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Category Archives for "guest/interview"

March 30, 2020

Aging brilliantly with Dr. Patricia Selassie

Nobody wants to get old, but we have to face facts that we will. On episode 427 of the 40+ Fitness Podcast, Dr. Patricia Selassie shows us the art of Aging Brilliantly.

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Allan (02:33):
Dr. Selassie, welcome to 40+ Fitness.

Dr. Selassie (02:36):
Thank you so much. I'm so excited to be on your podcast Allan.

Allan (02:40):
Well, I am eager to talk about your book because I loved, loved, loved the title when I saw it on Amazon coming out soon, and I was like, okay, I got to get this. I got to get her on here. The book is called Aging Brilliantly: How to Eat, Move, Rest, and Socialize Your Way to Long Life. And in that book, I think you do a really good job of just kind of taking us through some of the basic fundamental things that we should be doing to keep ourselves healthy and in doing so, aging better.

Dr. Selassie (03:09):
Absolutely. Yeah. It's back to the basics, you know, I think that that's always going to be the foundation.

Allan (03:16):
And the way I kind of get into it when I'm talking to clients is I'm like, let's look for the big rocks. You know? And it's, I think everybody pretty much knows I could eat better, I could move more, I could rest better and I can socialize more. So it's a, it's kind of this natural go-to. Can you kind of go through those four pillars and just kind of talk about what each one means to us and how we should be mindful and focused on each one?

Dr. Selassie (03:41):
Yeah, absolutely. And even though these are just the basics, I just want to say that the basics are heavily backed up. By research, I mean there's been tons of science and clinical studies showing that these four pillars are really important for aging brilliantly. So eating, I mean, you know, right now I think that everybody is really kind of gets excited about the latest trends, you know? And if you've been in the health field for a while, you understand that these ideas change. Like I think maybe 10 years ago or not even that long ago, everybody was like all excited about the paleo diet and eating bacon and now everybody's all excited about the plant-based diet, but if you're around 20 years ago, the plant-based diet is really just the vegan diet, but despite all the trends, no matter if you're like I'm gluten-free or I'm paleo, which is not a trend for some people, but no matter what diet you're on, the most important thing I think is really that you get some of the fundamentals that you see in all diets, which is going to be healthy plants.

Dr. Selassie (04:47):
No matter what type of diet you are on, you want to make sure you're including plants. And good fats are really important and I know that there was a time when everybody was eating fat-free and now we've got to like get with the times because when I fat-free is just not the way to go. There's been the most research done on the Mediterranean diet and I think it's a very adaptable diet for lots of people. Whether you have gluten sensitivities or you don't want to eat animal products or you can't, you know, you don't do well on dairy. There's always food available for people and ways to make it more tailored towards you. And the Mediterranean diet shortly is just pretty much lots of plants. You want to have nuts and seeds and oils, a little bit of fish, a little bit of protein.

Dr. Selassie (05:38):
And that's the basic pillar of, and there's definitely more details in the book. Moving is really important. I think that we all understand now that we live a very sedentary life. Most of us are working at a cubicle. We're not even standing. And studies show that even a little bit of moving, so I think a lot of people get intimidated because they think like, Oh, I've got to start that CrossFit now. You know, or I got to, you know, New Year's is here, so I got to start my exercise regime. But a lot of the studies are showing just even three minutes every hour makes a huge difference in your health and aging well. So moving and moving every chance you get.

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Dr. Selassie (06:19):
Resting is really important. People do not prioritize sleep. In fact, I live here in Brooklyn, New York, and people I think glorify like, Oh, I can get by on four hours or I only need six hours.

But it's really about if you want to age brilliantly, you've really got to prioritize rest and rest is sleeping, is associated with everything. Better body types or healthier body sizes, less stress on the brain, better performance at work and for school, for children. So rest is really important and I don't think it gets focused on as much. And then the last thing is socialization. Whenever you have people that you are loving around you, whether it's like your true flesh plant family or friends, which are like family that you choose. And also purpose, like serving people in the world, making the world a better place, those people tend to age longer. You know, there, there's a reason for them to kind of hang around. And so they do.

Allan (07:23):
Yeah, you based a lot of this off of Buettner's work, The Blue Zones. And so this is a brilliant piece of work. And I, I did have Dr. John Day on the show and he found a small city in a small town village actually in China that was kind of remote and found a lot of these same things. You know, the way they eat, the way they move, the way they rest, the way they socialize was just kind of their natural day to day life, which was a lot more reminiscent of how we were in 1700s, 1800s and early 1900s. And then automobiles and transportation of food and industrialization of our food kind of put us on this path of moving kind of away from that. And I think that's why we're seeing a lot of the issues that we're seeing today is because we're just not really applying these four pillars in our life on a daily basis.

Dr. Selassie (08:19):
No. And just like you mentioned industrialization of food and agriculture, there's also things that we've introduced in our lives that were not there in the 18 hundreds like smartphones and electricity and computers and things like that that are sort of keeping us attached to the desk, you know, so and getting us off our natural rhythms. You know, we can be looking at a smartphone way into the wee hours of the night and then realize later it's, Oh my gosh, it's 2:30 AM. I hear that a lot. So we forget about that. We're human and we have natural, you know, natural basic needs that we need to make sure we're incorporating into our life.

Allan (09:01):
Yes. Now the Mediterranean diet you mentioned, and I think this is really, really important because you know, like you said, there's, a lot of push and most of them, the way I turned them as their elimination diets, when you, when you kind of break down a vegan diet or a carnivore diet or paleo diet or keto. All of these diets are basically focusing on one type of food or deemphasizing the other foods. And saying, okay, you shouldn't eat this and you can eat really crap food and be a vegan. You eat really crap food and be a carnivore. Interestingly enough, you know, if you're not paying attention because you know, it drives me nuts when I'm like, Oh I'm just going to eat bacon for 30 days. And I'm like, okay, you'll lose some weight cause you'll get tired of eating bacon. But beyond that, is that, is that really going to help you age well?

Allan (09:53):
Is that really gonna give you the nutrition that your body needs to be healthy and maybe losing weight is something that's kind of important to you. The doctors told you you need to do that and if this helps you do that, that's great. But you have to go back to something that's generally sustainable. And that's the one thing that kind of comes out in the science over and over again is that the Mediterranean diet is effectively one of those diets that you can stick to. Uh, because people did eat that way and have eaten that way for centuries. Now that the interesting thing about the Mediterranean diet that I think is misinterpreted, this doesn't mean go eat at the olive garden every day. It's slightly different. Now you, you, you briefly touched on, on the Mediterranean diet. Could we dive just a little bit deeper into kind of the background for, you know, these folks are living longer and they're getting a lot of heart, healthy, natural ingredients. Can you kind of talk about that a little bit?

Dr. Selassie (10:50):
Yeah, sure. And I just want to comment on what you're saying that a lot of people you hear about these amazing results that they get on, they get from like, Oh, I went on the this X diet. Like the keto diet is a great example and you're right, it's pretty much eliminating products that might not be so great for us, like things made from flour, which doesn't really have a lot of life in it. And suddenly, they lose a lot of weight, but it is honestly a hard diet to sustain. And the Mediterranean diet is a diet that's very easy for most people to sustain. It's just a matter of making sure you include, it's very inclusive. You've got to include a lot of these foods. So I think that the foundation, like I said, is plants. There's a lot of, you know, all kinds of plants.

Dr. Selassie (11:36):
I mean, you know, you've got your leafy greens, you want your foods from cruciferous family, like the broccoli and the cauliflower and the chards. And you know, other foods like that have been shown in some of these blue zones to really be healthy for us. Tomatoes and eggplants and things like fava beans and all kinds of beans. Lots of these cultures that, that live where they've got people living to a hundred are eating lots of beans and all different kinds. Black beans in Nicaragua and fava beans around the Mediterranean, and even soybeans in Japan. So, that's really important. There's lots of olive oil used in the Mediterranean Diet and I think all of what all is in general have very healthy properties for us. They're very strong antioxidants. They even have even has antimicrobial and antiviral properties, or at least the olive leaves.

Dr. Selassie (12:37):
And the fat is really a sustainable oil. Like it helps us. It's a sustainable oil and it also helps us as humans to sustain our blood sugars. It helps balance out our blood sugars. And it's a really good fat You just want to make sure you don't cook on high heat. You know, there's, are there things like grass-fed butter for example, is considered a good fat. And also from close to around the Mediterranean. Meat, you know, an animal protein is also consumed but not in that, not these big pound quarter-pound burgers. You know, it's more like it's part of the meal that includes many other food. Also even sardines and fish and even eggs, but in smaller amounts. But it is included in the diet. Lots of spices I think are really important. And yeah, I think that you're right, when we think of the Mediterranean diet, we might just think, Oh, this means pizza, you know, around Italy or lots of flour products. But there are, you know, there are, there is so much processing and the American idea of a pasta is a little bit different than how it is in the Mediterranean. They're served much smaller proportions and there's a variety of other foods and variety is really the key.

Allan (13:59):
Yeah. And one of the other things that I will say about most of the countries that are around the Mediterranean area is they, they eat differently than we do. And what I mean by that is a meal is an event. They, they don't go, they don't go to dinner and eat and scarf down a pizza and then go watch Netflix. They meet up, they start socializing and they might have a beer, but they're going to sit down and they're just going to start socializing. And then there'll be kind of a, you know, some olives will be put out. So maybe some cheese, a little bit of this and a little bit of that. They'll sit there and nibble and then, you know, the main course will come out and you know, they'll work through that. But they're spending most of their time talking and showing and listening and getting along and socializing and de-stressing from the day.

Allan (14:47):
And then they might have a glass of wine, maybe two, but usually just a glass. And then they might have a light refreshing fruit or something for dessert and then boom, they're done. I mean that's their meal. But that meal took two hours, maybe two and a half because it's a part of their social environment building. So it's not, you know, the meal is not just to scarf down enough food to feel full. It's, it's intended to be a part of a social structure. So I think when you look at the four pillars, we don't often think of how related each and every one of these are. We have to eat to move, we should socialize while we're eating. And if we're using our time with friends and family in the right way, it reduces stress and just makes us feel more inclusive. So the Mediterranean diet to me is a little bit more than even just a diet. It's a lifestyle.

Dr. Selassie (15:36):
Yeah, I totally agree. Like, you know, putting your fork down in between bites, you're in parasympathetic mode, which is the kind of rest and digest mode you're practicing. That's actually what I call in my private practice, proper food hygiene. You know, you're like, you're resting you're not like answering emails on a computer while you're chewing, you're, you're actually looking at your friends and families in the eye or listening to what they have their day when exactly right. It's part of socialization. It's not these big portions of food that we all get quiet and dive into and talk with our mouth full. It's kind of like a much slower pace and the portions are smaller and there's rest in between.

Allan (16:20):
So yeah. It's an event and I think that's what I really liked about when I'm at the times I've been over in Mediterranean countries with people that are from that area is that they just, they approach everything a little bit differently. It's a little bit like that over here in Panama, but not, not quite to the extent of what I saw in Spain, in Italy. But, um, one of the areas that I really want to get into because it's part of the reason that I am in Panama is just stress. And in the book you did a good job of talking about what stress does to our brain. Could you take a little bit of time to talk about that relationship and what's going on?

Dr. Selassie (16:53):
Yeah. So I just mentioned it. There's, there's two different modes in our body. You can be in sympathetic mode, which is really fight or flight or parasympathetic mode, which is rest and digest. And in this day and age, most of us are in sympathetic mode, sympathetic mode. Our bodies were designed to shuttle between the two. I talk about like how you're most, you're supposed to mostly be in parasympathetic mode where you're like walking around, living your life with your family and then like a predator might jump in your way. And I'm talking about like thousands and thousands of years ago. And your, your design, when you see that predator to either run that's the flight or fight, fight the predator. But these days there's no predator. What there is our bills, an angry boss, a coworker that's hard to deal with, even work projects that have to get completed.

Dr. Selassie (17:50):
Commute's, terrible communities that people have to endure. And so a lot of the times our bodies are in a constant sympathetic mode. And what happens is you constantly stimulate your brain that way, and it sends signals to what's called the amygdala. And your amygdala is important for, it then sends signals to the hypothalamus, which is another part of your brain that basically sends messages all over. And if you're amygdala gets overused or over kind of overstimulated, then it gets bigger and bigger. And this is something that you don't want. You don't want an enlarged amygdala. You want, you know, it's sort of like when you, when you, you use your biceps over and over again, you get a bigger bicep. But that's something you do want with an amygdala you don't because now you're a McDilla is overstimulated and it sends these cascades to your body of all these stress hormones that happen.

