all this sodium that you don't even realize. And when you go to whole foods, there's no sodium. So you gotta make sure to add that salt back in.

Allan: 26:36 Yeah, I run, I run low on potassium and sodium already. So it is something as I'm, if I'm going to experiment with something that it is something that I, I would definitely make sure that I was getting my electrolytes.

Craig: 26:47 The body, it likes sodium and potassium to be kind of in balance and while eating carnivore, you know, beef and proteins are pretty high in potassium. But what the body has this pathway of, you know, if you're not getting enough sodium it will leach potassium until they're kind of unbalanced again. And so having sodium low can actually result in having potassium loss. So you gotta keep your sodium intake up to keep them balanced.

Allan: 27:16 Yeah. Craig, I define wellness as being the healthiest, fittest and happiest you can be. What are three strategies or tactics to get and stay well?

Craig: 27:28 Well number one I think is just to stay as active as you can. And I think a component of that is getting outside, you know, today we spend so much time in unnatural environments with, you know, artificial lighting indoors, never contacting with nature or the sun or out, outdoors. And I think that's detrimental to health and just mental health as well. But disconnecting and getting out in nature and getting outside I think is a huge component. And just I liked, we were in low carb universe in Spain and one of the speakers was a dentist from the United Kingdom and he said, you should eat like you're never able to brush your teeth again. And I thought that was a pretty interesting take on it and that, you know, anything that is going to mess up your teeth, it's probably messing up your digestive tract as well. And you know, if you, if you just focus on eating the healthiest for your teeth and your body, you're going to end up in a better situation.

Allan: 28:39 Okay. wonderful. Now Craig, if someone wanted to learn more about you, Maria and the book and all the wonderful things that you're doing, where would you like for me to send them?

Craig: 28:50 Well, we have a couple places they can go. They can go to our blog, which is all free recipes and free information that's at Mariamindbodyhealth.com. And then we have a support website for our subscribers with lots of eBooks and things that are available to purchase. And that's keto-adapted.com. And then you can usually find us on social media under Maria Emmerich or Craig Emmerich. And then on Facebook we also have a couple of groups, one called keto, one called keto carnivore and another called 30 day ketogenic cleanse for our cleanse book.

Allan: 29:26 Cool. Well this is episode 415, so you can go to 40plusfitnesspodcast.com/415 and you'll find all the show notes and those links there. Craig, thank you so much for being part of 40 plus fitness podcasts again.

Allan: 29:41 Thank you Allan.

Speaker 4: 29:47 [Inaudible].

Allan: 29:47 Did you know that we have a 40+ Fitness podcast group on Facebook? Yep. We sure do. You can get a 40plusfitnesspodcast.com/group . That's a great place to interact with me and other listeners of the show. I'm on there all the time trying to put out great content, trying to make it fun. It's a really cool place. We have weekly challenges. Go to 40plusfitnesspodcast.com/group and request to join the 40+ Fitness podcast group

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December 30, 2019

Take control of your health data with David Korsunsky

Allan: 02:08 David, welcome to 40+ Fitness.

David: 02:11 Thanks for having me.

Allan: 02:12 You know,I've known about your service Heads Up Health for wow. Probably at least four years, four or five years when I started hearing you on different podcasts particularly in the, in the community. Yes, there was a lot of interest there because your approach was centered on them. And I liked it when I first got on. I was like, okay, this is really cool because I can store all my data here instead of spreadsheets. Cause I, you know, all my health markers were on spreadsheets and same as just, you know, yeah. That just, that gets, that gets cumbersome and then it just gets to a point where it's not even useful anymore. Can you tell us a little bit about why you created heads up health and what it, what it would do for us?

David: 02:57 Sure. Well, I was always someone who was generally healthy, but I grew up in central Canada and I grew up on a, a pretty typical, I guess you'd call it the standard American diet or the standard Canadian diet in my case. But I was in the corn belt of Canada and was raised and didn't really have a tremendous amount of knowledge about what I was putting in my body. And I noticed that as I got older and I was in the United States and working in big tech, I became really interested in the idea of how I can optimize my own personal performance. I noticed that even though I exercise a lot more than everybody, I knew I was still heavier than everybody I knew and that that was, that didn't sit well with me. I knew that there was something more there. So I always had been really interested in the idea of self hacking, of using data.

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David: 03:54 And so to go back to your point, one of the most insightful moments was when I built that hideous spreadsheet and I called all four of my doctors. I had one in Boston, I had a couple in Canada, I had some in California. I put all my blood tests in a spreadsheet and that was a lot of work. You gotta be a pretty serious health nerd to go through an exercise like that. And Allan it sounds like you did the same. So we're kindred spirits there. But the first thing that happened was I could see the patterns and I'm like, wow, my doctor can't even see these patterns. You know, he's got one of these PDFs there's another six that have my medical history. And there were trends happening in the data that would be impossible to see otherwise, trends that actually needed attention.

David: 04:40 And I discovered those trends as a patient. And that was the moment where I realized how powerful the data can be when it was centralized. And that was right around the time that we were starting to get access to tools as individuals that were very, very sophisticated. And these were consumer grade devices that could do things like measuring heart rate variability, which 10 years ago you needed to go to a hospital to get and get hooked up to a massive machine. And now all you need is a Bluetooth heart rate monitor and a good HRV app. So I started seeing all of this information that we as individuals could monitor on ourselves, which was awesome. And then I saw how I could overlay it with my medical records. That's ultimately what helps us determine if we're really doing things properly or not. And I just became obsessed with building this system and making it available to everybody. And it's just kind of taken over my life since then.

Allan: 05:39 Yes, I can imagine.

David: 05:41 I guess that's the typical getting bit by the bug. It just becomes all consuming and you want to build this and create this and bring it to life. You know, you talked about people who've written books, and for me it's, I've written a piece of software.

Allan: 05:58 Yeah, and I think there's a, there's a ton of value there that is, it would be, it would be otherwise missed. I mean, you know, everybody likes simple, simple rules, you know, complete the circles on my Apple watch and I've done a good thing today. So you're getting a little bit of gamification, a little bit of information there. But that's just one little PISA data in just this huge sea of data that's coming at us. And there's more and more every year, you know, the watch that can look at your sleep patterns and the, you know the watch that can look at and do an EKG on you and obviously your lab results and, and you know, you go into your doctor and your prescriptions and you know, see you change your prescriptions and you see a change in your, in your trends. You know, what those prescriptions are doing to not just the symptoms that you're feeling, but your actual health markers. So I really liked that it's tying all of that stuff together in a way that is interpretable. I think that's the key. And that's where you've probably been spent spending a lot of your time, not just with, cause there's a ton of integrations, but then also just making sure that the data is interpretable.

David: 07:05 Yeah, we spent a lot of time on our user interface so that we could in essence, demystify a lot of these numbers. You know, how do you make it really simple for anybody to set up a dashboard and just look at some basic health stats even if you're not technically savvy. And you know, one of the interesting things Allan, is that our most active users on the system are actually the least technically savvy people out there. But they have a health issue. And we've made the dashboard intuitive enough that people can make some basic connections. They can test their blood sugar in the morning after they had a pizza the night before. And see how that's different from when they test their blood sugar in the morning after they stopped eating at 5:00 PM and just had a steak with veggies.

David: 07:49 And then these aha moments start happening for people. And these are aha moments that they may not actually get guidance on from the regular doctor. And that becomes exciting and that becomes fun. And then you get more into it and it starts to become very fun and rewarding. And you're basically just nerding out on your own health. And that's a win because I think the reason so many people are in a predicament right now with their health is because they haven't had the information and the insights and the tools, and they haven't had the knowledge about some of the risks of the foods we're putting in our bodies. And so we were kind of blindsided up to this point and now it's like, Oh wow, I have, I've got this microscope into all my health data and I can start figuring some stuff out myself. So making it simple and fun and easy and intuitive with big numbers, big buttons, easy charts, we just wanted to democratize it as much as possible. And as you know, we started this four or five years ago and I still read every single email that comes in our support queues. Most of our product direction is directly from our users. And we have our own private Facebook group where our loyal users are in there and they're testing the software and they're giving us the good, the bad, and the ugly, and, and we build in accordance with our users.

Allan: 09:09 Yeah, it's Drucker that said what what gets measured gets managed. And you're, you're providing a pretty valuable tool for folks that really want to get in there and manage their, their health. I was interviewing Dr. Will Cole last week. Yeah. We had him on and he, in his book he talks about the kind of the bio-individuality of us and how each of us is going to operate differently. Know even when we're doing things exactly the same. You know, I sleep eight hours, you sleep eight hours, you know, I have a glass of orange juice for breakfast. You have a glass of orange juice for breakfast. My blood sugar shoots up over a hundred. And your stay stable as a rock. You know, this is going to give us some of that data if we're checking our blood sugar and putting it in there for taking the time to, and some of this is automated. So if I go to a certain lab to get my blood tests, I can actually have that auto connected. So it's going to integrate right on in. So there's not the data entry to build those massive spreadsheets. And then there's the ability to interpret it on the backend. As far as the business, one of the reasons that I, I think this is kind of top of mind for me today is my wife and I moved down to Panama and we were going to go to a doctor here instead of going back to the United States to see her normal doctors, she's going to try to get a doctorate here. Um and she's like, well, I just saw my doctor, you know, three and four months ago and I have the labs for men. I'll just, I'll just call my, email my doctor and say, Hey, send those to this doctor. And they're like, no, we need a signed form and we need to either do that, do it in our office or fax it to us.

David: 10:44 And yeah, I mean, let me plug in the old fax machine there.

Allan: 10:48 Go find grandpa or somebody on this Island that has a fax machine for us to fax that document. And then fortunately there are some, but it was just such a pain in the butt. So just get the data and I told my wife, I'm like, let's just pay for another blood test because you know, I don't want to fly somewhere just to get to a fax machine, just to sign a piece of paper to ask your doctor to do something that you know you're asking them to do. They know what you and you know. So when you're, when you're doing these interactions, obviously, you know, we're, we're connecting a lot of things and we're pulling a lot of data in and that's a convenience. So you know, in a ways your service is a convenience. How is that data protected then? Cause I think that's what the concerns are. The doctor's like, well, I've got HIPAA and I've got these other regulations. That's why the fax machine, we need that security. How do you manage some of those security issues?

David: 11:44 Well, we don't use fax machines, unfortunately. Allan. Our system is, is considered a personal health record. And so the FDA treats that as being data that is owned and operated by the individual and the individual themselves. So if I am inviting my doctor to access my profile, that's a patient initiated action and that's different than the doctor initiating the request to the patient for data. So those are treated a little differently under HIPAA. That being said, one of the benefits of being a startup nowadays is we can build everything from the ground up on state of the art, HIPAA compliant technology. So all of the services inside Amazon AWS are HIPAA compliant and they use absolute state of the art technology. We have a very, very small footprint inside of Amazon. So we use all their HIPAA compliance services. We have to play by the same rules as everybody else does.

David: 12:54 One of the things we're working on starting in Q one is going to the next level of certification beyond HIPAA, which is called high trust. And that's an even more robust layer of security and compliance than HIPAA is. So we, we do everything we can on the security and the compliance side. We don't ever use the data for external use marketing purposes or anything like that. And that's all really, really clear inside of our terms of service. It's yours, you share it with whoever you want. And that's how we run the business. We're not in the business of making money on people's data. We make money on your monthly subscription.

Allan: 13:38 Cool. So you know, we've talked a little bit about tracking health data. Can you talk about some of the sources of health data that would reside in a tool in your tool? Uh,I know, you know, like we're talking, you know, certain integrations with things, certain things with upharmacies, but you know exactly what data would I be collecting and putting into your tool?

David: 14:00 So that's a really, really great question. And we look at the world and we categorize the data into three buckets. And the first bucket of data would be things that Allan is tracking at home. And so that's also called patient generated data. And that could be the heart rate data from your Apple watch. It could be the measurements when you step on the scale in the morning. It could be your blood pressure, maybe you're measuring that periodically. It could be your blood sugar, it could be more sophisticated health tech, like some of the new wearables like woop and bio strap and or ring.

David: 14:38 All of those do really, really sophisticated analysis on how well we sleep. How much cardiovascular load we're putting on our bodies during the day. So there's heart rate variability, which is becoming very popular because it helps us measure our stress. So everything you measure at home that helps you essentially gain biofeedback about yourself, the devices, the apps, the watches, everything like that. And so that's kind of what we call lifestyle data. That tells Allan, okay, how much am I sleeping? What's my calorie intake? You know, what's my blood sugar been over the last week? So that's the lifestyle data or what we call a patient generated. The second part is what you talked about earlier. Your wife's data, the clinical data. When you go to the regular old doctor and they run the blood work cholesterol, HDL, hemoglobin A1C white blood cell count inflammation markers.

David: 15:34 That is, that is the second bucket of data. And that's also really, really important because as you change your lifestyle habits, what you can measure in bucket number one, you're going to see the numbers in bucket number two, change. You know, prime example of that is hemoglobin A1C. And if you go on a really low carb ketogenic diet, you, you could easily just through dietary change alone have a significant impact. Maybe you bring it down from 6.5 to five or below just through a dietary change. So that's where one, you're looking at your, my fitness pal logs and your blood sugar from bucket one and your hemoglobin A1C from pro bucket two. So that's how that feedback loop goes. And then there's a third category of data that we focus on inside Heads Up that is a little nuanced and that's what I would call functional health data.

David: 16:26 And Dr. Cole probably may have mentioned this, but that would include things like heavy metal testing for some people is an issue. Mold exposure testing. It would include things like your microbiome and a lot of people who have digestive issues and they're testing the microbiome. It may include your genetic data. So that's like the third category, functional health organic acid testing. There's, there's a ton of information in urine and stool, which can be really helpful for people who have tougher cases with their health. So we're working with a lot of individuals and health coaches who do functional testing as well. It's not something you can get from your regular GP that's going to bill insurance, although insurance might cover some of the testing. So it's lifestyle, clinical, functional. Those are the three categories that we, that we integrate.

Allan: 17:23 Cool. And this is the tool that you've built out, not just for the end user to have access to share and use and see their data and analyze it. Practitioners can also use this with their patients, right?

David: 17:37 Yeah. Health coaches. We're, we're really focused Allan on the the cash pay wellness market. So these are doctors that you pay cash, functional health doctor, nutritionist an integrative specialist personal trainers. So we have a coaching portal where, and these are the people who want to see your Fitbit data and they want to look at your functional health data. They're going to spend an hour with you during your console and they're going to go over all of this stuff. And in a traditional medicine world, that system's not really built in a way where that data is, I would say, as valued or as part of the care plan.

David: 18:16 So we have a portal where health coaches can log in and they can log in and very quickly look at who of their clients need some extra help in terms of blood sugar. And they can look at dietary intake and personalize a protocol and they'll have access to Allan's labs going back 15 years. So your wife could show up to a functional doctor and, and provide access to the Heads Up profile and all the data. Is there all the labs, not just the most recent ones. Yeah. So we, we have a portal for health coaches as well and we want to be able to use the information as part of the treatment plan and there's awesome data out there. My doctor to look at it. I want to ask him like, why was my HRV higher this day versus that day and why, how, how do I personalize this?

David: 19:05 You've got my genetic data, you've got my lifestyle data, you've got my medical tests. Like they can dial it in for you.

Allan: 19:13 Yeah, that's, that's awesome. Now I define wellness as being the healthiest fittest and happiest you can be. What are three strategies or tactics to get and stay well?

David: 19:26 Oh, that's a great question. Three strategies and stack and tactics to get and stay well, I would have to say that understanding how to regulate your metabolism would be number one in terms of getting and staying well. And I say that because so many of the illnesses we have are metabolic in nature, sugar and foods that destroy our blood sugar and then cause a host of downstream effects. So getting a staying well means healthy blood sugar regulation. That will be my number one number two would be a high quality sleep and that's high quality sleep that you're measuring with something that can tell you the, there's a subjective component to sleep where you may think you're getting a great night's sleep, but you might have severe sleep apnea and you don't even know it and your sleep is actually incredibly disrupted.

David: 20:26 So getting really high quality rest would be the other one. And then the third one I would have to say would be probably related to community and spirituality. And I think that's essential. Having people around that love you and being able to give and receive love to people. It doesn't have to be a partner, it doesn't have to be a family member. There's lots of ways to give and receive love. It could just be through volunteering. But having community and ways to express and offer and receive love. I would say that's more of a spiritual than it is anything quantifiable and I think that's really important. So that will be my number three.

Allan: 21:09 Okay. Thank you David. Thank you for sharing that. If someone wanted to learn more about you, learn more about Heads Up Health, where would you like for me to send them?

David: 21:18 Well, first of all, I offer everyone to just contact me directly. I'm an open book. My, my inbox is a little backed up, but I'll do my best. I'm David Heads Up Health and if you're interested in the software we provide, it's at Headsuphealth.com we have our own podcast, Data Driven Health Radio where we break down a lot of these numbers and demystify them and teach people how to use them. So much like yourself, Allan we're providing educational content and then you'll find us on all the regular social media channels. We share all the good information we find out there on the interwebs as well. So there's lots of ways to track us down. And if you want to give the softwarea try, it's 30 days. You can try it free. There's no credit card required, just no pressure. If you like it, hopefully it can make a difference in your health. The data was hugely transformational in my own health and so that's my life's work at this point.

Allan: 22:11 Good. So you can go to 40plusfitnesspodcast.com/414 and I'll be sure to have links there in the show notes. So David, thank you so much for being a part of 40 plus fitness.

David: 22:23 Thanks for a great discussion.

David: 22:31 Did you know that we have a 40+ Fitness Podcast Group on Facebook?

Yep, we sure do. You can go to 40plusfitnesspodcast.com/group. That's a great place to interact with me and other listeners of the show. I'm on there all the time. Trying to put out great content, trying to make it fun. It's a really cool place. We have weekly challenges. Go to 40plusfitnesspodcast.com/group and request to join the 40+ Fitness Podcast Group

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December 23, 2019

The inflammation spectrum with Dr. Will Cole

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Allan: 03:15 Dr. Cole, welcome back to 40+ Fitness.

Dr. Cole: 03:18 Well thanks for having me. I'm excited to talk again.

Allan: 03:21 Yeah. On, on, I think it was episode 340 and I'll make sure it had a link in the show notes I had you on for Ketotarian, an excellent book for folks that want to be plant-based but also are interested in the keto lifestyle. I thought that was a great book. It changed the way I eat. I can honestly say that because I, I've incorporated a lot more vegetables into my diet as a result of that book, whereas before I was probably more carnivore than I really want to admit. But that book changed me. And now with this book, I'm thinking, you know, every time I have a pain or ache, I'm like, okay, is that inflammation? Do I need to change what I'm eating? So the book we're going to talk about today is called the Inflammation Spectrum. And it's a really, really good book for anyone who suffers from inflammation. How they can change their diet and lifestyle to live just a better, healthier life.

Dr. Cole: 04:13 Thank you. Yeah. And the concept of the inflammation spectrum, I'm writing about it for a long time, about 10 years at this point, but the, I actually talked about it in book form, in passing in Ketotarian cause beta hydroxybutyrate the ketone is a signaling molecule. It's a epigenetic modulator, so it helps to down regulate these proinflammatory cytokines like NF Kappa B and the NLRP three inflammasome. So I talked about how inflammation exists on a spectrum and Ketotarian and how beta hydroxybutyrate to ketone helps to lower that inflammation. So I wanted my second book to be a deep dive into this concept of the inflammations spectrum. And then ways to lower inflammation beyond ketosis are being mostly plant-based keto or Ketotarian, but just other food ways and other nonfood ways to calm inflammation. Because like you said, the aches and pains, like that's definitely one part, part of inflammation.

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Dr. Cole: 05:12 But inflammation is so much more and it's impacting so much more, more in more ways than people realize. So when you dealing with autoimmune issues, that's inflammatory, diabetes and heart disease and cancer, those are all inflammatory. And then mental health issues like anxiety and depression and brain fog and fatigue. There's a whole field of scientific literature kind of circling around what's known as the cytokine model of cognitive function. It's basically how inflammation cytokines are pro-inflammatory cells, how inflammation is impacting how our brain works. So it's so far reaching a chronic inflammation is, so I wanted to really give people tools to help to empower them because are largely overcomeable and reversible and he liberal and man at the very, very least manageable things.

Allan: 06:04 Yeah. I, you know, I'll have a conversation with a client and you know, then they might tell me, you know, I've, I've got a little bit of swelling and soreness and it's a little warm in my knee because they're having gout. And you know, from that perspective, they know, okay, there's an inflammation there. That's what that, that's what that is. But understanding what we can actually do with our food to kind of solve that, I think is really a critical tool because sometimes the doctors can't do anything but give you a medication. And you hope that it's going to work.

Dr. Cole: 06:37 Right? Right. Well, yeah. I mean, I think the training in that model of care and mainstream medicine is largely that it's to diagnose a disease and match it with the medications. So with inflammatory issues, it's, you know, if you're on, if you have an autoimmune condition, you're giving steroids or immunosuppressants to lower the autoimmune and inflammatory response. If you have a blood sugar problem, a diabetes, you're going to be given a medication or an injectable insulin and so on and so forth. I mean, these are all, well, what's, what's actually causing these in the first place? These are not, these health problems are not due to a medication deficiency. So hello, it's actually find, okay, let's deal with the inflammation because the body is interconnected and inflammation in one area can be get inflammation in other areas. But also the question that I'm having in the book is what's driving the inflammation too. So looking at food and looking at chronic infections and gut issues and all of these things that can drive the inflammation

Allan: 07:38 And, and one of the concepts she got into early in the book, and I'm glad you did this because I'll be talking to folks in like, you know, everybody should eat this way. Everybody should do this thing. This is the right way. And I'm thinking, well, no, it's not because things that I do today you know, I couldn't get, you know, I, I can't do today that I was doing back when I was younger. So there's this concept you bring up called bio individuality that can get a little bit into that concept. And then one basic question I have beyond that is we change over time or something happens where we're able to tolerate less, or is it just that we've always had the sensitivity, it just built up to a chronic state?

Dr. Cole: 08:19 Well, I'll probably a bit of both depending on who you're talking to. I think these largely are chronic health problems is this is the inflammation spectrum itself where you have mild symptoms like mild fatigue or background anxiety maybe might allow some mild digestive problems on one end of the inflammation spectrum all the way to the other end, which is the autoimmune disease or the, you know, whatever diagnosis call you're talking about. And then everything in between. So part of that is just the fact that when you're on with the lower end of the inflammation spectrum, things are going to be less volatile and less prone to flares when you're on the lower end of the inflammation spectrum. But the more you're progressed on that road, things are more volatile and you have less wiggle room. You ha you have less leeway as far as what you got away with quote unquote, before when you were lower on the inflammation spectrum scale.

Dr. Cole: 09:14 So that's part of it. And by the, some, by the time someone's diagnosed with an autoimmune condition or diabetes or any other chronic health problem, the things were brewing, like the inflammation spectrum was brewing for four to 10 years prior to that. From that diagnosis, meaning when someone's diagnosed with, with autoimmune condition or diabetes or any other chronic health problem, it didn't happen overnight. It took time. So definitely that's a component to it. And one that I talk about at length in the book and then the other is that there's a lot of variables to consider. I think that bio-individuality is definitely the heart of functional medicine and we have to find out what our body loves beyond food tribalism or you know, like a, a trend or F bad, like what's actually right for you. And that's that self exploration that I wanted the reader to go through.

Dr. Cole: 10:08 And it's a process that I coach patients through and consult them with to start asking these questions, start looking at these areas around their life that impact how they feel, the impacts, their energy levels or the digestion or their inflammatory symptoms. No matter how it's manifesting in their life. So it's definitely the book is while it's giving people pointers and giving statistics on things ultimately I'm teaching the reader how to find out what their body loves and hates. It's all, I mean, obviously it's under the umbrella of real foods, but underneath the umbrella of real foods, what macros worked for. Somebody like how much proteins, fats and carbs, his bio individual, some people do better on one way, a macro ratio, some people do better on other, same with micronutrients and same with food choices. So we're kind of asking these questions in the book for people to get that food piece that I think a lot of people are really yearning for because there is so much conflicting information and dr Google is like quite a confusing physician when you, you can really use, use Google to substantiate anything that you want to, whether it's your worst fears or an agenda that you have at a click of a button.

Dr. Cole: 11:22 So I really want people to sort of get beyond the noise and really just check in with themselves to see what works for them.

Allan: 11:28 Yeah, dr Google scares me, but dr Facebook really just terrifies me. You know, I read the posts on there and someone's like, well, you know go on a dry fast. I'm like, well, okay you know, some of those things just scare me to no end that. And so, you know, understanding what works for you I think is critically important and not just doing what someone else does because they said at work, you know, that's their experiment of one and good for them. I'm glad it worked. But you know, there, there's an approach here. And I like your approach cause you take an, this is actually kind of I'm not gonna that was eye opening, but it was something I knew, but I guess it's intrinsically new, but just really hadn't put them all together to think of it in these terms. But there are eight primary systems that you talk about in the book where inflammation occurs. And as it starts to spike up and one if it's not managed, then it spills over. And so can you kind of talk about the eight primary systems where inflammation occurs?

Dr. Cole: 12:32 Yeah. and again, when I went through the book, it's interesting and you know, cause you read the book, but basically the symbolic meaning of eight and you know, seven is this sort of number of order and systems and completion that we have seven days of the week, et cetera. And, and eight is going to move and beyond that limitations and getting freedom from health problems or freedom from food, disillusionment or whatever. But, and then I saw all these connections like, okay, I normally put people on these, these protocols for like eight weeks. And then I saw, okay, these eight foods that I see clinically and all of the stuff that was born out of my clinical experience, I started seeing these similarities. I'm like, okay, this is a awesome way to make it easy to understand. And I think it was a, a really a powerful thing for me to kind of see the, the synchronicity of a lot of the things I was putting together for the book over the, you know, two years I'd been working on it.

Dr. Cole: 13:28 The so the eight areas of the inflammation spectrum are things that I just see consulting patients and that's my day job is, is not writing books. It's, it's consulting patients online via webcam and kind of seeing the different areas of inflammation in people's body. So we start the book off with a quiz so people can kind of see where they're at on the inflammation spectrum. We actually have the quiz for free on dr wilko.com too, for people who want to just take the quiz. But it's in the book and we look at the brain, we look at the gut. We look at hormones, we look at the blood sugar regulations system. You look at the musculoskeletal system, we look at the detoxification system, we look at the immune autoimmune inflammation spectrum as well. And then the eighth is the interconnectedness of the seven.

Dr. Cole: 14:21 It's the PO concept of poly inflammation or you know, inflammation in one area can have a ripple effect, a down like a, a cascade of inflammation and other areas of the body. So things going on in the gut can impact the brain. Things that happen in the brain can impact the hormones to the brain. Adrenal was the brain, thyroid at the brain, ovarian or to stickler access and so on and so forth. The body is brilliantly interconnected. So for example, if somebody with one auto, I mean conditions that have 50 to 70% risk depending on who you're talking to and the health problem you're talking about. A is at risk for other autoimmune type problems or what's called poly auto immunity, where I got the term poly inflammation. So it's just kind of looking at the different, eh, the types of inflammation. So, depending on your quiz score and where you fall on the inflammation spectrum, which again, this, the quiz is just adapted from questions that I ask patients. And then they, at that point, they can kind of have their own plan that's based on the quiz score that is adapted from protocols that I put patients on. So it is that's, that's what the inflammation spectrum is and those are the, the seven sections and then the eight section being the interconnectedness.

Allan: 15:36 And, and I guess, you know, sometimes it, it's probably difficult to, to know how bad inflammation is affecting, you know, perfect example I'll give you is when I first went on to Quito and all of a sudden, you know, I'm cutting out grains and I actually, I cut out dairy when I first went into ketosis and I was like, wow. I, I didn't realize how foggy things were. So while I didn't recognize that there was you know, there was some, it probably some inflammation there. I, I benefited. And so I think if you're, if you're dealing with stomach issues, like irritable bowel and you start working on that problem, you're probably gonna notice benefits and some of these other systems as well.

Dr. Cole: 16:18 Yeah, for sure. Absolutely. That's something that I sadly, I see on an almost hourly basis. This sort of, it's not one thing, it's a confluence of factors that kind of give rise to some why somebody feels the way that they do.

Allan: 16:32 But we, we almost take it as normal. It's like, you know, that Bob is how we were, you know, I, you know, I can't, I can't eat certain foods because I in all ended up with the stomach problems, so I don't go out with friends anymore. You know? So it's, it, it really is kind of a snowball in that, you know, you're, what you're doing, what you're eating is affecting your life, but what, what you're now not doing is affecting your,

Dr. Cole: 16:56 Your happiness. Yeah. Yeah. And so many people, you're right, just settle for it. Cause they're like, well that's me. Or that's just part of growing older or that's just, they don't even think about it. It's not even, doesn't even give rise to even have thought. They just know that's their limitation or what they struggle with, whether that's energy or a food issue or a digestive problem or any other inflammatory health problem is something that I talk about throughout the book. Cause ubiquity doesn't necessarily equate with normalcy. Just because you're going through something every day doesn't necessarily mean you should settle for it. And yeah, that's the case for a lot of my patients.

Allan: 17:32 Oh wow. Yes. now what you're basically doing with your, you call it the core four and the eliminate they're effectively elimination style diets. But you've set them kind of at two different levels based on how, how we score. So someone who's doing reasonably well, well they can just do the core four. It's an easier program. Someone who's done, I like having some major issues, they may want to go further into eliminate. Can you kind of talk about those two? Compare and contrast them?

Dr. Cole: 18:05 Yeah, sure. So core four is the people that scored lower on the quiz score. And that's for a time. We are removing grains, added sugar, high Omega six oils like canola oil, vegetable oil and dairy. And then we have quite detailed descriptions in the book, especially upon reintroduction of those foods, like the types of grains and the types of bad sugar and the types of oils and the types of dairy, like the [inaudible] fermented, all this different variables we cut. I cut the guesswork out of it as much as possible because I'm not making a blanket statement against those foods. I really want the person to find out what works for the body and what doesn't. Like I had do not have a horse in the race when it comes to that. And that's the heart of bio-individuality. So when people enjoy certain foods, some people feel fine on certain foods.

Dr. Cole: 18:55 Okay, let that be that, let that be for that person. I'm okay with it. But as long as it's not impacting your quality of life, as long as you're living the life you want to live and you're not having a negative impact in your life as far as health is concerned, then go for it. So that's the core four and then the four more core, four plus four more are the eliminate. See my play on words like does not end in that book. Too much fun with that. But core four plus four more is the night shades, nuts and seeds, legumes or beans and eggs. Again, all whole foods, all real foods. I am not demonizing any one of those foods, but I'm talking about the different proteins like lectins and alkaloids and albumin and casein and all the different stuff that we, that research shows for some people could be problematic.

Dr. Cole: 19:45 So we talk about bio-individuality with that. And you may find like through that experience of food, you do fine with the six of those foods, but not with the two or you do fine with half but not the other half. That is the clarity and the food piece that I want people to find. But you don't know when things are all the, when you're disillusioned, biochemically speaking, when you're having inflammation and imbalances and reactivities and you don't know what, what's way is up and which way is down. So the process, and you're right, I mean the elimination diet and the way that we targeting this is still the gold standard in clinical nutrition and functional medicine. As long as it's properly formulated and reintroduction is properly formulated too. So we put it all in there. So you know, like really the gold standard when it comes to knowing what your body loves and what your body hates when it comes to foods.

Dr. Cole: 20:38 So that allows whoever, however you prefer to eat, whether you eat keto or paleo or men at a training or more plant based or more carnivorous, you will know what foods work best for you under that paradigm. So I was very clear on this. This is not a Quito book like my first, well this is not a plant based book. This is not any type of way. This is just looking at the research, looking at clinical experience. And so you can eat the best Kito diet that you can eat. You can eat the best plant based diet that you can eat when you learn what your body loves. So that's what the inflammation spectrum is all about.

Allan: 21:12 And, and that's again, when, as I went through the book, I was like, this is, this has to be the best book I've ever read on elimination diets. It walks them through step by step. It gives them exactly a Y a and it provides a lot of information about these [inaudible] that I, you know, I didn't even know. I didn't know there were two types of cases. I suspected that there were good proteins and bad proteins at some level you know, we like to say there's good protein, good fats and bad fats and there's good carbs and there's bad carbs. And, and I've always said, I said, I think for each individual there's probably some bad proteins that they should avoid. And the only way we're really gonna know that is by eliminating them and then systematically reinduce re reintroducing them.

Dr. Cole: 22:02 Yeah, exactly. Exactly. And that's the thing. I mean, people can just put the time in to kind of really give their, give themselves to that feedback. Because once you're on the other side of it, it is a no brainer because you feel better. Inflammation is calmed, you are residing more in vibrant wellness. And at that point it's like, okay, I like feeling better more than I missed that food. Like I don't really think about it because that food makes me feel really lousy. Why would I want to go back to eating that way? So that's the paradigm shift and the sort of like you are able to see things a lot more clearly both physiologically because you have left brain fog and more energy, but also you just have more biofeedback cause you kind of know, Hey, best food makes me feel bad. But most people don't even know. Like we talk about the ketogenic diet, maybe people have problems with dairy or certain fats or eggs and they're eating it thinking it's great cause it's just Quito. Well maybe not. Maybe you need to reformulate your ketogenic diet in a new way. So we talk about all those nuances in the book.

Allan: 23:08 Yeah. And like I said, it, it really, it really dives deep into it, but it, it sets it out very, very simply along with putting in recipes. So, you know, you don't have to guess. And I liked, I like also you can you want through and kind of talked about different supplements that can protect us or help us deal with each and every one of these eight systems as we're going through that. Along with some, some positive mind stuff with the mantra. So again, all those, just like I said, it's like resonated with this book really, really well. Beyond the food though and I'm glad you did this. You talk about eight lifestyle habits

Dr. Cole: 23:46 That can also help us through this journey and you, and again, as part of this process that you go through cool before and eliminate you walk us through adding these into our lifestyle as well. Could you, could you talk about those? Yeah, it was such a big important part for me to include these because it's not just about food and you could have the perfect macros on point. You could have eating, eat cleanest, like foods amazingly like a good stuff. But if you're like not dealing with the non food things, like if you're serving a body, a big slice of stress every day or if you're consumed with your smartphone and you're scrolling endlessly. I mean looking at the blue light and the FOMO inducing content like stress and shame and social isolation, those are all impacting inflammation levels as well. So we have to look at all these, what I call in the book non-food and flamers that also instruct our biochemistry because that is the connection there.

Dr. Cole: 24:45 I mean our external life impacts our physiology. And then in turn our physiology impacts our external life. Like we in structs on what we do or we're not doing our thoughts and emotions and all that stuff. So looking at that bi-directional relationship between us and the world around us or epigenetics really. So it's that's the non-food inflame or so we talk about stress in detail and all its different forms. Like we made eight nonfood and flamers to go along those eight weeks for the people that are on the eliminate track. And then for people that are on the core four track, they can just go and pick the ones they want to work with. But I would encourage honestly any reader to go through the eight a nonfood and flamers because the things that most people, most of us are going through to various degrees and there are things that are in many ways more insidious than the food.

Dr. Cole: 25:39 Like it's easy to say go off of sugar for X amount of weeks or go off of nightshades for this amount of weeks and bring introduced them, but it's a little bit harder when it's like negative self talk or it's screen addiction or like social media addiction or whatever the case may be. It's a little bit more permeated into our daily life beyond just meals. So I really wanted to raise the awareness of people realizing the fact that it's not just about the food. We have to look at all this other stuff too. We have to look at things like sleep as well. I don't know if I mentioned that or not, but all of these things, just one night of poor sleep will spike high sensitivity, C reactive protein, HS, CRP, which is an inflammatory marker that we look at to gauge inflammation from a lab standpoint. So definitely important because I see it a lot of times with patients is they have the food down pretty good, but it's the non-food stuff there is sabotaging them. Absolutely. So Dr. Cole, I define wellness as being the healthiest fittest and happiest you can be. What are three strategies or tactics to get

Allan: 26:44 And stay? Well,

Dr. Cole: 26:46 I would say decrease the amount of sugar you're consuming. Increase the amount of healthy fats you're focusing on. Specifically things like all lobes and olive oil and [inaudible] and oil. Although avocado oil and third, I would be bring an act of stillness into your life. So whether that's mindfulness of breathing or just getting out in nature or just turning off all technology and just being, I think those are the three things that I would say impact people the most.