Dr. Selassie (18:46):
And so furthermore, the frontal cortex of your brain as it receives some of these stress signals get shrunken. So you have such a thing called age-related cognitive decline. And that's basically, you know, when you start forgetting names of people, even people that are close to you or you can't remember that vocabulary word or you walk into a room and you forget why you walked in there, can't remember where you put your keys. Now this is a sign that your brain is pretty much starting to age, but I think a lot of it is really can be delayed if we were to kind of stop stressing out, take time to take care of ourselves and give our brains a little bit of a break. You know. And then again, all the pillars are intertwined. So like sleep is a really important time for your brain to regenerate. You're not regenerating or restoring when you're at work in your cubicle or washing the dishes, you're really restoring your brain when you're resting.

Allan (19:45):
Yeah, that's during one of the stages of sleep, that's when your body's actually flushing out the brain and cleaning it, which is are the restorative part of sleep. If we're not getting good sleep cycles or enough of them, we're not taking care of our brain. Now you touched on something and I think this is also really, really important because it's, it's so hard for people to do this and I'm just, I'm going to stereotype a little bit, but I don't mean in a bad way. It is. I think women have always been the caretakers of people and as a result, you know, so they're taking care of the children, they're taking care of the home, they're taking care of and they a lot of times it's very, very difficult to take that step back. I know as a personal trainer sometimes I just get so tied up into, you know, my business and taking care of the people I'm working with that sometimes I also don't do this and it's, it's called self care. And in the book you share some restorative self care ideas. Can you, can you kind of go through a few of those, what you think are some good ones for us to consider?

Dr. Selassie (20:43):
Yeah, I totally relate to that. I mean, you know, I'm a woman. I have five children, I have a private practice and a lot of times, and I talk about this in the book, that I get caught up in, Oh, I don't have time to prep a meal. I don't have time to, you know, drink a glass of water right now and be running to the bathroom. I have these children to take care of, I have my patients. I have, but let guess what I mean, if you don't take care of yourself, all of that, you will lose all of that, you know? So you've got to prioritize yourself and it doesn't mean that you have to stop everything and like move to Panama. Though that is really good. I would highly recommend that. But if you can't manage that right now, I mean there's a couple little tips that you can do.

Dr. Selassie (21:29):
Like for example, water is so important. You could savor a big glass of water. That's something that I do first thing in the morning before anybody else gets up is I make sure I drink certain amount of ounces of water and I savor it. And I really think about how this is, you know, hydrating me and giving me life. There's other things that you can do to just squeeze in a little self care, like a bath versus a shower. It might take you maybe 10, 15 minutes more, but it can, you know, your muscles under the hot water, it really, it really, let's go, you know what I mean? And then if you put some magnesium salts in there, you're adding some nutrients that can help relax your muscles. And it's alone time. It's me time. It's like there's nobody that can really bother you.

Dr. Selassie (22:16):
You can lock yourself up in the bathroom. Going out in nature, I think is a huge one. Even, you know, like I live in a city, so I'm either in my office or in the subway or in a car or in a building. But even just going out to a park, you know, a green space. And even just for three minutes, 3 to 10 minutes. It doesn't have to be long. Of course the more time you can spend in nature, the better. But our bodies need that. Our bodies are used to seeing plants and getting energy from live things. So that's also a really quick thing that you could do. Like literally just leave your building for a minute, look at some trees. Taking a nap, that's always my favorite one. Like there's nothing like you could be going, going, going and exhausted and you're really not getting much done.

Dr. Selassie (23:02):
But sometimes then that might be all you need. I talked about savoring a glass of water they can, there could be savoring a glass of herbal tea. I mean there's just, there's just so many things. Reading something inspiring I think is really important. One I really love is connecting with an old friend. I've had some amazing, fantastic conversations with people. Just pick one randomly that I haven't maybe talked to in a couple of years and just say, Hey, what's up? There's something really special about connecting with someone and it doesn't mean that, Oh gosh, I haven't spoken to John for two years, it's going to be an hour on the phone. It might just be, you know, 5/10 minute like I'm thinking about you just sending you some love, some good energy, you know, so connection is another one.

Allan (23:48):
Yeah. Now this can sound like a lot and I think when people are looking to change, they're like, Oh, I got to do all these things. I gotta do all these things and I for one I don't, I don't even have enough time to do the things I'm already doing. My to do list just grows every day and I keep pushing things off and pushing things off. And so this just feels, sometimes it feels like there's, there's more there to do. And I would say probably not, but it's really hard for a lot of people to just bridge that gap. Now in the book you talk about setting an intention. And I like, you know, in every chapter as you go through, you have a self assessment set of questions for someone to just kind of answer a few questions really easy, get a score. And then based on that kind of a general idea of how well they're doing on those things. So by the time they get to this sudden intentions part, they should have a pretty good idea where they're weakest, where they're strongest. And what are some of the questions that they answered that they didn't get the score that they thought they should've gotten. Can you talk about setting an intention and what are the steps? What are some things that people would want to consider as they're thinking about doing these things? Because I think you're right, setting the intention is really the key to getting anything done.

Dr. Selassie (25:03):
Yeah, I mean I, I totally get it. Like my things to do list seems to be getting longer and longer too, every single day. And the thing is though, if you want to age brilliantly, you're going to have to, that might have to be sort of a goal that you're going to attain. Otherwise you're basically receive what I call a certain future, which is just can it be aging? You know what I mean? If you don't take a step here or there, you're just basically going to be aging rapidly instead of aging slowly. So you know, that's the thing as you've got to take some time to sort of assess what's going on. I think the self assessments help you to do that and kind of see what areas of your life that would really make a bigger impact for you. So the smallest shift with the bigger impact is really where you start and after you do all the assessments, you'll kind of, you'll, that will kind of come through.

Dr. Selassie (26:00):
You'll kind of see like, wow, sleep is really a big thing that I've never prioritized. Maybe that's an, and I like to sleep. So maybe that might be an area that I really work on. And you want to kind of even look at yourself like where do you see yourself in five years? Where do you see yourself in 10 years or 20 years? Or like I would say that like if you're in your 50s now, you know, where do you want to see yourself in two decades? Do you want to see yourself active? Do you want to see yourself like doing and enjoying all the things you love? Do you see yourself with grandchildren? Do you see yourself playing tennis or you want to kind of project in the future and what will understand now? What will it take to get there? If you see yourself tennis in two decades, so like let's say you're in your mid fifties now and your mid seventies like what would that really mean?

Dr. Selassie (26:50):
That would really mean like preserving your joints, you know, keeping your joints active, you know, taking care of your physical body. If it's really just like seeing and being around your grandchildren, you know, maybe something like diet is going to be more important. You know, you can talk about that. You can think about your diet, you can set some intentions, you can think about your grandchildren and what you want them to see you doing. And I really believe in writing things down because when we kind of think about our intentions or we imagine that's really important, but when you write it down, it's sort of like you're writing a contract to yourself and it's sort of becoming manifested through words. So I really encourage people to get what I call a super agers journal. I'm a big fan of journaling and started. Sort of set these intentions down and, and write down what it is that you see yourself doing and how you can, you know, what are some baby steps or little tiny 1% shifts that you can take to get towards that?

Allan (27:50):
Yeah, I think a lot of people miss out on just how powerful small movements can be, particularly at first, you know, it's like as you're making a snowball, you start out with just a handful of snow and that handful of snow is easy enough for you to grab. And then as you start rolling that down the Hill, it's going to get bigger and bigger. And so just starting with something small over time can have some really great impact in your life.

Dr. Selassie (28:14):
Yeah, totally. I think that as a mom with five children, I can get really lazy and I can be like, you know, ask my daughters, go in the kitchen and fetch this for your mother or run upstairs and turn the thermostat down. But I started to really realize like I am, it's almost like I'm sitting on a throne and pointing and telling my staff what to do, but that's not going to keep me alive and around to see my grandchildren. So I make the extra effort to go up the stairs and put away the laundry or stand up when I'm seeing patients stand up every hour. These days, we've got so many little gadgets on our watches, on our smartphones that can remind us to do that and standing up. I mean, that can be something that can really impair someone as they get older is just standing up from sitting. So you've got to use your, you've got to use your joints, and even just standing up can make such a huge difference. You're actually pumping, there's no blood supply into your hip joint or your knee joint. And so pumping in the nutrition right directly into the knee joint by movement is really the best way to do that.

Allan (29:19):
Yes, 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. Selassie (29:30):
Well I think that one is definitely being active with your friends and family, especially like you mentioned, the women who sometimes start to really focus you know, where the time they're in their mid fifties they're really focused on their career. They're really focused on their family and they forget about their girlfriends. So I think that really enlarging your circle, social circle is really important and it doesn't have to be a huge social circle, but you want to always kind of be stepping out. So I think that that's one strategy, whether it's like having tea with a new person, maybe it's even somebody that could be a possible business colleague, but maybe you're going to go out and like ask about who they are and what's their family like and kind of include socialization into your life. Just a little bit more. Prioritizing sleep I think is one of my favorite ones and I think if you go to bed before rather than sleep in, you're going to, there's more of a likelihood that you'll get those sleep cycles in. Your, the sleep that you get before midnight is actually really important because I get more of those cycles and we're diurnal human beings.

Dr. Selassie (30:40):
We're not nocturnal like rats. So trying to go to bed early I think is another great strategy. You know, just go, just do it. Just put yourself in bed. A third one is kind of, you know, one that I think is really great is kind of go into your local farmer's market or getting, ordering one of these CSA shares online or are there so many different local agriculture, organic agriculture boxes that you can get and just trying a new vegetable, just like seeing it, kind of discovering it and cooking it. Just seeing what you can make out of it and enjoy it.

Allan (31:17):
Thank you. If someone wanted to learn more about you, learn more about your book Aging Brilliantly, where would you like for me to send them?

Dr. Selassie (31:26):
So my website is doctorselassie.com and the doctor is spelled out, so it's simply D O C T O R S E L A S S I E. and you can read all about me. I have a private practice here in Brooklyn, but I do see people via zoom or Skype or on the phone and there's, you'll see my book, but my book is basically on pre-order at Amazon right now. So you can just also find it on Amazon. Dr. Salassie aging brilliantly.

Allan (31:57):
Okay. Well. This is going to be episode 427 so you can go to 40plusfitnesspodcast.com/427 and I'll be sure to have a link to Dr. Selassie's page and to the book there.

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

Dr. Selassie (32:13):
I loved being here. Thank you so much Alan. Thanks for the good work that you're doing for all of us over 40

Patreons

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

– Anne Lynch– John Somsky– Melissa Ball
– Barbara Costello– Judy Murphy– Melissa Cardinali
– Bill Gioftsidis– Leigh Tanner– Tim Alexander
– Debbie Ralston– Margaret Bakalian– Wendy Selman

Thank you!

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Patreons

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

– Anne Lynch– John Somsky– Melissa Ball
– Barbara Costello– Judy Murphy– Melissa Cardinali
– Bill Gioftsidis– Leigh Tanner– Tim Alexander
– Debbie Ralston– Margaret Bakalian– Wendy Selman

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Allan (01:05):
Naomi, welcome to 40+ Fitness.

Naomi (01:08):
I am so excited to be here with you. Thank you. Thank you.

Allan (01:11):
Your book High Fiber Keto. Okay. First, you know, fiber and keto in the same book title right next to each other. Actually getting along, uh, a 22 day science-based plan to fix your metabolism, lose weight, and balance your hormones. So when I heard this book was out there, and like I said, keto and fiber in the same title and right up to each other and they're not fighting, they're actually getting along in this book. So I don't want to give all of the plot away, but, uh, you know, I just thought that was a very interesting concept and I was really eager to dig into the book and I'm glad I did because I learned quite a bit.

Naomi (01:45):
I'm so glad to hear that. You know, it's, um, to me, first and foremost, keto is something that I've been passionate about personally for about two and a half years. So I've been in a ketogenic nutritional ketosis state for about two and a half years. I've come out of it a couple of times, but most of that time I've been there. But I was born in Switzerland. I was born on a biodynamic farm and so whole foods and, um, clean, nutritious vegetables, meats, dairy, fruits, all of the things. And I've eaten a lot of grain over my life. Um, all of it started with this premise of whole food. And I, I really appreciate the philosophy of the concept that look, not one size fits all and it also depends a lot of times on our age. So I'm 46 years old. Nutritional ketosis is perfect for my body because I'm like 75% of the U S population, which says that they are carb or experiences Carb intolerance may not recognize that that's really what's happening, but they're carb intolerant.

Naomi (02:59):
Growing up in Europe, my mother's French eating baguettes every single morning, having a carb centric diet. It took me many years to get to the place where my autoimmune system was like, okay, I'm done. I can't take any more of this abundance of glucose. You know, my insulin was all over the map. My blood sugar was all over the map. And look, I was eating healthy foods, but it was the time in my life. And so I'm excited to sort of bring what fundamentally I believe is important for all of us. And that's fiber and what fiber does in our body, like 90% of Americans are deficient in their fiber. And then when you take, you know, there's soluble and there's insoluble fiber, some of the fibers that are out there, the soluble fibers have different types of fibers, like things like inulin that literally create the prebiotics that feed your whole microbiome. So your probiotics in your body love certain foods. And those happen to be a lot of these amazing fibers that connect with the nutritional ketosis.

Allan (04:18):
And I want to jump ahead to that. I want to talk about fiber because I think you're right. It's one of the big arguments when you go in and say, okay, I'm going to do this keto diet. And they're like, Oh well you won't get any fiber in your diet and therefore that's bad. But I know, and they're right, there's a lot of science out there that tells you that fiber is beneficial to your heart, but you got to get it from the right sources. So in the book you had the five fiber facts, could you kind of go through those facts and kind of walk us through, because one, I think it's going to show us how important fiber is in our bodies and then two, it's going to kinda dispel some of the myths of why Keto and fiber are not really against each other and they can actually work together.

Naomi (05:01):
Yeah. You know, I'll just give you a little bit of background and then we'll get into the five facts around fiber. What I would say with the five fiber facts is that when you're getting into nutritional ketosis, when you getting into nutritional ketosis, what usually happens is your body naturally in trying to sort of meet the 65 to 75% of the fat needs that you have, your body naturally just gravitates towards what's almost like a little bit easier and more simple. And so over time, what I was finding for myself in my own body is while I had always consumed a ton of fiber, I wasn't getting enough fiber when I started keto. So the five fiber facts were really like where I fell and started hurting my own health because I wasn't getting fiber. And then recognizing, okay, how do I bring these carbohydrates into my body in a way that's not going to take me out of nutritional ketosis?

Naomi (06:07):
Because by the way, I feel amazing in nutritional ketosis. So I would say the very first thing that anyone needs to think about when it comes to these fiber facts is that if you're eating things like cruciferous vegetables, you and I are both really big fans of them. What are they? Things like a broccoli, things like, you know, the, the most delicious cauliflowers. I mean there's cabbages. Like there's so many different, uh, Brussels sprouts. I had a ton of Brussels sprouts last night. So this family of vegetables do more than just bring in the good fibers. They have so many health benefits. I mean, we could go through the sciences. It's completely mind blowing as we know it. They also activate autophagy in our body. And my first book, Glow 15 is all about the ways that we can naturally activate within our system what we have. And activating a autophagy is our natural detox system.

Naomi (07:12):
We know that the cruciferous vegetables help to naturally detoxify our body. And so in order to have this optimal health, we have to make sure that we're really bringing in the right amount of fiber. So most people need somewhere between 25 and 35 grams of fiber. But because fiber's a carbohydrate, and in my view of nutritional ketosis, I try to keep my carbohydrates to about 50 grams a day. I don't play with net carbs or I don't or you know, the, I just say 50 grams of carbohydrates. So then I'm looking at fiber as part of those carbohydrates. And fiber obviously is utilized in the body in a very different way than other carbohydrates, right? It's not going to spike the insulin, it's not going to create the blood sugar issues. So it's, it's pretty exciting to sort of think about how that can work in the body.

Naomi (08:13):
So fiber helps to balance our blood sugar and we know that this balancing act that fiber does is just one of the sort of benefits of fiber. And what I found when I brought the two together, Keto and fiber was that the ketogenic diet also helps to balance blood sugar. So you take the two and you have like a 10 X effect, so that's a really powerful thing. Again, next one. Satiety. Nutritional ketosis helps us to feel satisfied and for me one of the best benefits was being able to take control of my mind again. We have like 60,000 plus thoughts in an average day. How many of those thoughts do we spend craving some sort of sugar or some sort of food or whatever it may be. When you get into nutritional ketosis and your body's able to really use your own body fat as your fuel instead of using sugar glucose as a fuel, you become satiated, your mind is able to focus on many other things because you're not an on this hamster wheel.

Naomi (09:31):
Well, fiber also really helps us to say sheet, which again helps us to not have those cravings. So it becomes like this virtuous cycle of positivity for our health and our wellbeing. So it helps with satiety and it helps with cravings. And the beauty of fiber rich foods, you know I have artichokes on the front of my book is a fiber dense food is a nutrient dense food. The whole food aspect of fiber rich foods is so powerful. So you get like a pack of all of that, which I love very much. And you know the artichoke is a great source of fiber. It's got about, on average a mid sized artichoke has about 10 grams of fiber. It's also got all of the important electrolytes. So one of the big issues that we have when we are deficient in fiber, which again about 90% of Americans are deficient in fiber, is we also become deficient in magnesium.

Naomi (10:37):
And we know that magnesium is this core mineral that we need for recovery when we exercise. We need it for over 300 reactions in our body. And yet it's not only about it not being in the soil like it used to be, it's also because all of our crops are being sprayed heavily. So even if you're eating organic, you're still not getting the levels of magnesium that your body needs. And then you take it a step further. If you're not eating fiber when you're doing nutritional ketosis, it makes it even more difficult. And magnesium is so critically important for anyone who's doing keto. It doesn't matter what diet you're doing, it's going to be super critical. But the electrolytes that you need to take when you're doing nutritional ketosis are more so than if you're on more of a carb centric diet. So the last thing that I would just say sort of as, as the five areas of focus with fiber is the fiber helps with our digestion. It helps to improve our digestion, it helps to increase the amount of butyrate that we're producing. And butyrate, as we know, is how our ketones are produced. And ketones are the energy source. You know, Dr. Dominic D'Agostino considers them like the fourth macronutrient. Um, there's a lot of research that we're going to see around ketones and what ketones do for our brain, what they do for our different organs. But the beauty of fiber is it works synergistically, truly with nutritional ketosis and within our digestive system it also helps with the production of butyrate.

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Allan (12:18):
So some of the core things that came out of that, then I want to kind of just reiterate here is one, you're getting your fiber from whole foods. This is not something where they say, okay, here's a cereal that has all this high fiber stuff, but we're still talking about real food. The other thing is, you know, for most people you can get in and stay in nutritional ketosis with 50 grams of carbs per day, particularly if a large percentage of those is coming from fiber. So if you're targeting that 25 or 30 or 35 grams of fiber and you're measuring your ketones, what you'll find is that you'll be able to get into ketosis. There's other people that will just, they'll cut out carbs entirely. They'll get down well below 20, maybe down to zero or 10 or something like that.

Allan (13:03):
And they find themselves in ketosis pretty quickly. But then they're not getting their magnesium. They're not getting their sodium, they're not getting their potassium. So they're having to supplement with those things. Whereas if they're eating a nutritionally dense fiber rich diet, that is also ketogenic they're less likely to be deficient in those minerals are going to be getting the nutrition they need. And so it's kind of like you said, it's the best of both worlds because you're going to get to eat your Brussels sprouts too. And I love Brussels sprouts by the way. We just can't find them on this Island. And often enough, every time I see him, I snatch them up. Uh, I had my wife, my wife went to David, which is a town about five hours away from here. And I told her she asked what do you want?

Allan (13:45):
I'm like cauliflower, all the cauliflower you can buy. Cause we can get rice cauliflower. But they charge like for like 16 ounces of it, they charge like seven, eight bucks. And so I was like, buy some cauliflower. So it's, you know, for $3 you buy head, she'll buy me three heads of cauliflower for nine bucks. So I made a bunch of cauliflower rice. Yes. And so you know that's kind of the cool thing about all this is that when you're giving your body what it needs it starts operating better. Your thought clarity, everything else is going better. You had a concept in the book that I just thought was awesome because I tried to tell people, you know, don't, don't feel like you have to kill yourself on a treadmill every day to get weight loss and also realize that, you know, sitting around doing nothing is also probably not the answer as well. You want to get yourself into a good basic protocol of movement and everything else. So you're finding kind of an optimal space for lifestyle. You mean the term you used in the book for that was dream metabolic engine. Take a few minutes to get into that concept because I really liked this concept.

Naomi (14:52):
Yeah. I love this concept. I'm very excited to share it with all of you. So as a woman in her mid forties, I'm always looking for ways to optimize my health. My biology, I have four children. I'm a founder and entrepreneur, you know, and an author so my time is so limited. And I also, you know, I know, but it feels like we all know what it feels like to have a body that's like really working with us and for us. And so I'm always striving to give my body what it needs at this time. And it's not static, right? We talked about different diets for different people. And I am not a dogmatic person. I've never believed like right now for my body, nutritional ketosis is what keeps giving and it's been two and a half years. But it doesn't mean in a couple of years that I'll be in a place where I can transform what it is that I'm eating.

Naomi (15:57):
It's the same thing with exercise and it all comes to, and like mindset is, is another example of it and how we leap and how much regenerative sleep we need. Um, but it all comes back to this idea of our metabolism. So just like, I fell in love with understanding how all we needed to do was activate autophagy in our body auto meaning self phagy meaning to eat as like the Greek definition of autophagy self eating, and that we could activate autophagy through the cruciferous vegetables, through different types of exercise, through a nutritional ketosis, through intermittent fasting, through, you know, tapping into your circadian rhythm, so when you sleep, you're really regenerating. I fell in love with metabolism in that same way and it was after I had interviewed over 80 experts. I did this docu series called the Real Skinny on Fat and the real skinny on fat really looks at, you know, everything around what went wrong.

Naomi (17:07):
Why did we here in the United States go from in the 50s having a 10% obesity rate and having a high fat diet to really getting to a place where there were a couple of events that occurred. Um, Eisenhower had a big heart attack. The president had a heart attack. The conclusion from his medical experts was that saturated fat was an enemy. And, um, you know, in Panama how much coconut is enjoyed and how much saturated good fat is enjoyed there. And so our country in the United States went to a place where everything became low fat, no fat. And now if we look at what has resulted from that, about 60% of our country is overweight or obese. Childhood obesity is a thing. It didn't even exist, you know, 50 years ago. And so for me personally, when I learned all of this information and I tried to think of how can I most easily affect my health, where I can enjoy my life and not have to spend, you know, 20 hours a week just trying to put the pieces together from this book or that book or whatever it might be, I felt that our metabolism was really the answer.

Naomi (18:26):
So our heart has a metabolic rate, you know, our brain, we have a whole body metabolism just like there's whole food. And so getting your metabolism to really work with you in the same way that autophagy can is, is essentially the premise of this book. It's the passion behind this book. And so a metabolic engine that's the stream is based on a couple of different principles. It's based on the idea first and foremost that the number on the scale is not the number that you should be thinking about. Right? The number on the scale is just a number. What you really need to be thinking about is the ratio and the ratio between the amount of lean muscle that your body has and is producing and the amount of body fat. And so for any woman, like when you hear that throw away the scale, we're going to get in the gym or we're going to learn about NEAT, which is non exercise activity thermogenesis, or we're going to, you know, increase our cardiovascular activity, whatever it may be, we're going to focus on strengthening and building our muscles and that's going to improve our metabolism so that we can live our most beautiful and healthy life. It's like a very empowering thought. So that's one of the principles around metabolic health.

Allan (20:03):
Yeah. So kind of from that, what we're basically saying is when you get to a good metabolic state, you're going to be lean, you're going to have plenty of energy. And you know, you're basically going to be able to live a very good energetic cause, you know, obviously, and you've said this in the book, energy is life. When we talk about feeling really good, uh, and those days when, when just like everything's happening for us and it's like our energy levels up and where it all comes back to it. I woke up, I rested well, um, I was refreshed, I got good nutrition and my energy was great and I had a great workout and I'm ready to attack day. So I think that's what we're really getting to here is when that stuff starts for you more and more and more, that's you getting leaner. So yeah, the scale is going to probably go down for most of us that are overweight, but that's not the end number. That's a piece of data in all the other data that you can be looking at because there's also, you know, they'll look at BMI, they'll look at waist to hip ratios and there's, there's some value in each piece of that data. But that's just kind of an outlying symptom of the metabolism being primed for you to have the energy and just really feel good.