Allan: 27:17 I completely agree. Those are perfect. I'm in the process of developing another episode. I'm going to talk about my favorite health and fitness books. And I'm glad I waited to record that episode because you're definitely hot. I love this book. I do think you should get out, go out and get the Inflammation Spectrum. If you're, if you're feeling anything and you know, there's some inflammation in your life. This is, this is the tool, this is, this is what I would recommend you get. So a doctor called people wanted to learn more about you, learn more about the book Inflammation Spectrum, where would you like for me to send them?

Dr. Cole: 27:51 Yeah, and thank you again for the kind words and for having me back on. I really appreciate it. Is that everything's a drwillcole.com. And on Instagram it's our Dr. Will Cole, but we offer a free webcam or health evaluation for people. If they want a functional medicine perspective on their case. And we just launched it online in group class, which I'm really pumped about too. So yeah, we have all that going on. They can get that information and they can order the books at drwillcole.com too.

Allan: 28:21 You can go to 40plusfitnesspodcast.com/413 and I'll be sure to have the link there. So Dr. Cole, thank you so much for being a part of 40+ Fitness.

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Another episode you may enjoy

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Clean 7 with Alejandro Junger

Dr. Alejandro Junger is a New York times bestselling author of the book clean. He completed his training in New York, downtown hospital with a fellowship in cardiology and he mixes Eastern medicine into the way he treats his patients holistically.

Allan: 01:02 Dr. Junger welcome to 40+ Fitness.

Dr. Junger: 01:05 Thank you for having me.

Allan: 01:06 I really enjoyed your book, the Clean 7 and I thought it was kind of fascinating. You were, you were in the book, you were talking about one of your mentors was actually one of the individuals that was in that plane accident. It got trapped up in the mountains, you know, the way they did the movie alive on. Yeah. I just thought that was kind of fascinating. Dr Roberto. Yes. And so, and he was, he was one of them that came down out of the mountains and actually got him rescued, wasn't he?

Dr. Junger: 01:31 He was one of the two that ventured off into the unknown, completely a mash created with meat of his friends' bodies in rugby socks and walked up and down the mountains for 10 days and arrived in Chile and found a farmer who called the army.

Allan: 01:51 That's just fascinating. Like I said, that would just be someone interesting to be hanging out with and getting to know. And then also being your mentor, you know, just wanting to really inspirationally look up to each day. It's like, I can do anything. I can do anything. You know.

More...

Dr. Junger: 02:06 The life force on this man is compared to nothing I've ever met.

Allan: 02:10 Well, that was just a cool little side to the story, that story that you had in the book, but I liked your stories because it was the real realism of, okay, you're, you're a Western really trained medical doctor and you're getting into functional medicine and then you're seeing examples of [inaudible] medicine and you're with your program now clean seven. You blending those together to give people tools to get healthy.

Dr. Junger: 02:36 Yeah, well, functional medicine and an understanding of why your very good medicine didn't come into much later. You know, I got sick and I started looking for solutions that did not include seven prescription medications for my health issues at the time and, and I went blind just on a search and it was through my search that I stand. I started finding things. One of the pillars of what I found was the concepts and practices of detoxification. And then once I got into it at the beginning, not understanding the biology behind it or the science behind it, but really experiencing the benefits. Then in my obsession to really understand was when I came aware of functional medicine, which really explained detoxification in detail, right? A word that they don't use anymore because it's kind of being misused and it leads to confusion. So the word now is biotransformation, which is what is happening to the toxic molecules. They get bio transformed from toxic into nontoxic and from lipophyllic or or fat-soluble into water soluble so that they can be excreted and eliminated.

Allan: 03:55 Yeah. I think that we're a detox to scare a lot of people because you, you, you get these crazies selling these shakes or these, you know, there's these things you drink and messes with your system.

Dr. Junger: 04:07 Yeah. Even even in the medical world when, you know, when I first heard somebody that told me, you know, they did a detox program, I had only studied as what you send your patients to do when they're alcoholics or drug addicts.

Allan: 04:24 Yeah. So in your Clean 7 there, there are three pillars that you're kind of bringing together to help us improve our health. Can you talk about those three pillars?

Dr. Junger: 04:34 Well, the first pillar is functional medicine, and I use concepts from functional medicine. Basically, the concepts from functional medicine that I use are the elimination diets and the five R's, right? What? In functional medicine, it's called the five bars. So the elimination diet is basically a diet in which you eliminate any foods that are processed, that contain any chemicals or toxic molecules or any non-natural ingredients, right? And he's based on whole foods, primarily vegetables and fruits. But there's other things too. And in my experience, the elimination diet alone is really, really powerful. When in my practice, people come and I, whether I have an idea of what they have at the beginning or I have no idea, will what they have in my first course rotation, while we wait for an blood tests and other tests, I put people on the elimination diet in about 60% of the people when they come back for the test results have experienced immense benefits, if not complete resolution of their problems.

So that alone is really, really powerful. The five R's are the first art is for remove, which means removing everything that hinders physiology. Right? Not only toxic molecules, but, but also bad bacteria or other organisms in the intestines, but company stress, stress, and by situations, right? So the second R stands for re introduce or replace, which is basically talking about reintroducing or replacing the bad things that we eat with nutritious foods, with foods that contain nutrients. Because what happens is the liver and other tissues that do the detoxification processes and reactions need substrates need elements need nutrients in order to attach to the toxic molecules to render them nontoxic. The third R is for re inoculation. As you remove the bad bacteria and other organisms in the gut, you want to reinoculate with good bacteria and organisms. The fourth R is for repair. And this specifically talks about the repair of the intestinal lining, which I called our Achilles heel because mostly all, if not all of chronic diseases of the modern world begin in the gut.

And one of the first things that happens in the gut, apart from the disruption of the, of the biome and leading to dysbiosis. The second thing that happens or concomitantly is the breaking of the intestinal lining. The intestinal lining should be made of cells that are stuck together in what is described as tight junctions, making it impermeable. Oh, for, for anything that is not actively and specifically chosen by the cells to be absorbed and thrown into the circulation. When that integrity, when that continuity of, of the barrier is disrupted, leads to what a lot of people now know as leaky gut or hyperpermeability. And the fifth R is for relaxation because apart from the toxic molecules that we are exposed through the air, we breathe the water, we drink and shower with the medications we use, the cosmetics, we use, the cleaning products that we use in our homes, but mostly through the foods that we eat.

The biggest factor together with those toxic molecules in our modern world is stress. So relaxation is really an important factor as well for restoring your body's ability to heal itself. Okay. And then beyond that functional medicine piece, you then get into the second. Yeah. The second pillar of, you know, the clean seven program are concepts and practices that come from Ayurvedic medicine. And even though I'm not an Ayurvedic medicine expert, I've learned from one of the legends of Ayurvedic medicine who really boil it down to me, made it really simple and taught me how to enhance the detox processes through certain Ayurvedic principles, right? One of them is the dosha system and the other one is the use of Ayurvedic herbs. And this is specifically as it relates to detoxification. So by using the dosha system, you further individualize the approach and you tailor the approach to the different doses, right?

And now Ayurvedic medicine, there's basically three doses or body constitutions. And this refers to the way that your body works energetically. And it's based on the distinction of the influence of the different elements which make everything fire, earth, wind, water and eat right. And each one of us has all the elements within us, but there's one or two that are predominant and the predominant element is the one that is most prone to go out of balance. So by determining your dosha or your predominant element, you will know what foods, what activities and what other things in your life are influenced most by the element that is your predominant element. And that will most likely throw your predominant element out of balance. For example, if you are of fire predominant constitution, anything that is of predominant fire country station will be adding fire to fire and throw your fire.

So for example, fiery foods will be the ones that you would need to limit yourself or eliminate at least during the times where when your dosha is out of balance. So by using this system of doses, this doctor dr Narendra Singh from, from India, who was worldwide known, taught me that the detoxification processes will be enhanced, right? The dosha system is applied to many other things of which I am only peripherally aware, right? But since I was really focusing on enhancing the detox processes in people and supporting the detox organs and systems, he said, if you use the dosha system, you will enhance the results, you will improve the results. The other thing that comes from Ayurvedic medicine is the use of Ayurvedic herbs, which not only provide people with a world of nutrients, antioxidants, and fiber, but also affect the body energetically through their product and prioritize the, the live energy within them.

That really helps to shift things around and mostly what I use in clean seven are what are called adaptogenic herbs, which really improve your balance physiological balance. For example, if you are adrenally exhausted, they will help recharge and that will help the adrenals work better, but if you are hyperactive in a way your adrenals are, are hyperactive, they will bring them down so they help your body adapt to whatever situation your body is in at the time. Right?

The third pillar of the Clean 7 program is intermittent fasting and this is something that now has become part of the mass consciousness. Everybody's trying some kind of intermittent fasting. But to boil it down to the basics for thousands and thousands, maybe hundreds of thousands, maybe millions of years, depending on who you talk to. Our way of life was much like the animals that are now living in the wild according to the way that nature designed them to live.

And living in the places where nature designed them to live and eating in the way that nature designed them. To me, and if you look at animals in the wild, what is life about? It's about looking for food feasting when food is found and then taking a rest and then starting to look for food again until they find one. And until they find one, they will have imposed episodes of fasting. So in that way, our genes evolved for thousands of years, let's say. And the time, if you draw a line in evolution, the time in which we had food 24 seven available to us is a dot. A microscopic. Dot in the timeline. So the concept that I'm trying to make people aware is that our genes have not had the evolutionary time to adapt to eating all the time. So the body and the and your genes treat food as and the whole thing around food as it was thousands of years ago, which means when food is found that your genes say, okay, this is what life depends on.

Let's slow everything else down so that we can utilize as much of what we are eating as possible and store as much as we can because we don't know where the next meal is coming from. This is how it used to be. Our genes right now cannot know that in two hours or in two minutes you're going to be eating again. So the moment you put something in your system, the moment your digestive system detects food, your whole functioning mode will shift into utilizing that time and the energy in your body will be directed mostly towards digestion, absorption, assimilation and storage, stealing energy from other systems. For example, everybody knows that after a huge meal you fall asleep or you've, you know, you become lethargic. And this is the prime example of what I'm talking about. Why? Because as long as there's food in your intestines, as long as your intestines are digesting, that is given priority and the energy is stolen from thinking, from moving, from detoxifying, right?

So as we live these days, we are mostly digesting all the time. We don't finish digesting one meal and we introduced another one. So there is not a time where we're not digesting. So the physiologic machinery is always turned into the feasting mode and he's never led be in the fasting mode. And it's like in a way, living with the sun is shining all the time without, without going into the dark and having the opportunity to sleep. And this is instead of having a ying and yang in your lives, only having yet it's non-sustainable. And this is one of the reasons that humanity is sick. This concept of breakfast, lunch and dinner and snacks in the middle is something that's new and it's mostly driven these days by economic interests. So we need to rethink the way we live up to the basic things that we take for granted, like breakfast, lunch, and dinner. And this is why intermittent fasting is part of the clean seven program because it really makes your genes happy and accelerates everything that we're trying to do by detoxifying or doing a detox program or a biotransformation program. And it also enhances not only the detox processes, but the healing and repairing processes as well. Yeah, I mean, because if you go into a fast, you're going to get some autophagy, which is where your body's going to actually start

Allan: 17:50 Getting rid of some bad cells and re-purposing them, and then also you're going to increase your human growth hormone. So it's, it's actually scientifically proven that the fasting process is a healing, restoring process.

Dr. Junger: 18:04 Yeah. Now, now you are going kind of deep into the subject, but the thing is, the thing is you're jumping the gun because when you talk about apoptosis or the process by which your body starts eating itself, starting with the disease cells, I don't think it happens within 24 hours of being in the fasting mode. I think it takes, and this is just my opinion and from what I've been observing, because there's no studies that categorically determine this, right? But I think it takes a few more days of being really in a fasting state in order for that to start happening. So this, I don't think this is part of why intermittent fasting is beneficial because people, when they intermittently fast, they fast forward 16 hours, 18 hours, 20 hours, 24 hours. But nobody goes further than that.

Allan: 18:56 Yeah, the only reason I think that it's some of that is naturally occurring is I'll watch bodybuilders that'll use intermittent fasting and they're not losing body mass. You know, they're still gaining body mass at a time when they're not intaking as much protein as they normally would. And I know there's going to be some amino acids circulating in your bloodstream, but for them to continue to put on muscle while doing intermittent fasting tells me that there's something going on where the body's reusing body cells at some level and the body is still able to be strong, get strong and gain muscle. So I know, I think some of that stuff is, is starting to happen. But maybe like you said, yeah, it's a third day or the fourth, you know, second or fourth day, somewhere in there where their body really starts to kick in with some of those.

Dr. Junger: 19:41 Listen, and you may be right or I really don't know because nobody has really determined this through serious studies, but let's stay tuned and find out what he does.

Allan: 19:53 Right? So, so our three pillars here are functional medicine that looks at the body holistically and does some elimination diets such that we can get the bad stuff out and give our body what it needs to restore and heal. We're basing it on [inaudible] principles of the doses so that we're eliminating the right foods for our own personal being and we're including some of the herbs that will support then our systems and processes in help get us into balance. And then the final bit is we're introducing intermittent fasting as a means of giving our body the time to have the processes and the restoration occurs. So

Dr. Junger: 20:31 That's right. And don't forget on the first one also the five RS.

Allan: 20:35 Yes. So now you take all of that and you put it into a program and the program includes some shakes. You've got recipes in the book. Could you kind of walk us through the process of what the

Dr. Junger: 20:48 Seven days are going to look like here? Yes. So, so what we're trying to do is to decrease the workload of the digestive system. And for that we replace many meals with liquid meals because they're easier to digest. They're kind of like fuel injection. They don't need too much work, they don't need too much prophecy. The nutrients just shoot directly into your bloodstream without the need of a lot of digestion. Right. And that is why we replace solid meals with liquid meals. Then the solid meals that are allowed during the program are to be chosen with a combination of the elimination diet, which is the same for everybody. And the dosha system, which is individual, right? So, so there's a list of foods that you cannot eat during the elimination diet. For example, dairy, sugar, alcohol, coffee and, and gluten. And if you are of fire constitution, we will also eliminate the fiery foods, right?

So like spicy foods and mango and there's very specific foods that will trigger your fire, right? And so you add both of the lists of foods to avoid and you follow that during your solid meals and also doing a liquid by the way. And then what we do is in my first book clean, which is a 21 day program, every day is the same. There's a shake for breakfast, lunch from a set list of foods and a shake for dinner. And there's supplements in between and it's the same and there is 12 hours between dinner one day and breakfast the following day, right? And every day is the same. And the 12 hour window between dinner and breakfast is because 12 hours is the minimum time in which you allow the body to at least go into a little bit of a more intense detox, right? Because eight hours is what is what it takes to digest a meal and then you give it four more hours for the body to really do the detox mode.

Now in this, in the Clean 7 program, the first day is shake lunch, shake. The second day is also shake lunch shake. But the second shake you do two hours before the first day so that they, instead of a 12 hour window between the second day is dinner shake and the third day's shake breakfast. Instead of 12 hours, there's 14 hours on the third day you do again shake for breakfast, a smaller lunch, and then the shake for dinner. You even do two hours earlier than the second day. So it's four hours earlier than the than the day. So that you, instead of having 14 hours between that dinner and the first and the, and the next shake in the morning on day four there is 60 now and then on day four do you do your breakfast shake. Then you do a small lunch and then you have nothing until the next day's lunch. So no dinner and no breakfast the next day. So you do a 24 hour fast now because you're sleeping part of the time it seem less is going to be less hard to do. Right. But there's still 24 hours and then and then you break your break your 24 hour fast with a shake. Then you have a dinner that night, a solid dinner, and then slowly you go back to what it looks like the first day.

Allan: 24:38 Okay. And so this one will kind of blend them into a day for 24 hour fast. You're incorporating these shakes which you have lots of recipes in the book for. You have recipes for their lunch meals and dinner meals, so it's all, it's all pretty much wrapped up there. I guess the one question is like you said, your clean program that you had before was 21 days. Most of the elimination diets that I see out there are anywhere from, like I said, 21 days to eight weeks. Is seven days really sufficient for someone to to get the results that thereafter with something like this?

Dr. Junger: 25:12 That's a great question because in my first book I talk about the need of 21 days to really cause a significant change in habits. Not only lifestyle habits but also physiologic habits. Right? And the 21 day program is life transforming. But the problem that I've seen since I wrote that book, and it's been 10 years, is that most people do not commit to a 21 day program. So, so even though I gave this incredible tool to the world to really transform their health, only a very small percentage of the people that would could benefit from it are actually doing. So I needed to find something that was shorter but wasn't just the first, the seven first day of that program, I needed something more intense so that in seven days you can really get a taste and in the hope that people after that won't want to jump back exactly what they were doing before. Right. So you're right, it is not enough. Seven days is not enough for a therapeutic plan. You using the elimination diet in order to reverse certain chronic diseases or improves it, but it's better than nothing. And together with everything else, it's a, it's pretty remark.

Allan: 26:39 Yeah, it does give them some pretty awesome tools to know how their body and the foods that are giving them trouble because as they try to reimplement some of those foods, they're going to pretty much pretty quickly understand if they can do gluten or not. If they can do dairy products or not, that'll come back pretty quickly to [inaudible].

Dr. Junger: 26:57 Yeah. There was a very famous guru in India who I personally met who used to say, you know, used to give people jewelry and other shiny objects, you know, and materialize those things out of thin air, right? So people would ask him, you know, you are, you're a guru of spirituality. Why do you, why do we give the shiny objects to be? Isn't that BS? And he will say, I give people what they want in the hope that one day they will want what I really have to give them. Right? And this is how I think about the seven day program. You know, people want something fast and easy and then they want to get results, right? So I give them that in the hope that then they would take it seriously. And they will take it to you know, to heart and really do the work that it takes to transform one's life, which you cannot, cannot do in seven days. And then just go back to what you were doing before.

Allan: 27:55 Well I agree. This is a, this is a very well prepared and set up program with the recipes. Everything in there for you and a lot of other stuff. There's a lot of tools in there. So I do hope folks will check this out and at least commit to the seven days. Cause I do think that it, I think it will do a lot for a lot of people. 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. Junger: 28:20 Well, I'm going to go away from your definition of of wellness, right? Because you know, because the truth is there's 7 billion people in the planet and not everybody can get to the fittest. They can be right. There's many different reasons why people are not able to be fit. Right. For example, myself, I had an accident four years ago that completely destroyed my knees and caused the problem in one of my hard vowels. And, and I, you know, I was, you know, I had a six pack before that and I used to be in tiptop shape and now I can't. So I had to learn how to live without being fit. Right. And then still be happy. So, yeah. And, and, and in a way, you said it before because you say the fittest, they can be right. Yes. No, that's not the fit. Not the fittest in the planet.

Right, exactly. Yeah. But when people hear the fit is you can be, they, you know, they, they, it's like it makes them anxious in a way, right? Because they imagine themselves being in perfect shape and a lot of people will never achieve that. So I defined wellness mostly as the state that one lives in. Right. And this is something that you feel [inaudible], you know, the maximum expression of wellness to be to for me is to be fully present. Right? And this is what, this is what I understand as enlightenment and this is really what I'm looking for and we, you know, even though I'm not a spiritual teacher, this is what I tried to make people aware of that regardless of your level of fitness, if you are in a present state of mind, okay, I mean you, you would experience peace and this is the best level of wellness that one can have because I've seen gurus that are completely at peace and they're not necessarily the healthiest, right?

Then sometimes they have a lot of health issues including severe ones, but their life is full and their wellness in my eyes is full because they're completely at peace. Now having said that, most people in the planet are not going to achieve the state of full, full presence continuously. Right? So then you do need to have your body functioning well because when it is not functioning well, it is hard to cook, to achieve a complete presence also. Right? So I think that we should strive for a combination of things and having your body functioning the best level possible. Right? And I believe strongly believe that we live in such a toxic world these days, that learning how to enhance your own already existing detoxification processes is something that is going to benefit the word greatly until we are able to make the word less toxic. Right?

Allan: 31:40 Well, I don't want it, that's going to happen anytime soon.

Dr. Junger: 31:43 I listen, I have three kids. I can't lose hope that things will continue that will at least start or continue to improve.

Allan: 31:52 Well, awareness is there. I think that's the core of that. We know that these chemicals are not good for us. And so where we can within our own control systems, we can start eliminating them. And if we're, if we're purchasing products and stop purchasing other products, that's a cool signal to the people that make this stuff. So not make the toxic stuff anymore. So

Dr. Junger: 32:13 Yeah. And it's like, let's remember, it's not only about toxic chemicals, right? It's about toxic relationship, toxic governments, toxic work spaces, toxic situations, right?

Allan: 32:23 Yeah. I go through Facebook now and I snooze anyone that posts anything political. So I don't see them for 30 days. And my Facebook feed is a lot nicer these days.

All right, well if someone wanted to learn more about you, learn more about the book Clean 7 where would you like for me to send them?

Dr. Junger: 32:42 So the, the book is on Amazon and every other online store. They can also go to our website, clean program.com/clean seven and learn. Because what happens is in the book I describe for people to do the program without the need to buy any products exempt except Ayurvedic herbs that, you know, you're not going to go and pick up from the fields if you want to use those. So people can, you know, follow the recipes and get everything they need. But you know, website, we do provide a kit in which we provide the shakes already prepared. You only have to blend them with water or almond milk or whatever and, and drink them up and they contain all the nutrients needed in there. You know, they're designed to really enhance the aspects of the program that needs to be enhanced and provide every nutrient that that is needed. And so people that don't have the time or the interest or the commitment to go to the supermarket in front of the recipes and then then they can just do it in a very user friendly way.

Allan: 33:56 Cool. You can go to 40plusfitnesspodcast.com/412 and I'll be sure to have those links there for you. Dr. Junger, thank you so much for being a part of 40+ Fitness.

Dr. Junger: 34:07 You're very welcome. It's been my pleasure and I'm, I'm going to come visit you in Panama.

Allan: 34:13 I've got a spare bedroom for you. So I'm looking forward to that.

Challenges

Thank you for being a part of 40+ Fitness Podcast. I'm really glad you're here and that you stuck it out with me. I hope you learned something wonderful from Dr. Junger.

We are going to be doing challenges at the podcast a little bit differently than we have in the past. I don't know if you know we do challenges, but we've done a lot of 28-day challenges with a lot of great results. I really enjoy them, but we're going to change things up a little bit and I'm going to start doing weekly challenges on our Facebook group so you can get a 40plusfitnesspodcast.com/group and there you'll find where we're going to be doing weekly challenges starting December 30th so check it out, 40plusfitnesspodcast.com/group these will be weekly challenges dealing with mindset, with food, with exercise, the whole bit. It's a great opportunity to over the course of 52 weeks in the year 2020 for us to do something exceptional for our health and fitness.

I am going to keep doing the 28-day challenges if there's an interest in it. So the way you'll let me know you're interested is you will become a patron of 40+ Fitness. Now you can do that for as little as a dollar. Go over to 40plusfitnesspodcast.com/january become a patron of the show. And then I'm gonna ask you what kind of challenges you would like for us to do. And then I'm gonna make sure you get the challenges that you enjoy the most that you'll get the most from. So go to 40plusfitnesspodcast.com/january Thank you.

Patreons

The following listeners have sponsored this show by pledging on our Patreon Page:

– Tim Alexander– Judy Murphy– Melissa Bell
– Randy Goode– Debbie Ralston– Leigh Tanner
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– Wendy Selman– Jeff Baiocco

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December 2, 2019

Yoga heals trauma with Beth Shaw

Beth Shaw is the President and Founder of Yoga Fit Training systems. The leader in mind, body education, yoga fit has trained more than 200,000 fitness instructors on six continents. Today we're going to talk about how yoga can be used to address trauma, both emotional and physical.

Allan: 01:12 Beth, welcome to 40+ Fitness.

Beth: 01:14 Thank you very much, Allan. It's a pleasure to be here.

Allan: 01:17 You know, I was excited to get an opportunity, I haven't had anyone on to talk about yoga in quite some time. And you know, most of the time when we're talking about it, we're getting into the strength aspects or the mobility aspects or the stress reduction aspects of it. But it was pretty cool to see that there's also some opportunity for us to use yoga in a therapeutic way around trauma.

Beth: 01:41 Yeah, it's a wonderful tool for anyone who needs to heal.

Allan: 01:45 And that's what I, that's what I really got out of your book. And I guess, you know, I grew up and I, you know, obviously I kind of went through your ACE tests and I'm like, yeah, yeah, yeah. So I, I'm going to say I scored better than 50% on your test, but I guess I tend to be maybe a little bit more resilient at some level. And, and that was where you kinda got into in the book is that trauma doesn't affect everybody the same way. And so we all are kind of dealing with our own battle with trauma at some level.

Beth: 02:17 Yeah. You know, we're all like snowflakes, whether it's physically, mentally, emotionally, psychologically. So we all handle things differently. But, you know, I think that it's common to the human condition for people to struggle.

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Allan: 02:33 It is, you know, it's kind of a core tentant of Buddhism is that, you know, that's what life is really kind of about. And it's more about embracing that than running away from it. And yoga kind of gives you a tool to do just that.

Beth: 02:48 Yes, it does. It really, it gives us the opportunity, um, you know, not only to heal but also to be the witness to our own process.

Allan: 02:57 Now in the book you shared something, it was called the ACE test that I spoke about a little earlier. Can you kind of go through this ACE test and what it, what it does and some of the questions that you ask and that would be asked in that test. So, you know, we can kind of figure out where do we lie on this and what are some of the things we may want to address as we go forward with, using yoga as a therapy?

Beth: 03:21 Well the adverse childhood experience test is a simple test, with under 10 questions. Basically asking if anyone was abusive to you, uh, in your household while growing up. If there was violence in your household, if you had a parent who died, you know, if he was a witness to any type of trauma, if you had any head injuries. So it kind of, it's the opportunity for us to index ourselves physically and emotionally and just answer yes or no questions. And, and typically if you have more than five yeses on that test, uh, you are susceptible to a lot of trauma related issues, including addiction, suicidal thoughts, depression, anxiety and so on.

Allan: 04:15 Okay, and I guess that's why we really kind of piqued my interest because I took the test and I'm like, okay, this is not a test you want to score high on. But I did and so as I got into.

Beth: 04:26 Allan, I just wished that that one, I wish that I had had that test when I was 18 years old. And two, I wish that they would give this test to everyone who's, let's say a junior in high school. Um, because, you know, had I've understood myself better as a young adult, my life, of course probably would've been a lot easier.

Allan: 04:50 And I agree with you, I think, you know, some of the choices and decisions I made, you know what I mean? We kind of sit there and tell ourselves, uh, when we're at that age, it's like, Oh, I would never do that. I would never act like that. Uh, you know, that's not who I'm going to be. Uh, and then you find yourself 10 years later doing some of those exact things you said you would never do. And so I think that's how, you know, and in a sense, you know, I, I had always told myself when I was younger, it's like, well, I'm always going to be fit. I'm always going to be in shape. Um, I'm always going to take care of myself. Uh, but my kind of my drive to perfection with my job, cause I think maybe that's where I buried a lot of this stuff was just okay, I need to be successful.

Allan: 05:32 That's how I'm going to be a measure of, you know, difference is to be successful. And I applied a lot of that energy to my job and I didn't apply it towards some of the more healthier pursuits like eating right and doing yoga. And so eventually kinda things fell apart for me. Uh, and it wasn't until after I kind of rebounded and said, okay, I've got to fix this, but I started doing some of these things. And I think I was able to turn it around. But from your book, I'm kinda getting an idea that I, you know, I may need to do a little bit deeper exploration. Guys don't tend to want to do that that often, but I think it might be worth it for me to do a little bit deeper dive. And one of the areas that I was…

Beth: 06:18 They said that they say that the unexamined life is not worth living. And yeah, I think it's good for anyone at any age to continue diving because sometimes even workaholism can be just another way of escaping one's pain. It's perhaps healthier than you know, being an alcoholic. But nevertheless, and this is just speaking from someone you know, I'm a workaholic. I excessively exercise their coping mechanisms.

Allan: 06:52 Yes. So when we're trying to do this, obviously trauma, trauma is not just a, it's not just an emotion. It actually physically changes our body and our brain. Can you talk a little bit about that?

Beth: 07:05 Yeah, trauma really does affect both our body and our brain in terms of what it does to the brain. It overstimulates different parts of the brain in particular the amygdala. And this is an almond shaped mass located deep in the brain and is responsible for survival related threat identification as well as tagging memories with emotion. So after a trauma, uh, this part of the brain can become highly alert and activated, which makes us perceive threats everywhere and also can make us hypervigilant. Also it affects our hippocampus and increases, uh, cortisol levels. And this, you know, can cause a whole variety of problems. Inflammation in the body, keeping the body and mind stimulated in a reaction mode constantly. And, also our prefrontal cortex shrinks and this is our decision making part of the brain. So we're not always making the best decisions for ourselves. Uh, so there are lots of changes in the brain and you know, your brain is really responsible for a lot of things. So it becomes problematic because of the very motor that's running us is not functioning properly.

Allan: 08:23 Yeah. Now, so obviously, uh, you know, as, as folks can go through the ACE test, is that something they could find online or is it available.

Beth: 08:31 Yes, they can find it online. They just need to Google adverse childhood experiences test and it will pop up.

Allan: 08:37 Okay. So if someone goes through that test or they suspect, okay. There, there was some or know that there was some trauma in their, in their past, uh, because of various events that were still kinda there. How has yoga going to help them with this journey?

Beth: 08:52 You know, well, first of all, yoga in its very is calming and relaxing. It lowers blood pressure, it lowers the heart rate, it gives us a pause. So it's just going to kind of take you back to a more neutral place. Um, it also gives you the opportunity to witness the body and the mind so you can kind of see what's going on in your body. If you're, you know, with repetitive practice, you'll be able to observe mental patterns that perhaps are not serving you. Perhaps you can then if you're a more contemplated person, witness patterns in your life that aren't serving you, you know, whether it's with relationships, friendships, job, and then also it, uh, helps our bodies produce GABA. And GABA is a calming agent produced by the brain. And when we're really stressed out our GABA levels are really low. So yoga is actually one of the only, it's not the only way other than if we take a GABA, you know, supplement or, or pharmaceutical, which strips you of your emotions. By the way, this is a great way to get GABA active in the body.

Allan: 10:04 Now when, when you start talking about trauma, this is just one of the things that kind of hit me because you have some case studies in the book that are really, really good and men, men and women, uh, and some with PSTD and other things. And I was just thinking, um, because one reason to hit home was I was in that unit, that guy, I can't remember his name, the plane crash. I was in 82nd airborne. I mean not not 82nd a hundred force airborne. Just right after that I joined the military and I was stationed at Fort Campbell. So we were hearing about the plane crash, you know, cause it was a peace time thing. And so you know, you would have these accidents and it was a question what's going on? Because we had some helicopter accidents, we weren't actively involved, but it was some people in our unit.

Allan: 10:51 So you kept, we kept having these, these series of accidents and you're like, okay, we're in peace time and we're, you know, we're at risk. And so every time you're getting on the helicopter, everything doing something, you just, like you said, hyper villaging you're, you're, you're watching out for your buddy, you're watching out for yourself. You're like, okay, we don't want to be the ones that had the accident. So it was, that's when I say it was kind of drew me in because I was like, okay, I can, I can feel with this guy's feeling at some level. It's hard sometimes to kind of lean into those feelings though. So you know, you're thinking about going into yoga. It just seems to be that there has to be a trust factor between you and the Yogi that you're learning from to take that step.

Beth: 11:31 Well, yes and no. If you know, we take that test and we decide, okay, I recognize that I do, you know, I have, I have this issue. Um, and I just want to explore a yoga practice. Cause I also recognize that, you know, I've got high blood pressure, I'm hyper vigilant. Uh, I'm highly reactive, you know, or, or whatever the case may be. Um, you know, you can go to yoga, you can partake in the practice. You don't have to discuss any of your, uh, trauma with the instructor. Um, if, you know, if you were the victim of a violent attack, uh, you're gonna want to make sure that, you know, you're not getting any surprise hands on the chest by your instructor. Uh, we really focus on this a lot at yoga fit. In fact, there was a reason article in the New York times about yoga teachers who are, uh, let's say getting a little too handsy with their students. Um, that just came out in the New York times, uh, over the weekend. But we teach our students at yoga fit too, to make sure that, um, they tell students that they're going to make hands on adjustments if they do and, and give the student an opportunity to refuse because for people who have had physical or sexual trauma in their lives, the wrong touch at the wrong time can trigger them be highly triggering.

Allan: 13:06 Yeah, I could see that. So as we talk about yoga fit, cause you mean your training, you've trained hundreds of thousands of instructors, uh, there's seven steps of yoga fit. Could you kind of go through those to get us a little bit more familiar with the yoga fit?

Beth: 13:21 Uh, well, the essence of yoga fit is breathing, feeling, listening to the body, letting go of judgment, expectation and competition and being present in the moment. And we encourage anybody who takes a yoga fit workshop, retreat or training to really embody these principles in themselves because yoga is a practice and it's a process and it's not a a one, one time event, nor is it a one size fits all proposition. So, um, you know, allowing that to be our foundation. Uh, and when we practice to, you know, we don't want to be competing with the person next to us or competing with the body that we had 10 years ago. Um, we just want to show up for ourselves in that day. And just, you know, when I practice, I'm just, some days I have an injury, some days I'm tight, you just kind of, it's an opportunity to just be with what is and do a little inquiry into the body and see what's going on.

Allan: 14:25 You know, I as a hyper competitive person, I could, I, I would, I would still struggle a little bit. I think it would take me a long time of practicing to get comfortable with just not competing against myself. I'm not going to compete against anyone else, but I, I still do have this strong inclination in myself to just want to see if I can be a little bit better tomorrow. So I, I like the seven steps. So I think, you know, the, the, particularly when you're talking about breathing and just kind of being aware of yourself, I don't, I don't think we give ourselves enough of that on a day to day basis, but I do see that this is a kind of a process that you'd have to practice for a while to really get comfortable. I would have to practice for a while to get comfortable with.

Beth: 15:05 Yeah. And you know everything's a practice in my usually. So, um, I just think that engaging in the process is very beneficial. Whether it's your first time doing it or your 1000th time doing it, it's just you're always going to get some benefits. And that's the beauty of it.

Allan: 15:24 Yeah. Awesome. Now I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and stay well?

Beth: 15:35 Well, I believe, uh, listening to the body is very important. I believe in setting an intention and action plan and then you have to follow your plan. And then lastly, be a little bit flexible.

Allan: 15:52 I really, I really liked those, especially the action part. So many people plan, plan, plan and don't act. Thank you for that. If someone wanted to learn more about you, learn more about your book Healing Trauma with Yoga or about Yoga Fit, where would you like for me to send them?

Beth: 16:09 Healing Trauma with Yoga, which is now out and available and shipping from warehouses everywhere and available in bookstores also can be ordered off of Amazon or off of yogafit.com if you're interested in the yoga fit workshop, conference or training, we have over 50 different educational programs as we run over a thousand trainings worldwide every year and 15 conferences across North America. They can go to yogafit.com. If you're interested in more health and wellness articles, anti-aging hacks, uh, information on dealing with depression via supplementation, red light therapy, weighted blankets, and all the other alternative and not so alternative things that I'm up to. You can visit me at bethshaw.com.

Allan: 17:03 Great. You can go to 40plusfitnesspodcast.com/410 and I'll be sure to have all those links there. So Beth, thank you so much for being a part of 40+ Fitness.

Beth: 17:14 Thank you. It was my pleasure and I wish everyone a fit and peaceful day.

Are you enjoying the podcast? Good. Now if you just do me one favor, go to 40plusfitnesspodcast.com/support. That's going to take you to our Patreon page. Now, patrons are really cool service that lets you support the podcast with very small donations and for every new patron we get during the month of December, I'm going to do a special bonus episode during the first quarter of 2020 and in that, I'll make the special dedication just to you. So please go to 40plusfitnesspodcast.com/support and help keep 40+ Fitness charging on into 2020 thank you.

Patreons

The following listeners have sponsored this show by pledging on our Patreon Page:

– Tim Alexander– Judy Murphy
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November 4, 2019

Raising the bottom with Lisa Boucher

When Lisa Boucher saw that she was following her mother's path into alcoholism and loss, she turned things around. Now she helps women break free from alcohol and live better lives for it. In this episode, we discuss her book, Raising the Bottom.

Allan: 01:03 Lisa, welcome to 40+ fitness.

Lisa: 01:06 Thank you Allan. Happy to be here.

Allan: 01:08 You know we're getting into that time of the year when there's you know, holidays and you know, we're going to have Thanksgiving coming up. And of course then after that there's all the Christmas parties. And then of course, New Year's. And you know, we associate all of these holidays, all of these events with alcohol.