Naomi (21:17):
yeah. And, and there's other very simple ways to optimize your metabolism. I mean, if you are not doing nutritional ketosis, okay, but start your day. If you're not someone who's sensitive to carbohydrates, but you make sure that you start your day with fat first, carbs last, that's going to support your metabolism. If you want to do an intermittent fast until noon in the day and you stop eating at 8:00 PM, that's going to support your metabolism as well. And we know, you know, to your point, this sense of energy and how our metabolic health really energizes our entire wellbeing, all of our organs. It's pretty phenomenal. There are so many misconceptions about our metabolism. You know, we always think a fast metabolism is what we need. But it's really an optimized metabolism. There are times in our life when our metabolism will slow down and that's appropriate.

Naomi (22:19):
There are foods that we can eat that can help to optimize it. So in the first chapter of high-fiber keto, it's all about metabolism and really starting to understand it from a fundamental level. And we built this assessment that you can do. I built it with a metabolic world renowned expert, and it's about, I think it's about 50 questions, but at the end of it, it's going to tell you what the true age of your metabolism is today. So I'm 46 I want my metabolism to be younger than my chronological age. And if it happens to be older, that's okay too. You can learn the simple steps that you need to take. Like for example, for a woman in their forties you know, us thinking about balancing our hormones. Well, it's something we need to be thinking about all along. But once you get into your forties your progesterone has gone down.

Naomi (23:20):
You know, your estrogen is starting to go down. Your testosterone could be at a very low level. Like that's really the time period when you know these sex hormones are going down. Most women hit menopause by the time they're 51 so understanding how your metabolism is affected by your thyroid and balancing your hormones and eating right for your body at this point in your life is critical. And maybe, you know , I firmly believe in um, in, in taking bioidentical hormones and it's not just about this idea of, okay, I'm going to have more energy or my skin's going to be better. It's also for example, like let's just take testosterone when we're in our forties and for most women it's really going down significantly. It affects our joints, it affects the way our body feels, it affects our ability to make good decisions and to even make decisions. So balancing the hormones and understanding how metabolism can have such a big part of that through the different exercises is really just so key.

Allan (24:31):
Now, one of the concepts that you've got into the book that I think it was again, another great thing to have in this book. There's so many little things buried in there. So we're talking just about the surface of this. And so this book is something that you can go through and I think read five times and you're going to pull something good out of it each and every time. Cause there was all these little tidbits woven in there. But, um, you made a, I think from an advice perspective, a mistake that a lot of people make is they will step in and they'll say, okay, I'm going to go on this elimination diet. They call keto. I'm going to get rid of all my carbs. Uh, and then I'm going to go ahead and I'm going to quit coffee. I'm gonna quit smoking and I'm going to start running five miles a day.

Allan (25:11):
And, um, I'm gonna make sure I call my mom at least once a week. You know, they try to change so many things at one time. Uh, and in particular it's the diet and exercise. And I want to kind of specifically get into, because so many people will go, you know, when, when it was new year's Eve, it's like, okay, tomorrow I'm in the gym and I'm also going on this diet. Uh, and their bodies are really not equipped to deal with that much change. So you introduced a concept in the book, you called me time. Ah, and, and I think I really liked that. It's kind of this gentle understanding that movement is still key, but it's not that you have to go spend, you know, an hour on the elliptical Monday through Friday. Can you talk about me time?

Naomi (25:57):
Absolutely. So me time is all about what stands for sort of like the metabolic edge time. So again, it's giving your chance yourself a chance to optimize and not have to like grind. I'm a firm believer that what makes us happy will also make us healthy. And that's, you know, fundamental and philosophical in my world. And I also firmly believe that every day is a new day and it's a daily renewal. So when we wake up in the morning, it's a fresh day. And what we do today is going to impact the way the day is experienced. So from the nutrition that we take, the movement that we do, the foods that we eat, the mindset that we have, this is a daily renewal and we have to constantly be renewing. Um, and it's also a very positive thought and me time goes right into that. So what I did with high fiber keto is I started with those 80 interviews that I did for the Real Skinny on Fat for the docu series.

Naomi (27:01):
Then I myself got into nutritional ketosis and went through all of the challenges. And about a year and a half after I was in nutritional ketosis is what I said, I want to get this concept of metabolic health out there into the world. Like this whole body metabolism concept. And I know that people will benefit tremendously because metabolic syndrome is such a big issue and most people don't even fully understand what it is and that it's affecting their health or that they may have two of the five, you know, or three of the different five factors around metabolic syndrome. So I was really, really passionate about that. But what I wanted to do is I wanted to do a clinical study to prove out the concept of keto and fiber. And so I did a clinical study at Jacksonville University and I did it only on women, not because we didn't want it also to work for men.

Naomi (28:04):
But because there's so much of a lack of science on women right now, we need more science on women in order to understand, because we're different obviously than men and our hormones play a big part in the way that we live in the health that we have. And so we studied these 25 women and the professors, the experts, the PhDs that created this study with me, what they said is that when a body is getting into nutritional ketosis, it doesn't matter if it's an athlete, it doesn't matter if it's my great grandmother, it doesn't matter if it's my eight year old son who by the way does keto. Um, and he does it, you know, to prevent seizures and he's done it for quite some time. It doesn't matter who you are, when your body is adjusting from using sugar as your fuel source to becoming a body fat burner, you need to focus entirely on that.

Naomi (29:07):
So the program that we did was 22 days and every single participant benefited. And so I thought, okay, we're going to put together an exercise program, but I was absolutely mistaken and the professors told me we're going to put together a movement program. And this movement program is all about NEAT, which is a new area of science. Meat is an acronym for, as I mentioned before, non exercise activity thermogenesis. And this a way that we can just simply move around. I'm going to give you some examples every day and actually burn up to 500 calories. So right now as we're doing this podcast together, I'm standing up, my body is activated, my glutes are activated, my core is activated and I'm, I'm moving my hands around a lot because that's my nature. Anyone who likes to Twitch or tap their knee, keep up the good work, right?

Naomi (30:11):
If your mother said, don't do that, don't, you know, bang your fingers on the table or whatever. All of that is NEAT. All of that is activating your metabolism and it's, and it's helping to burn these calories and it's a form of movement that's really useful. So in the book we show you a very simple plan of adding up to 7,500 steps a day. So you're going to get to that place. You're going to never sit for more than 30 minutes at any point, right? Like I want you just to get up and move around. You're going to engage in, you know, tapping your fingers, shaking your hands, moving around, just this physical movement, wherever, whenever, if it's, you know, we always here park your car away from the grocery store, do more walking. Growing up in Europe, we didn't really use cars in the same way.

Naomi (31:04):
And you know, for you in Panama you have more of a luxury of being on your feet more than we do here in the U S you know, it's, it's more difficult, but there's lots and lots of ways. I mean, even simply using a manual toothbrush like a couple of times a week or just doing physical things and then trying to get outside as much as possible because movement outside is so beneficial to your overall wellbeing. And I consider all that really great. So I don't want you to be exercising when you start this program in the 22 days while you're allowing your body to get into nutritional ketosis. Instead, I want you to be doing this, you know, me time or this metabolic edge time to really activate thermogenesis naturally with movement.

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Allan (31:54):
Yeah. So this is not a time to start. If you're going to start a nutrition program, focus on that. You still need movement, your body needs movement. Even if it's just something as simple as like you said, walking around, standing when you were sitting for awhile, tapping hands, uh, doing a little dance while you're brushing your teeth, whatever it is. Um, enjoying that time of movement. Our bodies were designed to move. In fact, our lymphatic system, uh, which is responsible for moving toxins out of our body, which if you're burning body fat, there's toxins being released in your body right now is a really good time for your lymphatic system to be optimized and movement optimizes your lymphatic system. So this is really good. And so it's not the time to start an exercise program, but what's going to happen is once you get into ketosis and your energy level starts optimizing, you're almost naturally going to want to start moving more.

Allan (32:46):
And so it's going to kind of be this self-fulfilling prophecy. As your metabolism gets better, you want to move more. As you move more, your metabolism gets better. And it just, it just builds on itself. So just recognize the exercise will come, the exercise program will come because you'll just have so much energy. At some point you'd be like, I've got to do something with this. Um, so that's going to come. But another thing that I really liked to do, you said it was 22 days for your program, which was, you know, I think it's a really good opportunity for someone to see if something is going to work for them. Too many people quit keto in the first week and say, no, it's unsustainable. If you make it through these 22 days, which you make pretty simple because you tell us exactly what to eat, what to do each day, but you don't just start with day one. Its like, you know, go in and eat all the carbohydrates in my house and run in and start this thing. You kind of have this little prefix prep period to get ready to get started and then the 22 days. Could you kind of just walk us through the program that gives someone an idea of how this all works?

Naomi (33:43):
Yeah. You know, changing our mindset is like the most difficult thing ever, right? I've been doing this for two and a half years. I grew up enjoying whole fats. I never ate low fat or no fat and I still have to work on my mindset because you know, nutritional ketosis is only enjoyed by a very small fraction of the population. And look, there are parts of the world, like when I'm in Alaska, the Inuits have been doing it for a very, very long time. And when I sat down and spoke with a number of the women over there and I said, okay, tell me about your favorite foods. Where do you get your energy from? They were talking about things like blubber, like whale blubber and a lot of the foods that they eat from the ocean, um, and all of the fats. And they never look at coffee as an energy source for them.

Naomi (34:38):
They always look at fat as it, but, but for most of us, education and learning and hearing this counter to what you may be hearing in the media is a challenge in and of itself. So the setup before you get into this is first helping to work with the mindset because otherwise, you know, it's like you'll self sabotage and then you'll be frustrated and you won't get the kind of results that your body wants to give you. Um, so I go into this concept of, you know, making sure that what's in your home, the foods in your fridge and your pantry are the right ones. Getting the mindset going, understanding that the first pitfall that most people experience is from a lack of hydration or, or going from, you know, having all of the hydration that's found in a carbohydrate to the lesser hydration that's found in a fat.

Naomi (35:40):
And so many people get keto flu. And how do you prevent that? So how do you get enough of the, let's say the green gel waters from cucumbers and celery and a lot of the vegetables that can penetrate more deeply into the cells than just a glass of regular water. We talk a lot about hydration in that. In that early part, I speak a lot about obviously the electrolytes and how important they are because that that change is a really big deal early on and then we get into exactly what the participants did in the clinical study and I try very, very hard to make this the most simple step by step guide. We have over 80 delicious recipes. I went back to like comfort foods to make these recipes so that your mind wasn't like, Oh my gosh, I don't want to eat these odd things that I've never heard of.

Naomi (36:37):
No. Like we have peanut butter and jelly fat bombs, we have all this good stuff. So just trying to simplify it so that when you get into the 22 days, you're going to be like the participants, you're going to benefit. Every single one of them had benefits to their health. Like some people, they lost as much as 9.7 pounds of body fat, seven pounds of weight. Um, everybody improved their blood sugar levels. Everybody you know, made changes around their circumference of their waist. Not everybody in the 22 days got into nutritional ketosis. Only 60% of them did. But everybody benefited. So you may be like the other 40%, it may take you a bit more time and I show you exactly how to go there and how to do it naturally and easily.

Allan (37:29):
Yeah. And that's what, this is a very gentle program to get you there. It's not the drastic, drop yourself to know carbs and go through all this heck, if you will for the first seven days with the keto flu and then you come out the other side feeling great. This is more of a gentle, we're going to lower our carbs to a steady state, which for a lot of people, 50 grams is, it's still, it's still a move. And so the preficts kind of gets you in the right mindset, gets you moving, and then you start going and then 22 days you see the effects of what this can do for you. And yes, there are recipes, really eager to try that Gouda cheese sandwiches that you had in there. That's on the repertoire. As soon as I can find some almond flour, I might not have it shipped in. I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and stay well?

Naomi (38:24):
You're asking me my top three. I just, first of all, I love what you just said. Um, three strategies I think to stay well and to be happy. Number one is getting into understanding how much sleep and regenerative sleep you need every night. So learning what your sleep cycle is. That's a really important strategy. So once I discovered that my sleep cycle was 90 minutes, I knew that I needed five sleep cycles to feel my best. And so seven and a half hours was better than eight hours. And so that's my number one strategy. Another strategy, and it's, and it's here in the book, is all about hydration, right? I think most of us believe, okay, I have to drink eight glasses of water to be hydrated or whatever. We know that you need to be urinating six times a day in order to be flushing through and really being hydrated and what are the ways that we can get hydrated.

Naomi (39:25):
I spoke a little bit about gel water. I'm really passionate about deep hydration at a cellular level. Because when we don't have that and as we get into our forties and beyond our ceramides, you know, the lipid I layer that sort of protects our body. It's like the mortar between bricks, it starts to break down on our skin and so our skin starts to leak moisture, it starts to leak that hydration. And so I'm a really, really big fan of understanding all things hydration and I think that's a huge piece. And then of course understanding what's right for your body, what type of foods are going to energize you and make you happy and healthy and being able to be flexible enough so that you don't put yourself into a box and then four years later your doctor's like, I cannot believe you've been eating these foods because your blood levels show this. Then you're deficient in that. So it's really about flexibility and constantly customizing your life for you.