Lisa: 01:27 Yeah. And you forgot Halloween because that's becoming a huge alcohol. Um, I know when I was raising my sons, my husband, we're still together and he's a drinker. And when they were taking the kids around when they were little, we had, um, I had a problem with the happy hour at every single house. So the parents would have their kids dressed up in their little costumes and each house would offer a cocktail. And I said, ah. So I ended up making my husband stay home and give out the candy. And I took the kids because by the time you get around, we had a, like a big circle. Half the parents could barely stand. So it starts, I mean there's, there's just no holiday. There's no event that doesn't say, hey, it's all about the parents. And we got to drink too. So what are we modeling?

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Allan: 02:22 I moved to Bocas Del Toro and you know, there's an expat community here and uh, you know, we get together and we have dinners and go out and watch our friends, you know, perform and you know, but it's, it's kind of a cycle of things of it. All of this is always going to involve alcohol, you know, bring your own beer, bring your own wine kind of mindset to all of it.

Lisa: 02:44 We live in a boozy culture and you know, for your listeners, I'm not opposed to drinking moderately, but I think Allan, we have normalized alcoholism in a lot of ways. And what I mean by that is people, I quit drinking before I was a daily drinker and I'm around a lot of people that drink daily and I'm not talking just one drink a day. They're drinking four or five drinks a day. And they walk around saying, well, I'm a social drinker. Well, actually, yeah, that's more like getting into alcohol dependence, alcohol abuse. They may not be full blown alcoholics, but it can have a detrimental impact on a life when if you're going to work, they say 80% of alcoholics have families and have jobs. So if your life looks like something like you go to work and every night after work, especially when you live in, in the tropical place like you do, if every day your social life, your after work life is at a bar drinking for the rest of the evening, at some point, by making that choice, you're choosing not to do a whole lot of other things.

And so I just encourage people to say, is this really what I want to do or am I just going along with the flow? I know when I quit drinking, there's so many things that I have found to do. I just went to a bird lecture this morning. I mean it's kind of a nerdy thing to do, but I'm really interested in nature and the birds and things that when I was drinking, I didn't even see the blue sky or the birds, I didn't notice. I wasn't really present on a daily basis or a moment to moment in my life. So there's a lot of things that you miss too with, with the drinking. And it's just a matter of really rethinking all the drinks and saying, is this who I want to be? Is this how I want to spend my time? And I know with like the people that do get sober, there's a lot of deep heartfelt regret of the things that they missed or the things they didn't do with their family, with their children, with their spouse or significant other, because drinking can take up a lot of time.

And I sobered up in my late twenties and I literally just squandered that whole decade of my twenties when you're trying to set up your life. And I had a lot of regrets about that, but much less so than someone who waits till they're 45, 50, even 60 to get sober.

Allan: 05:40 Yeah, you had a statistic in the book kind of hit me in the face. Um, it was up 10% of the population is an addict or an Alcoholic.

Lisa: 05:51 Yeah. I mean that is true. So think about it. Here in the United States, we have about 320 million people, roughly. So there are truly about 32 million addicts and alcoholics. And that's probably, that's probably under-reported because there's a lot of people like me, I did not go to rehab. I did not go to the doctor. I knew about this disease by being raised by an alcoholic mother. So I've been entrenched in this whole thing from the time from birth my whole life.

And, and I've had siblings who are addicts and alcoholics. And now that I've been sober 30 years, I work with a lot of people in recovery. My first husband was a raging alcoholic, so I've just been around this and they say, and I'm also a registered nurse. So here's another scary stat, is 14% of doctors so I've noticed working in healthcare, there are so many doctors, nurses, anesthesiologists, that end up in recovery. So that's a pretty high stat. 14% of doctors and 10% like I said, in the book of the general population. So these are people and the people that I focused on in my book are people that you would never suspect they had a drinking problem because I think that's, that's why more people aren't finding recovery. There's this stigma, there's this picture in our heads of an addict is, is the person, the homeless guy on the street, the people that are passing out in cars that we see on the six o'clock news and that is one face of addiction, but that is at the end-stage.

So I wanted to focus on the people again that were, that were more like myself or the 80% functional alcoholics. For instance, Caro, she's one of the, I have 10 stories in the back of the book of various women and, and out and a guide. Um, she was a surgeon. She was coming home every day making dinner, had two children that were well dressed, well fed in good schools, lives in a great neighborhood. All of these trappings that we look at from the outside facade and say, Oh, that's a great life. However, inside she's falling apart. Her kids are miserable. They can't stand her drinking. They are losing respect for her. And she finally one day just came home from work, started to open that bottle of wine and said, you know what, she went back, didn't drink that day, went back to the hospital, told her partners, Hey, I think I have a problem.

These are two other surgeons. And their response was, surely you jest, this can't be. So this is the attitudes of what we've got going out there and still working in healthcare a couple of days a week. I like to keep my foot in so I can tell you what's going on currently. And the attitudes are shameful. People come to the hospital, they are not getting the help they need. They get a lot of the times, all this anxiety, depression on happiness. The underlying issue is substance abuse, drinking too much, um, taking perhaps too many prescription medications like Xanax, volume, Adavan these benzos do not help a person's life go well. A lot of times they're meant to for anxiety. People get rebound anxiety, which is even worse than their original anxiety. So all of these medications are not helping. And what I'm still saying is the doctors are throwing medicine at these people.

They leave the hospital, their lives continue to spiral out of control. They're unhappy, they're gaining weight, they're losing their marriages, they're losing their children. It is a mess. And the doctors though still rarely address the underlying issue of substance abuse. And I'm saying, Allan, we need to get people clean and sober before we start labeling them with anxiety and depression diagnosis because that is what happened to my mother back in the 60s who was also an RN. She went and got on volume them, which was the pharmaceutical industry's first billion dollar drug that led into a 25-year addiction that escalated into alcohol to where she was nonfunctional. My mom was the woman laying on the floor like you would see in wine and roses, you know, she was a hot mess. So this is where it led for her. And so 10 years into my nursing career, I really started to wake up and I'm looking around and I said, my God, nothing has changed.

Nothing has changed. And let's not forget, there's children on the backside of all of these men and women who are caught up in addiction. So we are in essence cultivating a whole new generation of addicts and alcoholics because growing up in these environments with drug and alcohol fueled parents. I know as a child I was traumatized by it. My father was rather abusive. He's trying to control my mother's alcoholism, which is absolutely uncontrollable. She was incapable of parenting. So we basically raised ourselves. I have two older sisters and a younger brother and we've all been touched by addiction in our own lives. So this, you know, we're just perpetuating the mess. And so celebrating all these boozy outings and events, it's like what happens behind the scenes? Is anybody aware of that? Does anybody care?

Allan: 12:02 Yeah. And you know, from my perspective, you know the times that you know, where, where I would think, you know, I kind of get, for lack of a better word, dependent on the alcohol is I'm very much an introvert. And so if I'm going to go to a party or an event, which obviously here on the Island, just because all the time, you know, a couple of drinks makes me human. Um, from their perspective, um, when I'm not drinking and you know, there's always, my wife will get some questions. It's like, what's wrong with Allan? Just like, Oh this is, this is just half. He hasn't had a couple of drinks. I'll give them a couple of drinks and he'll be nice. There'll be a normal person in small groups, one or two, one on ones. I'm fine. But when I get into larger groups or you know, in places with people, it just, I shut down. And so the alcohol kind of just helps me loosen up a little bit.

Lisa: 12:51 Well, I get it. I think you're not alone. I think the majority, I know that I was very similar when I was drinking. It's like you have to have a few drinks before you get to the party. But when I got sober, I started to number one, be true to myself. So I'm not a big large gathering kind of person. I stopped going to a lot of them. My husband's more of an extrovert and I talked about this in the book. So how do you juggle a relationship, a marriage, whatever when one person drinks and one person's social and the other one is kind of how like you Allan. So I just told my husband there was, you know, pick a few parties that we are regularly invited to that you really want me to go to and I'll go. And the ones that are just, I don't feel the need to go anymore.

I prefer more meaningful activities, smaller intimate dinners or gatherings. Like I said, I've just had other things that I do with my time now then suffer through some huge event or gathering that I really don't want to be at to begin with. So it's, it's picking and choosing and being true to myself. And you know, I started to, when you work on your inner-self and some of the drinking was fueled by low self esteem. Some of my drinking was fueled by thinking, people are focused on me. This self-centeredness, that alcoholism breeds where we think people are going to notice us or look at us. And so we're self conscience. But the reality is is most people are in their own heads, focused on their own stuff and they're really not paying attention to us. I used to say that all the time, I have two grown sons now, but when they were in high school, my one son was always so worried what everybody else would think. And I used to say to him, they're not focused on you. Get out of yourself the, I mean, you're just another kid walking. They're not even paying attention to you. And I hope that that helped them get some of that spotlight off of thinking that people are focused on them when they're really not, when they're really not. So we can find other ways to love ourselves and just to say no, it's okay to say no and just not do certain things that I don't want to do anymore.

Allan: 15:15 Yes. Now in the book, um, you're coming from a woman's perspective, but that is in this book was somewhat written more for women and their perspective. Why, why is alcohol more of an issue for women, uh, than it might be for men?

Lisa: 15:29 Well, I don't know that, that it is actually in Raising the Bottom. I focus more on women only because I am a woman and I can intimately relate it to. But I will tell you before I scare off the guys, there's men love the book. Men love Raising the Bottom. In fact, there was a guy who founded in Seattle, he's a merchant Marine. He took it out to sea with him. He found me on Twitter months later and said it was life changing for him. And he's still sober by the way. So I think men really like it because they can read it and almost say like, wow, I can relate to all of this without feeling threatened at all. So I don't want to scare men off by reading the book, but I can relate to more of the women's issues and how we're responsible a lot of times for family and we get a lot of things dumped on our shoulders.

And I know men have stressors as much too, but I will say this, it seems like men do better at saying, Hey buddy, I quit drinking and their friends kind of respect that boundary I think better than women because I have a lot of women that tell me they really struggle with their so called friend groups who don't really want to be friends with them once they quit drinking and all this. And I find that so disheartening for many reasons. Number one, if your friend group is of that mentality, they're probably super heavy drinkers and they probably, I know when I was drinking, I hung out with people who drank like me. I was not hanging out with normal drinkers. And so I didn't realize there were people who didn't drink like I did that there were people who might have drinks a couple of times a month and then that was it.

And they were the true social drinkers who had a big life and were involved in many other things and their life did not revolve around alcohol. So the people that I socialize with were very much different and we drank every night and had parties and gatherings and we called ourselves social drinkers. So when you have that, like I said, want to boot people out or say they can't be friends or whatnot, and women seem to care about that and I tell them, well you don't need those people then find new friends. And I don't know why that's so threatening to some. And I think in order to change your life, to get sober, to maybe drink less, whatever it is that you decide you want to do, you have to be willing to face a little bit of pushback, which leads me to, as adults, why are we pushing back?

Why do we have to have this peer pressure, this adult peer pressure? When I used to go to gatherings early in my recovery and you're, I'm so uncomfortable anyway cause you feel this shame cause you're like quitting drinking and I don't, now I look back and go, Oh my goodness, what was I thinking? Um, but it's like we feel shame for doing something good for ourselves. If you go to a party and they have all these sweets and you refuse a sweet, nobody questions you. But if you go and you refuse to joy a drink, you get the 20 questions. If you're a young woman, Oh, are you pregnant? Oh, why aren't you drinking? Oh, are you on medication? I mean, it's ridiculous. And so I tell people, men and women, no, is a complete sentence, no thank you. We don't need to explain ourselves. And if somebody has a problem with me not drinking, it's usually because they have a drinking problem and they're very uncomfortable with that mirror of someone not drinking to kind of almost co-sign on their BS. So we can navigate these drinking. I go wherever I want, I do what I want. I have a very big life, but I just don't drink. And for the most part, nobody really cares. Like I said, the only people who I've ever really cared that I'm not drinking are people that ended up having their own problems with alcohol.

Allan: 19:51 Yeah. Now, this last month, uh, we ran a challenge, um, and I included an alcohol piece to it and I didn't say completely abstain from alcohol, but we're going to cut it back and continue to kind of regrets it and cut it back. I've had no alcohol challenges in the past and the turn around was relatively small. Um, so it'll be interesting as people get into, you know, the results of going through the challenge. People are improving their health there, they're losing weight. Uh, you know, that's part of the, the gist of the whole thing. Uh, so alcohol, you know, I think we all know alcohol can lead to weight gain, uh, and stopping drinking can actually help you in your weight loss journey. But there are other health things that we should consider with regards to alcohol. Could you kind of get into some of that?

Well, I mean, Oh my gosh, alcohol impacts really every organ in our body. So let's quit diluting ourselves and say, Oh, it's not that bad. It caused the seven types of cancer that's been proven definitively. Alcohol is a class one carcinogenic. So it is in the same class as asbestos. Now nobody is going to tell you that. And the research on that is when you, if you Google it, you're gonna have to dig a little bit. Cause that's not something that pops up immediately. But Oh, believe me, it's there. So in addition to like for men, there's a lot of throat cancers, esophageal cancers, stomach cancers, colon cancer, pancreatic cancer, and women with breast cancer. I know when I got into recovery here again, I started paying attention and I'm like, Oh my God, so much breast cancer in these women. And then years later I'm researching, doing all this research for Raising the Bottom.

And the light bulb went out and I went, well my God, no wonder all these alcoholic women have breast cancer. It's the booze. I mean we can't say for sure that it's the sole cause, I'm sure there's environmental factors. Stress is a huge one, but a lot of people drink because they can't handle their stress because they don't have good coping skills. So it all ties in together. Um, you've got people, when I was working in the ER, people who are diabetic drinking heavily, their blood sugars are all over the place. They're coming into the hospital because now they're having kidney failure from their unchecked diabetes because they were drinking too much. They're getting coronary artery disease from their unchecked diabetes because they couldn't stop drinking so much. So there are so many ways that alcohol and the alcohol turns to sugar in our body.

So you're just getting this bombardment of sugar, which causes inflammation. Let's move on to the brain. The extended care facilities. Nursing homes are filled with people who have a long history of drinking. Lot of alcoholics end up in the nursing homes. Lot of people with longterm benzo abuse or I don't even want to say abuse, people tend to get on those benzos and they stay on them for the next 30 years because the withdrawal to get off is so awful. They just stay on them. And I think that's how they were designed by the pharmaceutical companies. So they give you this benzo when you're 25 to help you not feel anxious and when you're 60, you're still taking it and pretty soon the mind just goes to mush. So these are things that people don't really understand about how and what it can do.

In the last five years I've seen a big uptick in women that are yellow because women do not have, we lack the chemical that helps to break down alcohol. Men have more of the, Oh, I was, that's a tongue twister for me to say. It's ADH is the, the short, but we women lack ADH. Men have more of it. So that's why men can kind of skate along and drink maybe a little longer and a little harder without it totally impacting them physically. Like at, well a woman, um, women go downhill much faster. And that's, I talk a lot about that Raising the Bottom because that was instrumental for me. Why I got sober when I did, because I saw how quickly once my mother crossed that line from drinking martinis at lunch to becoming a full blown alcoholic. Her demise was Swift.

Her, she ended up looking like she was nine months pregnant, her skin was yellow, she was dying, she was, she was dying. And that happened in a span of five years. So I'm seeing a lot more of that that I didn't see 10 or 15 years ago. I've been in health care for 25 years now. So that is new and it's all attributed, I believe, to the pharmaceutical, or I'm sorry, the alcohol, big alcohol is doing a very, very good job of spending their billions of dollars in ad budgets to target women. And so the new alcoholic often is well educated. She makes a good living. She wears designer pumps and she carries a diaper bag. And this is the new alcoholic of what we're facing. So now let me ask you this, Allan, what happens to those children on the backside in this boozy mom? Well, they end up like me probably will land in their own addiction later on because when you have a mother who's all about the party time, you're not present. You're missing a lot of the nuances that I know with my twins I was able to pick up on, I was two weeks sober when I found out I was pregnant with twins and I'm so grateful that I was a sober mom who was fully present. Both my sons went on to become division one athletes. Both of my sons went to college, they graduated college playing football. And I can just assure you it would've been a very, very different picture had I not been sober. Our family would've been very different.

Allan: 26:32 Now there are a lot of people that will say, okay, you know, and I don't drink that much. You know, I just have a couple drinks here and there and like you said, social drinkers. Um, I was actually reading a study the other day or there's actually several studies out there that show that we're, we're really not good at self-reporting what we eat, what we drink. Uh, so you know, if they ask you what you had for dinner last week and in general, um, you are going to under-report your calories, um, you're gonna report more healthy food than you actually ate. Um, and if you drank alcohol, you're probably gonna report less drinks than you probably drank. But you know, this is an alcoholism is actually something that unless you self-diagnose, nothing's going to change for you.

Lisa: 27:15 And you're absolutely right. So what changed my life was getting honest with myself because the standard alcoholic answer is I had two, Oh, I only had two beers. I only had two drinks. They always only have two. Yeah. So you're right, people lie. And so that's why doctors that are tuned in, most doctors are clueless about alcoholism. Some of the stuff that comes out of the psychiatrist's mouth that I hear like, Oh, it just drives me crazy. They'll say things like, Oh, they used to be an alcoholic, but now they just, they're using meth or something crazy like that. So like they just switched addictions is what they did. But back to your point. Yeah. So we lie, alcoholics lie, we all know that. Um, if you want to change your life, be honest. Nobody can, you know, I knew two years before I quit drinking that I was drinking too much, that I was crossing a line.

I had a home bar that I loved and I knew everybody kinda like on cheers. Everyone knew my name. And when I go, we used to go in there and start asking the person sitting on my right and left, who, or by the way, drinking right along with me and say, do you think I drink too much? And of course they're like, ah, I have no, you're fine. You know, what are they going to say? Yeah, you're drinking. So, but, but that was already, that was those early warning signs. Something was not resonating within my soul. And I knew, I knew that it was not, um, I don't even want to say abnormal, but it was abnormal for me because it's like people get so caught up on quantity. Like I said, I was not a daily drinker. I did not drink a fifth a day.

However, when I drank, I get a few drinks in me. There were times I absolutely could stop and I would be your designated driver. And there were other times I could not stop. So there was that unpredictability factor, which is indicative of potential alcoholism. There was the fact of how it affected my personality. I'm a pretty even keeled person. I'm not a drama queen by any stretch. Give me a few drinks. I know we're going to have drama. It's either going to be, I'm going to create something, I'm going to start a fight. I'm going to shoot my mouth off inappropriately pick, pick anything I would just do and things that I'd never would do and say sober. So that was another clue to me. I was losing my moral compass. That was another tip off where you start to rationalize and justify lying.

You know, I don't know, it was never really a thief, but I'm sure that could have come where, you know, you take 20 bucks out of your husband's wallet, don't bother to tell him, Hey, I took 20 bucks and you start, you know, I didn't do that then, but I could see where I could have maybe segwayed into that kind of behavior. And we tend to rationalize things like, Oh, that's fine, that's fine. Well now actually in sobriety it's about getting rigorously honest, living right, doing the right thing. And so I was really losing my way that way. And I don't know that I would have saw it as early as I did had. Again. My mother was instrumental in my recovery because she sobered up when I was in my early twenties, and I saw her change dramatically. So by the time I got sober, my mother had seven years sobriety under her belt, and she had morphed into this amazing mom that I think I wished I always had.

But it can impact us in so many ways. And I just really want people to understand you've got to throw out all these old ideas that an alcoholic has to look a certain way because no, there are no demographics, there are no boundaries. And I'll tell you the worst nightmare for an alcoholic is money. There's a lot of alcoholism. My father goes to Benito Springs in the winter and I go down there. So you've got a lot of affluent people in the Naples, Sarasota area. And as a nurse I see the loose blouses and the big livers and the guys in their golf shirts with their big livers sticking out. And it's just, Oh my God, I almost can't stand it because there's just so much. Their lives are golfing and drinking and eating and there's going to be a lot of, you know, earlier deaths because this is what they do and they, this is their social life, which is fine, but it's, um, it's scary and a lot of ways to me when I see how sick some of these people look and they don't even see it.

Allan: 32:01 Yeah. Now in your recovery and in your mother's recovery, you utilize the 12 step.

Lisa: 32:07 I did. Yes.

Allan: 32:09 So even that wasn't on your plan. Can you kind of just quickly kind of go through, cause I think you kind of hit on some of those points of getting honest with yourself. Um, and, and I think the 12 steps is actually kind of that approach to actually making that happen and making it real in your life. Not just an exercise you do over the course of a weekend, uh, at a seminar. But this is something that you have to live and do over course of quite a long time,

It becomes a way of life. Allan, I know people go to rehab and I just need to throw this out there. So many people go to rehab in their families think, Oh, they're cured. No, Nope. That is just the tip of the iceberg because a lot of people go to rehab just to get people off their back and they have no intention of really doing the hard work. It takes working on the core insight issues. However you choose to do that. I like the 12 step because it gives you a roadmap to do that. And really the first step is we have to admit we have a problem. So I don't care what recovery method you're going to use, smart recovery, whatever. Um, you have to admit you have a problem because you can't, I mean, it's almost like if someone who's overweight, you have to admit, okay, I decide I need to lose weight.

Until you're ready to accept that about yourself, you're not going to change it. And then the 12 steps really help a person look at their issues. I can. So what were some of mine? I was a very fear based person, which I didn't realize that. Um, so I had to look at how as a child my predominant emotion was fear. And I covered up with that fear with a lot of false bravado. A big mouth, that kind of thing. So I had to look at that. I had to forgive my parents. They did the best they could. I didn't think they did a great job raising me. Um, since I did kind of raise myself along with my siblings. Now I have a sister who stayed in addiction 40 years because she couldn't, she liked to blame my parents as opposed to taking responsibility as an adult.

Okay. Our childhood wasn't great, but it, it could have been worse. And I'm an adult now and I'm going to make the choice to make my life better and be a different parent to my children. And, and my sister couldn't do that. So yeah, you have to. And then it's about, it really focuses too on getting out of yourself. I mean, alcoholism is, We have to get humble. It's that I'm going to do it my way disease. It's a disease that is riddled with pride. People can be almost homeless and they still think they know what they're doing. They're unwilling to listen. They've lost four jobs, they're on their third marriage and they still swear they don't have a problem that you see over and over again. Anybody who's been married more than well, even three times, it's usually alcohol is in the picture there somewhere.

One of the persons involved was drinking and my older sister, she's on her third marriage. Yep. Alcohol has been involved in each one of those marriages, so we have to get honest about, we can't blame everybody else. It comes back to what are we covering up inside of us and dealing with that and working on the issues. Having that humility to say, I can't do this. Making amends to the people that we have harmed people. Moms especially, they say, Oh, I'm not harming anyone. Well, yes you are, because your kids may be well fed and you might get them to their soccer practices. But when you're standing on the sidelines with a cocktail in your hand, you're not really focused on the present moment. You're focused on, Oh, when this cocktail is empty, I got a hall over to my friend's cooler and get a refill.

And it's just a very selfish, myopic way of life, the drinking life. And most people don't really see it until they do get sober. And then the last factor is it's about helping others and doing it freely and willingly and giving of, you know, I do, I work with a lot of women. Recovery coaching is like really big now. I don't charge because it was freely given to me. And so it's an honor and a privilege to help a woman who is struggling, who says they want to change their life and then to give them some simple directions that they follow and their lives begin to change in amazing ways. So that is a gift. So it's, it's really a way of life and it's part of my life that I've just incorporated into my life and it's just who I am and what I do.

I go to meetings three a week, I work with others and I write books and I'm still in there sometimes.

Allan: 37:17 Lisa, I define wellness as being the healthiest, fittest and happiest you can be. What are three strategies or tactics to get that stay well.

Lisa: 37:22 The obvious Allen exercise, eat right, but here are, here are the three that I think are really helpful. Number one, stop people pleasing because that a lot of times people, people please. Then they have resentments which fuels eating and drinking and anger. So people are very angry, so stop people pleasing. If you really don't want to do something, I mean other than things that like we have to do, like go to work or whatever, but stop people pleasing so that you're not resentful. Number two, get engaged in something outside of yourself. As I said, help others. People are depressed, they're anxious.

Well, when you're only focused on your own depression and anxiety, it almost fuels it. Whereas if you're focused on helping somebody else, getting out of yourself, the anxiety and depression is cut in half. So I would suggest find something, find a hobby, find a way to help others. And you will watch happiness. Um, quotion expand exponentially. And number three, which is no problem for you down there in Panama, get out in nature people, 89% of adults spend 15 minutes or less a day in nature. Oh my gosh, no wonder we're drinking, right? Because you're around, you're in these sterile environments, be it an office or whatever. And then you go from that to your car, to your house. And I don't think, I mean, well, let's go back to hunters and gatherers. We're meant to be outdoors. You know, the trees, the greenery. There is a chemical in this greenery called Fido signs, and it is proven in Japan.

They call it shouldn't ring Yoku. They don't give out a lot of antidepressants in Japan, they prescribed nature walks and force bathing. So this fight assigns in the trees, helps to increase your immunity, decrease depression, decrease anxiety. So why are we not doing more of these sorts of things and forth? The drinkers know this does not mean you go sit under a Palm tree and have five drains that doesn't count, but maybe go walk amongst the butterflies or I think you mentioned early, maybe before we started taking that you'd have a rain forest nearby. I mean, what a gift. I can't imagine how amazing that would be to walk through this rain for some of this nature. Chirping and chattering above your head. These are things that really can make you feel so much better. And I wonder if people just, if they decided to do something like that every day as opposed to drink five drinks, maybe have one drink after you go on a nature walk and maybe that had be enough and you just had a drink. Your life could be really different in just something as small as those sorts of little changes can have huge impacts when you realize like, wow, I took that walk and I was fully present and engaged in my surroundings. I mean, I can't tell you how many people get sober and say, Oh my God, for the first time I like, I smelled winter or I saw spring. This is what taking alcohol out of a life can do. It's like ripping off the veil or the scales. It's like you see things just totally different.

Allan: 41:06 Lisa, thank you so much. If someone wanted to get in touch with you, learn more about the book (Raising the Bottom), learn more about what you're doing, where would you like for me to send them?

Lisa: 41:15 They can go to my website raisingthebottom.com. I'm on Facebook under Lisa Boucher award-winning author. I'm also on Twitter and Instagram at raising the bottom.

Allan: 41:26 Okay, well you can go to 40plusfitnesspodcast.com/406 and I'll be sure to have them there. So Lisa, thank you so much for being a part of 40+ Fitness.

Lisa: 41:15 Thank you, Allan. This was a pleasure. I enjoyed talking with you.

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October 21, 2019

Fit beyond fifty with Moira Berman

At the age of 35, Moira Berman decided to use weight lifting to change the way her body looked and felt. Despite the late start, she went on to compete in bodybuilding competitions and to work as a trainer. She is producing an online video summit called Fit Beyond Fifty set to release later this month.

Allan: 01:18 Moira, welcome to 40+ Fitness.

Moira: 01:21 Thank you so much, Allan. This is really exciting to be on your show.

Allan: 01:25 Thank you. And I was very proud when you invited me to be a part of your summit, the Fit Beyond Fifty. I really enjoyed our interview. And so I know, if, if you liked the podcast and you'd like today's showing that resonates with you, you're definitely going to like that conversation with Moira and me because it was a really good interview and, I really enjoyed it. So thank you for letting me be a part of the summit.

Moira: 01:48 Oh, sure. And I think the best part was maybe when you knocked over the mic.

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Allan: 01:57 The summit is video. So you know, this is, this is an audio podcast, so you don't see me moving my arms around and you know, just doing all the things that I do while I'm articulating and talking. But yeah, had my computer propped up so I had good angle and better lighting in the house we have here in the jungle and boom, I knocked the computer over. It was, it was a moment.

Moira: 02:22 It was pretty good though.

Allan: 02:26 One of the things I like about your story that, and I really wanted to kind of get into is that like a lot of folks, you knew that eating well was, was something that you needed to do to kind of maintain your weight. So you would, you would go on a diet, lose a little bit of weight, put on a little bit of weight, and finally you kinda heard someone or resonated with you at least a little bit better. That maybe weightlifting resistance training was, it was something you needed to do.

Moira: 02:57 Yes, I had, I said being dieting, you know, you sort of do the yoyo. I was doing writing, I took exercise classes, but someone said to me, you know, if you used weights, if would change your body shape. And that was all I had to here, body shape will change. Okay, I'm in. So that's how I got started. But I didn't really know what I was doing. I had a friend show me how to use the weights and one of the small YMCA gyms that is now near us. And then when I got hooked on that cause it, it seems like fun. I was being, I was able to push a little bit more and more weight and I thought I was just really terrific. So I joined a gym and there weren't many, they weren't many gyms. There was, there were women gyms that were purely women and they had a few machines or some they aerobics and there were men's gyms.

Moira: 03:56 You know, this was going back a while, but one enterprising gym owner had opened up a women's gym above his men's gym because the men wouldn't let us work out with them, obviously. They were hardcore. So we had our own gym above there's, but we had access to the men who would show us things and, and they had some trainers who would show us. So that was really the start. And it absolutely did as I went forward because I was hooked, it did change the way my body looked, so I was really happy.

Allan: 04:34 Yeah, it is hard to explain to somebody that once you start lifting and you start getting stronger and you kind of get that rush of the pump of moving weight and feeling it, it, that it is something much like running, much like most other exercise programs, it's easy to get addicted to.

Moira: 04:56 It really is. And I was definitely, I was definitely addicted to it that I moved forward and got so involved that I did a contest. Luckily I was so naive. I had no idea what I was really doing or what I was in for that. I just followed the directions of some of the guys in the gym and just went for it, lost some weight. Put on a little bit of muscle and entered. I think that's probably the best way to do these things when you don't know too much.

Allan: 05:26 Yeah. Because there's, there's less opportunity for you to overthink it.

Moira: 05:31 That's right. Or get or find stumbling blocks because, you know, once you have a lot of information, then your mind starts telling you, Oh, but you can't do this. Oh, but you don't compare with the others or you know, Oh, but. But I just thought, I'm gonna get, you know, 90 seconds on stage. Wow. That's more than I'm gonna get for anything else. So yeah, I'm going for it.

Allan: 05:56 We did about something, and I, and I want to kind of get into this because this is one of the major objections. I'll, I'll have a conversation with a woman and invariably she'll tell me, well, you know, I don't want to get huge. I don't want to get bulky. If I lift weights, my legs are going to get just bigger and I don't need them to get bigger. I want them to get smaller. When you talk about changing body shape, you're not talking about turning into a man?

Moira: 06:20 Oh no, definitely. When I was talking about body shape, for me it was losing kind of what I thought was excess fat on my thighs, my legs, toning my arms, you know? That's what I thought about body changing. It was clear to me from an early age for some reason that women had a lot more trouble building muscle and this is borne out. We don't build muscle as readily as men. And when you do see, bulking of sorts, usually it's a little bit of muscle that's developing and women are still carrying the fat over the muscle. But once you lose that fat, you can, you get these long lean muscles. So it's hard to bulk up with a lot of muscle for women. And this you really go out and try, you know your genetics are right. You might get some help with some pharmaceuticals.

Allan: 07:19 That's where I wanted you to go with this because I think that's what they say, that there's two. I think there's two real huge misconceptions when they look in the magazines or they see one of these huge muscular girls that's a bodybuilder. There's two things that that woman's doing that you're not going to do. One is she's going to take steroids and a lot of times you can see it in their face because they're faced with structure changes. The other thing that you'll often see is, is the fact that they're in the gym six hours a day and sleeping the rest of the time. Because the sessional bodybuilders, that's, that's their job is to lift weights and exercise and get big. So they're in the gym. If they're not lifting, they're working on their posing. If they're not working on their posing, they're working on their tan, and they're trying to cut the body fat down to just is really unreasonable number that you can't sustain for a long period of time. And so they're doing these things that you just, you wouldn't do, you just wouldn't spend the time to do this because it's not your priority in your life. If you're looking to get healthy, you do need to do resistance training because you are losing muscle mass and you're losing bone density pretty much every day.

Moira: 08:31 Yes, that's right. And you know, I heard those same stories when I was, body building. You know, I was influencing friends or they were asking me and invariably the questions came about, aren't you worried about getting too big? And my answer was, I wish if I could, if I could get some more muscle, that would be absolutely wonderful because it does take, and I was already thirty-five, thirty-six. So I had age against me in terms of rarely getting a lot of muscle. So yet we don't as women, unless you get some outside assistance like pharmaceuticals as we said, you know, steroids and it's really important too. And what I found then was, okay, now I have being doing the body building. I'm not competing anymore, but I still need to maintain working out with weights. And then the motivation was because I realized that it was going to help keep my bones strong. Just keep my muscles from atrophying, my muscles strong, keep me healthy, I'm going to look more vibrant. And just the hormones that you release from lifting weights, especially if you work out, you know, reasonably hard, the hormones are going to release, they're going to just have a bearing on keeping you younger. That's definitely important

Allan: 10:03 Heavy lifting, and this as something, women do have testosterone, they don't have as much as men. That's why they can't get as muscular as men. Um, unless they, they use steroids then then anything's possible. But lifting heavy weights helps men and women release a little bit more testosterone and a little bit more testosterone is just kind of one of those chemicals in our bodies that just make us feel a lot better, look a lot better. And our muscle tone and quality of our movement is just better.

Moira: 10:34 That's right. And I, I learned recently that women actually produce more HGH, the growth hormone when they work out than men do. Men produce more testosterone but women produce more HGH, which is the hormone to keep us younger. So we've got an advantage when we workout. We may not get the testosterone, but we're gonna look younger.

Allan: 11:01 Now you said something and I, and I think this has changed quite a bit, but, um, I do want to talk about this cause I had lots of clients and lots of people I've talked to over the years and it's, you walk into the gym. And most gyms, you see the treadmills and then after the treadmills, then they have some of the machines and then after the machines over in that little corner over there and sometimes a whole section in the gym. Now you see all the free weights and yes, the big guys are back there lifting probably grunting and doing their thing. And there's now whole series is of chains and whatnot that are trying to get away from that so people feel less intimidated about the gym back, you know, 20, 30, 40 years ago, it was all guys in the gym for the most part. Then they started coming out with women's gyms and most of those were like you said, not so much designed for muscle building, resistance training, strength training, those types of things. But things have changed a lot. You know, the advent of CrossFit, other things, people, we're more used to having women come back into the freeway section and lift heavy. We're seeing it more and more so it's not as different or, you know, I guess unusual, as it was 30, 40, 50 years ago.

Moira: 12:20 That's so true. I think there's still an intimidation factor for someone going in for the first time, but it's not the same as it was. It isn't just because there are men there. I think it's because the thing, all these fit people, and as you said, CrossFit, that can be intimidating for anyone walking into that kind of place.

Allan: 12:44 Yeah, I agree. I think the, you know, but what I mean by this is, and this is the point, okay, yeah. You see this, this big hunky guy, you know, he's, he's lifting heavy weights. He's grunting, he's there with maybe two or three of his buddies. You know, they're doing their thing. And I can tell you straight away they're not interested in you. They're, they're happy you're there cause you're helping to support their gym. You know, their gym membership. If it was just the three of them paying for this gym, it'd be a lot more expensive. The fact that there's 200 people that have signed up for the gym means a gym membership is affordable for everybody, and they're not all having to buy their own equipment and they can come work out. They're happy to see you in the gym. They're happy to see you do things for your health. They're not staring you down. They're not watching you. And I'll tell you just from my experience, okay, the only time I notice anyone in the gym is when they're doing something that could hurt themselves.

Moira: 13:38 Yes.

Allan: 13:38 But I, I reserve and I stay back. Now I'm, I own a gym. So if I were to see someone doing something, I thought that hurt them, I'm going to step up and say something. But those individuals are there for a particular purpose. They didn't get big and strong by sitting around watching other people are playing on their phone. They come in the gym, they do their workout. Yes, they may have longer rest because they are lifting heavier weights, but they're not really there too to watch you. They're there to get their workout done and you're just as welcome to that equipment just as welcome to being in the gym as anyone.

Moira: 14:12 That's true. In fact, I was kind of hit, you know, going to hit there that we were intimidated at one time by seeing those men in the gym. I think, I think that most people are less intimidated, especially if you, if as you said, you just realize that they are only too happy that you are joining so that they don't have to pay the full cost of keeping a gym open. But I think that there are some of us just as people were intimidated going into a new situation. Yeah. I think for, for women in particular, if it is the time, I'd suggest that you go with a friend to a gym. And especially if you're going into one of the chains, they're immediately going to offer to show you around because they don't want you doing something. It might hurt yourself and they'll offer you one or two days, maybe have some free advice, free training just to get you going. And so that's really good. It is good too. If you are going into a gym for the first time to get a trainer, to get someone to show you how to use the equipment to find out what you should be doing for your body. You know, the kind of work that you do, Allan is just perfect because you actually analyze what the person needs and then give them a program. So anyone who got that advice from you would feel quite comfortable going into a gym

Allan: 15:45 And you've hit on something that's really important there. You know the gym thrives on, on people not hurting themselves for the millennial coming in there and continuing their membership, and for them to get stronger and show improvement. And they're going to probably, when you get in there, they're going to probably ask you if it's particularly, it's a big box, you know, franchise style gym. They're going to introduce you to their staff. They're going to introduce you to the gym. They're going to, you know, probably do some general assessment work with you and that may or may not be free, but they're going to make sure that you have a, an opportunity to start and access to support of a trainer to help you do that. Now, most gyms will also do this. They will have their personal trainers walking the floor when they're not training someone.

Allan: 16:34 And it's their job to help you if you have a question now that, yeah, not going to train you for free, but if you walk up and you say, look, I want to move from the barbell over here for the bench press or want to move away from this press machine and I want to do the same exercise with free weights, with the dumbbells. Could you show me how to do this properly? And they will be glad to do so. So if you feel uncomfortable, ask a trainer that's there, asked the person at the desk if someone can come show you how to do an exercise properly because it's, that's very, very important that you not hurt yourself. Particularly when we're over 40, over 50. Those injuries don't heal nearly as quickly as they did when we were in our twenties.

Moira: 17:21 That's right. You know, things have changed a little bit. Um, I worked in a gym at the time that I was training for, or sorry, after I had completed the competitions, the gym kind of offered me a free membership. If I would work in the gym, you know, a couple of days a week or a few hours a day. So I would, I would be one of those trainers. I would train people if we had a meeting set up or my job was to walk around the gym. I find it much less so today that they actually walk around helping people. They use the up back at their stations looking at, you know, who else is signing up. So that is a shame. I just have to mention now that isn't every gym, every, you know, all gyms are different, but no one should feel intimidated to go up and find a trainer or find one, you know, one of the staff and ask them to help you with something even if they're not walking the floor because that's what they are really there for. And they will, you're right there. They will be absolutely helpful once you ask them because they don't want anyone to be hurting themselves. So don't feel shy about walking up to someone who happens to be sitting at one of the desks and ask them for advice. Just show you how, how maybe there's a machine that you don't know that you haven't used before. Ask them to show you how it works.

Allan: 18:43 Yeah, it's, it's, it's just, it's funny, you know, because to me, the, that's part of the lifeblood of any gym is their willingness to help, help people without having to make an extra buck, you know, on the side. I actually, you know, with the gym now, one of the things that I've done at my gym is I actually will throw free weight lifting clinics for beginners. And I'm like, okay, come in on a Saturday, I'll come in for an hour, I'll show you how to use all the equipment in the gym absolutely free and you'll leave here with a workout program, the basic workout program to get you started. And so, you know, I did one of those and it went over pretty good. The people that came really enjoyed it. I'm going to host another one here soon at the gym. Gut I also do the online training.

Allan: 19:30 So you know, there are other options out there if the gym is not supporting you by, having the support there with people walking around or you know, you're able to afford to have personal training sessions because if you're having them all the time, which is actually really good for accountability, for doing the exercises properly and, and just, you know, somebody that is going to be there to kind of push you a little bit harder. If they're not doing that, you know, give me a call. I'll be glad to help you out.

Moira: 19:57 Yes, that's true. And I agree with you that having a train particularly when you starting out is absolutely worth the money because you want to learn how to do things properly. You want to get a program and you want that accountability. And then when you feel comfortable to workout on your own that you're motivated to go into the gym without having to, you know, show up for an appointment, then it's great. You've got your program and you can continue. I think I once wrote an article in a blog going back a while, so it's probably out of date was how to hire a trainer.

Allan: 20:35 I've actually done an episode on what to what, what to look for in a trainer. And when to fire a trainer (https://40plusfitnesspodcast.com/fire-personal-trainer/). A trainer should be listening more than they're talking. A trainer should be paying attention to what's going on with you? Um, you know, I have some clients, they're not always happy with what I tell them to do. Sometimes I'm actually asking them to do more and there's times I'm actually asking them to do less. And they don't always understand the do less part, but it's when I see a client can't handle the exercises they're doing or the form is just not right there. I'm not going to put load on them. And I think what a lot of people forget, it's like, well, I can lift more weight. And I'm like, not the way you're doing it. You're going to break and I don't want to break you. You and I have something very well in common. We both tore our rotator cuffs.

Moira: 21:25 Yes, we did. I think we we empathize with each other, but we didn't approach it the same.

Allan: 21:33 We approached it very differently. I went through the surgery and when the doctor got in there, he was like, this was a bad one. Uh, but I went through the surgery, went through the therapy and I'm in pretty good shape. All things considered. I lost a lot of strength as a result. I have a little divot in my shoulder as a result. But you know, I have full range of motion with my shoulder, and I'm able to do most of the things I was able to do just not quite as strong. But that was my path. You chose a different path.

Moira: 22:04 Yes. I think when I had, when I tore mine, I was a little older than you were when you tore yours. We won't go into detail, but the doctor I went to, you looked at me very, I thought very honestly, he spoke to me very honestly and he said that I had an 80% chance of recovery. And I know that you said that would have been a plus for you. For me, that was a minus. And I was very fortunate that I found a functional rehab trainer, online actually. He lives in Australia, but he did marvelous for me because he said to me, he looks at the MRI size and said, I can help you get your full strength back in a different way and not have this pain and not have the surgery. So it wasn't that if you decide to have the surgery, I'll help you recover.

Moira: 23:01 But he said, I would recommend that you don't. So I decided to trust him and I'm very pleased that I did because I do. I have full range of motion. I have a lot of the strength back. I won't say it's exactly the same as it was, but I just am using the muscles differently and using different muscles to compensate, and I don't even notice it anymore because I've trained my brain, I guess, to just do things in a different way. So yeah, we chose different paths. Both had success, which is, which just I think shows there's no one way, and I think whatever you believe is going to work for you is the thing that's going to work

Allan: 23:41 As long as you're willing to dedicate the time and the effort to do what's necessary. So the one thing we did have in common was I was in therapy, physical therapy. I had the surgery on Thursday, I was in physical therapy Monday. And you listened to your therapist and you did exactly as he instructed you to do and you built compensating muscles to allow you to move and do the things you needed to do. So we chose different paths for different reasons and different ways that we look at things. So I agree with you. There's a, you have to look at this and say, but the injury is not a give up. The injury is actually a flag for me, do more, but do it differently or do something different to, to fix this, to solve this, to work around this. But, so many people will injure themselves and decide, okay, this hurts. Therefore I'm going to stop.

Moira: 24:41 Exactly. It's so tempting to do that. I have to say that I have a functional trainer that regardless of what I say I've heard, he will give me an exercise to fix it so that I don't slow down. It's a, it doesn't mean I go, okay, I can't go running, you know. No, no, you can just use your leg this way. Not that way. You know, he said he does not believe in stopping for a second. And if you have someone that you trust like that, and if you're the kind of person, as you said, who is motivated to continue around, over or through what might be a challenge, then you definitely come out stronger and better on the other side.

Allan: 25:26 Yeah. I, I have a client and, um, he right now and he's, he's done so good. He works so hard and he's addicted to it, for lack of a better word. He's having issues with his elbow. So when we do any kind of pull movement, we have to be very careful, with his elbow. And he has now some arthritis in his shoulder. And so when we're doing push movements, particularly overhead, we to be very careful about those push movements and he's, you know, he's making some decisions on how he wants to deal or if he wants to deal with those medically, but there is pain involved. So we're, we're trying to modify the movements, we're trying to do all of those things that you said functionally allow him to do the things, because I told him it's basically tendonitis in the elbow.

Allan: 26:13 Rest is the primary prescription, but we've tried three weeks of rest and then the pain comes back. So it's like, you know, that this is something more than just what rest might do. He still wants to pull. So I'm like, okay, let's talk about where the pain starts, where it finishes, let's figure out ways to modify the work so that you're still able to build muscle and build strength, without putting yourself in a compromised or painful position. And he's working with me. We're diligently through that process. And it's, it is a process. And it's, it means he's actually had to work harder to get past this. And I'm so proud of him for doing it because a lot of folks would sit there and say, I don't like the pain and I'm quitting, but the pain is actually probably a signal that you need to change something and you probably need to work a little harder to make sure you're doing the right things.

Moira: 27:06 It's actually fascinating because usually we're working with clients who are putting up their own blocks, you know, missing a session, going off exercise for awhile, giving up. But you also have to be careful of clients who are the act the opposite who maybe want to push too hard, push through the pain. You have to slow them down just slightly,

Allan: 27:28 Just slightly. Yeah. Yeah. Because when he told me, I had to do a back workout. I'm like, okay, well let's talk about how you did it, what you felt, where were we, you know? And then we get into the actual exercises and I'm like, okay, let's change this exercise and do this this way. Let's change that exercise and do it that way, and then let me know, report back how that felt. And so each, each week we get on our calls and you know, where we're going through this stuff. And yeah, I've got other clients that if something goes wrong in their day, they're gonna, completely just miss a workout miss, scheduling a call with me. Something like that. And I'm like, no. So I have, I have both sides. You're right. I do have clients that, that required both and I understand both. I've been in that situation where, you know, you can't work out and you really want to, or you just, a time when you, you feel a lot of something going on or DOMS or something like that I really don't want to waddle into the gym today.

Moira: 28:27 That's right. I actually found that happening after I'd been competing, that I was kind of burned out. I would drive to the gym because it was habit, you know, the car just went there and I would sit outside and I remember there were one or two times when I never actually went in. I just thought, no, I'm going home. It was very strange. It was a very strange, I, that's why I remember it so clearly because I just couldn't get myself to go in. So I do understand people who do that.

Allan: 28:58 I've actually had that happen myself. I was working a very stressful job, at a very stressful point in time at that job. And I just like you did, I remember the alarm going off in the morning. This is back when I actually used alarm clocks and the alarm went off in the morning for me to go to the gym and I hit the alarm and I was thinking to myself, I am either going to the gym or I'm going to work because I can't do both.

Moira: 29:27 Yes.

Allan: 29:28 And it was just that understanding that, working out is a stressor. If you're already chronically stressed, sometimes the workout, you do better to spend that 40 minutes meditating or are soaking in an Epson Salt bath or something that's going to distress you, than actually getting in the gym and pushing yourself really hard. So yeah, I think there is an aspect where you do, you do listen to your body, uh, but, but, but don't let that body just to eventually talk you into, uh, well let's, let's drop by Dunkin Donuts and do those types of things. It's more of a conversation of saying, okay, I understand, you know, very stressful week. I'm fatigued, I'm not sleeping well. I would do better with an extra hour of sleep than I would by spending that hour in the gym and gave yourself that permission.

Moira: 30:25 Right, exactly. As long as it doesn't become the habit, it's a very good thing to do. I know you probably had this too. I have friends who will not miss a day. And I keep saying to them, you don't understand that rest is actually good for building muscle and rest is good for the rest of your workout. And you can miss a day. Their habit is to go in every single day and it's almost like an addiction.

Allan: 30:54 Yeah. I just tell him this, professional athletes have de-load periods. A bodybuilder will work hard for, eight weeks and then they'll take a de-load week where they don't lift. The other thing they are doing that a lot of us are not doing is most professional athletes will sleep for eight or nine hours every single night.

Allan: 31:23 And that's because they understand the value of recovery. So you need those de-load weeks. professional athletes that put like the football players. I can tell you as soon as they finish their football season, they take three or four weeks off and unless they need to go in for some form of surgery to rehabilitate for the next season, they just take an act like normal people for three weeks. And they don't go to the gym and they don't exercise and they don't train and then they let their body recover and with that recovery they go to the gym hungry because they didn't feed that desire, that work, you know, that, that, that thing for three weeks. And when they went back in the gym, it was, you know, they were ready to go. But you need that. You need that recovery time.

Moira: 32:09 Absolutely. I'm glad you mentioned that because we are, we are discussing here how to encourage people to get into the gym. But you also say everything in moderation, especially when you start out.

Allan: 32:21 Oh yeah. The way I like to put it, I put it in the book is what you need is you need gentle nudging your body, your body will change. You just have to give it these gentle nudges, the progression to make that happen.

Moira: 32:34 That sounds like a good description. Very good description. I like the gentle nudging. It sounds so much better than get in there and push.

Allan: 32:42 There's little bit pushing in there, too. You want to find that line and, and you know a lot of people you'll hear this term when we talk about resistance training of failure, pushing yourself to failure. You don't have to get to failure for your muscles to grow. You just need an adequate stimulus. Now failure is a is typically a good indication that you definitely have that stimulus. DOMS can be an indicator that you have affected that stimulus, but they should not be the objective. The objective should be where, you know, the muscle was worked, it was worked through the full range of motion and you can feel that you worked at, now you may wake up the next morning and feel just as capable of, go in and do that workout again. Most cases probably not. But as long as you're giving your body that stimulus and then you're giving it the food and the nutrition it needs and then you're giving it the rest, then you're giving full cycle for your body to grow and to get better.

Moira: 33:43 Yes. Exactly, that full cycle. And I like what you said about the sleep because when I, when I was seriously into it, during the competition, I would be in bed by nine o'clock every night getting up at five or six to go train. But I, nothing stopped me from going to bed and getting the full eight to ten hours sleep. I wouldn't, I won't say ten but definitely eight, eight or nine. I get out of that habit

Allan: 34:15 I'm in bed at eight 30 and nine o'clock almost every single night. I have not used an alarm clock in four years unless I have to catch an early morning flight and I'm just don't want to make sure that extra sleep cycle happen. I sleep until I know my body's gotten at least five sleep cycles, which is seven and a half hours. And occasionally my body will want a sixth one, which will put me up to about nine hours. But I just let my body sleep until I wake up and say, okay, I'm good to go. And where I am here in Panama's actually really nice because the days and the nights are relatively the same.

Moira: 34:50 Same, right.

Allan: 34:51 Gets dark around seven o'clock. So by 8:30 it's, it's been dark for a little while. I'm able to just go ahead and go to sleep very easily. And then it gets light around 5:30. So you know, right now pretty much it just the, just that Twilight morning stuff, you know, it's like can see it coming through the window. That's usually my spur to get up. And if I feel it, I do, if not, I'll, I'll go back to sleep and sleep for about another hour and a half, a good sleep cycle. And then I'm up really good at seven o'clock so I know every morning I'm going to be up by seven o'clock for sure. And I plan to start my days usually at nine o'clock. So no problem. I have time to shower and do all the things I want to do, but I don't use alarm clocks and I try to keep my evening activities to a minimum.

Moira: 35:38 I think that's excellent. Um, I think I got into, you know, working full time in corporate field. I got into some bad habits of working late. It was almost expected really. You just had things you did at night. And so I'm slowly getting back into the longer sleep cycles and switching earlier nights and then earlier mornings.

Allan: 36:00 Yeah, I guess I just got, when I got towards the end of my corporate I was like, you know, I've worked my way up to this point. I deserve to rest when I want to rest. And so I would sit down, I'd pull up my phone and I would check email at about seven o'clock at night and after I checked that email at seven o'clock, I'd set my phone in the, in the living room and I'd grab the bedroom and go to sleep. I don't even have the cell phone in my bedroom and so I was out of sight, out of mind. I'd go to sleep when I woke up, like I said, 5:30 in the morning, I would go in there and check my work email because I figure if they stayed up till 11 o'clock working and they sent that email and went to bed, wake up in the morning, and my email response would be there and then I didn't have to be up at 12 o'clock to answer that email if I answer it at five o'clock in the morning. So, I had my own system.

Moira: 36:47 Good habits.

Allan: 36:47 Still stress was a big problem for me and it caused me some issues and so I've, I'm still working on that whole thing, but you know, just say, listen to your body and give it the rest of needs, push it a little bit. It'll grow and it'll get better. And then it just the patients and persistence of keeping at it,

Moira: 37:05 Definitely. It's a keeping at it. That's it. To be consistent. Yeah.

Moira: 37:10 I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and stay well,

Moira: 37:19 And of course this would be personal. You know, everyone has a different approach. So yeah, here's what I thought about this for quite a while actually. And I decided one is to do something active every day, whether it's going to the gym, taking a long walk, going for a jog, taking a hike, but do something active every day.

Moira: 37:41 Have a morning routine. And I've really gotten into my morning routine, which includes the meditation, some deep breathing, perhaps a 10 minute yoga or some exercise just for 10 minutes or something to wake me up. And then some abs. I want always do some abs in the morning, just do it then. Okay. So that's my, my morning routine and that seems to be good for what I do. And I think whatever you choose to do your morning routine should be consistent because it sets you up for the day.

Moira: 38:18 And then the third thing would be to connect with friends as often as you can because that's really one of the things that gives us the internal hormone boost that keeps us happy, content and feeling connected

Allan: 38:34 I really liked those. Thank you for that. Moira, If someone wanted to learn more about you, learn more about the fit beyond 50 you haven't set up the website yet so I'm going to, I'm going to tell them the link actually summer [inaudible] break in and say, okay, you can go to 40plusfitnesspodcast.com/fit50. Again that's 40plusfitnesspodcast.com/fit50 and that's going to take you to the signup page for the Fit Beyond Fifty Summit. But Moira if there's any other address, is there anything else that you want them to know about? Feel free to let us know.

Moira: 39:10 No, I think that that's great. Signing up there is the best strategy because they could email you or me, but I'm having, I have a feeling they're just signing up. There is going to be the easiest. And the, the, the summit is going to air on the 28th of October. I have a variety of speakers including a special speaker, Allan Misner.

Allan: 39:40 Yeah. I don't know if you cut it out, you probably said you said you might be cutting it out. But yeah, I didn't knock over my computer while we were talking. So it was a very fun conversation. Much like this one was some way. Right. Thank you so much for being a part of 40+ Fitness.

Moira: 39:56 Thank you so much for having me as a guest. I really enjoyed the conversation.

You can learn more about the Fit Beyond Fifty summit at https://40plusfitnesspodcast.com/fbf.

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Another episode you may enjoy

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October 14, 2019

Adaptogens with David Winston

Adaptogens and nootropics are becoming much more popular as the flaws in Western medicine become more and more apparent. David Winston has spent over 50 years studying herbal medicine. Today we discuss his book, Adaptogens: Herbs for Strength, Stamina, and Stress Relief.

Allan: 01:02 David, welcome to 40+ Fitness.

David: 01:05 Thank you very much. It's a pleasure to be here.

Allan: 01:07 You know, more and more, in the last 10 years. It just seems like it's a, it's kind of a building thing, which I think is really good, there's more discussion about some of the natural healing properties of plants and herbs. Looking back at some of the Eastern medicine, Chinese medicine, Ayurveda from India, and actually adopting some of those now as treatments and protocols and not going with the chemicals. So your book Adaptogens really kind of gets into the history of this and to what they are and how we can use them. It's fascinating to me how much as out there and we're just still just kinda scratching the surface.

David: 01:56 Well, that's true. You know, it's interesting. This year is the 50th year since I started studying herbal medicine. And I joke a bit, but I'm not entirely joking when I tell people after 50 years, I now consider myself to be an advanced beginner. There is endless amount to learn whether we are talking about traditional Chinese medicine aryuveda, the middle Eastern Teb Al Nabawi, Kampo from Japan, et cetera, Tibet Medicine, American eclectic medicine, physio medicalism, all these traditions are rich in the use of plants for medicine. So these traditions in some cases go back at least 3000 years. Plus you then combine that with the vast amount of plant, medicinal plant research that is occurring throughout the world.

More...

Very little unfortunately in the United States, but extensive amounts in China, India, Iran, Japan, South Korea, Sweden, France, Germany. So all around the world there is a tremendous amount of plant research and in many cases, this plant research, this modern plant research is confirming, although sometimes going well beyond the understanding that people have had for thousands of years of how these substances can help us to live healthier, better lives.

And one of the things that's really important to understand, a lot of people have this idea that it's sort of an either or situation. It's either Orthodox Western medicine or it's complimentary alternative medicine, herbal medicine, natural medicine. And honestly, nothing could be further from the truth. Where Orthodox medicine is strong tends to be where things like herbal medicine aren't that effective and vice versa. Where herbal medicine is really strong, tends to be in areas, especially dealing with things like chronic degenerative disease where Orthodox medicine often has little to offer.

So when it comes to the individual, the patient, the client, the real win-win is understanding which is appropriate in a given situation. Herbs are not the answer to everything. Adaptogens are not the answer to everything, but then nor does Orthodox medicine have the answer to everything. So understanding which therapy, which treatments are most effective, most appropriate for a given situation, for a given person is essential.

Allan: 04:36 Now an adaptogen is not just a chemical compound they're pulling out of a plant to, to make a new medicine with its, it's actually using the whole plant. Right? Can, you can talk about adaptogens, what they are and what they do?

David: 04:50 Absolutely. And this is going to get slightly complex. Um, but I will do my absolute best to keep it as simple as possible. So initially, you know, in all these ancient systems of medicine, there are tonic herbs. So in Ayurveda they're called Rasanayas, in TCM, in traditional Chinese medicine, they're known as Chi Tonics or kidney youn tonics or blood tonics. But these traditional definitions of a tonic remedy do not necessarily equate to what we today call an adaptogen.

An adaptogen is a modern scientific concept developed initially in the Soviet Union. The initial research was done by Professor Lazaroff starting in the late 1940s. If you think, wow, they must've been very, you know, forward-thinking to do this kind of research. The reality was this was initially military research and the Russians were, the Soviets were trying to do what cruise chefs said, and that was to bury the West. They were trying to find ways to make better soldiers, better cosmonauts workers so that they could outdo us and literally win the cold war.

Basically what happens is the research eventually goes from the initially started looking at chemical substances and with Dr. Breckman who is considered the father of adaptogenic research. He switches over to looking at plants and they eventually settle on a plant called, at the time in the United States, we learned about it known as a Siberian ginseng, but the proper name for it is Eleutherococcus senticosus and that's where the initial research starts. And what they did is they first promoted a definition of an adaptogen using a very simplistic three parameters.

Number one, the plant was nontoxic in a normal therapeutic dose. Alright, so that's, that's fine. The problem with that is that describes almost every herb in the material Medica. I mean they ask, there are some toxic herbs, but most herbs are relatively benign in a normal therapeutic dose.

Secondly, they decided that these herbs would create what was called a nonspecific state of resistance to stress. So that means they help you to resist stress, whether that stress is psychological, physiological, or environmental. But the problem there is that other categories of herbs including nervines, which we think of as nerve tonics, things that are common also help you to deal with stress more effectively. So that doesn't really mean that is absolutely an adaptogen.

And thirdly that they would have what is called an amphoteric effect on the body, helping to normalize function of multiple systems, especially the endocrine system, nervous system, immune system as well as the cardiovascular and digestive systems. So that was the initial definition. And that last started, I think that was, that definition came out around 1969 so after that and the intervening where now 50 years later, the definition has changed.

Now those first three parameters are all still true, but they have added to the definition. So in the 1990s they determined that adaptogens work primarily through two master control systems in the body. One is called the HPA axis, that's the hypothalamic pituitary adrenal axis. This is the master control system of almost all endocrine function, much nervous system function, immune function and what also what deals with chronic stress in our lives. And then the second system is called the SAS, the Sympathoadrenal System. And this is your fight or flight mechanism, which deals acute stress. So in order for an adaptogen to be an adaptogen, there has to be evidence that it is primarily working through one or both of these two master control systems. Further research showed us that adaptogens also work on a cellular level.

So what does this mean? It means that they do several things.

Number one, they help reduce stress hormone production. So that's especially cortisol, norepinephrine, and they help prevent cortisol induced mitochondrial dysfunction. So for instance, some of the conditions associated with stress induced mitochondrial dysfunction include things like fibromyalgia, chronic fatigue immune deficiency syndrome, which is one of the reasons adaptogens can be so useful as part of a protocol for treating those conditions because underlying those conditions is basically elevated levels of stress hormones, specifically cortisol, which shuts down the mitochondria, which are the engines of yourselves. So if your mitochondria are not working, you are going to have all sorts of problems with fatigue, with muscle weakness, with muscle pain, uh, with cardiovascular issues and et cetera, et cetera.

And they do this, not only do they shut down the excessive production of cortisol, but they do it by up-regulating certain stress modulators in the body. These are noticing heat shock proteins, fork head proteins and something known as neuropeptide Y.

So in order for an herb to be an adaptogen, it has to do every single one of these things. Of course the ancients had no idea about any of these things. So when they are talking about a Rasanayas or a Chi tonic, you know, those things, some of them actually turn out to be adaptogens, but of course, many of them do not because they don't meet the parameters of today what we know is an adaptogen.

Allan: 11:02 Okay. So kind of my key takeaways from this is that that one, adaptogens don't just address one part of the body. Like I think in the book you talked about how tumeric actually supports the liver, a single organ versus actually supporting the whole body through the, you know, HPA and through the SAS Yes. Right. And then the other piece of it is it doesn't just push us in one direction. It's sort of a balancing, getting us more towards homeostasis than pushing us in one direction just because we're stressed trying to push us unstressed. It's literally just kind of trying to find that balance.

David: 11:42 Correct. Now I will say that turmeric by the way of course is not in adaptogens. The turmeric, it just doesn't work on the liver. A tumor has much broader implications. In fact, the majority of herbs have a wider sphere than just working on a single organ. But adaptogens you could, yes, I think your, your definition, think of them as almost systemic remedies, but they're primary effects are on endocrine nervous system and immune function. That is where, because that's of course what the HPA axis and the SAS, those are the things that they are affecting. Now of course the reality is is that the SAS also and the HPA axis also affect skin function. They also affect circulation. They also affect reproductive function, both male and female. So again, very wide ranging effects.

And at the same time you'd mentioned homeostasis. Adaptogens work in a really interesting way. So think of it this way. We, we, anybody who has had anatomy and physiology learned about homeostasis, where the body tries to maintain its normal balance. So some things are maintained in very, very tight, like your serum sodium levels, your blood serum, serum levels of sodium have to be maintained with a very, very narrow range. And so the body will work exceedingly hard to make sure that it stays there. And the idea of homeostasis is everything's tries to stay the same. Well, in reality, there is a second process known as allostasis that the body uses to maintain homeostasis and adaptogens also enhanced allostasis.

What is allostasis? So any of your listeners who have ever gone surfing, and you don't even have to be a surfer, you could go skiing, you could go ice skating, skateboarding, anything where you need really good balance. So if you got up on a surfboard and you stand absolutely still, as those waves are moving you in every direction, you're gonna stay on that board for about a second. In order to stay on the board, you start moving and shifting your body weight to compensate for changes. That is allostasis. Allostasis is the body's ability to change in order to maintain balance and adaptogens help in that process.

Allan: 14:16 Okay. So most of the book we're talking about stress, so we're talking about our body is going through, it'll can go through acute stress, which just basically means, you know, I see a bear and Oh, I've got run, versus chronic stress where my CFO is the bear and he's on me every single day. And so that stress just sticks with me and my fight or flight is basically every waking moment. Adaptogens can kind of help us with that. Right. So can you kind of talk through the stress reaction process and then how adaptogens can support us as we deal with chronic stress.

David: 14:53 They're working on multiple levels and that's where it gets a bit complicated because, just to give you an example: I mentioned earlier that among these sort of molecular chaperones or stress chaperones that adaptogens affect, we have what are called heat shock proteins. These are molecular chaperones. And so these molecular chaperones heat shock proteins protect, mitochondria from stress induced damage. Then they also regulate a chemical called FOXO. It's a fork head protein and basically FOXO basically is a neuro. FOXO is upregulated and it promotes the synthesis of proteins that inhibit the effects of stress. It helps detoxify cells. It also has been shown to enhance longevity. I also mentioned it basically up-regulates in neuropeptide Y, which is a neurotransmitter which has been shown to relieve anxiety.

It's been shown to inhibit pain perception. It lowers blood pressure, it inhibits addiction, it inhibits cortisol release. So those are just some of the compounds that it is affecting and having a broad ranging effect on the body. So when we are under stress, there is a whole cascade of cellular and organ response in the body. And adaptogens are saying to the body, think of adaptogens as sort of like a stress vaccine. Some people call it a stress memetic. In fact, what adaptogens do is they say to your body, stress is coming. So let's get ready for stress. In that sense, it's a little bit like going to the gym. So many of your listeners probably work out, maybe some of them are runners. You did the first time you ran, you didn't run a marathon, at least not if you were smart the first time you start running a short distance and then the next day you run again and again, or you go to the gym and you start off with a low amount of weights and a small amount of repetitions and you gradually work your way up to where your muscles become stronger. We are more stamina, more strength and the ability to do more

Adaptogens work very similar to this. They basically say to your body, stress is coming yet ready. And so the body builds up so that it is more prepared to deal with stress when the actual stress comes, whether that is an acute stress or a chronic stress. The one difference between adaptogens and say going to gym is that if you go to the gym and you don't go to the gym for two weeks, you may lose a little bit of strength and stamina, but you still have a significant long-term effect adaptogens to be taken regularly because the effect doesn't have a long term effect. So these are things you would take on a regular basis. And of course, which adaptogens and individual takes are going to depend on the specifics of that person because it's important to note that adaptogens are not a one size fits all phenomenon.

A lot of people think, Oh, you need an adaptogens, just take any one. Well, that's not true. There are stimulating adaptogens. There are calming adaptogens. There are heating adaptogens, cooling adaptogens, drawing adaptogens, moistening, adaptogens, nourishing adaptogens. And so the key is, and that's more of course, one of the reasons I wrote my book, is that I wanted people to understand what I would call the personality of each of these adaptogenic herbs so that you can figure out which one or ones, because remember, traditionally in all of the great systems of verbal medicine, herbs are never taken as simple as meaning one herb at a time. They're taking in complex formulas.

Why? Because we are dealing with complex people with complex problems. And so the idea is which adaptogens or adaptogens and the sort of supportive herbs or companion herbs for adaptogens such as nervines Nootropics, we'll talk about this more later, or restorative tonics that you take with them to help create something that is actually going to be beneficial and work for the individual. Great herbalists don't treat diseases. We treat people.

Allan: 19:17 Let's go ahead and jump ahead then and let's have that conversation about the nervines and the supporting components and, and, and the Nootropics. Let's get into those. Just a little bit so they know what we're talking about.

David: 19:29 Okay. So we just, we've defined what an adaptogen is and we'll talk more about them. But there are other, and I include this in my book, there are other herbs that I would call companion herbs to adaptogens. They work really well with adaptogens.

And so the three categories of these, and the first is nervines are nerve vines in England and these are calming herbs. I mentioned that briefly before and they basically helped restore the emotional foundation. So for people who are especially type A personality, for people who are emotionally labile, for people who have number ten reactions to number one problems. Nervines can be really useful along with perhaps calming adaptogens. For a person like that.

Then we have water known as no a tropics. Now I have to define this because nootropics, some people call them smart drugs.There are three different categories.

There are the chemical smart drugs, which are often designer drugs created in the laboratory with no history of previous use and no record of safety. Uh, I am very leery about these substances.

Then there are the supplement, nootropics and these include things like L-carnitine and things like that which have a very good safety.

And then there are our herbal Nootropics and there are a wide variety of herbal nootropics. These herbs tend to be neuro-protective. They are anti-inflammatory on neuro anti-inflammatories. They enhance cerebral circulation, they enhance memory, focus, concentration. And there is some evidence that at least some of them may help at least slow, if not possibly help prevent something like dementia or Alzheimer's. But that is a very, very preliminary.

Then we have what I would call restorative tonics. And these are basically herbs that are nutritive. They help to enhance overall function, but they do not meet the definition of an adaptogen. So now I'll mention a couple specifically.

We have herbs like the goji berry. Very, very popular herb. And the Chinese herb astragalus. Herbs like this are wonderful nutritive herbs, but they are not adaptogens, even though a lot of people tend to throw them in that category, unfortunately, they just don't meet those definitions.

Allan: 21:58 Okay. If I came to you as a client and generally, okay, you're just a general description, over 40 and high chronic stress and you were going to kind of put together a general protocol, what are some of the things that would be included in that protocol?

David: 19:17 Well, unfortunately, that's not enough of a definition, a description that I could come up with something because I need to know everything about you.

You know, as is somebody who is a patient of mine. I need to know not only their age and their weight and their blood pressure. I need to know their medical history. I need to know, I need to know everything I can about them, you know, and they would bring in their blood work from their physician and their diagnosis is that they have from their doctor. And you put together a protocol that is specific to the patient.

Because remember as I said, great herbalists don't treat diseases. Medical men, Western medicine focuses in on disease. We don't focus in on disease. We focus on creating protocols to help people be well, to help people prevent disease. To help people to gain maximal health, strength, longevity, et cetera. So, but what I would look at is, for instance, if you were somebody who was deficient and depleted, I might include some stimulating adaptogens and stimulating adaptogens would include things like, perhaps, Asian Ginseng or Rhodiola.

On the other hand, if you were really depleted, deficient, exhausted all the time, then I want to make sure I include some of the nourishing adaptogens. So there may be something like American Ginseng. If you were a type A personality, you know, you can't shut your mind off, then we might consider some of your calming adaptogens such as Ashwagandha or Schisandra. And so there are different ones that we would use.

And by the way, not every single person gets an adaptogen. And I don't want people to think that adaptogens are panaceas. Adaptogens are incredibly useful. Don't get me wrong, I do use them a lot, but I'm using a broad spectrum of herbs. Adaptogens are just one part of that. And I need your listeners to understand. Adaptogens are not a replacement for the foundations of health.

Foundations of health are adequate, good quality sleep, a good diet, exercise, healthy lifestyle choices. So if you are eating fast food three meals a day, only getting six hours sleep, running yourself ragged, training for a marathon, working in incredibly stressful job, and smoking, I don't care how many adaptogens you take, it is not going to make up for the fact that you are abusing yourself. And in fact at best it's going to simply allow you to abuse yourself a little bit longer until you finally collapse.

It's kind of the whipping the exhausted horse. You can make it go a little further, but it's going to collapse. So adaptogens are not a replacement for the foundations of health, but for the average American who is overfed under-exercised, not getting enough sleep, especially when it's a situation where, for instance, you're actually trying to take care of yourself, but maybe there's a new baby in the house.

You're not getting enough sleep. Or maybe you just graduated from a law school, passed your boards and you just hired on to a new law firm and they're expecting you to work 70 hour weeks. Or maybe you are in college and you're having to pull all-nighters and study, which I do not recommend as it reduces comprehension dramatically.

But you know, adaptogens under those circumstances where you mentioned the example earlier where your boss is on your case all the time and it's incredibly stressful and maybe you don't have the option to change. Maybe you're in a situation where you live in a small town where there's only one employer and you don't have a lot of options. Adaptogens can be incredibly useful. Again, helping to prevent stress-induced cortisol elevation, helping to reduce the stress-induced anxiety, helping to reduce the stress-induced elevation of blood pressure and the resultant of course, mitochondrial dysfunction that comes with elevated cortisol levels.

And I will point out that elevation of cortisol can come from lack of sleep, obesity or stress And chronically elevated cortisol levels not only basically shut down the mitochondria in the cells. Chronic elevation of cortisol is proinflammatory and of course all of our chronic degenerative disease is inflammatory in nature. It raises blood pressure, it interferes with sleep, it interferes with digestion, it decreases the immune response, and increases the growth of tissue including skin tags, benign prostatic hyperplasia in men, fibroids, uterine fibroids in women cancer, chronically elevated cortisol is really not good. And so anything we can do to help our body to reset and be at a, you know, a healthier baseline on a regular basis is going to a long term have profound positive implications for our health.

Allan: 27:31 So I guess the way I kind of take this, as you know, you can't just say, okay, I need ashwagandha. I need a Chinese Ginseng or Asian Ginseng root. I need American ginseng root and everybody needs that. The reality is you're going to have to kind of put together a protocol for yourself based on your own personal needs.

David: 27:51 That's actually true. You know, they're there. First of all, as I said, not everybody needs adaptogens, period. But if you do feel you need adaptogens, and again, that's one of the reasons I wrote the book is so that each herb has its own monographs. You can read about it and say, wow, does this make sense for me? And I often mentioned like, I often use it with this or that so that people can kind of get a sense if they don't have access to a clinical herbalist or a naturopathic physician who's trained in botanical medicine or a medical doctor who knows herbs. If they don't have access to someone like that. They can at least educate themselves so they can decide which of these things may, would be most appropriate for them. And again, not everybody needs them, but I would say that, you know, discounting cultures where they're either people are actively starving, suppressed or at war, Americans are some of the most stressed out people in the world.