Allan (40:35):
Thank you for that. Naomi, if someone wanted to learn more about the book, it's called High Fiber Keto. Learn more about what you're doing. Where would you like for me to send them?

Naomi (40:45):
They can go to highfiberketo.com we have a website, Naomi Whittel. I have a YouTube channel and we've got tons of videos showing, you know the recipes and different activities within the book. All of my social platforms. And then our website is just naomiwhittel.com.

Allan (41:03):
You can go to 40plusfitnesspodcast.com/424 and I'll be sure to have the links there. Naomi, thank you so much for being a part of 40+ Fitness.

Naomi (41:13):
Allan, thank you so much for having me. I love being here with you.

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Another episode you may enjoy

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March 2, 2020

Your body in balance with Dr. Neal Barnard

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

More...

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Another episode you may enjoy

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February 17, 2020

Cryotherapy for health and fitness with Kyle Jones

Cryotherapy is getting more and more common as clinics like iCryo bring it to the mainstream. Today we meet Kyle Jones and talk about the health and fitness benefits of cryotherapy.

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Allan (01:40):
Kyle, welcome to 40+ Fitness.

Kyle (01:42):
Hey, how's it going,

Allan (01:43):
It's going well. It's going well. I have been following cryotherapy for quite some time. You know, I love this stuff. I geek out on the health and fitness stuff and things that are going on. And obviously as things go, you know, there's the early the people who are early on, you know, they're going to be the early adopters that are out there looking at these different technologies, different approaches. And so I like to kind of know what's happening because typically that kind of stuff starts hitting mainstream, you know, four or five years later. So I've been reading and hearing about cryotherapy for years along with some other therapies that are coming along. So I'm kinda excited to see these things out there, you know, and particularly where now we've got a lot of evidence that scientific evidence that these things are actually doing some good. So your company is called iCRYO, they offer the cryotherapy services along with others. Could you take just a moment to kind of talk about what cryotherapy is and the different types and you know, how it came about?

Kyle (02:47):
Yeah, most definitely. So we actually, it backdates all the way into the 70s. Uthere was the Japanese scientists that was trying to treat rheumatoid arthritis and fibromyalgia, but doing it in a natural way to kind of help accelerate the body's healing power and, and the mechanisms behind the way the body, you know, moves through any modalities as far as healing's concerned. And what he did was he was administering people in subzero temperatures using liquid nitrogen as a cooling application. And as the years progressed, as they performed and perfected the technology, we have machines and chambers to date that are just far superior than really anything else you'd see in the wellness market in reference to convenience of a therapy and as far as what you get out of that therapy from an immediate benefit standpoint. So it's kind of funny, you know, we live in this instant gratification society and when you go and look at a recovery mechanism or something that's of an all natural standpoint, normally it takes some time, right?

Kyle (03:49):
Normally you hear to live a healthy lifestyle, to eat healthy, to you know, whether it's going to work out the gym, you got to spend it hours and hours upon weeks to do these things. When I looked at cryotherapy, it's a three minute session, so it's very fast, and the benefits are immediate. So as soon as you step out of the chamber, you start to feel the effects from that session immediately. So we're capturing the convenience of it being a very short time window for people to have to allocate each day to do this. But even better, it's an immediate benefit. And so wrapped up in a nutshell, cryotherapy, we use liquid nitrogen to cool the chambers down, get those to subzero temperatures. We can set the setting of the machine to a few different levels based on skin sensitivity.

Kyle (04:36):
So the hottest, I always tell people, and I laugh and I say the hottest but the hottest, the machines can go, are roughly around negative 150 degrees Fahrenheit. When I say that people are just blown away, their trying to figure it out.

Allan (04:50):
Those are the experiments where they throw, they throw coffee in the air and it freezes.

Kyle (04:53):
Yeah. So when I say that people kind of give me the deer in the headlights look on, you know, how am I able to stand in a chamber that's negative 150 degrees Fahrenheit and that's at the hottest level. The coldest that we can get some of these chambers down to would be around negative 240 degrees Fahrenheit. So we're talking about extreme cold now. The interesting part about this is nitrogen is a repellent type molecule, so it actually hits the skin and it reflects right off. So we're not actually penetrating the surface of the skin. And getting inside the muscle tissue, which I'll get into the science later around why ice isn't really effective as much as we thought it would.

Kyle (05:32):
But yeah, so we use liquid nitrogen actually repellent hits the skin and reflects off. So we're essentially tricking the mind into going in that fight or flight response for active recovery. So when your body hits that fight or flight mode, it thinks in essence it thinks you're going into to kind of like a dying mode, right? Right. Your body's in shock. You're shocking the central nervous system. So what it does is it rushes all the blood from the extremities to the core. It does this because we have amputees walking the planet today. So we know that we can live without our arms or legs, but the one thing we can't live without is our vital organs.

Kyle (06:09):
So it pushes all the blood to the core basically to save itself is kind of the layman's way to think about it. And then after your two to three minute session of cyrotherapy is done, that blood is enriched during that process and reoxygenated and it goes back out to your extremities and it just provides the body with a sense of euphoric feeling. There's a lot of serotonin, melatonin and endorphins that are released through this process. So you have a kind of that runners high that people could experience. You get that mood enhancement from the serotonin release. And one thing that I do cyrotherapy for is that most people don't realize that it can really provide a benefit is sleep. You take a look at people not allowing their bodies, not allowing melatonin to release properly and they're restless because of that.

Kyle (06:55):
And so what do we do? We go get a prescription for some sleeping medication, right? And then it alters us in different ways that we didn't want the first place. So it, the benefits of cyrotherapy are really, really across the board. Anything from stress, anxiety depressional issues, that's all cognitive rehab, right? That's all mental and I always try to explain to people cryotherapy is not just an athletic recovery tool its there to enhance any part of your life that you're really having trouble with.

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Allan (07:28):
So, you know, I was very, very active growing up and all the way through my twenties, and then I sort of took a little hiatus from the whole athletic aspects, but I turned my ankle really, really bad when I was about 20, I guess 26, 27 to the where the doctors, when you go in, they are like, Oh, it's broken. And then it was like, Oh, it would have been better if you broke it. Cause you've done a whole lot of damage. And ice and contrast therapy were a couple of things that we did you said that cryotherapy is different than ice. Can you kind of compare and contrast those so that we can kind of understand why this is, even though you're doing something localized, it's not exactly the same general effect?

Kyle (08:08):
Yeah, definitely. So ice is a, is a penetrating cold. So what I suppose is when you apply it to the skin, it actually penetrates the surface of the skin. The cold gets actually in the muscle tissue. Everybody harnesses inflammation differently. So for a physician to say, you need to do ice for 20 minutes on your knee and I need to do ice for 20 minutes on my knee. Really, that's just kind of a shotgun approach to the rehab portion. He doesn't really know the exact amount of time because everybody recovers in a different time period. Right. So realistically, if you do ice for even a minute longer than you're supposed to, you can start to damage that muscle tissue because you're applying the cold for way too long. And in doing that, you start to damage the recovery process. So you're doing opposite effect of what you were intending to do in the first place.

Kyle (08:59):
Now with with cryotherapy, using liquid nitrogen, as I said before, is it acts as a repellent so it hits the skin and reflects off. Therefore you're getting all the benefits of a cold therapy without any negative side effects of actually damaging the tissue. So it's a much more, and not just enhanced version of cold therapy or cold recovery, but it's a safer mechanism to do what you're trying to do. And, and I think when, when physicians in the medical field adopts it here in the United States it will be part of a protocol for chiropractors, for PTs, for orthos, really anybody that's dealing with some type of a pain or an inflammation type issue. The nice thing about cryotherapy is we don't just offer whole body cryotherapy. We offer a localized treatments as well. And so with the localized unit, it's completely different machine.

Kyle (09:48):
We can actually pour the nitrogen into a hose and centralize it to a specific area, whether it be a wrist and ankle, a low back, a knee. So we can really target areas, not just for pain, but for recovery as far as post-operation. So somebody gets a shoulder replacement or a total knee replacement, and we can spot treat a specific area. Now, realistically you would want to do the whole body cryotherapy over the localized because it provides a systemic reaction. It allows the body to act as one rather than just focusing on a single area. But realistically they're both very effective mechanisms for healing.

Allan (10:29):
So as a healthy person, I mean, so the healing I could see as a healthy person. You know, you talked about some benefits, the sleep, the stress and things like, can we kind of go through some of the basic benefits a little bit deeper? You know I'm like a big fan of anything that's going to reduce inflammation because that's kind of a trigger for most of the diseases we have today. Can you talk about some of those things and just let us know how cryotherapy actually does that?

Kyle (10:54):
Yeah, most definitely. So everybody's going to get a different benefit from cryo. And when somebody asks me if they're a candidate for cryotherapy, the very first thing I jokingly ask is if they're living, breathing human beings. And I say that because every person that walks the planet harnesses some level of inflammation. Now it's kind of a double edged sword because inflammation is necessary, but it's not necessary in a chronic standpoint. So the first step to healing is actually inflammation. So inflammation is required to heal. But what we're trying to do is minimize that inflammation process to where you can heal faster, right? So a lot of people don't understand that the actual first stage of healing in any area of the body is inflammation. So it's a necessary component. We just want to minimize that window on how long that inflammation is actually there.

Kyle (11:43):
Now, for people that deal with chronic inflammation like rheumatoid arthritis or psoriasis or fibromyalgia, things that are just chronic, they deal with their entire life. There's no cure, but there has to be a way to treat these things. That's where cryotherapy really comes into the picture. Now, what people really don't understand is cryotherapy is working on an internal level. So it creates a systemic reaction inside the body. And we're essentially moving blood external or internally from one point or another. So you're really taking into account the central nervous system, the way that the mind communicates with the rest of the body I think the interesting part is these chambers that we're dealing with today are told total body chambers, you actually walk into a space where you're covered from head to toe. There's a nerve in the back of the neck called the Vagus nerve.

Kyle (12:36):
It's one of the largest communication tools in the entire body from the brain to the rest of the body and interacting that with subzero temperatures and cold, actually triggers that response. So we're able to take the body from just a normal recovery standpoint and multiplying it immediately through a cryotherapy session. So during a session your mind is talking to the rest of the body and is trying to figure out where it's harnessing the inflammation the most. And it's a very interesting tool that we tell all of our guests during a cryotherapy session. You may feel colder in certain spots opposed to other spots in the body. It's because the cryotherapy is actually recognizing where the inflammation is being harnessed and it's attacking that specific area so it could feel colder in your knees. If you have bad arthritis in your knees, it could feel colder in your lower back if you have metal plates running in your spine, depending on where you're harnessing the pain and the inflammation, that's where it's really gonna feel, guess most aggressive during the session.

Kyle (13:40):
So doing it from a physical standpoint, most people don't look at the mental capabilities that come from the benefits side. We can tolerate things as far as, or we can deal with things as far as headaches and migraines. Those are some things that you deal with on a daily basis that are directly correlated to inflammation. Those are things that cryotherapy can definitely help with. So when I, when I talk about how the number one benefit is inflammation, yes. Most people don't understand inflammation is tied to almost every single issue a living person deals with on a daily basis, physical and a mental standpoint. If you have sleeping issues or even women with uneasy or are not scheduled menstrual cycles, you're dealing with chronic stress, anxiety, depression, a lot of these things are triggered because the body's not naturally releasing endorphins like it should or it's not naturally releasing serotonin like it should.

Kyle (14:36):
And, and I think the one phrase that we started using years ago is cryotherapy unlocks the body's healing power. It unlocks what it's harnessing and not releasing on its own. So it's a very interesting concept to see when the body isn't properly releasing things. Like it should, as long as you can just shock it through a cryotherapy session and essentially trigger that response and allow the brain to communicate with the rest of the body by targeting that vagus nerve. We're able to cut, literally heal the body on its own, which is, which is an amazing technique to be able to do that.

Allan (15:13):
Yeah. You know, the benefits are definitely there. Recently in the press, and I'm probably not a good subject matter to be talking about. But Antonio Brown, who used to play for my loved Pittsburgh went crazy and he ended up at the Raiders. He actually used how cryotherapy as a part of his athletic recovery process, but he burned his feet and he couldn't perform. And so you kinda hear these horror stories, but you hear a story like that and you're like, Oh, there are some risks to cryotherapy that I need to be aware of. Can you kind of talk about some of those risks?