Allan: 28:51 Absolutely. That's why I moved to Panama.

I define wellness as being the healthiest fittest and happiest you can be. What are the three strategies or tactics to get and stay well?

David: 29:07 Well, three, let's go back to the foundations of health that I just mentioned. In 1910, the average American slept slightly over nine hours per night. Now, the average American sleeps less than seven hours per night. In the intervening 100 plus years, we have not evolved to need less sleep. We're just chronically sleep deprived.

So number one, make sure that you get minimum seven hours sleep at night. Eight is definitely better. If you're sleeping more than nine hours a night, that suggests some issues. So somewhere between seven and nine hours is probably ideal. But the key important thing is when you wake up in the morning, do you feel refreshed? Do you feel rested? Because even if you're getting 12 hours sleep at night and you wake up in the morning and you feel tired, you're exhausted, then you have some type of sleep issue. And so it is absolutely essential that you figure out what that is.

Because, no matter what you have, if you have sleep issues, your chances of having a heart attack increase. If you have sleep issues, your chances of dying from cancer increase. If you have sleep issues, your blood pressure's going to increase. It gives sleep issues, your cortisol levels are going to increase. So sleep is foundational.

Number two, move and move a lot. We sit too much. We are not active. And of course some people are not as capable as you know, heavy exercise. I'm not talking about you have to run marathons, do what you can, whether it is swim, whether it is dance, whether it is practice yoga, move

Number three (I'm going to go beyond three). Eat a healthy diet and I'm astonished at what people think is a healthy diet. I have my patients fill out a three-day diet diary and I'll just sit there and scratch my head sometimes. Because people tell me, I think I eat pretty well. And so of course, food is foundational.

You know, they say as computers, garbage in, garbage out. Well, the diet is the same way. Garbage in, garbage out. You are dependent on your food for what Chinese medicines called the Gushi, the Gransha, the nutrients of that food to feed every cell in your body. And so eat healthy.

I am not a big fan of fad diets. I think that you need to figure out what works for you. And some people can be very healthy vegetarians and I've met people who just can't do that diet. So it's not like there's one diet that is good for everybody. You have to figure out what works for you. But what I can tell you very clearly is fast food, for instance, fried foods, a heavy, heavy meat diet, things like that are generally not good for almost anybody.

Then number four, emotional health. Emotional and spiritual health are, in my opinion, again, foundational. Having loved ones, whether it is anything from a companion animal to friends, to a life partner, to community, social networks. these are incredibly important. And I am a big believer in the power of a higher power, of having some type of spirituality in your life. I am not necessarily talking about a specific religion, but having something that you realize that you are a small part of something greater than ourselves. So having a meaningful ceremony, whether you think of it as the Gaia, the power of nature, God, or Allah, that to me is not as important. Of course for individuals I'm sure it is very important. Their spiritual and religious beliefs and that's great, but find something that works for you and works within your life.

And so for me, those sorts of things are absolutely foundational to health. And then we have other things that can add to that. And some of them, like nutritional supplements can be useful. Although I am much more interested in using herbs because I think they are more, much more bioavailable. And in a form that people can actually utilize more effectively. Those kinds of things. Stress reduction techniques are sort of built based on that foundation.

Allan: 33:49 Well thank you David. You know, one thing I'll say about the book is if anything and everything that you want to know about adaptogens, this is the book, that's called Adaptogens, but it literally you, you covered the history, you cover what they are, how they work. You know, all the different types. Cause there's, there's lots of them. You said there was 250,000 plant species that we've identified and we're just starting to learn how those can help us. But this book really, I think you could have called it the encyclopedia of adaptogens or the complete book with androgens. It really is comprehensive. And so if you're interested in adaptogens, I strongly suggest you check out David's book.

David, if someone want to get in touch with you, learn more about the book or things you're doing, where would you like for me to send them?

David: 34:33 Well, couple things. Number one, if anybody is interested in the book, they can get it. You know, simply from Amazon, if they like or their local bookstore. It's widely available. You can also contact me or reach me through to websites. There is my school, I have a two year urge studies program for people who want to train to be clinical herbalists and that is herbalstudies.net and then I also have a website which is an educational website where people can download free articles, information articles from my library, which is one of the largest private herbal research libraries in North America. Information on my classes where I'll be teaching around the world. I teach all over the US, Canada, Europe, occasionally central America, and that a website is herbaltherapeutics.net and those are the two are places that people can get additional information or contact.

I also have through, I believe it's herbal therapeutics website. I have a Facebook page where I do posts about every two weeks so people can tune into those posts and read the old posts every on thing. I'm mostly on the topic of herbal medicine and my travels and things like that. And so hopefully people will avail themselves. The book, Adaptogens, herbs for strength, stamina, and stress relief. This is the second edition and I think anybody interested in the topic will hopefully learn quite a bit and be able to make better choices for themselves in their use of adaptogens, nervines, nootropics, and restorative tonics.

Allan: 36:27 All right, you can go to 40plusfitnesspodcast.com/403 and I'll have the links there for the book for David's sites and all that.

David, thank you so much for being a part of 40+ Fitness.

David: 36:39 Thank you Allan. It's been a pleasure. Thank you for having me.

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– Tim Alexander– Judy Murphy
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Another episode you may enjoy

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October 7, 2019

Your vital force with Rajshree Patel

Rajshree Patel is a mind and meditation expert and an international self-awareness coach, trainer, and speaker. Over the last 30 years, she has taught hundreds of thousands of people in more than 35 countries the power of meditation, mindfulness, breath work, and other ancient tools for assessing the innate sources of energy, creativity, and fulfillment within. Today we discuss her book, The Power of Vital Force.

Allan: 02:06 Rajshree, welcome to 40 plus fitness.

Rajshree: 02:09 Thank you Allan. Happy to be here with you.

Allan: 02:11 You know, I was traveling back from the United States. I'd gone back to do a few things, work on my education is a personal trainer and then tried to get my house a little bit further shaped up so someone will actually buy it from me. And so it's been go, go, go, go, go. And then I had to drive cause I was trying to save a little bit of money on fly spirit, drive from Pensacola down to Fort Lauderdale. It's nine and a half hour drive. I do that drive and then I get on an airplane. I fly overnight, I arrive into Panama city at 1:30 in the morning, get to my hotel, go to sleep, wake up early. Cause you know, it's just normal wake up time. Uh, go ahead and do what work I can get to the airport, fly over to Bocas. And I got here last night and was just like, I just, I'm just drained, you know, all the, all of this is on me and I think we use that word a lot. Drains, you know?

Rajshree: 03:06 Yes, we do.

More...

Allan: 03:07 And I think, you know, and when you, when you really kind of start putting that together and you say, well, okay, why is my back starting to hurt? Why is my posture suffering? Why do I, and why is my head kind of hurting? And it's that draining and so it is really, you know, we, we use that in the Western vernacular of, of force of energy, but we don't really break that down to think of it in terms of all the other aspects of our health and wellness.

Rajshree: 03:35 No, no, I don't think we do. To your point, I mean I was going through a similar thing at some point before I got exposed to what we're going to talk about it a little bit, this idea of a force or energy. I was a lawyer in LA doing all this stuff that anybody has to do. Going to court, managing my files, you know, family, friends. I had just moved from New York to LA, so I was isolated doing my own thing on my own and trying to find a place to sort of fit in, connect, so emotionally there were things going on. It was a lot of stress going on mentally in terms of a brand new job. It was actually my first job as an attorney and a new city and so on. I was somehow getting through things. I knew I was tired. Obviously I was waking up in the morning not bouncing out of bed and dragging myself and kind of wishing no, what the heck happened? How did this night go by so fast and to your point, I hadn't really connected the dots. When I say I'm drained or I'm wiped out or I'm exhausted, I was really talking about not being charged or fueled enough and your basic food or gym.

If I happen to have done it that day or that week just wasn't getting me through the day until by chance. In 1989 I discovered this whole notion of vital force and how really we have too fuel all the levels, you know, of our life in order to do what we have to and then some of the things we want to do.

Allan: 05:10 Yeah. You know, as I was kind of looking at myself and trying to, you know, kind of build a better me because I knew I kind of, same thing, I went the public accounting route and then into internal audit and worked my way up C suite and all of that. And when they finally let me go, uh, it was kinda like this gush of pressure of everything. It's like, Oh, and when I took some time kind of sit back, that's when it has kind of really dawned on me that I had never really gotten completely there because I had not really ever paid enough attention to the things that were going to bring me what I needed. So like I defined fitness as being the healthiest fittest, happiest person you can be. And, and even though I was doing things in my life, that brought me some happiness and some joy, I really wasn't getting all the way there all the time. And it was too many things pulling me, pulling me back into the abyss. Now in the book you talk about the three main pathways to happiness. Could you take a few minutes to talk about those? Cause I think this is, this is critical if we're really going to get to wellness that we address this, this first, you know, happiness. I actually did them in reverse order. I should uh, dealt with the happiness first and then started with the, the fitness and the health cause I think it would've been a lot easier.

Rajshree: 06:29 Oh sure. I mean, so I think everybody knows, you know, what it means to be happy at whatever level. But we never really break it down. There's this sense of happiness that we get. Just a quick thing, a momentary thing like you show up to play or watch soccer and you enjoy it. You want something, you get it and you enjoy it and you're happy about it. But the moment it's over, it's over. And that has its own impact in terms of how it wipes us out. Because if it's just that level, what I find is I need more and more of it, you know? Uh, I entertain myself with one thing and then the next weekend I want a little bit more. So yeah.

Allan: 07:08 I get depressed when football season ends.

Rajshree: 07:11 Yeah. Because it's, it's over like you need the next thing. And even in football you notice you want like the next game, the match has to be a certain way. And who the, who's really, you know, with each other, which player against what player, what coach with what team. So we want a little more of it. But then there's this other layer of happiness where you don't just watch, it's not momentary. A metaphor would be you actually go and play soccer so you engage, you participate. And that brings another level of joy or happiness. It stays with us longer. It has comradery too. More meaning, more engagement, you know, a sense of, Oh wow, I did something cause we kind of tapped into some part of ourself that we hadn't really expected. Perhaps we played well or something.

Allan: 08:01 To me, I actually do that now through tailgating. I, you know, obviously the college football team's not going to let me on the field. So I go to a tailgate beforehand and hang out with my friends and have conversations and all that. So that's, that's where that engagement comes in for me.

Rajshree: 08:16 Exactly. And it stays with you in a very different way because even when you go home, you're talking about the game and what you saw. But somehow that, that sense of belonging in this in a way is part of the whole picture. And then beyond that is this notion of coaching the game of soccer. You know, really getting involved in another level yet that's even more meaningful, more lasting. Where you contribute to somebody else's life as much as you contribute to your own joy. And I think that joy, that kind of happiness gives us, in my opinion, the resilience to get through a difficult time. It kind of boosts us from the inside out. It gives us a lot of energy and then we deal with the ups or the downs that are coming, you know, in the day.

Allan: 09:08 And I think that's why I so much more enjoy being a personal trainer and a coach then I did being an internal auditor. Yeah. I mean I'd go off for my weekend, you know, and I would, I would go to a college football game and I would engage with my friends. So I had the pleasure of being at the game. I had the pleasure of just the all of game time experience and then the time with my friends. And then yeah, there's the Facebook message group where we're all gonna be either really happy about the game or be really upset about the game or either side and everybody's arguing. And even that I like just kind of sitting back and watching all that, but then I, I kind of go to work and it's audit, you know?

Rajshree: 09:46 Yeah, yeah, exactly. But you know, there's another level to all this, which most people don't really connect the dots to. And that is like when we feel our best, when we feel like we have the most amount of life energy and doesn't matter what's going on outside, we feel really charged up. Like you come back from vacation, you know everything's still the same. You come home and all the things you have to do are still there. But somehow your outlook Monday is much more optimistic, much more positive, and you're ready to jump into the day knowing that it's going to be a lot of work cause you're out for a week or 10 days. And that kind of happiness, it's what I would call more innate. And it's directly, what I've discovered is related to how rested your mind is how much energy you really have. And I don't mean the caloric energy, you know, the food and, and the sort of your daily maybe green juice that somebody might do or coffee or sugar. I'm really talking about this thing called vital force, which you're sort of born with. Like if you look at kids, you know, they're not playing soccer, they're not watching and they're not hanging out. But there's a lot of joy and strength and stamina. And that's really what we're talking about when I say vital force.

Allan: 11:08 Yes. Now you got into a part in the book and as I went through it, I think I had to read it twice to kind of really walk myself down the line of, you know, the past, the present and the future. And how so many of us kind of get stuck in this loop and it prevents us from really kind of experiencing the joy the way that we could because of the things in the past that you know and, and the things we think are going to be in the future. And you kind of talk through that line because it, it's not a straight line. Like you would think like we had our past, is over. We have our presences now and then the future is there. But we don't live that way.

Rajshree: 11:51 No, no we don't. Um, so obviously depending on the event and how intense it was, you know, somewhere we store it in our system, our brain, our body, our mind, ourselves. Hold on. Two pleasant or unpleasant events and situations, you know, and we clearly know that if I bring up an unpleasant thing, depending on to what degree you've let go of it, you can have a reaction in this moment. And if we look when we're holding on to things, it brings with it a certain spectrum of emotions and we don't really realize it. But impatience, agitation, frustration, anger, regret, guilt, blame these emotions which are clearly not serving us, they're negative. That's what takes away our happiness are related to something that's already happened. It's done and gone. And if I asked someone, can you be angry about something that hasn't yet happened? Our general tendency is to say yes, of course.

But really if we examine it's not possible. If it's about something that hasn't happened, we're going to be afraid. We're going to be worried, we're going to be anxious, we're going to have doubts, insecurity. That's about something that may or may not happen. And I often like to use this, um, analogy of a, a computer. See a lot of times we're working on a file and in the background we have a lot of files open because we worked on something a week ago, 10 days ago, a month ago, and we kind of forget about it. But those files are still open in the background. They're doing something to our hard drive, our brain in the computer, the hard drive and what it's doing is everything from slowing it down, creating glitches, draining energy, taking the life away from the file, the moment that's in front of us. And a lot of times, you know, Allan, if you go to search something on a computer, you anticipate based on history, the computer anticipates based on your prior search and opens more options.

And I think that's really what's going on in our life. Our mind, our brain or body is filled with stuff that happened yesterday, year ago, 10 years ago in the moment we come in front of something. This moment, it anticipates all of that. We start hitting on those emotions and we're not conscious of it. And similarly the future, you know? I love to think that we have a future, but honestly we're so hardwired, we're kind of conditioned by the time we're 10 years old with through osmosis taken all kinds of things on with our friends and family and parents and school system that our future's really, us being anxious about, Oh my God, I hope what happened yesterday, last week or in my last job, it doesn't happen again. So it's really an anticipation of the past. Everybody talks about, Oh, live in the present moment and all of that. But we've never really broken it down to what it's doing when we are in the past or when we are caught in the future.

Allan: 15:09 Yeah, I, I was, as I was reading that, I was, I was kinda thinking back to like the last three years when I was, when I was doing the internal audit stuff and kind of the first year we came across like a downturn in the market and we got into November and the talks about layoffs started happening and then in December there was the layoff. And so I was like, okay. And it was, and that's horrible. If you've ever experienced that, I can tell you it's just as hard from the manager's perspective as it is from the employee's perspective because you're having these conversations that don't necessarily deserve to leave.

And then what happens is I got into football season and as we got closer and closer to November, which means, you know, September, October, when we're at prime of our football season, I just started getting this, this anxiety. As soon as football game was over and I'm driving back home, back to go to work on Monday, you know, my head's already into this funk. And so I didn't have that energy in that balance to go back to work. I had this dread and then you know, we got into November and these conversations started again. And then in December there was a layoff. And I can tell you kind the final year I was there, that dread started in July. And you know, I can't tell you how many wonderful things I did during that period of time that I couldn't be fully present for because of the anxiety I had for what my November and December were probably going to look like. There were no conversations about head count at that point in time. Everything was positive at the company. You know, we're going to do this, we're going to grow that. We're going to, you know, we've done this. All, all that was there. All those conversations were positive at work. I just had this looming dread that something bad was going to happen in November and I couldn't enjoy myself. Now what I had a dread for actually did happen. Um, so, you know, I'm not, you know, but, but there was nothing I could do to stop it from happening. It was completely outside my control. And rather than kind of be rational about it and say, I can't stop this from happening, this is not my call, not my thing. All I can do is, but I missed for the better part of two years. I miss a lot of joy because I just kept letting that cycle play out in my, in my mind.

Rajshree: 17:41 To add to a little bit of what you're saying, it's true. You had no control over it. You know, you lost two years at whatever with all the other beautiful things that may have been going on in front of your life. I also believe if we have so much attention on something, we invite it at some level, you know, if we really have a lot of attention on something being positive and uplifting and it's going to be great, then somehow I feel like the universe smiles back at us and we invite at least the positive vibe of the moment. And if we're really anxious and were concerned, Oh my God, this is going to happen, this is going to happen, this is going to happen. Just our vibe sometimes invites that. And so we lose on on multiple levels. We're just not aware of it. Um, the time now, the two years that you mentioned and who knows, perhaps if the outlook could have been different, maybe a different kind of result could have happened. We just don't know because life is so much more than just what we see, touch and feel and, and I think it's important to see that we can't change our future and we can't change our paths.

But nobody really not at home or in school has ever taught us how to get the heck out of there and say, okay, what's in front of me and how do I reboot myself to look at this moment fresh and new.

Allan: 19:04 Yeah. And I think that's, that's where I struggled with it as I just, I kind of just put that all on my shoulders and carried it. Yeah. And it just got heavier and heavier and heavier until it was lifted off my shoulders by the layoff. And then I was like, okay, now I have a wide open future. And I can just figure out how to make this the best I can make it.

Rajshree: 19:27 Sorry, I was just going to say I'm in, I'm in the middle of a, uh, sort of a big personal challenge at the moment. Yes. This book is coming out, but going through a lot of family things and I see that my mind wants to lock into that, you know, and not the joy of whatever's going to happen as a result of this book. And I have to consciously bring myself back. I need to take a short pause to say that's there and your worst imagination doesn't mean that's what's going to happen. Let's see what you can do about it now and get busy and get active in trying to address it. So it is a matter of being conscious and inviting a pause into my life to say, what can I do about it rather than how does it help me to sit here and worry.

Allan: 20:16 Yeah. In the book you put together an actual exercise where someone can go through and methodically put together these things and walk through the positive, negative, the emotion, the past future, the now can you kind of just briefly talk about how that exercise works?

Rajshree: 20:34 Yeah, absolutely. And I really invite people to sort of take inventory. Um, I do it for myself, you know, every three months or so. What I'm asking myself to do is to say, okay, what's keeping me up at night? What is the thing that lifts for me in my head? And I, you know, just make a list of it. And I always invite myself to make a list of 10 things that are going on. So like before I woke up, I saw my mind was running on, Oh yeah, I have to connect with Allan and how's he going to go and where's it going to go? And it's just a recognition that's not something that's happening now. It's about the future. I'm concerned about my mom's health. So that would go on the list, you know. My niece going away to college and the struggles that she's having as she's leaving home for the first time. So I make a list about 10 things that are either keeping me awake or I find myself talking about or thinking about, you know, or continuously somehow coming back to, and the moment I do that, first of all I've put light on it. It's not going on unconsciously in the background. Like those open files and then the exercise, ask the reader to look and see is it generating a positive emotion, feeling or experience or a negative feeling or experience. So I'm planning my vacation and that's positive. And at the same time somebody could have in the background, yes it's great, but Oh my God, so much work is going to pile up, or how am I actually gonna end up paying for this because things are more expensive than I had hoped for.

So just asking the reader to put a plus sign or a negative sign next to it to realize how much of our mind our time, our brain is caught up in positive or negative. And then to kind of label it, you know, there's a lot of talk on emotional intelligence, but we don't really know how to get cognizant of it. And if you'll look, um, not just positive or negative, but to say, wow, this is something that's already happened. It's about the past. And, and putting that down next to it or this isn't going on now. It may never happen. It's really about the future. It's a year away, 10 years away or I don't even know if it's going to happen. Okay. It's about the future and just making a list, taking an inventory about what is it positive or negative. And then if you add it up to see out of 10, is 50% of your life for time positive or 50% negative or is it more 60, 70, 80%.

And the unfortunate thing is we as human beings are hard wired towards a negative bias. Meaning if someone gives us 10 compliments and one insult, we really remember the insult more, it kind of sticks to us more. It's just how we are hardwired. So similarly, if we look at that list, I find that most people, we'll discover that 80%, eight out of 10 things are not working for them. It's not positive and they weren't cognizant of it. And the moment they notice it, they see it's a, a sort of a rude wake up call, you know, to do something about it and make a shift.

Allan: 23:55 Yeah. I um, you know, I was kind of looking at things right now that just weren't positive in my life that I had some control over. Uh, you know what, I had control over what I didn't and, and I just started saying, you know, I've got it all this negative on my Facebook feed for all this political stuff, you know, and so I said, you know, they have this pause feature on Facebook. What if I just pause this person for the 30 days? What will that do? And I did that for, you know, probably about, I'd say about six or seven people on my feed and my feet got nicer. It got more positive. I started seeing, you know, positive affirmations. I started seeing joy in people's lives. I started seeing birthdays and all these things that were good. And so I kinda got a little addicted to pausing people, sorry, friends.

But all you're gonna do is talk about politics and how terrible life is on earth. Uh, I need to take a break from you. And I did that as a kind of an experiment about a month ago. And my feet just kind of really got nice and I enjoyed the interaction with the people, enjoyed seeing positive things in their lives. You know, grandchildren and births and marriages. And there was some sad, you know, a friend of mine lost his wife and things like that. But all in all, I saw a real life and, and not that. So I, you know, I think you're right with those 10 things, I realized one of my 10 things was this, this negative Facebook feed and you know, rather than just walking away with it from it because that's, you know, next to impossible. I just, well what if I just tried this tweak to it and it kind of gave me an opportunity to be more in the now with my friends and what's actually going on in their lives.

Rajshree: 25:43 Brought a lot of positivity to the other people who are in the feed. Right? It's not just you by that simple act of putting a pause for a few people, you uplifted and up-leveled you, your energy, your vibe, what's happening for you and enjoying that. But at the same time it brought more of that for other people and, and it kind of becomes a conversation we spoke about earlier in terms of happiness. You know, it's, it's going to the football game and having the barbecue outside first and engaging with it and then driving home and going home and saying, okay let's guys stop over and get a beer here and see what happens. So you in a sense became contagious. The happiness became contagious. And so I love that. You know, why not spread something more positive and why not become more conscious about how do I want this to look for me in my life?

Allan: 26:35 Absolutely. Now I've always been a big fan. Well once I, once I figured it out, a big fan of breath and breath work you the meditation cause that's what a lot of us in the Western world as we start kind of getting into this whole, how do we deal with stress? How do we take care of ourselves? It kind of always comes back to, well you know, meditation and that starts with breathwork for most of us. As I got deeper into the thought about breath, it kind of has the two things. One, one that you've kind of bring up in the book, but the other is the energy processes. In our bodies require oxygen. So if we're not bringing in the breath, if we're just, you know, because when we're stressed, there's little short little breaths and we're not really giving our body the energy, the force that it needs to be successful. But it does also give us this opportunity to be right here right now.

Rajshree: 27:24 And both are valuable, right? They're actually synonymous. If you have a lot of energy, that's what allows you to be right here and right now. And the more you are in the right here, in the right now, the more energy you have. So it's a virtuous cycle. And to your point, when we're under stress, if we are caught in the fear, worry or anxiety or the anger or the regret, we notice that our breath gets shorter and shorter. The more stressed we are, the more we kind of hold onto our stomach muscles in a way we hold onto our breath and we naturally tell people, come on man, just breathe. Okay? Just breathe. You know, because we notice that physiologically the innate response to stress is to sort of shut everything down. What we call fear or freeze or flight, you know, and just that tiny awareness, Oh my God, I'm getting stressed.

Let me make my breath longer. Does exactly what you said. Both those things. I notice if I elongate my breath, I calm down, but then I feel refreshed again. If nothing else, you're dumping out the CO2 that's just sitting in the lungs, which makes you tired. You know, in a closed room, you go to a doctor's office or you're, you're sitting on that flight. This happens to me all the time. As soon as they close that door, there's not enough fresh air in the flight. I start to get drowsy, groggy, and I crash until they actually open up the vent and allow fresh air to come in. I don't know if people know that they kind of don't let enough air in until they reach a cruising altitude. You know, everything is is just the bare minimums. So fresh air has a lot to do with our perception our outlook. It kind of gives us a fresh way to look at things. So more energy, more present, more present, more energy.

Allan: 29:22 Yeah. I still tell you they don't, they don't have enough fresh air on that airplane.

Rajshree: 29:25 No they don't.

Allan: 29:26 I don't want to touch anything. I don't want to breathe, I breathe really shallow on a plane. Cause I just, I just know I'm going to get sick. I'm just like, I gotta be positive about it. But yeah. So, you know, I guess this was a disconnect I always had because did you get into the concept of breathing, meditation and mindfulness? That, in my head it's always been one thing. But in the book you kind of say, no, isn't it? Meditation and mindfulness are not actually the same thing.

Rajshree: 30:02 No. At least not the way we understand mindfulness today in the Western world. You know, it's, it's more of a noun rather than a state of mind. Mindfulness is become a name and the way we practice it here is really using more mental stuff, more monitoring, more, you know, labeling more attention to what's happening in the mind. And well, it's just really hard to do. If we could do it, we wouldn't need mindfulness in the first place. And unfortunately, or fortunately, of course there's a lot of value to it, but 60 years ago when it first came into the West, people went, you know, to the far East and went into monasteries, spent some amount of time there and they took a single thread of an entire system, which was to label and to monitor physical activity and what's going on in our head. And that had its value in that it gave us the ability to have more, what I call frontal cortex, meaning greater rational, logical decision making aspect to us.

And it was really necessary in those days because times were different. But today we're so hardwired with our computers in our cell phones, they're kind of like an extension of us, we are always on. So our thinking brain is always on, it's always processing. And so meditation, the way I'm using it is really letting all of that mental brain stuff to settle down, to get quiet, to shut it off somehow or another. And you'll see when I say we're always on, you see the sleeping industry is growing like crazy, meaning the pills and the pharmaceutical world. Because what was once natural isn't happening anymore. We're not sleeping. I know so many, many people, every course I do, students show up and if I ask how many of you feel like you go to sleep and wake up more tired in the morning, 60% of the room will raise their hand.

How many of you people feel like you had eight hours in bed but you're not sure it was I thinking all night or sleeping? 70/80% of the room will raise their hand feeling like, yeah, I just feel like I'm processing or thinking all night. And that means we're keeping that thinking brain on. And so what we really need to do now is to click off, not just close the file we're working on in front of us in this moment, but close the tabs in the back. So we conserve energy so that we give a rest to the whole computer. You know, the hard drive. And so mindfulness is good for something specific, but meditation is a conscious pause, a willingness to let the mind drift, not hold on, not be aware, not lock it into something, allowing it to drift, let it be as it is.

And that unwinding actually gives us deeper layers of rest. When we go to sleep, we kind of connect better with people in front of us cause where are we listening in instead of our own stuff that's going on in our head that's constantly on, you know, it gives us more energy of course, and so on and makes us happier.

Allan: 33:27 Yeah. I, you know, that was one of the challenges that I've, I had when I was, you know, kind of in my hyper stress state of how do I, how do I actually get my brain to stop this stuff? You know, I'm drinking out of a fire hose every day. How do I shut it off, you know? And that made sleep very, very difficult. And so I worked on things that, it started with breath work. It started with taking just short pauses during the day, uh, where I would sit down in a quiet office and say, okay, you know, and I had the Headspace app on and I'm kind of going through this process of, of getting mindful or at least, you know, being aware that all these thoughts were actually out there all at the same time.

And then I was jumping from one to the others before I even got to play out. One idea, one thought, one fear, one anxiety. I was onto the next one. So they were, they were just constantly looping in my head and I had never really figured out how to get somewhere else other than in those stress loops.

Rajshree: 34:28 But, but what if we didn't even have to figure out or even notice those thoughts? What if we had an on off switch to all this thinking, you know, that's really what I'm kind of talking about. Let's go past that. Having to be aware because the truth is, look, if you see parents tell their kids at a dinner table or while they're studying focus, you know, be here, be present. Come on, stop thinking about all those other things in focus. If that kid turns around and says, okay, mom, okay dad, how?

They really wouldn't have an answer to that question. If you ask adults to sit still for a few minutes, it's not easy. If you ask them to close their eyes, they're like, no, I can't do that. Right? Eight out of 10 adults will say to me, I don't know if I can sit that long. I don't if I can sit still, I don't know if I can close my eyes and so what I say is, okay, don't worry about it. Use the breath like an exercise. You don't have to close your eyes. You don't have to find, you know all the paraphernalia of sit well in, in a proper place, in a quiet place or anything. I just say three times a day create a pause. Any way you have to breathe. I'm just asking you to breathe consciously as an exercise, not as something that you focus or have to pay attention to.

And so first thing in the morning, as soon as you wake up, I tell people just lay in bed, doesn't matter or sit up and lean against your headboard and do 10 long breaths in and out. You're just consciously breathing. I don't care if your mind is focused or not focused thinking or not thinking. And you know, looping from one thought to another, just 10 long breath thing, it'll do exactly what you said earlier. Number one, it brings in more oxygen. We've been, you know, laying still, we haven't been active. Our lung and our breathing capacity has reduced. So number one, it brings in more oxygen. For number two are out-breath is an off switch to thinking. And a lot of times we wake up in the morning processing stuff that we were entering into sleep with. So 10 long breath, first thing. Second thing is I always say before lunch, if nothing else, you've ordered your food.

Maybe you're sitting down in your office cafeteria just before you eat or as you're walking to the cafeteria, nobody knows you're doing it. You don't need to close your eyes, do 10 long breath in and out because you're breathing. Number one energizes. It's going to bring in more oxygen, but number two on the out-breath, you're going to empty something from your head. You're going to lower the number of thoughts that are going on in your head and that's going to change how you digest food, how fit and well you feel around what eat. It's important that we absorb, we assimilate, we digest with a calm state of mind because we're not just our body. We are what we eat and yes, we eat carbohydrates and protein and all of that, but if we're sitting there stressed out, you're kind of chewing that stuff back in and in an old traditions, you know, there was a time when we sat quietly to eat, not just because, Oh, it was some ritual, but it did a lot.

And today we know about gut health, we know about biome, we know that friendly bacterias thrive when we're not under stress and when we're under stress there's too much acid. So we don't thrive. So again, if not every meal, at least before lunch, 10 breaths, then go ahead and eat. And the most necessary if you do it nowhere else is before bed because how you enter sleep is really gonna determine the quality of sleep. I just know that I could be so wired with so many things when I get into bed, say, okay, a day in a life is over. I did the best I could and then I start to take long breath in and out. By the time I get to my fourth or fifth breath, I'm asleep, I'm out. And what I'm doing is shutting off the would of could of should of, you know, the yada yada files that go on.

And if we enter sleep like that, our emotional brain, our unconscious or subconscious is going to be processing that. That is a computer that's getting drained and then we wake up feeling like somehow I just feel like I got up on the wrong side of the bed or I'm not so rested and I wish I had more time. So just these three pauses, nobody needs to know you're doing it. It doesn't matter if you've got your eyes closed or not. Honestly, if the listeners out there, you know, if they just do it, they'll say, wow, okay, this is something I'll not let go of anyway. I have to breathe. I'm going to do it consciously three times a day.

Allan: 39:40 If they listen to last week's episode, when I had Amy Serin on and I and Dr. Serin, We actually talked about this specific thing with the parasympathic nerve, that nervous system and the, and the stress switch and, and everything there. And so you're, you're, you're, you're talking right up my, I'll have, you know, we've got to turn this thing off. We've got to get our brain to think, okay, we're safe. We don't have no fight or flight to go on right now. We can go to sleep and actually get good rest.

Rajshree: 40:08 Yeah. Yeah, absolutely. And, and I don't think that, I mean when unfortunately we've never taught that. Like your breathing is connected between these two, right? The sympathetic stress response, as we say, fear, freeze or flight, which was meant for emergencies in life and it's connected to the parasympathetic meaning the rest, the calm, the happy, the loving state, the easy-going state. Internally body can be dynamic. But internally calm, I mean if you see any, you know, professional, any athlete, their mind has to be calm but their body is in high gear, high-performance mode and your breathing is connected in such a way that if you elongate your breath, if you make it longer, you move from, Oh my God, Oh my God to I'm going to do it. Your mind naturally shifts in attitude and so anybody can do it.

The kid or the adult, you know, as busy as we might be, you do it while you're moving in a board meeting. I often tell people, because by the time you leave an hour of a board meeting or any meeting for that matter, you just kind of sat there, wiring yourself up with, Oh my God, one more meeting. Why is this happening? Why do we need to listen to this? Oh, it's the same old stuff. All that's happening is we're getting wound up and then you gotta go sit at your desk and do all that work. And so I just say to them, just sit in the board meeting any, anyway, listening isn't gonna get taken away because you're breathing. So do both of those activities. Let the listening be there, but breathe a little bit long in and out. And you'll walk out of that meeting and say, okay, well that's that. Let me get back to what I have to do.

Allan: 41:56 Absolutely. I wish I'd had that advice three years ago. Um, I define wellness as being the healthiest, fittest and happiest you can be. What are three strategies or tactics to get and stay well?

Rajshree: 42:13 So for me, uh, again, I say, you know, no matter what breath is your number one tactic to stay well physically, your body needs the oxygen mentally, it brings your mind in there, present in the here and now. To some degree it lowers thoughts depending on how well and how long you breathe. Number two, I always invite people and I do it every day when I go to bed, I really tell myself, you know, sometimes out loud, even my hand sort of lands on my chest and I say, this day is over.

It's like a life over. However it's been, tomorrow I invite new possibilities. I really consciously let the day go even if it's in words and a concept only. That's the second thing that I will always do. And the third thing is I invite people to say, no matter what, you're the driver behind your life. You got to take five minutes a day, morning or evening too, just quiet down and reflect. To be grateful to recognize that everything that we think isn't as bad as we think that you know, the universe is behind me. Just five minutes, maybe as you enter your, your bed, maybe as you get up in the morning after the 10 breaths, just to say, I'm going to make it a great day. It's a type of meditation. It's self-connection self-awareness saying I matter because I'm the driver of my life, I have to take a break. Five minutes.

Allan: 43:52 Rashree great. Thank you for those. If someone wanted to connect with you, learn more about the book, where would you like for me to send them?

Rajshree: 44:00 So certainly for the book they could just go to Amazon. The Power of Vital Force. Actually, I don't know how to make this available to your readers, but if they just go to my website, Rajshreepatel.com and put down that you came from your show. There is an online course with a lot of tools and tips available to people. It's 11 sessions. The last session is a live webinar. That could be a big bonus gift in terms of the book and how to use it. So the Power of Vital Force on Amazon or Barnes and Nobles or rajshreepatel.com.

Allan: 44:40 Great. Uh, well I'll definitely have links so let's stay in connection at that. Thank you so much for that gift. You can go to 40plusfitnesspodcast.com/402 and, and I'll make sure to have those links in the show notes. So Rajshree, thank you so much for being a part of 40 plus fitness.

Rajshree: 44:59 Thank you so much for having me. Happy to share my morning with you. Absolutely.

I hope you enjoyed our conversation today with Rajshree. If you'd like to continue this conversation or talk about anything else, health and fitness related, I'd like to invite you to join us at our Facebook group. You can go to 40plusfitnesspodcast.com/group. It's a really supportive group of people, not overly, you know, bombastic a have too many posts and whatnot, but just a nice group of people to hang out with, ask questions, have some support, have some accountability. I really enjoy interacting there. It's the best way for you to get in touch with me and interact with me. I'm on there every day talking to folks, so that's the best place to go. If you want to be a part of my community, go to 40plusfitness podcast.com/group.

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Another episode you may enjoy

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September 30, 2019

Turn off your stress switch with Dr. Amy Serin

Our guest today is a world-renowned neuropsychologist and stress expert. She's literally written the book on how to turn off your stress.

Allan: 01:50 Dr Serin, welcome to 40+ Fitness.

Dr. Serin: 01:54 Thank you so much for having me. Allan.

Allan: 01:56 You know there was a quote in the book and sometimes I get stuck on numbers. I'm an accountant by trade before I got into fitness. So I get stuck on numbers. So you're hearing me talk about numbers and lists all the time, but every once in awhile I run into a quote and I'm like, okay, I need that quote in my life. This was, this was exactly what I needed to hear today. And this was one that was in the book.

“When you resolve trauma, reduce stress and heal, what lies beneath the layers of soot of suffering is pure beauty. When a person on covers this love and kindness towards the self and towards others is the only thing left.”

Dr. Serin: 02:37 Yup. That's the truth.

More...

Allan: 02:39 You know, and it's funny because I sit back and I've said it many, many times, I wrote it in my own book is, you know, our journey to health, our journey to wellness, it has to include self-love. It has to start with self-love. And I think I struggled with stress so much I never really got where I to be because of the layers of soot.

Dr. Serin: 03:03 Well. Yeah, you know, and I think I, I think that we need to get to self-love in order to get to other things, but we cannot access self-love when we're stressed out. And this is, I think the big, you hit really the nail on the head. The big thing that we're missing and the big way that our thoughts about stress and our thoughts about our lives and who we are are misguided, is that when you are in a state of stress, I call it the stress, which when you're stressed, which is medium or high, you can not access self-love. You can not access love for other people, you cannot be your best self. And we, we think we are what we do on a daily basis. But if we have a lot of stress [inaudible] in our lives and I'm not talking about we have a crazy mother-in-law and we have a stressful job. If our nervous systems in too many moments or putting our stress, which is on high right? We cannot access the deeper parts of ourselves. We cannot access the goodness. And it doesn't have to do with who we are as much as it has to do with how much we're stress. And this is why, you know, this is the stress is the main thing that we need to look at and we need to reduce in order to have a better life.

Allan: 04:11 Now, I've had other authors on because uh, and you don't know a lot about my story, but I was, I was in corporate in the last three years of my corporate career was just a series of merry Christmas layoffs. And so I just was constantly going through this cycle. And so I actually, at that point I had started doing the podcast and I'm like, well, I have access to all of these authors and I would bring them on, granted, they all had value. They all brought value to me as I listened to what they had to say. Most of them though. What I found was that they, okay, kind of focus more on tactics and less on, you know, what are the things that are inside of us that we just need to know to actually resolve stress rather than cope with it.

Dr. Serin: 04:57 Right. And the tactics are great. You know, everybody wants recipes. Everyone, we're really hungry now for, okay, how do I follow this? The Paleo Diet. You know, how to like do this. The things we are culture of addition and we're a culture of doing. So we always want somebody to tell us, do this different, add this to your day, do all these things. And it's very easy to kind of bite off those pieces and think that you have something tangible that's worth doing. But honestly, we're completely misunderstanding stress. So while there are some tactics in my book, a lot of it is just I have to retrain you and understanding what this stress response really is and what it's doing. Because it's not what you think. You know, people are like, well I know it's you know about cortisol and it's about right hemisphere and left hemisphere and it's about debriefing and all these things.

And it's like, no you don't. There's a new neuroscience of stress that we've discovered. We have amazing brain imaging technology now and amazing the things that have just come on the horizon, the last three, five that people don't know about and we're still thinking about it in the old ways. And the result is, we're taking the tactics that people or telling us, and it's the same old stuff. Take deep breaths, meditate, exercise more, do yoga, but we're missing the point. And we're also giving people so much to add to their day that stress management becomes stressful. Because what that does is leave people feeling like, oh, I should have done all these 50 things today and I only did 20 of them and now I feel bad and now I'm more stressed out and I'm depleted. So we have to look at it a different way and we have to give people things to do in the moment to reduce their stress that are actually going to work. Because deep breathes are great, but they only work when you're mildly stressed. If you're moderately stressed out in the moment or higher than that, you cannot access the part of your brain and you cannot actually access deep breaths to override that system. It literally shuts down. So we're telling people in the moment that they need these techniques to use techniques that break down and then people are disappointed with themselves. It just doesn't make sense.

Allan: 07:00 Yeah. It's like you rush up to a 10 and you're, you're peaking at a 10, you know, red line all day, and then you say, okay, I'm to do this deep breathing and it gets you down to a nine, which is 10% better, which is, you know, in the moment it feels good. Uh, but you're still at a nine and you, you know, ratchet, right back up to 10 within a limited amount of time. Now in the book. And I like this, you kinda like walk us through, I guess for lack of it, the process of what stress is and you know, focus and core of our central nervous system. Could you take just a moment because I don't, I think I've ever really sat down with anyone and just talk through the central nervous system and how stress manifests there.

Dr. Serin: 07:44 Right? So stress is your body's in the moment reaction to a trigger. And so you have a network in the brain called the salience network. And what this network does is it's actually, it actually dictates what you get to pay attention to. So if you all, you know, whoever's listening, if you think about how you're feet feel right now, you were not paying attention to that a minute ago probably. And the reason why is because it's not salient. It's not important for what you're doing. If your salience network is working, you're mostly focused on this conversation with maybe distractions being woven in here or there, but if there's a loud sound, you will actually orient that loud sound as those and that becomes salient. And so the salients network is dictating how you pay attention to things because there's too many things going on in your environment versus how much you can consciously be aware of in the moment.

Okay, so it's funneling all the things that are getting processed and giving you a tiny little snippet to pay attention to. It's also turning up and down your stress, switch so you think about your stress switch like a dimmer is turning it up and down in the moment without your awareness based on what's coming in. So if you are listening to this conversation and you have a distract, a distracting thought gets automatically generated something like, oh no, I forgot to turn the oven off. Oops, I forgot to feed the dog. Your salience network is actually sending you that alert and it's also tacking up your stress switch so you will feel more stressed out than you did a moment ago because you had that automatic thought. Okay. Now this is being done for you in pre-conscience network. So we used to think, okay, I see a snake, I recognize the snake, and I go into fight or flight.

Nope, you see a snake, your salience network puts you into fight or flight, and then you recognize consciously after the fact what happened. It's two consciousnesses too slow of a process. That's why our bodies are biologically wired to go into fight or flight first. But what people don't realize is your body goes into moderate states of stress first without you even knowing why. And so then you have to go back and kind of explain why I think I'm stressed out because of this or that or this. You know, your heart's pounding and your stomach hurts and whatever else. And we're always trying to figure it out on the backend. But the reality is, is that these networks in the brain are automatically, and we call it the, that's why it's called the automatic system. It's automatic. It's doing it for us. And then we're trying to control it with the wrong networks.

And it doesn't work. So if your heart's pounding and you're in fight or flight and eat, you can even access the thought to breathe. You won't be able to breathe. So you can actually use breaths to bring your stress, which is from like a five down to a three but you really can't use that to bring yourself from a 10 down to a nine actually, because you can't access that you're hyperventilating at that point. And you're only all of your brain resources are focused at that moment is survival and sometimes it is a matter of survival. You know, I have snakes coming at me, right? And I have to run, but a lot of times it's my cell phone's ringing and I can't find it in my purse and I'm going into the state of fight or flight. That's not a matter of our survival.

But our nervous system is confused and it's turning on our stress, which too often, too much. And the result is poor quality of life, poor health outcomes, being irritable, lack of sleep, all these things that stress moderates.

Allan: 11:13 Now, in the book you talk about this, this concept called the pleasure principle. Could you take just a minute to go over. that?

Dr. Serin: 11:22 So when we're talking about pleasure, we're really talking about an in the moment. We are going to move towards things that have been pleasurable in the past or that are we think are going to be pleasurable,unconsciously. we're going to move away from, we're going to avoid things that are unpleasant. And again, these are choices that are being made for us. You think that your consciousness is doing all of the work, but it's not. So there's a lot of things people avoid and they don't even know why.Oor there's a lot of people, things that people do via the pleasure principle that they don't want to do. And this is where we get into addictive behavior. Um, you know, gambling, shopping, eating chocolate, you know, drinking, all these things. Anything that has brought us pleasure in the past and has regulated some of our neurochemistry, we are more likely to do in the future. So one of my biggest things when people say, well, if you know, let's say something terrible happens, like, um, your parent dies. Okay. What is your recommendation about behavior? And my recommendation is don't start any new bad habits because in those moments of despair, of grief, of stress, of whatever, if you start a new bad habit, then that is going to get locked into the, what we call the pleasure principle. And what it's gonna do is your brain is going to unconsciously signal you to keep doing that.

And so, and if you have an old addiction that's been dormant, let's say someone's been sober for 20 years and something really bad happens, they are way more likely at that point in their lives to go back into the addictive behavior. And this is why we get people relapsing after so many years, right? Because the need for regulation is so high. The need for relief, the need for feeling better because of the stress that people will look forward to in ways that are dictated by the pleasure of prince. So we want to understand that our behavior is not under as much conscious control as we think, but it's being controlled by the pleasure principle sometimes. And also distress, which and what it signals you to do. And when we understand that we can kind of do a better job of, staying away from some of those behaviors or regulating ourselves and also not beating ourselves up when we do do the things that don't make sense to us that have consequences.

Like, oh my gosh, I just, you know, went out and I'm on a diet and I just ate, you know, consumed a thousand calories of dinner and like, why did I do that? We have the answer. Well, you know, why you did that, you needed some regulation and your consciousness in that moment wasn't that powerful. But what we can do is we can hack into the stress system and lower the stress and then the cravings will go away. The likelihood of going into those behaviors go away. And even if you do the behaviors when you're not stressed out, you don't get that reward. Okay? So teachers know this, right? If teachers have a rough day with their class and they drink wine at the end of the day, it's really, really great. But if they have a fine day and they go home and drink wine, it's just like I could take it or leave it. So it's the in the moment reward that you're giving the brain. It dictates how good it feels, how likely you are to repeat that behavior.

Allan: 14:33 Okay. Now there's one final piece that I want to put together because what I'm kinda building a layer here, and you kind of did this in a book as well, which I really liked, was the 10 cognitive distortions. Can you kind of quickly go through those? Cause I think when you, when I put these three concepts together, you know, the central nervous system, particularly the salient network, a pleasure principles, and then these cognitive distortions. I think we kinda build a, the platform to understand why tactics alone really isn't enough when you're in that state.

Dr. Serin: 15:08 The cognitive distortions are basically ways of just thinking this is where we, we get consciousness in the mix. Now they said these other things we're talking about, well, very little to do with consciousness, but now we bring consciousness in and go, what is the quality of our thinking? Right? And if we can identify the cognitive distortions, we can lower stress through that and we can kind of put these all together. So an example of a cognitive distortion would be emotional reasoning. Well, and that's when you have a feeling and then you think it must be based on some kind of reality. And the reality is that we have feelings based on how much sleep we got that night or certain triggers.

I mean, we can show pictures of you, and or we can show pictures to people in psychological research. Let's say that they don't even encode visually. So you don't even know what you saw. But let's say if I flash really quickly a picture of an angry barking dog and a gun and something, you know, really like a, a terrible scene, you don't even know you've seen it. And then we start talking, you know, you'll have a more negative view of me. You'll have a different feeling about me than you would had I not done that or have you not seen those you know, preconscious pictures beforehand. So the brain isn't just this passive thing taking in information. We can prime the brain to go into all kinds of states. So if we think, oh, I have this feeling, therefore something horrible must have happened or this person might be bad or whatever.

We're using emotional reasoning and that can get us into trouble and increase our stress. The other thing we can do is, um, fortune-telling. We have no clue. Allan. No clue what is going to happen in five minutes tomorrow or the next day or in 10 years. We have no idea. And yet we all are making these predictions and depending on whether the prediction is negative or positive, we feel stressed in this moment. So we want to be mindful of, oh, that's me fortune telling again. And people with OCD and generalized anxiety, they have a really hard time with their brains automatically. Fortune-telling and also doing something called catastrophizing thinking that things are going to be horrible. Right.

So my mom has anxiety and my brother got laid off from a job a few months ago, he was a very high paid salesperson and she calls me going, oh, this is so he just, you know, his whole life is ruined. His wife's going to be so mad. He's not going to find a job… I said, stop, stop, stop. And I go, mom, go back to the book or put your touchpoints on because you have no clue how this is going pan out. And my brother's very intelligent, very resourceful, top in his field. Sure enough, within a week he had another job. He's doing great. Loves it. It's fine. Now, not everything works out fine. But the point is, is that in a moment you're making a prediction. You're fortunate telling you're catastrophizing. You're actually creating a tick up on the stress switch. So you may start off a three and then start to work yourself up and your thinking all the way up to a nine or a 10 or full-blown panic if you're not stopping yourself and realizing, oh, this is where my consciousness actually can help me when I'm a three, I can use my consciousness and this understanding to make it not go up to a seven or an eight at a level three you can take a deep breath and go, okay, I'm catastrophizing. I don't know how this is going to go. He's always had a job. He's resourceful. Things are okay, you know, and then your stress can stay at a low level. So sometimes our stress, which is our being turned up without our awareness and sometimes are conscious process is actually with our awareness, pushing our stress switch up. And that process is the one that we have the most control over. But all of the stress, which issues now can actually be hacked into with some new technology and some things that are not just thinking and paying attention and being mindful.

Allan: 19:17 Now, I had always, I, and I guess it's, you know what I've read what I've thought, how I've always viewed, stress is that it's, you know, it's just something you have to, you have to cope with it. Just something. But I guess recent research and particularly research that you've done, it's showing that, you know, we, we can actually flip that switch as you will, uh, the stress switch and cure stress from, from the perspective of putting ourselves in the position where we're in mildly stressful states that we can then through tactics deal with. Can you talk a little bit about that concept of curing stress?

Dr. Serin: 19:58 Right. So we need some stress. So, you know, when we're going to go perform, when we're giving a talk or if we're an athlete, we're going to, um, go into some states of stress. So we, this isn't to say that we're going to give people zero stress because zero stress means that you're dead, right? But we're talking about coping excess stress. I'm talking about that when your cell phone is in your purse and you cannot find it, you're not going into fight or flight because that's a waste of, that's a waste of stress, so to speak. Right? We shouldn't, you know, we should only be in the stress when we are in a life or death situation or when we're under, you know, extreme time pressure or things like that. And then we should go back to baseline. But that's not what's happening.

People's stress, which is are on, you know, maybe they're at a four or five pretty much day long, fluctuating up and down from that and their bodies are inflamed and they are, you know, their quality of their thoughts is automatically negative and those sorts of things. So what I'm talking about sharing, yeah, excess stress. I'm talking about a default level, a default stress, which motive of being pretty low. Okay. And then your stress will go up. If there's a really loud sound right now, Allan, or let's say a fire alarm went off and you and I both heard it, we would go into fight or flight. But we would go into fight or flight and our stress switches would be a 10 and then our bodies quickly lower it down to a default level, somewhere between zero and two that's what's ideal. This is what happens in nature.

You know, I'm a predator, starts chasing a zebra and the zebra runs away, goes into fight or flight and as soon as the Predator's gone, the zebra goes back to, well we call homeostasis low stress and then it starts grazing and hanging out and doing all that. The Zebra is not sitting there thinking, well what a lion that was, oh my God, I nearly escaped and I'm sure going to die tomorrow. These things. And so this is sort of the price we pay for consciousness. So we owe it to ourselves to create a low default stress switch, and depending on who you are and what you've been through, the prescription for that is different. But the technology that I talk about that I developed to prevent PTSD is one of the first steps. So you can actually have this technology on your body. It's noninvasive. It's just haptic micro vibrations that vibrate back and forth. And believe it or not, that adds an input into the salient network that's deciding what to do with your stress switch. And it lowers your stress switch. So the research is that it will lower your stress about 62% in 30 seconds. And that's with the sample of over a thousand people. And so if you have access to this, it can bring your stress, which down very, very quickly. And then people spot use it throughout the day to keep their stress low.

So we use that and then we also have people, the other, you know, cure part of this is a base of healthy behaviors and that's where you come in, right? A base of healthy exercise and diet and sleep regulation. And I don't mean when I say diet, I think people freak out. They're like, oh my gosh, I have to start counting macros and I need to, you know, go on the LCHFdiet, I'm not talking about that. I'm talking about a reasonably well balanced diet where you're not drinking two sodas a day, right? You're never ingesting things that have a huge spike, create a huge spike in insulin. You're not binge eating. You're not only eating white and brown foods. I'm talking about very basic, healthy diet principles. Okay? So you don't have to add two hours of obsessiveness to your day trying to maintain a healthy diet. Right? But just the basics, okay. You have the basics of the exercise, the Diet and sleep regulation, and then you add the technology and then you add some of the knowledge in the book. And I think that is all the recipe that you need for success unless you've been extremely traumatized or have PTSD, had a terrible upbringing. If that's the case and there's a lot of trauma in your childhood, then we add to the prescription things like EMDR therapy and maybe neurofeedback in our clinics. And so, um, but whatever the reasons or the case or however bad it is, we can cure the excess stress.

Allan: 24:23 Yeah. And I think, you know, as, as you know, as I talk to a lot of people come to clients, you know, on online, uh, just the conversation. I'm actually, I mean, I used to have this mindset that, you know, there can't be that many people with, you know, PSTD but I guess I'm coming to understand that as the world and the technology and everything has, has moved forward at this pace, all that kind of piled on to potentially childhood trauma to you know, just major things that are going on in our lives right now. Um, we're just over, we're over done. And it's really pushed a lot of people over that line to a point where yes, you need proper nutrition. Just make sure you're getting the vitamins and minerals your body needs, the protein it needs to rebuild and do the things you're getting, the proper sleep, so that your body can heal and recover and you're moving, you know, you have a movement practice where you're building a fitness level to be the kind of person you want to be.

And do the things you want to do. If you, if you're doing all of those behavioral things right, you still might find yourself just not able to flip that switch. Um, so I do want to talk a little bit about the technologies. So let's start with the EMDR. What is that? What's that kind of therapy like? And um, you know, if someone really does, they've got, they know they've got trauma, they've tried all the tactics, they aren't, they're eating well, they're exercising, their sleep isdisrupted because of the stress more than likely and maybe haven't figured out the sleep part, but they just know they're not getting where they need to and it's time for them to consider some therapy. What is this like, what would that be like for them?

Dr. Serin: 26:08 Yeah, I get patients like this all the time and you know, some of them have been to therapy. Some of them have been to talk therapy and while it was moderately helpful and they liked their therapist, they're still having these responses and it's not getting resolved. We have to resolve it at the level of the nervous system. If we don't do that, every time you get a trigger that's associated with something, your stress, which is going to go up to what it's default is for that trigger. So I think about, you know, someone goes, well I think about my ex-husband and it goes up to an eight and then I, and, and we're not, again, consciously trying to think about it. It's just sometimes the thoughts happen automatically or sometimes we get an email from them and then boom, eight, eight, eight, right? We want to change that.

So the EMDR therapy incorporates a lot of the ingredient of some other therapies. So it's sort of like cognitive behavioral therapy plus the therapists will use eye movements and also similar technology or the technology in the touchpoints which you can now use at home. Um, and those are just the vibrations that bring down stress. And so you process the trauma or whatever happened and sometimes you didn't even know what it is. All you know is that when something happens in your life now it creates such a stress response or panic that we start there and then you will start processing everything in your memory networks associated with that, whether or not you think it makes sense and then that gets resolved in the nervous system and then it doesn't take your stress switch up anymore. So it's that simple.

But we are so obsessed with consciousness and convoluting things and thinking that, you know, defining ourselves as our anxiety or this or that, that that I just need to whittle it down for people and say if we were thinking of something, and while you're thinking of that, you can get your body calm instead of the stress that becomes your new normal for that thing and then that will generalize to other things. And that's how we heal trauma. And that's how we create a different default in the stress switch. And the EMDR therapy does a beautiful job of that. In fact, research shows that if someone's got post traumatic stress disorder from a single incident, like let's say a near death experience or one combat experience, then they actually only need about six sessions of EMDR to cure it.

Allan: 28:31 Okay. And then the blast technique, which is the bilateral alternating stimulation tat tie, which you kind of talked about the touch points, it's, it's Kinda tapping into the salient network. Can you talk a little bit about that and how that works? Cause that's something that someone can use at home as, as needed, right,

Dr. Serin: 28:50 right. So if you think about, you know, if you in a loud, if you're at a conference and or a restaurant even and it's really loud and there's all these jarring sounds, you're going to feel more stressed out because your salience network is ratcheting up your stress switch based on all of that sensory information. But if you are in a dimly lit room with music and with calming things, your stress switch is actually going to be turned down for you because of that sensory information. All the blast does. Bilateral alternating stimulation in tactile form. I know that's a mouthful. Nobody, nobody's going to be tested on that. So we just call it blast. All that is is it's a better sensory input that will lower stress faster than let's say listening to a calm song or in a bathtub or something like that.

We're using a sensory network to downgrade the stress response in real time and we can do it very quickly with these alternating vibrations. It's amazing. So people can use those in situations where they're normally stressed out. So we have people using them during tests for test anxiety. Or, um, parents often struggle with kids who are sitting down to do homework and they hate homework and you pop it on the kids for kids and Tantrum or for cravings. Remember, if you're stressed out, you're more likely to want to reach for a donut versus a salad. But if we lower your stress, those cravings, will go down because there's no stress to regulate in that moment with a donut or alcohol or something else. Um, so there's all kinds of applications at home that you can use this technology for. And what I like about it is you don't have to stop what you're doing.

People go, well, what do I have to do? Like leave my desk at work and you know, meditate for five minutes and then go back. And I'm like, no, you, you don't need to do that. Um, in fact, good luck leaving your desk and trying to meditate for five minutes. You're probably not going to be able to willfully get your stress down enough to get into a meditative state. If you can that's wonderful, but most of us can't. So at your work desk is something stressful. You just put them in your pockets because they just have to be on one side or the other side of the body. So you can put them in pockets, socks. You can hold on to them with your hands. They come with a wristband so you can wear them on your wrists, but a lot of times people want to hide them so they don't want them on their wrists. Anyway you want.

Allan: 31:19 Yeah, someone's going to ask, why do you have two watches on,

Dr. Serin: 31:22 right? What is going on? Right? And actually we're using these incorporate wellness. So in a, in some companies now it's just sort of like, you know, everybody just knows what they are. It just becomes part of the culture. Like, Oh, I'm using my touch points, you know? And, or if HR has to deliver some bad news to people, they put the touch points on to lower their stress. So there's becoming a part of some companies, cultures, and it's becoming kind of this normal thing that you would do. Um, but for most culture companies it would be like, what are these weird vibrating things that you have and you know, what's going on? But the cool thing is, is that I'd had some, you know, mavericks in their companies just go, hey, think of something stressful. And people are like, okay. And they go hold these. And then people are like, wow, you know, and then they get it. So it's so instantaneous. It's relief that people get from it, that it's very, very easily, um, demonstrated. It's harder to explain than it is to just get these in people's hands and they feel an immediate relief and then it's very easy to understand, you know, why the person next to you ask these on. So,

Allan: 32:26 Yeah, I think if I, when I was in corporate and you know, as I was reading through, I was thinking I would just need wear them 24, seven one I was when I was in corporate, but, uh, hopefully they would, they would act a little bit faster than that, but I would have no qualms telling them, okay, look, you guys stress me the heck out. So, uh, I'm gonna, I'm gonna wear these on, on both of my wrists and a pair, all my ankles if I had to. But it's very interesting in the technology. It's very interesting, you know, kind of where we're going with this and just to say, okay, if the tactics aren't working for you it's probably because your stress switch is just way too high and some of these therapies are just something that you're gonna need to consider as a means of getting their stress point down to a point where you can actually use the techniques and get some benefit from them.

Dr. Serin: 33:13 Right. And not procrastinate and not avoid them too, you know? I mean, how many workouts have we not done because we wake ups, we're stressed out and we're like, oh, I just can't handle it today. Those are all cognitive thoughts that aren't true. You know? Of course we can handle it because if somebody forced us to do it, we could absolutely do it. Right.

Allan: 33:34 If a bear showed up you'd start running.

Dr. Serin: 33:36 They would run right? Oh, I can't run today, right? No, you can run today. But this is what you're telling yourself and what you're telling yourself is exactly correlated with where your stressed switches and that moment. So again, a lot of people think, oh well I think something and then I get stressed. It's not true. Your body is stressed. And so then you think something. So a lot of times with just the technology, you know, in touchpoints and certainly with things like EMDR therapy, positive, spontaneous spots are increased. just from that, so we know that it's not a one-way street where we're, it's not a top-down process of, Oh, I'm either going to choose to think positively or negatively. If you're stressed out, you can not, a lot of times you can choose to think positively. You don't have access to that level of thinking, but as you lower the stress switch, the positive thoughts suddenly emerge.

Things like, well, I guess I could handle that. I can do that. You know, I'm, wow, that's interesting. I had that thought that I couldn't run today, but I absolutely can and I know I'm going to feel better if I do it. So I'm going to do it. You know those things spontaneously re-emerge it's just way too hard to try to white knuckle this from a top-down perspective all the time. And just try to use consciousness, consciousness, consciousness to produce what we want. Um, we have to kind of fight ourselves to create these new habits. And it's really hard. We know it's really hard to tell people to change their behavior without some other kind of intervention.

Allan: 35:06 Dr Serin, 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. Serin: 35:15 So the, the overarching principle is do things with high impact, right? So the first strategy I would say is to look at, um, the top three things, sleep, diet and exercise. And what would create the biggest boom, you know, what create the biggest impact you, if you were to shift. So a lot of people are only getting five or six hours of sleep a night. And if that's the case, the no brainer in that is seven to nine hours of sleep every night. And you know, make that a goal. So that's the first strategy I would use is to kind of tackle the big things, the big things that have the highest impact. Um, switch those up. Okay. And if your sleep is off, that's the absolute number one thing as you get your sleep back on track, if you can't get yourself sleep by on track, just by putting down your cell phone or know turning off the TV at a decent time.

There's other things you can do like ad orange glasses that will block out the artificial light and things like that. But you know, we don't need to get too detailed with it. So slay the major dragons is kind of the first thing. The second thing I would say is too, you asked me for three, right? Okay. So the second thing I would say is too pay attention. And this is in my book. Pay attention to how your choices perpetuate your own stress switch. So a lot of times, like I said, your stress, which is being turned up and down for you, that's not necessarily a choice. What is a choice is if someone does something that I don't like, it's a choice for whether or not I have three phone conversations that night to kind of complain about that to other people. That's me actually consciously ratcheting up my own stress switch.

Yeah. I want people to agree with me. Can you believe she said this and did that? Yeah, I know. That's terrible. Oh, you know, that's, those are the things that you can consciously cut out of your life. I'm not going to spend time complaining right, to other people. I'm not going to try to get other people upset about the things I'm upset about. I'm not gonna watch people fighting on the news. Right. That's a conscious choice. When you watch people fighting on the news back and forth, that's actually a conscious choice that you're making to be embroiled in upset. Okay. And anger and all these emotions while you're stress switch gets turned on. Okay. Why do you want to be in that state?

Right. You, I'm telling you right now you don't, it's terrible for your health. It's terrible for things that you have no control over. Like the political climate, unless you're in politics and all these things, why do you want to spend an hour or two a day surrounding yourself with people that are stressed out that don't need to be in your lives cause they're on TV. Right? And so paying attention to when am I choosing to engage and get other people riled up and what am I choosing to become riled up by things I can't control. And then you wipe that out and then you have energy to do things that are more positive. Right. Okay. So that's two. And you asked me for one more. I'm trying to think of one more. I think that my advice be if your default stress switch is high, if you're somebody that wakes up and it's high in the and you do have sleep disruptions and you can't seem to just choose all the healthy behaviors that you want to choose and maybe you had a traumatic childhood or you know, have had really traumatic things go on in your corporate life or whatever your family life, then I would consider therapies like EMDR, um, and really getting some professional help not because you're damaged but because you want to be well.

Allan: 39:07 Absolutely. So thank you so much for being a part of the 40+ Fitness Podcast. If someone wanted to learn more about you, your book and uh, touchpoints, where would you like for me to send them?

Dr. Serin: 39:19 So I have a website at amyserin.com that's amyserin.com and there's links to the book and or just touchpoints. Also, the book is available on Amazon. In fact, it hit number one for preventative medicine in kindle on Amazon a few months ago. Thank you. Yeah. And then I have clinics too. I'm at serincenter.com so if anybody's interested in working, you know with more of that cutting edge neuroscience and some of the treatments we talked about, then I do have clinics and um, would just love to help anybody that is seeking a more fulfilling, happier life.

Allan: 40:01 We'll have the full show notes 40plusfitnesspodcast.com/401 you can find all those links there. So Dr Serin, and again, thank you so much for being a part of 40+ Fitness.

Dr. Serin: 40:13 Thank you so much Allan.

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Another episode you may enjoy

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The health habit with Elizabeth Rider

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Thank you!

One of the best ways to see a significant change in your health and fitness is by adopting healthy habits. Elizabeth Rider through her book, The Health Habit, helps you set those healthy habits and provides over 300 recipes to make it even better.

Allan: 01:10 Elizabeth, welcome to 40+ Fitness.

Elizabeth: 01:13 Hey, thanks for having me.

Allan: 01:14 You know, I'm really excited to talk about your book, The Health Habit: 7 Easy Steps to Reach Your Goals and Dramatically Improve Your Life. And kind of the subtitle of that is actually what is so attractive to me because I know from experience and working myself and with my clients is once something becomes a habit, it's just this automatic thing that you do and it makes staying healthy so much easier. The more of these health-based type things that you stack on top of each other. So I really appreciate having the opportunity to talk to you about this book in particular and then about habits and kind of approaches here.

Elizabeth: 01:55 Yeah, I'm thrilled to be here, thanks. I love talking about habits, I'm all about habits that people enjoy. So this, the book was really a quest for me with my online audience and now my book to find a way to build habits that we truly enjoy and look forward to and not create something that feels too restrictive or like a prison every day. So this book is 10 years in the making and I'm really excited to share it with everyone.

Allan: 02:24 And yes, with 10 years in the making. Wow, it's very well put together. It's very well structured. It's a very easy read. I really enjoyed that part of it too. Like you're just kind of your common sense approach that if we go at this too restrictive, we're setting ourselves up.

Elizabeth: 02:43 Yeah. I mean, I've been a health coach for, oh gosh, seven or eight years now and I've been blogging for over 10. I started blogging before Instagram was even invented before influencers were a thing. I've just been blogging for a long time, which led me to do, um, to host online programs. And this book really came from pouring over the feedback forms of over 10,000 women who have done my online program and really trying to get at the root of, we know how to be healthy, right? We know that every woman on the planet knows that blueberries are better for you than snickers. We know how to be healthy, but why is it, why does it feel hard and why aren't we doing it? And really when I pour over the feedback forms, the overwhelming majority was that people, just women especially I think men too, but you know, I work mostly with women feel so restricted and that they know they can stick to a quote diet for a short period of time, but they always fall off. So what I, what my work has been is how do I help these women build habits into their daily life based on what they already enjoy instead of just prescribing a completely new way of living. Because that, you know, that's difficult for people. Again, we can, anybody can do anything for a week or even 28 days, you know, a certain period of time. But we eventually slide backwards into old habits. So instead of prescribing a completely new lifestyle, how can I help you look at your current lifestyle and just make tweaks to make it healthier.

Allan: 04:08 Yeah. Most people, you know when they're going to make a change. So there's, okay, I want to get healthy. Or the doctor tells them, you know, hey, you need to lose some weight, or there's a family member that that gets sick and has a chronic disease. And they're like, okay, I don't want that to happen to me. So they kind of have this immediate kind of wake up and then they're going to set goals for themselves, but we suck at getting to our goals. So in the book you talk about 4 reasons that we're not meeting our goals, do you mind going over those four reasons?

Elizabeth: 04:39 Yeah, no, I'm happy to. For me, what I've noticed with people with goals is, and I have a business background. I came from corporate America before I became a health coach. And what I started to notice, what I started to notice was, and I think this process works in all areas of life, but what I was noticing in health especially is a woman who would say like, I would say, well, what's your goal? And she would say, well, I want to lose 15 pounds, or I want to sleep better, or I want more energy. And those are great places to start. So it's not telling people no, you're wrong. But really at the root of it, those are desired outcomes and goals need to be daily and actionable. And we learned this in the context of business. Smart goals are specific, measurable, achievable, relevant and time-bound.

Elizabeth: 05:22 And we don't need to get businessy, you know, in the context of our daily habits. But we do need to set daily, actionable goals. So you still want to have an outcome in mind. If it is, you know, you know you feel better at a certain weight and you want to achieve that. If you just need more energy during the day, if you want to sleep better, if you want to reverse symptoms of a condition that you have, those are all great places to start with their outcomes. And we need to work backwards and figure out what are the daily actionable goals that you can have to actually achieve that. So for instance, if somebody wanted to lose weight. A daily, an example of an a daily actionable goal would be no matter what the first thing you eat in the morning has to be low in sugar because if you spike your blood sugar in the morning, it's proven that you can eat up to two to three times more food during the day or engaging in time restricted eating, which is a horrible word.

Elizabeth: 06:10 It's a form of intermittent fasting. It's way easier than it sounds. Just reducing that window, not reducing the amount of food you eat, but reducing the window during the day in which you eat your food. For instance, you eat from like 9:00 AM to 6:00 PM and then you're done eating at 6:00 PM and then you don't need to get until 9:00 AM the next day. So you're just giving a longer window for that fast that we do overnight. And in the book there's a ton of resources and ideas to meet a variety of different goals. But I want people to get out of the idea that a goal is this like big accomplishment that at the end of something, and we don't even know how to get there. The goals have to be daily and actual. So that's the first thing is just people confuse outcomes with daily actionable goals.

Allan: 06:53 Yeah, and I liked in the book you talked about, so basically we have, we have what we call I guess desires and then we take that over to actions and then we have outcomes. And so if your goal is desire bound or outcome bound, it makes it that much more nebulous and difficult for you to know that you're on track.

Elizabeth: 07:12 Absolutely. I think that's, you know, the second mistake I talk about with people is that they misunderstand the feeling that they desire. So any action we take is driven by desire. And I think sometimes on the surface, and I'll use, I don't, you know, I'll just tell you a side note real quick. I really did not want to write a weight loss book. And I intentionally wanted to keep this book out of the weight loss category because I think women are bombarded with this idea that we have to lose weight and it's generally not true. However, I think that we all know as individuals that potentially we feel better at a certain weight or there's been a time in our lives when we felt better at a certain weight and there's nothing wrong with that. So I'm kind of neutral to weight loss, it's not a good thing.

Elizabeth: 07:51 It's not a bad thing and you can have your own desires. But I intentionally wanted to keep this book out of the weight loss category and Amazon chooses the categories, the author and the publisher do not choose the categories that goes into. And of course the first category went into is the weight loss category. So, you know, we can't control everything and that's fine. But, um, so I'm using weight loss as an example here, but you could use these for, you know, energy or sleep or any of the other things that we talked about when it comes to weight loss specifically, I think a lot of women think that they desire weight loss because they'll feel better. You know, they'll, they'll have higher self confidence or something will happen and then we lose the weight or something happens and then we realize that it didn't meet any of the desire, that we don't feel the way we thought that we would.

Elizabeth: 08:35 And when it comes to weight loss specifically, I think focusing on vanity is not a bad thing. It might be like the first thing that you think of. Like I want to look a certain way in my clothes, which again, there's nothing wrong with that, but it has to be driven by a deeper desire to feel good. I know for myself, if I let vanity drive any of my goals, they all fizzle out. So really understanding what do you desire, how do you want to feel? Do you want to feel confident? Do you want to feel accomplished? And I go through a lot of different desired feelings in the books. You can really determine how you want to, how you desire to feel, because that will drive what your daily, actual habits are.

Allan: 09:11 Yeah. You know, I tried to tell my clients, so, you know, vanity vanity is not bad when you, it's based on work that you've done. So if you've gone out and spent 20 weeks of training your body of watching what you eat and you've gotten to, you know, body composition that you're just really, really proud of, be proud. Uh, but the, the vanity that you see a lot of times on, particularly on the social media where they're comparing themselves to someone else, you know, that's often kind of the struggle is, you know, I'm not going to look like, uh, you know, Dwayne Johnson, no matter how much training I do, uh, you know, but that said, I can be a better person myself and I can feel better about myself if I'm doing the right things for myself.

Elizabeth: 09:57 Absolutely. And Vanity. I'll just say I think women, women especially, I know I've had this internal struggle a lot and I've talked to a lot of women about this and it's taken me a while to overcome it, but you know, on the surface we start to feel like, oh, vanity is bad. So once we, once we kind of say, okay, I can't just be driven by vanity, then we start to, we swing the other way and we think the vanity is bad and really just like weight loss. It's, I hope that women can come to a more neutral, men to a more neutral position where vanity is part of your biology in the sense of not, you know, putting Mascara on and lipstick and that type of vanity. But all animals groom themselves. You know, when we look a certain, when we look healthy, when we look a certain way, it attracts a mate. And that's a biological process. It's ingrained in us to want to look good. And so I just want women to know like it's not, it's not bad to want to look good, it's just part of your biology. It's like you just said, it's not going down that comparison rabbit hole because, hey, look, I'm friends with a lot of Instagram influencers and I know that they take 500 shots to get the exact pose together to get it. Hey, you know, there's that too, but we can't compare ourselves to that.