Kyle (15:47):
Yeah. And that's one thing that I saw very early on. I was actually pursuing my doctorate in physical therapy when I came across cryotherapy and so I knew from a, a protocols in a safety procedure standpoint, a training system had to be put in place. And it was extremely interesting when I looked in the cryotherapy and I looked into equipment. And in the process of purchasing, purchasing equipment, there was no training established. There were no guidelines, there wasn't a standard process of care there. There, there was no certification, there was no schooling that was required. Literally Joe and Jane Smith on the side of the street could go purchase a cryo machine today and start a cryotherapy company. And to me, from a physical therapy mindset, understanding that any therapy that's done at any point in time without any education or training can be very detrimental to the person that you're administrating this too.

Kyle (16:45):
And so we took it as an advantage early on for our company to create the very first training platform for cry therapy services. And we still use that platform today to train every single one of our staff and every single one of our locations across the country. I saw this as an issue when it first came out. There are cases all across the nation of user error. And it's not a lack of these people not caring about the business or not caring about the industry. It's just a lack of knowledge, right? It's a lack of understanding that it's a therapy. It's cryotherapy and it has to be treated as such. So that's one thing that I think the industry has a few years to really grab a hold of. Kind of pushing with the rest of my company, the safety side of the industry.

Kyle (17:36):
If, if I could, to be honest, I would probably start a school. I had started an Institute of some kind and train people on the safety behind cryotherapy, the different devices that we use and most liquid nitrogen because that's where these, these burn cases are coming from with the Antonio Brown situation. That's also something that I really wasn't afraid of. Those cases, even though I don't like to hear about them. And I feel really bad for Antonio and all the other people that have suffered these issues, it kind of brings more light awareness and visibility to the industry. And I'm hoping that one day a governing body will either be created or somebody will come in from the government and say, Hey, we really need to pay attention to this. Right. and, and I'm pushing for that because realistically we're prepared for it. We have the safety protocols and the systems and the training manuals that if the government were to ever get involved we would be ready for that.

Allan (18:34):
Well, I'm a fan of not having the government involved in the industry kind of doing the right thing in the first place. What are some of the things, I mean obviously burns, but beyond, you know, burning a part of your body what are some other things that could go wrong with a session like this, if you're not dealing with professional people that understand what they're doing.

Kyle (18:53):
Yeah. I mean, we are dealing with the nitrogen, so there's nitrogen in the air that we breathe today, but there's only a certain percentage of nitrogen, right? So the air that we breathe is a certain percent oxygen, a certain percent nitrogen, but it's not 100%. Dealing with 100% nitrogen there is a time period where if you breathe in too much, you could get a little dizzy. If you breathe in even more, you could actually pass out because you have lack of oxygen to the brain. Now, realistically, if you breathe in nitrogen, are you going to die? No, you're not. You'd have to consume a large portion of nitrogen consecutively to really get to that point. So it's not impossible, but it's definitely a slim to none chance.

Kyle (19:31):
Outside of that, those are really the two biggest issues that you can encounter when dealing with cryotherapy is a burn case, which we've seen that happen way too many times,uwhich is why we're trying to help steer the safety side of the industry and, and, and control that a little bit. But outside of that, you know, really just getting dizzy or maybe passing out in some instance, but it's actually quite interesting. I'm glad you brought this up, but there's new technology on the market from Poland,uwhere the chambers are actually separating the nitrogen from the oxygen and an exhausting out the nitrogen molecules and pushing in the cold air to the chamber. So it's breathable air technology.

Allan (20:11):
Okay. So you think they'll still be able to get down to the same temperatures with an air mixture versus just a pure nitrogen?

Kyle (20:18):
They have. We're actually using that unit right now in our corporate location. We're in the process of swapping all of our existing locations to this newer unit. Number one, because of the safety side of it, right? So understanding that when the guest is inside the chamber, they're breathing in just cold air, right? It's nothing that's gonna allow them to pass out in doing those, since we're not doing a direct nitrogen into the chamber this lowers the risk for burn cases tremendously. I have actually tested this machine out for almost a year before we rolled it out into the rest of our locations and we rolled it out into our franchise model. And I can say right now I've pursued, I've encountered it coldest temperatures this chamber could possibly do and there was zero side effects of even running into a burn issue. So it was, it's almost like we just came out with the iPhone X or the cryo chamber is the way I think about it. It's just a far superior model in the terms of it's extremely safe. And so that's why we decided to make a transition.

Allan (21:24):
Okay. So it's important for someone to do a little bit of research before they pick their therapist or their location. They're going to go just to kind of figure out what type of equipment they're doing, how the people understand the use of that equipment. And you know, obviously the reviews and things like that that are going on with them just to make sure they're getting a good therapist.

Kyle (21:43):
Yup. I think that's one thing that people aren't doing right now that I encourage everybody to do a little bit more is, not just research, not just online research, but call it a place of business where you're thinking about doing these cryotherapy service. Walk in ask your questions. If the person that that's responding to your questions can't answer them thoroughly or they're fumbling or they feel like they don't have a legitimate answers and they're kind of making stuff up on the fly, leave and go somewhere else. Because I think the problem that I have right now is most people are getting a bad taste in their mouth from cryotherapy therapy. Not because of cryotherapy isn't working properly, but because number one, they aren't being run through the process appropriately. Unumber two, they're not mean,uth they're not given the correct explanation in the benefits of the service, so they don't even know what they're doing it for.

Kyle (22:31):
Realistically, they probably just saw LeBron James or Floyd Mayweather or an athlete talk about it. So they wanted to try it out. But just conveying lack of communication in terms of conveying the correct material, walking them through the safety measures as far as how to properly, you know, take a guess. Walking in the door and administer a cryotherapy session. So I really just think there needs to be an enhancement of awareness in terms of when somebody looking into whole body cryotherapy, they just asking the right questions and even if they aren't the right questions, ask any question that comes to mind and make sure that you're getting the right service.

Allan (23:09):
Cool. Now let's say someone has a, they know they've got some inflammation, they've got some joint pain and arthritis and various parts of their body and they want to do the whole body cryotherapy when they walk into the clinic. What does a typical session look like for them? And you know, roughly what is this going to cost them?

Kyle (23:28):
So for the very first time, a few of our centers operate on different pricing structures based on where they're located in the nation, right? We offer the very first session at an intro rate. It's a discounted rate because we know you've never tried this before and it's new to you and you want to experience it, but you don't want to break the bank, right? So some of our location, we have a special of $9.95 for your very first time. Okay. $10. Ureally the barrier to entry is extremely low and we wanted it that way because we want you to try it and we know it's an unknown and we want you to at first before you really start spending money. Usome of our locations and most of the industry will charge anywhere from $20 to $30. So the first session, which in my opinion, that's still extremely low for something that's providing the amount of benefits it is.

Kyle (24:16):
And then after your very first session, it's something where we sit down with a guest and we try to customize that package to them. Not everybody needs to do cryotherapy every single day, but realistically we want to know what you're coming in for so we can help design a plan and a membership specifically to you. We have four different tiers of pricing as far as what our memberships come out too. So based on those four different membership levels, we try to customize that membership directly to that person that's looking in, inquiring about doing cryotherapy throughout the weeks of the month. And so I think it's really crucial to understand what that is person is doing it for and then we help educate them on how many times they should be doing it a week or a month and then get them to understand there's a certain reason why we're recommending this, this membership. Most single sessions after you've done your first session, we charge $50 a single session.

Kyle (25:12):
The industry standard that's still actually pretty low. I know a lot of cryotherapy centers across the nation charge upwards of $60, $70, $80, $90 a session. Me personally, I think they're just gouging the guest. I don't think it's appropriate to charge that much. I do think there is a great value to this service. But what business owners in the cryotherapy space are not reminding themselves about, is it's a therapy? So any therapy that's done consecutively over extended period of time, you're going to see more benefits of, right. If I were to do a massage once a year opposed to once a month, which one do you think I'm gonna get the better benefit from? Probably the once a month. Right? Cause I'm paying attention to my body and I'm helping the issues that I'm dealing with on a regular basis. So I always encourage people to try to fit in cryotherapy as much as they can.

Kyle (26:02):
The very first month they start to try it. Because that's going to do two things. Number one, it's going to get them to understand the real benefits they are going to gain for it because they're obviously doing it on a reoccurring basis. Number two, it's going to get them to recognize how they can actually fit this in their schedule if they're going to continue doing cryotherapy. So it really just points out a lot of good points in the picture of, you know, how often should I be doing cryo and what are the main reasons I should be doing it for?

Allan (26:31):
Okay, now I saw a video on, I think it was on your website where you had a guy kind of coming in and he was walking in for his very first session. And so, you know, there was some, some guidance, there was someone talking him through, okay, you know, do this, do that. Can you kind of talk through that? How, how when I go into the session, you know, how am I dressed, what am I doing? What am I feeling? And then what are the things, like I noticed you told him, keep your head up so you're, you're breathing more oxygen, the nitrogen and that type of thing. Could you kind of talk through that just so they could feel the mechanics of a session?

Kyle (27:05):
Yeah, most definitely. So first time guests, every single time that we encounter our first time guests, it's exactly the same. So yeah, number one, we want to make that instant connection. We have a culture here in iCRYO that I believe is very different from others. We'd like to make relationships with our guests. We like to establish that we're not just here to sell you on something, we're here to get to know you and to actually help you. There are some deep rooted issues that people deal with that they get extreme pain or headaches or some stuff they're not willing to share with just the average person. So you really got to get to know these people. So the first time guests, we make that instant connection. We have a conversation with them for about a minute or two on why they're coming in in the first place, how did they hear about us, what are the issues you're dealing with, and that specialist actually takes them on a tour of the entire building.

Kyle (27:53):
We offer six different services at each one of our centers. Each service provides a different benefit to whatever they're looking to accomplish in their recovery goals. So in doing that, we give about a five to an eight minute tour. We explain all the services that we have one by one in the benefits that they can gain from each service. After the tour is done, we bring them back to the counter. And it's funny, a lot of times they may have come in for a cryo facial or a whole body session or compression therapy session. And after we take them through that tour and we give them some education, they realize, wow, you know, there's, there's maybe two or three or even four services that I want to do now. Right.

Allan (28:31):
It's not just the one service that I came in for, but specifically if they're coming in for whole body cryotherapy, we get them to fill out a waiver and an information sheet so we can better understand some of the issues that they're dealing with. Okay. We set them up with robe, socks, slippers and gloves. On the newer chambers. We actually,udesignate a face mask that covers their mouth and their ears. We do that because you're breathing in extreme cold and we want to be able to block that barrier of cold from the esophagus just for another extra level protection. It's, it's really not required, but we like to take safety to the next level. Uand so in doing that, we provide a face mask, which you can see on some of our newer videos or pictures or website material.

Allan (29:13):
Yeah. This guy was recording a video so he wouldn't have wanted his mouth covered, but yeah. Cool.

Kyle (29:22):
So we designae a dressing room to that guest. We put them in there with their socks, robe, the gloves and slippers. They, they strip down from head to toe. Usually you can wear undergarments. There just can't be any moisture or metal. If there's metal, if obviously you're gonna provide a burn,ulike a necklace or something that's metal, they had to remove those and then any undergarments has to be removed if they're sweaty. So sometimes people will come in directly from a workout or a run or you know, a long day at the plant or a construction worker and they're, they've got sweaty underwear or sweaty under garments. So we asked them to remove those and then we can, we supply them with, with clean and dry undergarments that they can do the session. But yeah, so after they get dressed,uthe cryotherapy specialist brings them over to the chamber explains basically how the operation is going to work. Its a three minute session. So it's extremely fast, which people love.

Kyle (30:17):
We actually created what we call the commandments of cryotherapy. And there are 10 commandments. Uit's basically 10 checks points that we run through with every guest to show them the do's and don'ts of this session. So once again, it's just another thing that we supply in our safety system that shows our guests that we take it to a completely different level when it comes to how safe this process is after their session is complete. Uwe basically just give them some education on what they possibly are feeling and how they're going to feel throughout the day. They go back, they get dressed, so all their dirty laundry in the dirty clothes, and then we take them back at the front to walk them through and guide them down a path of which package or membership is most appropriate for them.

Kyle (31:03):
The one thing that I preach in this company second to none is don't sell somebody. Lets understand what that person needs and design a plan specific to that person. The last thing that I want is somebody spending hundreds and thousands of dollars when realistically they may have needed to purchase, very cost-effective package, right? So I think that's one thing that we do very well opposed to maybe some other crowd therapy concepts in the US we're not there to sell. We're there to educate and then guide them down a path to where they know every dollar that's being spent is being used properly.