Allan: 11:02 Yeah, yeah. And then, then they, they dehydrate themselves and fast for three days before they do a photo shoot and then, you know, Yeah. So we've gotta we've gotta be realistic. Um, another area you went into the, in the book that I really enjoyed was you started talking about vision boards. Could you get a little into that?

Elizabeth: 11:20 Oh, yeah. I mean, visualization is a proven technique to help you achieve what those desired outcomes and goals are. It's what, you know, if we even at a higher level, like Olympic athletes are our coach to visualize themselves winning because it is proven that that can help accelerate their progress. So visualization is so important. When something is in our mind, we gravitate towards it. I mean, the most simple example, we know this if like if I tell you today or I'm really into red cars, now all of a sudden when you're on the road, you're gonna notice a lot of red cars, right? Because it becomes, it comes to the forefront of our mind. So anything that you look at all day, every day, and this is why your environment is so important. I talk about this, your environment in the book as well. If you are in an environment where there is a bowl of candy on the counter all day or at your desk or whatever it is you're looking at all day, of course it's going to be the only thing on your mind. You're looking at it all day. A Vision Board is a similar thing where when you can take what you want to achieve and actually physically put it in front of you, your mind will naturally gravitate towards whatever it is that you've put up there.

Allan: 12:29 Yeah. Like if you visualize yourself being able to scoop your grandchild up when they come to visit over the summer and be able to walk the zoo with them with no, you know, not without having too much fatigue where you're just pooped out and have to sit on the bench. You know, those are visions that you can have for yourself and then they're going to somewhat manifest in the activities that you start doing because that's what you're, that's what you're preparing yourself for. It's more like training than work.

Elizabeth: 12:56 Yeah, absolutely.

Allan: 12:57 Now you use a concept in the book that I just adore. It's called the qualitarian. And so it's effectively saying, you know, however you're choosing to eat or what, like as a way of eating via Keto or Vegan or some of the other things that you might use, like Mediterranean or dash or all those different titles or labels that we have for the different diets that are out there. Most of them diets are intended, okay, you're going to do this for awhile and then you're going to quit. But you're looking at it more from the lifestyle perspective and that leads us to qualitarian, what is it? And you have some commanding principles that I think are really crucial for us to know.

Elizabeth: 13:38 Yeah, the qualitarian weight is, you know, I've been, like I said, I've been a health coach for a long time. I've literally seen every diet and eating style available and something I'll talk about really quickly, I talk about this in the book and people can go through this to determine which one they are both before the qualitarian wayeEven just understanding are you an abstainer or a moderator? Because one of the biggest problems right now that I see in health and wellness is that coaches don't understand the difference between somebody who does well in an abstainer model and somebody who does well in a moderator model. And if somebody gets into a program that, like if you're a moderator and you are trying to follow an abstainer way, it's going to be very difficult and same the opposite way. If you're an abstainer and somebody is trying to tell you to moderate, it's going to feel difficult.

Elizabeth: 14:23 And really you just can determine that by which one makes you feel more free. So an abstainer would be somebody that follows something like the whole 30 or Vegan or some a very strict diet label that you feel more free with fewer choices and some people feel that way. And I'm sure there are people listening to this right now that are going, yeah, yeah, I do feel better when I have a very strict rules that feels good to me. I know exactly what I'm doing. I like that black and white structure.

Allan: 14:49 You actually described me, I'm an abstainer.

Elizabeth: 14:51 Okay, great. Yeah, that's awesome. And then there are people, I'm a moderator. There are people like me who that makes me feel so heavy and restricted and it makes me feel like I'm in prison. I hate that feeling. I do really well on a moderate or model where it makes me feel more free to know like I'm going to follow a certain way of eating a qualitarian and I'm going eat real food, high quality food. And occasionally if I want to have pizza, I'll still have really high quality pizza, you know, made from the best ingredients. But I don't, if I have one slice of pizza, I'm good. That makes me feel more free. I don't need to have more. Right. I don't, it doesn't, it's not the model of like, you can't just have one. I'm like, yeah, actually can just have one. Um, but everyone's different. So like you just said,

Allan: 15:37 I'm eating half or the whole pizza, just depending on how good it tastses.

Elizabeth: 15:40 yeah. Yeah. So really determining, you know, which, which model do you fall under? And because if you're a moderator, like I don't label my eating habits. I think if somebody hung out with me for the week, they would think I was Vegan because most of the food I eat is Vegan. I gravitate towards that. I really don't do dairy or animal products. However, I might be out at dinner with a girlfriend, um, you know, and have a glass of wine. We might share like a flatbread or something. And, and that feels good to me, but some people, like you just said, you're an abstainer, you know, that is you just like the black and white rules. That feels better too. So really we have to find which of those things work better for us. And then within that model, the qualitarian way means that no matter what, whatever food you decide to consume, whether it's, you know, your salad or your pizza or you know, your bowl, your smoothie, that you choose, the highest quality food that you have access to. Meaning, one thing that I see a lot, and I think you know this too, everybody's on the Gluten Free Bandwagon and hey, I don't eat a lot of gluten either. But what happens is people end up buying gluten free, junk food, right? And gluten-free junk food is still junk food, you know, packaged, processed. Just because it's gluten free doesn't mean it's not made with stabilizers and preservatives and denatured oil and high amounts of sugar.

Allan: 16:57 Yeah, I've watched this cycle so many times. You know, something will come out like gluten free or like keto. And so this idea comes out and everybody wants to try it and then all of a sudden you start seeing the freezer section in your grocery store has a little section of it now and then it gets bigger and bigger. And then there's a whole section over, you know, what they call the health foods section, where you're going to have all of these Keto friendly foods or these gluten free foods and you look at the label and it's not food anymore. It's, it's basically manufactured, um, calories.

Elizabeth: 17:34 Yeah, absolutely. So, you know, under the current qualitarian model, the qualotarian way, I think the most important question to ask, whether it's plant based or animal based, what's the quality of this food? Am I eating the highest quality food that I access to? And when I say that I have access to, you know, I've lived all over the world, um, and all over the US and right now I'm currently on the coast in Seattle. Big cities have access to more food. And I realized that I'm from a small town in Montana and I realized that not every single place in the world has access to, uh, you know, free range, uh, air chilled chicken, right. Or whatever it is that you want to eat. So, and budgets are also a concern. So whatever it is. Um, and I give a lot of tips for, you know, budgeting and eating well on budgets in the book, but just choosing the highest quality food you can.

Allan: 18:23 Yeah. I think that's critical. If it's not whole food, um, you have to, you know, you have to realize that it was manufactured to, uh, to make you want more.

Elizabeth: 18:33 Yeah, absolutely.

Allan: 18:35 Now you have a process, I guess a method that you've put in the book. And I really like this one. It's called the book end method.

Elizabeth: 18:44 Yes. I'm glad you liked that.

Allan: 18:46 I do like that.

Elizabeth: 18:48 Yeah, you know, I have an online membership for health and I was putting together, um, one of our monthly bundles and I was just thinking about morning and evening routines because I've been getting a lot of questions about this and I think there were some confusions, we all have heard probably by now that it's really great to have a morning routine and then an evening routine. But I think people were getting confused of what those things are. And I started talking about it's really important to book end your day with, even if it's 10 minutes, you know, five, 10 minutes, you know, maybe 30 minutes, whatever it is, Everyone's different of intentional self care because that sets you up to make better choices during the day. And what came out of that as the book end method.

Elizabeth: 19:29 And really what the book end method is is like I just said, you have something in the morning and morning routine or ritual, even if it's just five minutes. I know a lot of people have kids, they have jobs. There's so much happening. You don't have to spend two hours every morning in the morning ritual, 10 minutes, 15 minutes that you can in the morning, 10 or 15 minutes in the evening and they have different purposes. In the morning you want to choose things that increase your energy, that set you up to make great choices during the day and the evening you need to set yourself up for better sleep so they actually have different purposes and they're not interchangeable but in the morning, and there are some things that you can do in both of them, you know, journaling, some type of meditation, whether it's mantra based meditation or mindful mindfulness meditation, even just deep breathing, stretching.

Elizabeth: 20:15 There are some overlap, but really in the morning, how can you healthwise set yourself up to make better choices during the day? Because we know that how you start something affects every choice that you make. It's why if you look at, if anybody's ever done theater or you know something in a theater group, there's always a prayer circle before the big show. It's how you start something. It's why, uh, in sports teams there's always the big huddle before the show, right? How we start something dictates how it goes during the day. So if in the morning, if you can just commit to 10 to 15 to 30 minutes of very mindful intentional health practice, you will make better choices during the day. And that brings us to the evening. If you can dedicate five, 10, 15 minutes, whatever it is to setting yourself up to sleep better. Sleep is so critical to health. But I would even say sleep is as critical to health as what you eat. I think sleep is completely underrated and quality sleep, right? Not Junk sleep where you're tossing and turning. You can't sleep at night. Um, and there are things you can do to set yourself up to sleep much better. I've been on a quest for better sleep for the last 10 years and I'm finally sleeping really well. But yeah, just book ending your day with two practices can make a world of difference in your health.

Allan: 21:27 Right? So now someone gets your book cause yeah, there's lots of, there's a lot in here of different things that we can do different approaches and so someone starts setting goals and getting action and they're starting to develop these habits. In the book you go through a series of tools that we can use to help us stick to the habits. In other words, quite a bit there. So I, you know, I don't want to ask you to share all of it, can you go through just a few of whatever your favorite tools that would help us stick to the healthy habits that we're getting.

Elizabeth: 21:59 Yeah there are, there's quite a few in here. I think one of the biggest thing, just the mindset shift of the crowd out method. Meaning instead of, if you're on the quest for healthier habits and you want to start with food, think about adding things in, not taking things out. So again, that's kind of the moderator of sooner model where you know, people want to be gluten free or dairy free or Vegan or whatever it is, which is not a bad thing. But what that model does is it removes things where the credit method introduces things. So instead of telling yourself like, I can't have you know, Tacos or whatever it is that you want, add things in so you know, I'm going to eat a giant bowl of veggies or salad or whatever it is, something that you know is healthier. I'm going to eat this, I'm going to bring things in instead of taking things out and that will naturally crowd out the bad things.

Elizabeth: 22:45 I think that's one of the best places people can start for healthy eating. Instead of saying, I can't ever have something again. Say what will I have today and if I still want that other thing. Sure. And usually you know you're full by the time you have the thing that you said you were going to have, so you don't even want the other thing. I think the crowd out method is absolutely key to building healthier habits. I think something else that's really, really important. We alluded to social media a little bit. I love social media. I use it, don't bite the hand that feeds you. I think social media is a great way to connect. But I also, um, you know, throughout the book, something I'm really encouraging people to do is to understand that how you do one thing is how you do everything.

Elizabeth: 23:26 And that's why I talk about environment and I talk about, you know, detoxing your laundry and all these different things because how you do one thing ends up to be how you do everything. So if you want to change your food habits and you're having a difficult time making great choices, start in other areas of your life, right? Once you start to clean up other areas of your life, it's easier to clean your food. So one thing would be curating your social media feed. I, you know, have gone through periods of time where I'm following someone, even a friend, someone who I know and I just find myself comparing myself to that person a lot. You can curate your social media feed, unfollow accounts. You don't have to, unlike, or you know, it doesn't have to be with any haste, but you can mute accounts, you can unfollow accounts, don't let your social media feed be filled with things that make you feel less, because if you're allowing, it's that little tick and your mind every time you see that that brings you down. And of course the more you feel down, the worst choices you're going to make.

Allan: 24:23 Yeah. I took one my work, uh, related, uh, Twitter accounts and I just went through and I said, okay, if someone posts something political, I'm just going to unfollow them. And I did that for like three days and after about three days, there were, there was no political posts on my Twitter feed for, you know, when I was working during the day. So if I went to check Twitter, I wasn't getting bombarded by it, all the political conversations. So it became a very peaceful, zinful feed because it was filled with people who were positive and and talking about health and wellness and not going off on those daily Tangents of negativity that were starting to impact the way I felt about the world. I'm like, no, when I'm doing this, I want to think about health and fitness.

Allan: 25:14 I want to think about wellness. I want to think about joy and I'm not getting it from these people. Even though a lot of what they put out there was extremely valuable. It was just, there was just, I wanted, I needed to get rid of that other piece, and so when I did that, it's like that feed is my kind of my little goto zen place. Every once in a while I'll log in there and just read what people are saying there rather than other places because I know I'm just going to get hit and bombarded with things that are gonna just be negative.

Elizabeth: 25:40 Yeah, absolutely. I think, you know, no one, no two people's social media feeds are identical because the algorithms know based on what, even if you slow down to scroll, even if you don't like something, they know what you like or that you're at. You think they know where your attention goes and then your work feed is filled with more of those things. So I've, I've hear from a lot of women who are like, Oh, have you seen this? It's all over Facebook. And I'm like, I haven't even seen that. And like you like it because you're going to websites that are talking about that and you're liking things. You're slowing down on those posts. So they're giving you more of that. So I really, you know, especially women who are newer to social media in the past like five or 10 years, the reason your, your feed looks like that, no one else's does. It's because you're gravitating towards that. And you can curate that. You can change that by unfollowing or unliking things. And then really making sure that you're liking or commenting on things that lift you up. You know, your social media feed really should be a place that gives you inspiration, lifts you up if you're ever feeling down after you look at your social media feed, you need to curate it.

Allan: 26:40 Yeah, absolutely.

Elizabeth: 26:42 Yeah. And then I think, you know, a big thing too is that I would leave people with is that good health is not all or nothing. And I think we are bombarded with the idea that if you do one thing that's not on your plan, it's all for not. And that's not true. Your health changes in cycles and seasons in life you'll change. You know, the average person eats around 2000 times a year. If you're eating like three to five times a day, let's say you're going to eat 1500 to 2000 times in a year. And I don't know a lot of people who can get something 1500 out of 1500 or 2000 out of 2000 right. That's you know, I know some pretty high performers. I don't know if I can find anybody that doesn't, there's not any error in that. So, you know, I think what we need to understand is that we constantly need to be moving the needle towards better health.

Elizabeth: 27:35 I do believe that we need to eat real food. We need to, we need to learn what it feels like to feel good. Because once you feel good, you don't slide back into unhealthy habits and recognize that we should be always searching for progress, not perfection. Because perfection is a complete illusion, it doesn't exist and it doesn't have to be all or nothing. Now I don't want that to be a get out of jail free card to just, you know, go eat fast food or something because we need to stay away from food that is harmful to us. But good health is not all or nothing. So if you are at, you know, your sister's house or your friend's house and they make this big feast and it's not necessarily within the way that you eat and you want to enjoy the party with people, go ahead and do it. It's what you do the next day and the next day and the next day. It's not one meal that's going to sabotage everything that you've done.

Allan: 28:25 Yeah, I completely agree with that. Um, you know, something I've been paying a lot more attention to really in about the last two years, particularly since I started writing my book, um, back aways it was that words have such a profound meaning beyond what you would just attribute to them if you were reading a book. You know, like if you're reading through a sentence and the word I can't comes up. Yeah. And it just seems like a simple word, but you know, for, for the person like you, that's a moderator and this is, this is one of your, your hints here, your, your tools is, is to replace I can't with, I don't.

Elizabeth: 29:05 Yes. Yes. This is another scientifically proven mindset trick that takes the pressure off the burden off or the heaviness off of, you know, oh, I can't have ice cream after dinner. Whenever you tell yourself you can't do something, it is going to be at the forefront of your mind with, I don't eat ice cream after dinner or I don't eat ice cream after dinner unless it's Friday. Sure. On Fridays, whatever, whatever day you pick. Maybe you like your ice from on Tuesdays, um, or maybe you make your own. There's a recipe on my blog for healthy homemade ice cream out of coconut milk that's really low in sugar and you want to some that every night after dinner, go for it. For me, I use time restricted eating. I generally don't eat after seven o'clock so for me it's not that I can't eat after seven o'clock sure.

Elizabeth: 29:51 If I'm hungry, I can eat. I just don't eat after seven o'clock and I don't do that. And again, as a moderator, intermittent fasting is proven to work if you do it at least five days per week. So on the weekends, sure, if I'm invited out, I'm not going to tell my friends I'm not gonna eat after seven. Right. So I, I still have that balance and that flexibility in my lifestyle. But in general, when I'm at home, I don't eat after seven. And just that simple trick of using, I don't, instead of, I can't put you back in the driver's seat and it gives you a position of power instead of a position of why can't have that.

Allan: 30:22 Yeah. And the mindset is so critical in us. That's why I really liked that tool was because I think a lot of folks just feel so restricted when they go in and say, okay, well I'm going to, you know, I'm going to go ahead and try this Vegan Diet and they're not thinking of it as a way of eating. They do see an end point there, but now they're like, well, I can't have a hamburger. And then, so now they're in the shop looking for fake Burgers, uh, you know, to kind of appease this thing. And so it Kinda sends them down the spiral path of I can't, and I can't and I can't. And they just want it that much more.

Elizabeth: 30:56 Right, right. Absolutely.

Allan: 30:58 Now, I define wellness as being the healthiest fittest and happiest you can be. What are three strategies or tactics to get and stay well?

Elizabeth: 31:08 Oh Man, I think so much of it has to do with mindset. If I could pick three things, two of them would probably might be mindset based because if again, if we're just, if we're skipping the mindset piece and then we're just going straight into the food, we're always going to stop at some point. It has to be mindset based. I think the first thing for women that I've noticed that I would say is in getting your mindset right is realizing that you are constantly changing and evolving and nothing is ever set in stone. If you want to be thinking your whole life, great and that works, I think it's great, but what works more I think for a lot of women is that to understand, I mean women are cyclical by nature, right? We have our cycles by nature. You might want to eat different at different points in your cycle every month you might feel better vegan, meat free one week and you might realize that you need a little bit more protein and you gravitate towards animal protein another week.

Elizabeth: 32:02 Also the seasons change. The seasons are cyclical, right? Um, you might find that in the summer you like more raw and cooked food and in the winter you gravitate towards more, you know, heavier cooked food and then the cycles and seasons of your life change, right? You know, the teenagers, adolescents then we turn into uh, you know, young adulthood into this like more mature area of life. So the first thing for women, what I would say in order to be healthy and well is realize that you are free to change course at any point in your life. And that's a mindset trick. You are afraid to make a change. If you've been labeling your eating habits and that no longer feels good to you, you are completely free to change anything in your life. So I think that would be the first thing is just realizing that life is cyclical and you can make a change at any point.

Elizabeth: 32:49 Um, the second thing to be healthy and well I would say is to visualize it and that goes back to the vision board and create an environment. So this is mindset and you know, starting to get into like something physical you can do, you have to create an environment that supports your healthy lifestyle. And that has to do with how you, you know, whatever's in your home, whatever, how are you set up your day? You've got to create an environment for yourself that feels good to be healthy and well. Because if you don't have the environment to support your lifestyle, it's going to feel very, very difficult to be healthy and well. And I think the third thing is just really goes back to food. Understanding that there's one, not one right way for everyone to stop searching for silver bullet diet because it doesn't exist. Um, and really just follow the qualitarian way. Those would be the three things that I would tell people.

Allan: 33:39 I really appreciate those. Those were excellent. Thank you. So if someone wanted to learn more about you and the book, The Health Habit, where would you like for me to send them?

Elizabeth: 33:49 Oh yeah. Um, my website, Elizabethrider.com and there are over 300 recipes. There are, there are a ton of healthy living resources and with the book coming out we are giving away free downloadable book bonuses. I'm with checklists, downloads, cleanup items are so many fun things to download with the book and that's at Elizabethrider.com forward slash book or it's really easy to find on my website but I would love to send everyone there so they can grab those bonuses with the book

Allan: 34:14 Outstanding. This is going to be episode 395 so you can go to 40plusfitnesspodcast.com/395 and I'll be sure to have the links right there. So Elizabeth, thank you so much for being a part of 40+ Fitness.

Elizabeth: 34:28 Thanks for having me. I'm thrilled to be here. I appreciate it.

Let me ask you a question: Have you lost your edge? Do you just not feel as sharp as you used to and things aren't going your way at work or in life? Maybe you just lack the energy you once had that got you where you are and you want to get that back.

If this is you, go to 40plusfitnesspodcast.com/edge. I made a short little video for you, I think you are going to like. 40plusfitnesspodcast.com/edge

Another episode you may enjoy

August 12, 2019

Midlife and prostate cancer with James A Hill

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Cancer is the scariest word for many of us. James Hill takes us through his journey with prostate cancer and by doing so gives us a solid approach for dealing with the disease and the thoughts and fears we'll face after diagnosis.

Allan: 02:28 Jim, welcome to 40+ Fitness.

James: 02:30 Thank you Allan. Glad to be here.

Allan: 02:33 Now your book, Midpoint, aptly named. You know, I'm sitting here at 53 and I'm thinking, okay all those things that I did as a kid, you talked about some of them in part of your book where you're riding your skateboard and then that happens and there's an accident and blood and scars and this happens in blood and scars. And I'm thinking, you know, when we get this age, blood and scars are actually really scary.

James: 02:59 Yeah. It's a remarkable a for me that this is the point in life for a lot of men, that really marks an inflection where we, where any kind of a, um, a brush with health can be more than just important, more than just a scar on your under elbow. It can be something a lot scarier. So, um, it is an important point for me to explore in the book.

Allan: 03:21 Yeah. But beyond the being scared part. I, you know, I think, I think what the purpose of this show and then when you're listening to this show, I want you to know why we're here. We're here because men tend to have this trait of pride and obstinance and wanting to be the provider, wanting to be that man that's out there doing these things. And many times, you know, we neglect those little things. We neglect doing the things that we shouldn't be doing to manage our health. Fortunately, even though you said you, you may have avoided screenings, not, not completely avoided them, but delayed them somewhat, you did make a point of making health screenings a part of your regimen.

James: 04:03 Very much so. Yeah. I mean I would describe myself overall as being a pretty earnest health care consumer. I always took my health pretty seriously. I work out, I've always been very focused on taking care of myself, but like, like so many guys there certain things I just don't want to be, you know, physical as being one of them. I talked about this in my book. I just never much cared for physicals cause I felt like they marked at least once I hit my forties and fifties, they started to mark a decline in my, in my physical strength and my, in my physical being. So I was probably not as earnest as I should have been on certain screenings. And then of course the PSA test, which my doctor eventually had me take, I should have taken more ownership and asking for it rather than just being a passive recipient of his recommendation to get it done. Because I was at an age where depending upon who you talk to, typically over 50 men should be getting their PSA.

Allan: 04:59 Yeah, it's part of my wellness testing, my, my PSA and so far I haven't had any, any issues, always less than that. And that's always been, that's been the case. It's always, it's always been below two well below two, well below one actually. So I feel pretty good there. But it was funny because for a long time as we looked at these tests, doctors were actually starting to pull away from them and saying, we don't need diagnostic tests because we get false positives and we ended up with people freaking out. We may even end up with procedures that we didn't need to do. But the thinking's turning around on that a little bit, isn't it?

James: 05:36 Yeah, it is. It's, you know, as I mentioned in the book, the, the subject of whether to get PSA testing is an enormous point of controversy in men's health. And it's one that I think has done men in general a disservice. You know when PSA testing kind of came on, the scenes became popular in the 90s. Everybody was recommending it to gives, it seemed like you're her first really reliable or, or reasonably reliable diagnostic for, um, screening methods available to men to catch, to catch a prostate cancer. And it does, it does. What a lot of people didn't come to terms with at the time is that there are multiple reasons why your PSA, your prostate specific antigen might be elevated if cancer is only one reason. And so what ended up happening is men who had BPH, benign prostate hyperplasia or prostititus, which is an infection of the prostate or other things that might cause their PSA to be elevated. They were rushing out and getting a, getting a biopsy which can, which can result in an infection and complications. And they had a lot of general adjuncts around the fear of cancer only to find out that they, they never had cancer in the first place.

So then the medical community pulled back from PSA testing and said, you know, if you look at it statistically, it's not saving enough lives. Well, I'm not a believer that any guy wants to be a statistic and I'm one of those people who had I not gotten my PSA tested, could have ended up very easily with metastatic prostate disease. So yes, the view has changed back and forth. I think that's why any man, I think over 50 and certainly over 55 needs to own that process, needs to understand what prostate screening or PSA screening is all about. Needs to consult with either his urologist or his physician about whether he thinks at a digital rectal exam is sufficient or whether he wants to get a baseline PSA and continue testing. But it's the one thing you shouldn't ever do is not have the discussion with your doctor needs to be something that you do in a methodical, calculated way. And at least if you make a decision not to be tested, at least you're owning the decision.

Allan: 07:54 Yeah. So for the first several years, you know, when your doctor was going through the standard of care, he was using the old rectal means of testing to see if there's any abnormal swelling or growths or anything like that. And you were checking out just fine.

James: 08:11 Yes. Every time. Yeah. We, we've been checking, I think since I was 50 and I was diagnosed when I was, I want to say 50, 56, almost 57 so yeah, the nature of that exam of course is that a digital rectal exam only has access to part of the prostate and it's a pretty good screening test if you have a capable physician or pa or nurse Practitioner who really understands what a prostate should feel like and can recognize a nodule or some irregularity. But again, if you've got a, if you've got a lesion on the, on the far side of the prostate that's not accessible through the rectum, that's not going to be detected through a DRE is as they're called. And that was the case with mind and why mine was, was had reached all the way to stage three before they ever found it.

And it also that very fact, even when I had my biopsy, they typically they take 12 cores, tissue cores in a biopsy, only two of mine, showed, showed cancer, which led them to a very reassuring diagnosis of stage one prostate cancer with a Gleason score of six, which is a, which is a very low grade cancer. Well, by the time we got through MRIs and everything else, we found out that I was actually stage three with a, with a high seven in which we can talk about it to like, but so I had to go all the way through MRI and eventually through the surgery to really understand the nature of the disease. So, you know, it's a process of understanding what you have is very much a process of choosing the right procedure and getting a more complete picture of what's going on down there.

Allan: 09:50 Yeah. Now as you went through the book and it was Kinda like you're walking us through some of the learnings that you had as you went through here, because prior to this you had no reason to know a PSA relative. You know, it just, if it's better or bigger than two or lighter than two, but you know what it means when it's excessively at higher than two. You learned what the Gleason score was and how almost somewhat, I'm not gonna say subjective, but there's a little bit of, we learn as we go because we, we probe further and you know, biopsies will do something MRI's will do something. But, even after the surgery, they're there, they're still coming back and trying to look at that data to say how aggressive was this? Do you mean because going to the Internet for some of this stuff, I guess you can be, should be scary as hell reading stories. But how does someone swim through all that information and get their head clear on, on the, the treatment that's right for them.

James: 10:47 That's a great question. And it's such a personal process, Allan. I mean, that's a remark. I get a lot from a lot of guys because maybe it was how I presented the process I went through in the book that made men thing. Geez, I don't know if I would have the desire or the or the staying power to do the kind of research I needed to do to make an intelligent decision. And a lot of guys don't. Honestly, you know, I've spoken to a lot of men who kind of went the, from the moment they met with their primary care physician, whatever that primary care physician recommended they did. And in some cases they have good outcomes. In some cases they don't. I'm a great believer in the whole model of the empowered healthcare consumer. I think it's critical that a man, as I said earlier, own his health and particularly in an area that is so fraught with controversy.

So what I did is I simply didn't believe everything I was told at first blush. Acknowledging that everybody in the healthcare system and all of the information on the Internet is to a certain sense. It's, you know, there's some subjectivity to it. There's certainly some controversy there. So I made it my job to talk to people. First of all, I knew who had been through prostate cancer themselves, what their processes were. I tried to find out where they went for information and what they had learned so I could kind of leapfrog or, or piggyback off of what they had they had done and if I could of saved myself some time by using their research I did. But I also, I very much guided myself by going to the best, the best resources online. So I was in my career, uh, prior to having cancer had been in content marketing where we published good clinical information on behalf of some major hospitals and hospital systems.

And so I knew who the, who the great cancer centers for example, were. So I tended to go either to.org or.edu sources online and you know, so names like Sloan Kettering or Mayo Clinic or Harvard health. And the more scientifically sound that information was, I found the more tended to align well. And the theme that I kept hearing over and over again is your situation's unique. You need to interact very proactively with your caregivers and be picky. And so I did a ton of research. I read up everything I could on PSA at Gleason scores, on staging, on radio radiation versus surgery versus what they call cocoa therapies, which are for early stage cancers. And I kept asking a lot of questions. I also happened to be very fortunate. My wife is a very smart and very capable partner and so she at the same time was challenging me and challenging doctors that I was meeting with and we just kept asking questions and challenging the kind of the prevailing wisdom until we felt like we had enough information to make a decision.

And I want to credit some of the doctors I met with for, for having said early on, look, because treatment plans and treatment decisions aren't always clear for a man because there are so many variables and there's so much unknown about prostate cancer. It's a, it has to be a collaborative process between the doctor and the patient. And I've even seen that taken to some ridiculous levels where some doctors will say, it's your decision, just tell me which one to do. The doctors that I dealt with were much more collaborative and said, look, here are your options. You know, here's what I would recommend, but you should go out and meet with people that you, uh, that you think and kind of eliminate the matter for you. So for example, I met both with a radiation oncologist and a surgeon and then of course a number of urologists and positions and PA's along the way. And my thought process eventually took me to surgery, but um, you know, for it, had I been 10 years older, I might've gone with radiation. It just depends on your, your particular situation. So it's, for me, it's all about ownership of the healthcare process and decision making process.

Allan: 14:49 Yeah. And, and beyond, you did something that I think a lot of us would actually find very difficult. You fired your first position effectively.

James: 14:58 I did, yeah.

Allan: 14:58 He wasn't supporting you in a way that, you know, we're not talking about a diagnosis or work. I mean, but the two of you just were not connecting on an emotional level where you felt comfortable with him. Can you talk about that a little bit? We're not going to name him cause he wasn't named in the book, but could you talk a little bit about that, that process of, okay, I've got a doctor that I'm asking him a question and he's sarcastic or belittling me in a way that I just don't feel like he has my best interest at heart.

James: 15:30 Yeah. And, and um, he, you know, he was, this doctor was, was honestly, I think a good guy and an excellent physician. But like anything in life, certainly in healthcare, which is such a, it's such a human interaction. I just believe that you need more than your expertise. You need somebody who respects you as a human being who understands that your approach to making decisions about your health care might be different from the other patient who doesn't. You know who, I don't care for sarcasm. You know, if somebody sitting with cancer, the last thing they need sarcasm. So this particular doctrine I simply weren't clicking. You know, as I mentioned earlier in the book, I had been advised early on to get an MRI before I had a biopsy and I push really hard with this doctor to do that because the idea is that an MRI gives you a visual picture of the entire prostate before you go in there and start poking needles because if you, if you don't have that visual picture of what you might end up getting is an incomplete diagnostic perspective, which is what in fact happened with me.

We only got two cores when in fact I had quite a large tumor. So I pressed this particular doctor for an MRI and he responded largely by saying he didn't think it was necessary, it wasn't the best practice and made me feel a little bit like a hypochondriac for asking. Well later when I was still considering using him as my surgeon, I subsequently went to Sloan Kettering and the first thing they asked me was, did you do an MRI before your biopsy? And I said, no, I, my doctor divided against you. They said, well here we wouldn't consider doing a biopsy or MRI. So you know, that entire view that I had taken was very much validated. And it was also just a manner in which he opposed me on that decision. It just felt like he was asserting his medical, I don't want to say supremacy but, superiority and I you're a patient, I'm a doctor. You need to listen to me and not acknowledging the fact that I had done my homework.

Allan: 17:39 Yeah. Well and, and realities, you know, are the generation before us and before that and then the white coat walked in and said, do this. We just did it. But now with the advancements in medicine and what's going on in the world, standard of care changes all the time and for the doctor gets you up to speed and say, no, this is, there is a standard of care. And if there's no reason to believe that doing an extra step is going to give you a better outcome. I was just surprised that when you said you were willing to pay out of pocket for this because you weren't, you know, you were told you would probably have to do that, that he just said no. Whereas it would just been a data point. And you know, again, I'm a big fan of the more data points you have, the clearer things can be as long as you just don't get overrun with it. But I think it would have been a point that you've obviously now hindsight definitely should've had.

James: 18:31 Absolutely. And the fact that it was validated the way it was and validated with really good information in the sense that the folks at Sloan Kettering explained that, you know, biopsies first of all, it not that you want to go back in and do, but also it causes bleeding because you're poking all these holes in the prostate. It causes bleeding, which obscures any subsequent MRI image for several weeks after that. So it actually impede the ability to get it to get a good perspective. So there's really a very practical reason to do an MRI beforehand. Now that you know, you mentioned standards of care. The problem with, I think with dealing with with prostate cancer is that standards of care are, they're changing, they're shifting back and forth as, as new data comes in and as doctors debate what to do. Another example of that would be the level of sedative or anesthesia they give you for biopsy and a biopsy is pretty painful. Either I'm a whimp or biopsys are pretty painful.

Allan: 19:30 No, I think 12 holes in the human body.

James: 19:37 Yeah, yeah. Particularly that area. Yeah. It's not, it doesn't feel good and the standard of care is to give you at most of a valium to calm you down and a local anesthetic. Well, when I asked the doctor after the biopsy was over, I said, wow, that really hurt. Has there been any discussion of putting guys under under general anesthesia? He said, yeah, I actually missed his credit. He said, I've been proposing that for a while, but it hasn't been adopted as a standard of care. And so that's one of those examples where it's an evolving thing and I think to a certain degree, medicine is always kinda catch up with what it's learning from patients. And frankly, part of my objective in writing the book was to educate doctors as much as patients about what the process is like so that when they realize, Oh gee, you know, these biopsies really hurt, or Oh gee, it makes it more complicated for a patient if we don't let them do an MRI beforehand. Maybe that's something we can revisit, whether it's on an individual level or on the standard of care level.

Allan: 20:36 Now you mentioned earlier three, three different approaches to treatment. You were passed one of those by already being a six, but do you mind going through those three and then in particular the surgery and the radiation. Spending a little bit of time talking about the pros and cons.

James: 20:53 Sure, absolutely. So the two most common forms of treatment for prostate cancer are either a prostatectomy, which is surgical removal of the prostate or, and by the way, it's always the entire prostate. There is no such thing as taking out part of our prostate, which was illuminating for me at the time. You had to take it all out or you're leave it in. The other option is is radiation therapy, which irradiates the prostate gland and potentially some of the areas around the prostate with radiation to destroy the the cancer cells. They've also developed for men who are very early in their, in it with a very localized cancer or small low grade cancer, have what they call a focal therapies, which are, they use all kinds of exotic things like cryoablation, where they go in and they actually freeze the cancer cell with a, with a needle.

Those focal therapies, as the name suggests, are very focused, therefore very well located small, early cancer. By the time they found my cancer, I was a stage three that the malignancy had moved out beyond what they call the prosthetic capsule or the envelope that is basically the membrane that whole step that surrounds the prostate. So I was by virtue of that the end, it was I think a two centimeter tumor. I was not a candidate for focal therapy. So for me it came down to either radiation or surgery. I should also add that for many men, particularly men who are potentially in their seventies or and who have a slow growing low grade cancer, they have what they call watchful waiting, which is simply to do nothing and to go and maybe every six months or so to get your PSA checked.

And if it's really not growing quickly, there's a great likelihood that men like that will die from some other natural causes before the cancer ever presents a real problem. And that is very much something that's being recommended for men who are older. I was not a candidate for that because I had a very high PSA and it was changing. In fact, it changed from about 15 to about almost 20 in the space of six weeks. So they immediately ruled out watchful waiting. And the fact that I was in my fifties so the decision for me came down to surgery or radiation. And surgery, I think I'd have to check this thing, but surgeries are more common. There's been a lot of push back among some doctors against surgery because they think it's too often proposed for people who could have avoided it.

And I think that probably was the case. It's less so now. But there are, there are various types of surgery that's performed. The most common now I think is a laparoscopic radical prostatectomy, which is the doctor uses a laparoscope that, that goes in basically through five small incisions in, in your abdomen. You know, they use laparoscopes on you know, for example, to repair damaged knees. It's a way of having a smaller incision and cutting less tissue to make repairs. So you get five small incisions into your abdomen. They go in with these kind of like robot arms and they with a doctor looking through, uh, through a video monitor, they removed the prostate that way and, and uh, fix things up and send you on your way. Radiation on the other hand is a process of going in I think typically for about six weeks, five times a day and lying under the beam and the pros and cons are with radiation.