Allan (31:42):
Cool. 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?

Kyle (31:53):
Well, I think one is understanding. And educating yourself on mechanisms to get you to well, right? To get you to feel amazing and to get you to love life. Sometimes people just don't know. It's the lack of education. And so not just in, I do this in every wellness service, not just cryotherapy. If you're doing your research online, that's great. Looking at reviews that awesome. But realistically I tell people to go face to face, walk into these wellness centers. Learn more about these services and the benefits directly from the people administering them. Two things are going to happen from that. Number one, you're going to find out if they actually knowledgeable about what you're going to do, right? So you're figuring out is this the place to do it or not? Unumber two, you're gonna educate yourself during the process.

Kyle (32:41):
And I think the lack of knowing is where we have a lot of our issues today. I think obesity is at its highest, not because of any other reason than the lack of education. And to be quite honest with you I'm mentally looking back into my middle school and high school years. We didn't have a real health education class, right? And so it was kind of a joke. It was kind of just like a gimme class and I think if we just paid more attention in our schooling systemsin our education program about educating these kids at a young age, then will go through college. Will go through our young adult years and look at food in the things that we consume in the way that we treat health and wellness a lot differently.

Kyle (33:26):
I was out to dinner. I don't mean to get off track here, but I was out to dinner with a friend of mine the other day and I was asking him why he picks certain meals to eat throughout the day. When we were at dinner, he chose a meal and I said, Hey, why did you pick that meal? And he just told me, cause it sounded good. Well me, when I pick a meal, I'm actually analyzing that meal. The calories, the carbs, the fats, the protein, the sugar content. I'm analyzing each meal before I even order it. And it's because I'm educated on what my body needs at a specific point in time of day. And it's just unheard of, I think that way because people just buy things because it's either an impulse or somebody else bought it. Right.

Allan (34:09):
Yeah. Okay. Well, Kyle, if someone wants to learn more about you or your business iCRYO, where would you like for me to send them?

Kyle (34:18):
Well, I would say go directly to the website. We house all of our information on the website. It's icryo.com and you can also check us out on social media. We're very active on Facebook. We're very active on LinkedIn, on Instagram. I like to connect with people in multiple different ways. I think this day and age, the amount of content you can voice out there should not be limited and the amount of conversation and in the ways that people can reach you out should not be limited either. So yeah, the website definitely the number one.

Allan (34:49):
Cool. Well you can go to 40plusfitnesspodcast.com/421, and I'll be sure to have the link there. So, Kyle, thank you so much for being a part of 40+ Fitness.

Kyle (34:59):
Yeah. And I appreciate the time today and I look forward to really honestly helping out anybody that listens to this podcast. I think you guys have done a great job creating this platform to educate people and I really hope people tune in and plug into the information and I hope I added some value to their lives.

Allan (35:15):
You did, Kyle. Thank you.

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Another episode you may enjoy

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February 10, 2020

Cannabis and CBD for health and wellness with Aliza Sherman and Dr. Junella Chin

I thought for episode 420 it would be kind of cool to bring up the pot issue. Cannabis and CBD are becoming legalized across the United States. They're being legalized in other countries and for the first time, in a long time, using them as medicine and therapies is being widely looked at and studied, more so than it ever was before. I want to bring on some experts and I could not have done better. Today we'll meet Aliza Sherman and Dr. Junella Chin. They are advocates for cannabis and CBD use. We'll be discussing their book: Cannabis and CBD for Health and Wellness.

More...

Allan (03:13):
Aliza, Dr. Chin, welcome to 40+ Fitness.

Aliza (03:17):
Hi, thanks for having us.

Dr. Chin (03:19):
Thank you for having us. So excited to be here.

Allan (03:22):
Now, this is episode 420. And I thought it was apropos that I have a conversation about cannabis and CBD. So I was glad to see you had a book out there. It's called Cannabis and CBD for Health and Wellness. It's just perfect. So really excited to have the two of you on here. Enjoyed the book. I always like learning new things and obviously with cannabis and CBD just starting to kind of make a run at being somewhat legalized in some places and obviously illegal in others. You know, there's some things we've got to work through before we could actually even start this conversation, but where it is becoming legal in California, Washington, it's Colorado particular, I think is where they're opening the most. Florida I think is doing now some medical marijuana. So obviously some recognition that this, this does have a place in health and wellness and that cannabis is in fact a medicine.

Aliza (04:16):
Yeah, absolutely. The whole landscape has changed since just three years ago when I got into the industry. And this is Aliza, by the way. You know, I have a cannabis education company to educate women in particular about the health and wellness benefits. And when I first started out, there were fewer States that were legal and the stigma was intense. I was even afraid to tell anybody what I was doing. I was transitioning from the tech industry into cannabis, but I was experiencing a lot of health and wellness issues myself. Aging issues, 40 plus 50 plus. And cannabis seemed like a good natural alternative to some of the medications that they were trying to give me. So I really feel like we've come a long way in three short years, but we have a long way to go.

Dr. Chin (05:15):
Well, especially with the different States having medical programs now, I mean there's you know, 30 over 33 States when I started this integrating medical cannabis. I, I've been practicing this for over 10 years because I had the medical advantage of going or the educational advantage of going to medical school in California shortly after they legalized it. And that's over 20 years ago. So for me, I was in this middle of the Switchbox and I had the best of both worlds, learning, you know, conventional MD school, but also learning how to integrate cannabis with my patients. And now we have dispensaries, I'm in New York now. We have to spend stories that have a pharmacist in it and every dispensary and dispensing it like regular. So it has come a long way.

Allan (05:59):
Yeah. You know, I was coming from a corporate world a few years ago and I remember when they started legalizing in different States and making it recreational cause I was wondering, okay, if it's medical, they probably can't fire you for it. But if it's not medical, if it's just recreational then how does that play out? And I was talking to our general counsel and I said, so if someone goes to Colorado where it's completely legal to use this substance, they use it and then they come back here and obviously, you know, they're completely back down to normal and they're walking around doing their job. And we do a random drug test, can we really fire them? And he says, “Yes, absolutely.”

Allan (06:43):
You know, so can we talk a little bit about, you know, the legalalities of, and some of the stigmas here because you know, the whole point of it, and it's weird cause I'm down here in Panama now and the culture is very different from Arkansas as you might imagine. A lot of my friends use cannibis on a daily basis. And not just for medical, I mean they are clearly recreational. But can we kind of talk a little bit about that? Because it's interesting because it's, again, you know, against the law federally and it's legal in certain States and you know, it's just bizarre to me. It's really hard for me to wrap my mind around where people, where this is and why it's shifting so fast.

Aliza (07:27):
Well, so this is Aliza. I can tell you I'm living in Alaska and people don't know, but Alaska pretty much legalized cannabis in 1975. They absolutely decriminalized it and you were allowed to grow it in your home, carry up to an ounce on your person. It's a very different scene up here in Alaska, but pretty far removed from everything else. If you think about it, it's incredibly complex. So you mentioned federally illegal. Yes. That adds a huge layer of complexity over the fact that each state has their own set of laws, rules and regulations. Each state manages their cannabis retail growing retail, manufacturing, all in different ways. So no matter where you end up going, there's a whole set of rules. So one of the things I do is market cannabis and CBD companies and trying to navigate what's allowed and what's not allowed even from an advertising and marketing standpoint is very challenging.

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Aliza (08:35):
But to your last part of the question, why is it happening so quickly? Well, there's a lot of money to be had. And where there's money, there's powering greed. I mean, it really boils down to that. We think about when the internet first became something available to the public, all the big companies came in as soon as they knew that people were there. So if people are consuming and people have access, everyone's going to be looking at this industry for the money. Whereas a lot of us, like June, like myself, I like many of the people we work with are looking at it for the health and wellness benefits. I mean, the money's there. We're not gonna ignore that, but I think that's a driver.

Dr. Chin (09:19):
Yeah. And it's really inconvenient for patients, for even continuity of care. For example, I have a 73-year-old patient who has Parkinson's and she finds cannabis quite helpful for appetite for her muscle spasms. She's able to feed herself at the dinner table, which is a huge, huge feat. And she has, she's a, she has a home in Boca, in Florida. She sees me in New York and then she has another home in Arizona. So she carries three different medical cards and has to see three different physicians you know, in each state. Cause she can't take her medicine that works for the Parkinson's too, when she goes down to Florida for them. You know, when she has New York winters and she goes to Florida. So she has to, it's really, really, really inconvenient for patients.

Allan (10:06):
Yeah. And you know, that's one of the things I was, you know, looking at, cause you did a really good job in the book of kind of going through the different ways that we can use the canvas. So like, you know, not just the smoking or the vaping not just the brownies. But then basically, you know now I guess they got, you said they had capsules and, and, and other means of getting it. But it's still, if you get caught transporting it at the airport, TSA, you're going to get busted.

Aliza (10:35):
Well, yes and no, but don't do it. I think TSA has actually in, in certain States, and especially from legal to legal States, I hate to say it, but they sometimes will turn a blind eye. I would never ever risk it and never, ever recommend that anybody do that or try that. But if you also look at some of the cases, like the grandmother who has the CBD tincture for her arthritis, getting caught, getting arrested, but then everything gets dropped and everything is returned to her because there's this ambiguity. So I think some of what June was talking about with patients, there's a lot of confusion for patients. There's a lot of confusion for anyone who purchases, consumes and may have it on their person. What can I do? What can't I do?

Dr. Chin (11:27):
What I, what I also do, and you made mentioned about employment is you know, if it's medically necessary and patients come to see me to get a medical card sometimes I'll write a letter the patient will ask that I write a letter to their employer, you know, saying, you know, if the drug test comes out positive, it's because you know, they're using the CBD or THC or combination of the cannabis. And I'll just write out my note, you know, patient will use it according to the employer's policies. So, you know, not maybe not during the work hours but after hours or a number, they're not on call, et cetera. And usually I haven't had any issues with any patients actually even with this letter, with a supporting letter.

Allan (12:09):
Okay. Well the other stigma I think is, you know, obviously we're going to have family members that are going to be like, okay, what are you doing? Why are you doing this? Why are you becoming a pothead? And you know, how do we have that conversation with them?

Aliza (12:25):
Well, you know, it's not even just stigma, it's stereotyping. So if you think about all of the media, even entertainment, the image of the stoner dude, I think it's really important for first and foremost for anyone who is comfortable consuming it, either in a recreational, as you say, sort of a relaxation and enjoyment fashion or in a medical fashion that they talk about it, that they're not afraid to do so. The more we talk about it and normalize it and show it is everybody from every different walk of life is potentially a consumer of cannabis, particularly on the health and wellness side. So if we can just get rid of some of those stereotypes, I think that would be extremely helpful. And as a mom, as a busy mom who doesn't want to be ever, ever altered or high around my kids, there are many different ways to consume cannabis. And now with the advent of CBD products, without getting that high, but getting the benefits, the nourishment internally for your systems to regulate hormones to help you with anxiety. I mean those are the kinds of things that are helpful to moms, but you don't have to buy into that stoner dude persona. You can be very successful, very productive, very active, and very engaged and still be a consumer of cannabis or CBD.

Allan (14:02):
Okay. Let's dive in a little bit and talk about how cannabis actually works within our body. What is actually going on when someone consumes or smokes cannabis.

Dr. Chin (14:14):
To understand how cannabis works with your body and your brain. I just want to go over the existing systems that we all know, what we have in our, on our body. And you know, we know about our circulatory system, our digestive system immune system, our central nervous system. You know, what gets us up and going in the morning. But there's another system that was more recently discovered called the endocannabinoid system. And we don't learn about this in medical school or science class, but the endocannabinoid system is our body's own system that makes cannabinoid like molecules. And that's why our body reacts well to plant based cannabinoids have coming from the cannabis plant because our body has a system that's equipped to react to it. And this system is so important, it actually modulates and regulates all the other systems. It interfaces with all those other systems that you've learned about.

Dr. Chin (15:07):
And that's why it seems like, Oh well, you know, I hear that it works for Crohn's disease and anxiety and migraines and PTSD and then Parkinson's. And it seems like, Oh, this is just a snake oil is magic elixir. But it's because this endocannabinoid system regulates all these different systems in our body. That is why the CBD or cannabis or different parts of the cannabis plant works so well for humans.