They don't remove the prostate. So some of the side effects of not having a prostate are entirely avoided. So there typically is less with radiation, they are less issues with, with continents, less issues with, uh, post treatment potency. And a man still has his prostate. So physiologically he can still produce semen, which a man cannot live without his prostate. So for a lot of men who, who can, for whom radiation is an option, it's a good choice to give. They can, it has less of an impact on their sex lives. As an example, and my, my own brother-in-law went that route and was, was very pleased with it. The trick is, and this is what helped me form my decision with surgery, my, by the time we had my MRI results and they had, they kind of accurately stage my cancer.

They knew that I was stage three. They knew that it was aggressive and they knew that it had moved outside of the prosthetic capsule. It was likely, in fact, I was told I had about a 50/50 chance. My radiation oncologist explained I had a 50/50 chance of needing radiation after surgery as well. So if you have radiation as your first line of defense, the tissue is so substantially changed by the radiation that it really can't handle surgery Afterwards. Now Sloan Kettering is developing what they call a salvage radical prostatectomy where they will go in if necessary and remove the prostate. That's already gone through radiation, but it's very tricky and recovery is tough and there are a lot of side effects to it. So generally speaking, if you think you're going to need radiation later on as a followup, because maybe the surgery couldn't get all the cancer guys will go prostatectomy first radiation second. It's worth noting too that the cure rates are about the same for radiation and surgery. So making the final decision very much comes down to how bad is the cancer, how fast is it moving, how old are you, what's your life expectancy? All these variables that are unique from man to man. And it was that process for me that was really kind of essential kind of core to my experience with cancer, which was realizing that just because my brother-in-law got radiation and it worked for him and just because my best friend got surgery and I work for him, everybody's different and you cannot just make a decision based on kind of generalized views of these treatments. You really need to dig in deeply and understand your own cancer.

Allan: 27:10 Yeah. And I think that was, that was kind of the core because you had done some research and found surgery's gone really bad. And um, that like you said, the radiation could have done something and then it would've been much more difficult if there was a Reoccurrence. So it is something I strongly considered as far as you know, which you feel good about and you know, what the facts in your particular case are saying. I guess one of the parts of treatment that kind of, I guess I didn't really think a whole lot about, you know, I thought okay, well you have the surgery, they remove it, you know, you heal up from the sutures and you're on your way. That's not the case with prostate cancer. There's, there's a lot of uh, post treatment that needs to occur. Without going into all the gory details. I can kind of talk about cause you need, yeah, you need to buy this book if nothing else to read that story. But um, uh, can you go through some of the details, you know, some of the things that you have to do just to get yourself back to normal.

James: 28:07 Yeah, the main, and of course my experience is specific to the surgery. I can't speak to, to radiation, which does have it have its own side effects. What I didn't mention is that radiation can have side effects affecting potency. And, and I'm from continent, but they tend to be deferred by six months to a year. Whereas with surgery, those side effects of course are immediate coming out of surgery. But the typical things that, that a man needs to worry about coming out of surgery of course, is potency, which is, which requires obviously intact of nerves and in tact blood flow to that part of the body. And sometimes the two nerve bundles that make an erection possible are affected by the cancer and one or both have to be, have to be removed. Now you only need one, but if even one is removed, that's gonna require some post-surgery work, which we can talk about.

But under any circumstances, the trauma that's done to the body during the surgery, particularly the nerves and a man's groin send those nerves into what they call hibernation mode, which can last for one to two years where the nerves simply don't work properly, their healing and they just kind of let like a bear going into a cave. They just stop physiologically functioning during that time. The tissue down there that's required for an erection literally it needs to be regularly stretched in troll with blood. And if it's not, if that doesn't happen, there can be term long term effects on a man's potency. So, and then the other issue is incontinence, which is a very significant problem for man because during a prostatectomy, the urethra is surgically detached momentarily from the bladder to do the surgery.

Then it's reattached and that affects all the muscles down there and the ability to control urine flow. So the two things that are typically one thing certainly has done most commonly coming out of prostate surgery is they're going to recommend that men do with they call Kegel exercises. That's very well known to women who are advised to do with these after they have have a child because the muscles down, they're affected by childbirth. Same thing goes for men after a prostatectomy is literally just like clenching, clenching the muscles of the pelvic bed over and over again, like a workout. Honestly what it is. And in my case, I was advised to do these exercises before surgery and then to do them right after surgery to to just like anything else, you want to have strong muscles. So that's a big part of, of regaining continents.

And then in my case, Sloan Kettering has a group called the sexual health clinic, which is really pioneering ways to keep men functioning from a, from a, from a potency perspective, functioning well, while those nerves recover come out of hibernation mode and that's they, they have various ways of dealing with it. But the most, the way that they use most is an injection therapy where a man gives himself a shot that actually physiologically reproduces, creates an erection, which allows the tissue to be stretched and so forth and, and oxygenated until they heal on your own. So, unfortunately, that is not a therapy that is widely known about known by men, and it's not as widely recommended as, as it should be in the result of a lot of men. Too many men end up having potency issues when they didn't need to. They could have actually recovered normal, normal functioning.

Sloan Kettering is fabulous about that and I was actually part of a study, a 2-year study and following up with men on that and comparing the results of that therapy with men who didn't go through it. And the results are dramatic. I mean dramatic, the kind of improvement in that they see when you're on kind of therapy. And then of course the only other thing I would add, Allan, is that both going into a prostate surgery and coming out of it, the more you can be in good shape, eat well, not be carrying any extra weight, have good muscle tone, all of that prepares you for the what is a pretty significant assault on your body. I mean the prostatectomy takes four to six hours, it's a big deal and a lot of men don't realize it's one of the most complicated cancer surgeries out there.

It messes up the body in a pretty significant way for a while. And it takes a long time to do all the healing that's necessary. The more fit you are both before and after the surgery, you know the better you're going to handle it, the more quickly recover. Some of big proponent of be fit all the time, follow it, have a good diet so that you're not inadvertently helping the cancer or the cancer recur by eating the wrong kinds of foods. All those things. The same things that we're told anyway about being fit and healthy very much affect the outcomes of a prostate surgery.

Allan: 33:04 Yeah. And you know, as you were talking through that and you're getting yourself physically fit. I was, I was thinking about a quote that you had in the book, you talked a lot about how you didn't really see cancer as a battle or at least you didn't like that kind of that phrase of encouragement battles. But you did say this in the book. You said cancer cells are the terrorists of the human body, the weaponized bundles of angry, twisted cellular matter that have come unmoored in their restraints. And, and I thought about that in the basic ways of saying, you know, if we prepare ourselves generally for life, we're going to be strong, we're going to be generally healthy and that's going to put us in a better place. So it's not necessarily a battle so much as knowing, okay, we have this insurgency that uh, we now have to deal with and if we're physically fit and generally healthy, our bodies are going to be more resilient. And then there's always the mental side of this of, you know, terrorism is scary, not knowing when this could happen or if this will happen is scary. And in a sense it kinda changes the way we think about life when those scary moments happen.

James: 34:15 Yeah, yeah, very much so. I'm fortunate that I was always somebody who just was interested in staying healthy as much because I wanted to look good and feel good. But you know, it turns out that healthy has a lot of dimensions to it and you just don't want to go into a scary diagnosis like cancer with anything already compromising your health or that makes it just much more of an uphill battle. And I joked about it in the book about doing, you know, following that was so earnest about following the, the physician's advice for, or being prepared to physically put surgery. I followed advice they didn't even give me, but that's how seriously I took it. And you know, one of the things also that they push you to do, which I talked about quite a bit in the book, is walking right after surgery.

I mean they have you up walking down the hallway within four or five hours of the surgery and then walking subsequent to that while your catheters in and during that, that first 10 days or two weeks of recovery, physical activities so important and the more fit you are going into that process, the more quickly you're going to be able to resume that physical activity that is so central to your healing. The human body was made to move and we're not, certainly after a surgery like that, you might have fluid in your, in your lungs that you need to be able to call from. The stronger your body is, as soon as that can happen, the stronger your circulatory system, the more likely you are to replenish the blood flow to your groin. All of that benefits from being in a generally good state of health. I can't say enough about the importance of that and you know I honestly, I as hard as I've worked at it, there are even things I could have done a lot better. It's just a matter of doing everything you possibly can.

Allan: 36:03 Yeah. Now I define wellness as being the healthiest, fittest and happiest you can be. What are three strategies or tactics to get in stay well?

James: 36:14 That's a great question. I would say from my perspective and within the very specific context of prostate cancer treatment, it's leading a fit lifestyle. Not when I say a lifestyle, it's not just, it's not just going to the gym, but it's maintaining good physical and mental health. So eating right, getting exercise, managing stress, making it an approach to life rather than something that you do when you're not stressed out about work. So I'm all about just making health and matter of lifestyle coming out of surgery also, I believe that the best thing you can do to, to regain that sense of wellness, just to be a model patient, doctors know what's required to, to return to a good state of health. And so I'm a big believer in follow exactly what they, don't be a c student, do everything they say you're supposed to do, ask questions and they know how to get you healthy.

And they're going to push you to do that and don't subvert that process and you know, something. The third thing I would say, Allan, is that a lot of men overlook, particularly in this context, the importance of psychological changes that happen during middle age and particularly during treatments for prostate cancer. It's a disease of the male reproductive system, which is central to our sense of wellbeing. And men need to, who go through this need to prepare themselves for those psychological shifts. How they see themselves, their relationships with the partners, uh, how they see the world around them now as they are some in some ways altered. So surrounding oneself with support, with loved ones who can, we can be there for you if you start to stumble or you feel down or if you're not pushing yourself as hard to recover. That's just as much about wellness as is staying physically healthy. And it's something I end on that point. Particularly think of the thing. It's something that too many men, particularly in the context of prostate cancer, come to, uh, not pay close enough attention to.

Allan: 38:12 Thank you for sharing those. Uh, I do want to kind of close this a little different because there was a quote, some advice that your father gave you that I want to share here because I think this is really important. And he basically told you, he said, make sure you live your life before the hard times come. And I think that's some advice we should take to heart and realize that you know, we should be living the fullest life we can possibly live because this type of stuff can to us. Stay healthy, stay fit and enjoy the life that we have while you can. And so I appreciated your father's advice and I appreciate you sharing that along with your entire story in this book, Midpoint. If someone wanted to get in touch with you, learn more about the book and the things that you're doing, where would you like for me to send them?

James: 38:57 Well thanks for asking. I have my website is www.jamesahill.com and that is both a place where there's more information on me, my book and I also blog regularly on issues related to this. And um, and also of course the book is, is uh, going to be released in a few days on July 30th on Amazon. Barnes and Noble is all the, uh, all the major booksellers online. So anybody who wants to reach me can certainly reach out to me through my, through my website contact page there.

Allan: 39:29 Cool. You can go to 40plusfitnesspodcast.com/394 and I'll be sure to have links there to the book and to Jim's website and all of that. So Jim, thank you so much for being a part of 40+ Fitness.

James: 39:43 Thank you for having me on. I enjoyed the conversation.

Another episode you may enjoy

August 5, 2019

The Mindful Runner with Gary Dudney

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Our guest today not only walks the walk, he runs the run. He is a wonderful storyteller and I really enjoy my conversations with him. Even though his books are about running, I can tell you that you can get something out of this for pretty much any fitness endeavor that you want to take on and that was kind of my challenge in this episode was to make sure that that's exactly what happened. So even if you're not a runner, I think this is an episode well worth listening to. It's my pleasure to welcome back Gary Dudney, author of The Mindful Runner.

Allan: 01:14 Gary, welcome back to 40+ Fitness.

Gary: 01:17 I'm happy to be here, Allan.

Allan: 01:19 Yeah, it's been three years since we talked last. That was episode 131 this is episode 393 so I've gone through a lot of these, but I was really excited to see your book come out because I enjoyed the last book, the Tao of Running because you're such an excellent storyteller. I mean, you know, you're talking about a race and you're going through the details of it. You know the locations, you were the struggles and it's, you do a really good job of, even though I'm not doing ultras, putting me in the place, in the conditions and in your frame of mind, all in a really well told story.

Gary: 01:55 Well thank you. That's, that's really my goal was to bring, I was a writer before I was, I was running. So I'm not a runner who wrote a, wrote a book. I'm a writer who runs and, um, I thought getting the whole experience down on, on the page was the important part. And of course I, as you know, I use those stories to make my points about the mental side of running. You do. And so you know, this book is called the mindful runner and like I said, it sort of a,I guess I'd call it a second edition of the other book.

Allan: 02:31 It kind of takes it in a slightly different direction with I think a lot more of, you know, the other was about enjoy, I think more about enjoying running and then there are challenges and things like that, but that's part of the value of it. This talks about, I particularly like that you're talking more to the beginning runner or the person that's looking to try to start doing, performing a lot better. Maybe setting some higher expectations for themselves and the fact that they're going to have to push to make this happen. And that's all going to start with their, with their mindset rather than what their body's capable of doing.

Gary: 03:06 yeah. I had, I had a lot of material that I wanted to, um, include in a new book that I didn't get into the dow of running and a lot of stories and even some short fiction that I've published in the past that I wanted to put into a book for anybody who's interested in reading about running. And then my personal focus is of course on what's going on in your mind when you're running. And there's just so many different ways to be thinking about what to be thinking about while you're running and so many mental frameworks you can bring to it. And with each new mental framework you bring to it, you find a new richness and running and you get, you get more out of the experience. And so again, I wanted to capture all that in the new book.

Allan: 04:00 Yeah, I think so many beginners will go out there and you know, they're excited because they, you know, maybe this a new year's resolution or they get on the phone with someone, they get excited, they've signed up for a 5K and you know, they're all jittery and then they're going to go out and do their first training run. And once they start moving, their body just starts in the brain, start saying, stop this, this hurts.

Gary: 04:23 That's the first thing you discover is that it's pleasant for a little while. But then invariably if you push just well beyond your comfort zone, which you really need to do in order to improve then you get right into the mental struggle. You know, do I keep going? Is it worth all this effort? Surely it shouldn't hurt like this. Whereas it's very natural for things to hurt when you, when you're pushing yourself beyond your limits and improving. And it's actually a positive thing that you're feeling that way when you do because it means you're improving and that you're reaching your potential and you're reaching the goals that you're after. If it's coming easy, you're probably not pushing hard enough.

Allan: 05:11 Yeah. And you use, you used two words that I think are critical for any training. This is not just running, but anyone that wants to achieve a result from their body through physical training, resistance training, running, whatever it is that the words are patience and determination and they somewhat counterbalance each other, but they work very well synergistically if you know how to apply them, can you talk about how we can apply it patience and determination into our training to get the most out of it?

Gary: 05:44 Sure. Those are, those are two qualities that I've just found, you know, 30 years of running and, and 20 years of ultra running are just a critical component of succeeding at what you're doing. And it occurred to me that patience is starts right there with the beginner who is trying running out for the first time or going back to running. In variably it's not going to feel good at first. It takes, you know, it takes a couple of months of continued effort in order to start getting the benefits of being in good running shape. And I think a lot of people they read about how running is you know, such a pleasant experience and such a good way to stay healthy or their friends are telling them that and then they go out and they try it for a couple of weeks and you know, something, a lot of little pains will pop up and manifest themselves and then go away if you stay after it.

But I think a lot of people get discouraged right at right at the beginning when they've been working at it for two or three weeks and you know, they still feel awful at the end of their first mile. And so, You know, the beginner needs to show some patience in getting to that month mark or two month mark of regularly getting out there and running to get to the point where they start feeling the benefits and then they can expect to get that good feeling of getting out there and getting into a rhythm and being able to get through the middle miles without, without too much stress and discomfort and whatnot.

Allan: 07:37 Yeah, I think I've found that the folks that get really comfortable with running and enjoy it the most, they've reached a certain point of training where their bodies effectively trained and now they're not really pushing their comfort zone as much. They're just staying within their comfort zone because they're happy. You know, they may be a short distance runner or they may be at a middle distance runner, you know, they like half marathons or 10 ks and that's their happy place and they run it their comfortable training pace and then they race at a, maybe a little faster pace. But the folks that I, you know, hear the most or that I really enjoy in the running, they're not really pushing themselves to do something faster or harder. They're not that driven kind of person. They're more the, I just enjoy doing the run kind of thing. But it takes a while to get there.

Gary: 08:21 Yes it does. It takes a while to get there. Your body has to make a lot of adjustments. You have to build up your endurance and your stamina and that takes a while and if you can stay patient and, and realize that you have to stay patient, then it will eventually work out. But patience also plays into when you're racing or when you're doing a longer run, you get to a point where things are becoming uncomfortable and your first inclination is slow down or drop out of your race or whatnot. And at that point when your thinking is going negative, you want to try to use thoughts about being patient and determined sort of as a mantra. And you can just, if you're aware of the fact, Hey, I have to show patience here. I have to endure the way I'm feeling right now.

This is a normal thing that I'm feeling. And if I stay patient, I will be rewarded. You know, that's somewhere to go with your thinking instead of going into a negative frame of mind where you're thinking, wow, this is just too much for me. I should have trained harder. Maybe it's not my day. Maybe I could, you know, come back next year to this race and do better. All those are excuses for not reaching your goal. Whereas if you can block those thoughts and feelings, those negative thoughts and feelings and tell yourself, you know, patience will get me through this patience, the determination will keep me in this race and, and keep me after my goal. That's a nice positive thought. And then you can get back into your race and, um, and go from there.

Allan: 10:11 Yeah, the determination part I think is, is really, where the growth comes from, the patience is just kind of making sure that you're, you're there, you're showing up each day you're doing your training, you're in the race, you're going to stick with yourself and you're, you know, this, this is not just something that you're going to wax over. The determination is kind of that point where you're beginning to push yourself because you want to get done faster, you want to move further, whatever the, the goal is with this training or with the race. And so I do feel, and I actually, in my book, I use the word persistence, but I like your word better.

Gary: 10:45 Yeah. Determination is sort of the irrational part of your brain that is keeping you in there. When the rational part of your brain is telling you, you know, this is hurting too much, or I'm trying too hard. Or determination is if like ignore all the rational thinking that you're doing. You're going to stay in this and you're going to continue it and you're going to keep performing despite everything that you are, you know, your mind is telling you.

Yeah, it was, um, I was in the army and in basic training, they broke us up into platoons and they did it alphabetically. And so we were, you know, with the last name M I ended up in the third platoon and for one reason or another we were just, we were all just the worst. Every, every competition we went into, we came in last place and the fourth platoon, every competition they went into, they came in first place. And so we, by the end of basic had this chip on our shoulders. It's like, okay, who are these guys and why? You know, how, how did alphabetically, the top end of the, of the alphabet end up with so many, you know, somebody better soldiers or better athletes. And so we were going into the two-mile run and everybody was talking about, you know, one of the kids who he ran track in high school and was, so he's a track star.

And you know he had scholarships but decided to go into the Army instead. And so I'm like, okay, I want to see how fast this guy really runs. Cause they were telling me it was really fast. I'm like well I wasn't all that too shabby myself in the two mile when I was in high school. Probably not competing in his level but you know, I'll try this. And you know, you go through basic training, you're teaching your body in many cases to ignore the pain. You know, if you know it's not a pain that's going to kill you, do you tend to push through it? And so by this time I had done enough of this that I felt comfortable. At being uncomfortable now outside my comfort zone. So I was like, I wonder if I ran my quarter mile split at the start of the race, what I could do in two miles if I could actually hold that for all the two miles.

And so I did, I literally took off, you know, with about, I guess it's probably about a 1/15 split on the quarter and you know, the, a couple of guys in my unit are walking over cause they just seen you taken out there. So I finished like the second lap and they were like, what are you doing? You know? And I just was running as hard as I could run now because I was turning off all of the pain things and not thinking about it and trying to just really focus on my breathing and just continuing to go and not, not completely red line out. I actually pooped myself, running, he did actually beat me. But the thing I can say is coming off of that run, it was, it was the fastest two mile I'd ever run in my life. It was the first time, it was a first time I broke 11 minutes and, and so, you know, even though I came in second, I felt really good, at least personally, I had to keep running and go to the bathroom and cleaned myself up. But, uh, then that embarrassment, it was where I saw that kind of cutting out the pain of it and knowing that the pain was not something that was going to sideline me forever. I, you know, I knew I might be paying and paying for a couple of days, but I didn't have to worry about it. We were passing the PT tests. So at that point, running the, you know, running the two miles was the last athletic thing I had to worry about doing for awhile. Well I knew I had that in me. I wanted to see how hard I could push myself. I wanted to see how much I could push past. And that's when it Kinda hit me why a lot of the elite runners are who they are is because it's not because they don't feel the pain, it's that they ignore it. So how do we push past that pain when we're training and how do we recognize when it is that kind of pain that we should be pushing through?

Gary: 14:35 Yeah. Okay. I will address that. I just wanted to make a final point about patience and determination. And then, and then we'll, we'll talk about that. Allan, one of the things I focused on the book, the mindful runner in the title, mindful of is associated with mindfulness, but I also want you to take the title, literally the mindful runner in that it's a runner who is aware of what is going on in his mind, his or her mind. And I think that's what so many runners, they're always focused on the physical side of their workout, how far they're going, how fast they're going, that sort of thing. And when they think about, you know, what's going to happen in the race, they're just, they're thinking about, okay, I want to hold this, this pace, I'm going to do this particular distance, that, that sort of thing.

But they don't think about what's going to happen to me when things get really bad and my mental state starts to deteriorate. And my experience from all the running I've done in all the ultra running I've done, is that if you pay attention to the mental side of the equation and you practice the mental side of the equation then when you're in the, when you're in the race or you're deep into a long run or something like that, then you're much more adept at using mental strategies to keep yourself in the race and keep yourself reaching your goals. And so just having this understanding of what is the role of determination and what is the role that patience in what you're doing. If you're thinking about that and you're aware of it, then that's a very helpful tool that you have when you're in the race and things start start getting difficult for you.

And I think you're way ahead of the person who just thinks, okay, when things get hard, I'm just going to get it out. And that's the only strategy they have because when that strategy starts failing for them, then they have nowhere to go. But if you've got these mindsets and ideas in mind, when you hit that point then you have some, some resources to try out and you can cycle through different mental strategies for keeping yourself in the race. So I wanted to just say that being, you know, aware of these things are being aware of the importance of these things is very helpful. But one of those is pushing through the pain. And I think having one strategy or many strategies that you've practiced for that point of the race where things get really painful is really critical and really helpful.

And I say that from some experience because when I was, was working up through my ultra running career, I got to the a hundred mile race, which is sort of the holy grail of ultra running is to you know, do that a hundred mile race cause it's such an iconic distance and whatnot. And I started doing them and I had done eventually 26 of them. And if you look at my records for that first 2,600 mile runs that I did, I had sort of indifferent success. I was making it to the finish about two thirds of the time and about one third of the time I was dropping out. Then I did another 2,600 mile runs. So I had gotten up to 50 to a hundred mile runs. And in that second half, the second 2,600 mile runs, I never DNF, I never did not finish. I made it to the end of every single one of those runs and a lot of things happen in a hundred mile run that can knock you out of the race that are almost beyond your control.

So it's pretty amazing to have that consistent record of finishing. And I look back at that record of the 52 runs and the point where I started not ever DNF'ing was that point where in my career where I had really started focusing on the mental side of what I was doing and I started developing the mental strategies that would help me when things got, as they inevitably do, when they get painful in the race. So it convinced me that it was, you know, nothing else had changed. My training hadn't changed. My level of fitness hadn't changed. The types of races I was doing. Nothing had changed except that I had some mental strategies to rely on when things got very difficult out there.

Allan: 19:24 So let's, let's talk about a few of those.

Gary: 19:26 Okay. So pushing through the pain. The thing about when you start feeling stress or fatigue or you know, the aches and pains, especially in a long race, like an ultra, you know, your first inclination is to deny that it's happening to you or try to run away from it or escape from it or, or just not accept that it's going on. And that's usually not going to get you very far because you can put it out of your mind for a little while, but then it's gonna just reassert itself. And when you get to the point where you realize ignoring it is just making it worse, then you're in trouble.

So I think that the key to pushing through pain is to meet it head on. To acknowledge the fact that it's happening to you. I'm not as comfortable as I was before. I'm getting very tired. What objectively is happening to me here. You know, how exactly does this feel? How bad is it? And you sort of face up to it and in a way, just just that act of facing up to the fact that acknowledging that you know you're not feeling great anymore and you are feeling bad is going to take little bit out of this, of the sting out of it and take some of its control over you out of it.

And then you want to tell yourself, this is a normal way to be feeling at this point in this race. You know, I'm not, if I'm running a marathon and I'm at mile 20 you're not going to feel good. You're going to feel really bad and you're going to feel distressed that you have six more miles to run and that you're, it's very hard to hold the pace that you were hoping to keep. But that's a normal and a natural feeling. It's also a feeling that everybody else in the race is experiencing along with you. You are not alone in feeling badly. You can't train so hard that when you push yourself, you're not going to feel this pain. So again, accepting it as just a natural and normal part of what's happening to you. It's feedback to you that you are indeed pushing yourself hard and that you're getting to your goal and that you're doing what you're supposed to be doing.

So your job now is to find a way to accept what's happening to you. And like I said, you do that by, you can sort of sink down into it a little bit and just let it, how does this feel? How, how bad is this? And usually when you do that, it's not as bad as, oh, you know, you don't let the fear and the self doubt take over. Instead you let your sort of objective look at that pain be the what's uppermost in your mind. And then once you face that you try to get back into what are all the other experiences that I'm having here besides this pain. You know, what's, what's going on around me, what are there other people around me I might be talking to or you know, what is this part of the trail look like? What am I seeing? And hearing and smelling, I'm still, I could still be focusing on my breathing or on the rhythm of my arms swinging or there's a lot of sensations going on in addition to the pain.

And so you want to try to focus back on all the other things that are going on and try to let the pain recede into the background. And that's very helpful. You, you want to try to, you know, keep your thinking positive and not give into fear and self doubt about how the pain is going to get worse and worse and you're not going to be able to stand it. You want to go to a positive place. This is the normal thing to be happening to me and I need to accept it and then I need to move beyond it and think about what else is going on in the race and what else I might be doing that will help me stay in this race.

Allan: 23:42 Yeah. I think one of the things you said in the book that was, you know, that kind of helped me a little bit in this area was we're not going to see performance gains and we're not going to have our best race if we're staying inside our comfort zone. So the fact that you're feeling this discomfort is really just proof that you're right where you need to be.

Gary: 24:02 Exactly. Yeah. I mean, and that sort of mental Jujitsu on that pain has been for me, one of the really critical insights that I've had. Because now, I mean, it's hard to believe, but now when I'm in one of my a hundred mile runs for instance, and things start feeling really bad as they inevitably do, I sort of, it's not that I welcome it, but it's like, it's like it's an old friend. It's like, okay, I know this was coming and here it is. And uh, I've dealt with it many, many times before and so I know that now I'm engaged with the beast. I know that I'm getting the job done and I'm, I'm getting to that, I'm getting to the point where where the real meat of the run is. And, uh, I'm almost happy I'm there because it's, I'm getting to the, you know, I'm, I'm getting into the real contest now. And of course it's getting to the hard things that are so validating in the end. I mean, when you get to the end of the race, if you've gone through hell, then you're, you're really happy to be at the end of the race and you, you have the real set, you get real satisfaction out of it. Whereas if it, you know, if it was easy it wouldn't be as cherishable.

Allan: 25:24 Yeah, I have clients and I've had friends that, you know they'll set stretch goals, you know, and they'll want to get to those goals. Like I've, you know, my, my stretch goal for that two mile run was, was to beat the fastest runner. You train and you train and you train and maybe it doesn't happen exactly the way that you, you saw it in your mind's eye. So at one point you to it, well you told this story in the book at one point you were training to run a 40 minute 10k. Can you tell us about that experience?

Gary: 25:52 Yeah. I'm trying to remember the point I was making.

Allan: 25:56 Well I think the point being you trained hard for this, for this particular goal. It was it at the time it seemed very, very important to you and you didn't quite make it.

Gary: 26:04 No, I never did.

Allan: 26:05 The things you learned about yourself, things that you were then able to do physically, you did have some benefits coming out of that.

Gary: 26:13 Yes. That was, you know, having a goal is a, of course a great motivator and that was one for me to get under 40 minutes for a 10k and the journey that I went on in trying to do that was infinitely satisfying. Even if in the end I never got to the goal that I had set out. But working through the training, going to the races, giving it everything you had, all that was well worth the effort. Even if in the end I didn't make it.

Allan: 26:52 Yeah. And I think that's why it's, it is important for us as we're looking at our overall fitness to have that target that's maybe slightly above what we think we're capable of, that, that kind of scary thing we're after then we know it's going to take a lot of work, but if we dedicate ourselves to it, we use patience and determination and yeah, we push through and get outside of our comfort zones. The more and more we do that, the better we're going to improve our overall fitness. We're going to improve our mental toughness and that's going to help us in so many different ways.

Gary: 27:24 Yes. And I should say that quite a long while ago, I mean I'm getting up in age, I'm 66 now, but quite a long while ago I stopped running with so much intensity where, you know, I was trying to break old, um, 10k records and that sort of thing. And I shifted my focus, not so much on making a time goal for a particular race, but getting the most out of the experience of running. And the way I did that was I chose to run new distances so that, you know, it was a new kind of race that I would be running or I chose to move out of my neighborhood and you know, travel around the country and do runs that are exciting just because you know, you're there in a particular location like the New York marathon or the Chicago Marathon. And that's also, those goals are also a very rewarding goals and they don't necessarily require that you run with so much intensity that you are, you know, liable to hurt yourself.

Allan: 28:41 Yeah. Uh, you know, there, there are marathons, 10ks, 5ks all over the country. Uh, you know, I ran big Sur, I ran Washington DC, you know, I ran the blue angels down in Pensacola. So I mean, you know, there's tons of opportunities for you to make this more than just trying to complete a run. I mean, initially when you first start running that maybe it's a local 5k you want to finish, but you get online and you look for races and, and pretty much anywhere you want to go on any given Saturday, they're probably going to be a race somewhere nearby during the season.

Gary: 29:14 Yeah. I even have a chapter in the mindful runner, it's called Yo, I know you're in there, which is about, well, the, the first example I give is I was in Sacramento and I was doing a, I was doing a 50 mile there and the night before the race, I was in my hotel room all by myself. And suddenly I heard this pounding on the door next to mine and it was a drug dealer or something like that, who was a shouting at the person inside the room. And he was going, you know, Yo, I know you're in there. Get you, get Outta here, give me you giving my 20 bucks, you get the, you get the hell out here, give away 20 bucks. And it just went on and on and on. And this is in the middle of the night, about three o'clock in the morning.

And I called the front desk and they said, yeah, we're aware of the situation, but they weren't doing anything about it. And so the guy was at the door for about an hour shouting and screaming. So I wrote about that for a race report for Ultra Running Magazine. And I'm an editor of the magazine, wrote me a note back and said, I loved your race report, especially the part about the drug dealer. And it made me realize that the experience of running, it's not just the race itself, if you're going to travel to a race, it's everything that happens around, you know, preparing for the race and dreaming about the race and, and making arrangements to go there and then traveling there and the night before and trying to get to sleep and getting to the starting line and the race itself and then getting home and the satisfaction of having gone and done something like that. And the whole, it's an example of where running or whatever activity that you are using to get exercise is just, can be such a rewarding and rich experience for you if you think about all the things that go into it and not just the running itself.

Allan: 31:24 Yeah. I completely agree. You know this, the stories, the people you meet for the longer races that the pre-race meeting, you know, when you're just sitting around looking around at the other, the other athletes that are going to be doing this and you know, saying, okay, wow, you know, this guy's, this guy's 68 years old and he's going to be out on the same course I am. And I was when I was 29 and I'm like, this is, this is kind of amazing to see this breadth of people sitting in a room.

Gary: 31:48 Yeah. Now that guy is me.

Allan: 31:51 Well, you finished.

Gary: 31:51 I launched a goal several years ago to try to run a hundred mile race in every state in the union. And I'm up to 34 states now and hope to get to 50 in a maybe two years.

Allan: 32:12 Yeah. I guess the question is, does, does every state have a hundred mile race? Because I know Mississippi had a 50, the touchstone 50, but I don't even know if they have a hundred yet.

Gary: 32:24 Mississippi does.

Allan: 32:25 Okay, cool.

Gary: 32:26 There are a handful of states that don't have, you know, sanctioned 100 mile runs. I'm not sure what I'm going to do about that. And maybe by the time I'm like you're going to be, there are so many runs popping up, who knows? Those states will come on board before I finish. But the point I wanted to make is that traveling to these races has, is so much fun and I've enjoyed so much seeing new places and meeting new people and getting to know the race director at every one of these events. It's been the most rewarding thing I've done in my life, I think.

Allan: 33:04 Yeah, absolutely. In the book he had a quote and I just have to share this. It's short, it's simple, but it's so right to the point that I just want to use this. “No one can do your running for you.” And I'm like, you know, that that's all you had to have. You know, it's like if for anyone that wants to go out and do something, they set a challenge for themselves. It's you, you know, and then the book is going to help you get in the right frame of mind to do this stuff. But in the end, when it comes to the training and it comes to the actual race day, it's you who puts one foot in front of the other.

Gary: 33:38 Yeah, exactly. And that was, I think I said that in the context of, um, there's a lot of ways to get help out there. When you're running, there's people who when you're sitting at an aid station and you're really discouraged and you want to quit, sometimes somebody can come along and say, just the right thing to you and get you up out of the chair and get you going on your way. Get your determination back. You can hook up with another runner and have a conversation and feel a lot better just because you're getting your mind off your own misery for a while. But in the end, it is all you that is going to get you to the finish line and nobody can do that for you. They can, you know, they can encourage you and help you along mentally, but they're not going to be the ones that get you there, which in the end is what makes running I think so wonderful and so satisfying is that it is very individual sport and it's something that you've accomplished and you know, once you've accomplished it, nothing can take it away from you.

Allan: 34:46 I agree. I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and stay well?

Gary: 34:55 You know, I think the key, it doesn't matter what discipline you're, you're doing triathlons, ultras, shorter races or whatnot. I think working towards some big goal is the thing that keeps you engaged in the activity and keeps you coming back over and over again. If you're only thinking, oh, I should, I should run every other day just to keep fit and you don't have anything in mind at the end of that, it's just, it's pretty easy to find yourself thinking, I, you know, not today. I don't really need to, you know, there's no reason why I need to go out today, but if you have a goal that you've set, there's a race, you want to do a half marathon, you've never gone that far before in the race or there's a marathon and in some distant city that you'd like to go to and you have that in mind.

Gary: 35:51 I think that's extremely helpful and extremely motivating to know that at some point the training that you're doing has a purpose and it's leading towards something and it doesn't matter if that goal is just you going off to have some experience. It's very helpful. And then I think it's helpful to have different goals that you, you know, if you've always been running marathons and that can get sort of stale after awhile if you decide, okay, well, you know, maybe I'll train for a 10K and see how I can do at this point in my life running a 10K or maybe I'll try a trail running instead of running on the road. Or I'll try, you know, a 50K ultra. Um, if you get off on some new quest, I think that's something that it's very helpful to reinvigorate what you're doing and you can find yourself more excited about the training that you're doing because you have this new goal.

Gary: 37:01 And then the new experience itself might be something that you know, you might, I know the first time I did any trail running, I was totally transformed from a road runner to a trail runner. Like the very first time I ran on a trail. Because I just found it so, such a wonderful experience to be out there in the woods jumping over streams and getting lost in the forest, you know.

Allan: 37:27 Yeah, that happens. A true story.

Gary: 37:29 That's a couple of things I'd suggest.

Allan: 37:31 Yeah. Thank you so much for being a part of 40+ Fitness. If someone wanted to learn more about you, learn more about the book, where would you like for me to send them?

Gary: 37:38 I have a website, it's called the taoofrunning.com and that's a tao, spelled t, a o and it's all one word, so the taoofrunning.com. And that's where I've gathered all my material that I've written for ultra running magazine over the years. All my race reports, all night articles with advice about running and the mental side of running and where I linked to my books and I linked to a lot of other running websites. The books you can get on on Amazon, The Mindful Runner or The Tao of Running. They're both available as paperback and Kindle and as audio books. And then also I write a regular column for Ultra Running Magazine and an online magazine called Endurance Sports and Fitness. I do a regular column for them as well. Those are all places you can find me.

Allan: 38:37 You can go to 40plusfitnesspodcast.com/393 and I'll be sure to have all of those links there. So again, Gary, thank you so much for being a part of 40+ Fitness.

Gary: 38:48 Hey, I enjoyed it. Allan

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