Aliza (15:33):
And also if you think about the chemical compounds within cannabis, we write a lot about this in our book, cannabinoids and terpenes being two of the most common chemical compounds in the cannabis plant. Well cannabinoids that June just mentioned that we naturally produce cannabinoids, they're called endocannabinoids when they're in our body, but phyto cannabinoids or plant-based cannabinoids are very prevalent in cannabis. So cannabis happens to have over a hundred cannabinoids that have been identified so far. And that is more than pretty much any other plant out there. So in a sense it's, it's like a super food or a super plant because it's just so rich in these chemical compounds and each one of them has sort of a different set of effects. And the one I like to really talk about and that appeals to me is linalool Oh, I'm sorry. That's actually it's terpene. I was just going to move into terpenes next. Terpenes though are other chemical compounds that are in foods, color, smell and taste of foods are the terpenes and lina lu being one of them is also in lavender. Myrcene is another terpene also in mangoes.

Aliza (16:57):
Back to the cannabinoids is a lot of alphabet soup. So it's, we know THC that is what alters your perception. We know CBD now and Cannabidiol. And that is sort of almost the antagonist and partner of THC in a way. They really interact with each other a lot. They're CBN that makes you really sleepy. But if you have too much of it, it makes you paranoid. So if you just think about it, there's all these chemical compounds in the plant that make it an effective medicine. And as June mentioned, it affects all these different systems and all these different facts. And that's why sometimes everyone thinks it's just too good to be true, but it really is just such a richness of chemicals that react well with our bodies and brains.

Allan (17:55):
Yeah, I think, you know, one of the key benefits as I'm not going to say that cannabis is mainstream yet, but it's, it's, it's, it's definitely getting there is that, you know, you're hearing about how they can, they can do different formulations of the cannabinoids and the terpines to get certain effects. So if you want to relax, so you're dealing with maybe doing some, you've got some chronic stress or anxiety there's a formulation that's going to work best with you to help address that specifically. And so you're not just saying, okay, I'm gonna take all the good and the bad. They're getting pretty good at zeroing down on some of these things, aren't they?

Dr. Chin (18:36):
Yes, we know the profile. So we know the different plant compounds. There's testing for that. We know how much there is. So here in New York, when we recommend medical cannabis, we're talking about milligrams down to the milligrams. And I chart how these cannabis medicines react with their prescription medications. So we keep track of that and we can be quite precise. So it's not take a bite of this cookie or a sliver of this gummy, but we're, you know, we're using oils that are measured, we're using capsules and tablets that are fast dissolving or Enteric Coated that might work in your stomach in a timed release. So there's really there, I think they're using pharmaceutical type technology when making cannabis medicine now. When they're doing topicals or using certain penetration enhancers and grabbing technology from the dermatitis dermatological field. So it's, it's come a long way.

Aliza (19:34):
And also the products that are coming out back to the cannabinoids and terpenes products are coming out that are emphasizing certain cannabinoids or certain terpines or combinations. So you might see something that is heavier in CBN as a sleep aid or something with THCV, which is a variant of THC. And that would potentially be for focus or even for appetite suppression, which is kind of weird because yeah, we think of the munchies if you have THC, but THCV can suppress appetite instead of stimulate it. So you're starting to see products that really narrow down the cannabinoid concentrations and terpene concentrations for also those specific effects.

Allan (20:22):
I think, you know, it was funny because let's say funny cause it was actually a comedy, but you know, the Cheech and Chong movies and the guys, you know, they're joking about you know, glaucoma medicine. You know, I think that was the big joke back in the 70s and eighties of, of what what pot was for. But it's, it's much better than that. It does a lot more for us as a medicine. Can you talk about some of the different things that we can use cannabis for as a medicine to include acute issues, chronic issues, and even some mental and emotional issues?

Dr. Chin (20:54):
The number one I think I see in my patients are chronic pain and chronic pain is a very broad diagnosis. It can come from fibromyalgia. It can come from low back pain, migraine deep and pelvic pain for women. Because it's, CBD is such a potent anti-inflammatory. And I talk about CBD and THC the most because it's the, well most well researched, but CBD is a very potent anti-inflammatory and what patients are finding for chronic pain is that it really gets to the root of the problem. So you're not just masking it by taking care of the pain and just taking a pain reliever, but you're getting rid of that underlying inflammation that's causing the pain in the first place. Parkinson's patients I had mentioned before,it's very good for the muscle tremors and also for the sleep and appetite. I see ALS patients, epilepsy patients, both pediatric and adults. I see quite a bit of epilepsy patients. Insomnia, anxiety, Crohn's disease, collitis. So it's a varied practice. Upatients usually come to see me after they've exhausted all options. Of course I see cancer patients cause it helps with nausea, appetite,and pain and the immune system as well.

Allan (22:10):
And one of the other things you mentioned in the book was it was good for gout.

Dr. Chin (22:16):
Yes. So gout is great because what do you think causes gout? Inflammation.

Allan (22:25):
Yeah! And so this, you know, and I think, you know, if you actually look at most chronic diseases, inflammation is kind of a basis for almost every one of them.

Dr. Chin (22:33):
Exactly. Exactly. So when you have chronic inflammation, that's when it becomes a serious disease. I mean, you look at you know, high blood pressure, diabetes, that all comes from inflammation.

Allan (22:43):
Now you know, a lot of people are going to go at this and they're going to do you know, self-medication, if you will experimenting. And then of course now with it, you know, becoming medically legal in most States or a lot of States they can, we start working with their doctors if their doctors are familiar or willing to get into this. Kind of talk about the contrasting of whether people should be doing the self experimentation or whether they should go to a doctor first when doing some of this stuff.

Aliza (23:11):
Well, I can talk about my personal experience and also because I mentioned elementa before. My company that educates women about using cannabis and CBD for health and wellness. The thing that we recommend most of all is see your doctor. But that's very, very hard if they're not in a legal state. And it's also hard if their doctor is connected to a hospital. This is something I learned from June. If they're connected with the hospital, the hospitals are federally funded so they cannot even talk about it. So you're really looking for either somebody in private practice, but in some of the States you also have natural paths who can talk about it. But from a personal standpoint, I'll totally let June talk about from a doctor standpoint. But from a personal standpoint, what I've learned is what is on the label. If you don't have a doctor available and you're not consulting with the doctor, what's on the label as a recommended dose, you should always start lower.

Aliza (24:07):
And the saying is start low and go slow. You incrementally add a little bit more over time until you get to that feeling that you want that relief that you want, the effect that you want, but that you don't just hit your body right away with the cannabis. I have gone from cannabis to CBD just because I find that a lot of what I experience is either anxiety or inflammation. And so I know that with CBD you can actually take a lot more of CBD than THC. You kind of need to in order to get an effect on the cannabis side, 2.5 milligrams is totally enough for me where if other people are like 15 to 25 milligrams or even more,uon the CBD side, 25 to 30 milligrams is more my sort of dose. So it's a lot of numbers is a lot of calculation. You really have to pay attention, but you can't overdose on either of them. You might get uncomfortable, but you can't actually overdose and die from either cannabis with THC or CBD as an adult, as a healthy adult.

Dr. Chin (25:26):
I think the take home message really here is that cannabis is unique because there's really no precedent. There's no other drug in the world that we're using recreationally and medically. And so patients really have to demand that their health practitioners get educated. You know, really doctors need to tell patients the difference between their opinion versus scientific fact. And with plant-based medicine, there isn't one size fits all thinking. And unfortunately with the medical model and what we're taught in med school, it is one size fits all. It's here's your pill, you know, here's five milligrams of your blood pressure pill. I expect to see you in a month and we'll measure your blood pressure again. But with plant-based medicine, it just doesn't work that way cause everyone will react differently with herbal medicine. And really this whole movement, I, I see it as a plant sort of going back to plant-based medicine, this medical cannabis movement, because it's a wake up call to the healthcare system. Patients are turning away from mainstream medicine and heading to support groups like Elementa or apothecaries that have CBD shops or a cannabis shops because these support systems are giving them what they need. They're listening, they're connecting better with their consumers or their patients and they're providing education and an alternative, a more natural approach to health and healing.

Allan (26:43):
You know, in the kind of the full circle of this. It's interesting because, you know, I guess the, the reason pot's illegal is because it's, it was, it was deemed a gateway drug to do these other things. But with the opiate epidemic, you know, basically, you know, now we're in pain meds and everything that people are taking. This might actually, this is a safer alternative for a lot of those pain issues that people are getting addicted to opiates.

Aliza (27:05):
Well they're calling it an exit ramp drug now. And the reason it's illegal though there's a lot of misnomers about why cannabis was made illegal. And it was not because it's a gateway drug and it was not because people actually proved that it was a gateway drug. It was really based more on historical, you know, greed propaganda control and power. It was not about the medical issues around it because it was being vilified back in the 20s, the 1920s and the 1930s. And so we just forget the history of why it was made illegal. It had nothing to do with danger at all. And so we've just sort of been brought up with these false narratives about it being dangerous and it is not, it is certainly not on the same level as heroin or cocaine even though it's been scheduled that way in the U S and it can help with addiction. And it's a healthier alternative to some of these very terrible drugs. It can really bring you back to balance and health and keep you away from some of these dangerous substances.

Dr. Chin (28:24):
Well also when you look at the history too, it was during the time when they started to create inexpensively manufactured, you know, precisely dosed, easy to swallow pills versus a tincture. You know, it was at 1898 Bayer synthesize aspirin from birchbark. And then we had barbiturates that came, that came in. So we really take pills and capsules for granted. But you know, before that time it was, you know, yes, here's a tincture, here's a drop of this, put this in your tea. So it was really, I think that a perfect storm, you know, in terms of politics, the anti-immigration thoughts, you know, caused by the great depression. And then there was a pharma.

Allan (29:05):
Okay, well Eliza, I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and stay well.

Aliza (29:16):
Well, having written this book, Cannabis and CBD for Health and Wellness, but also I, my previous book was the happy healthy nonprofit where we did a lot of research about what does it take to get well. And I know even for myself really important is sleep, getting a good night's sleep and moving your body. We're in such a sedentary world now sitting behind a desk at a computer, hunched over, your body is suffering and so much disease is from not moving around. And then the final thing is just be really mindful what you put into your body, what you put on your body. Because if you think about even when you put things on topically, your skin is your biggest organ is what I've heard said, and it absorbs things. So what do we put on our bodies? What do we take into our bodies? Be really super mindful about those things.

Allan (30:11):
Okay. Dr Chin. Again, 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. Chin (30:22):
I would have to agree with Aliza. Number one thing that I always talk about with my patients more than anything else is nutrition. So not necessarily putting yourself on a restrictive diet, but really taking a look at what you are consuming. You know, how much sugar you're consuming, keeping a food diary. Meditation is a big thing that I also talk to my patients about. And exercise and exercise can be something small, a 10-minute walk to start with and slowly building up, but moving your body that gets the lymphatic tissues moving. So when we think of, you know, like, Oh yeah, of course diet and exercise. But think about how it changes the physiology. My Parkinson's patients, cannabis does not work for my Parkinson's patients unless they do rigorous boxing exercise. So for those that take the cannabis, if they don't do any exercise to cannabis starts to not work. But if for those patients that exercise rigorously, they have to be out of breath, the cannabis works double.

Allan (31:21):
Okay, cool. Thank you for that. So I'm Aliza and Dr. Chin, if someone wanted to learn more about you in the work that you're doing in this book, where would you like for me to send them?

Aliza (31:35):
Well for, for me it's elementa.Com. It's Ella for the French for her, and menta Spanish for mind. Her mind elementa.com.

Dr. Chin (31:50):
Wonderful. And you can find me at drjunechin.Com.

Allan (31:56):
And I'll have those links at 40plusfitnesspodcast.com/420. So Aliza, Dr. Chin, thank you so much for being a part of 40+ Fitness.

Aliza (32:06):
Thank you.

Dr. Chin (32:07):
Thanks for having us.

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Another episode you may enjoy

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February 3, 2020

The collagen diet with Dr. Josh Axe

Allan: 01:28 Dr Axe, welcome to 40+ Fitness.

Dr. Axe: 01:32 Hey Allan. Thanks for having me. Excited to be here.

Allan: 01:34 I'm really excited to talk about your book, The Collagen Diet because I recognize, you know, collagen is this kind of resource and I think at one point, doctors or specialists or experts or cougars or whoever they were they made it pretty clear once you burn through your knee cartilage, once you've used up that, that, that resource that's there, you're pretty much done and you can't rebuild the cartilage, but they're finding now that with proper diet and appropriate movement patterns, you can in fact improve your cartilage, improve your body in ways that we didn't know as possible. And your book gets into that, which is, I think that the science is coming up now. The things we're learning are just so exciting.

More...

Dr. Axe: 02:14 Yeah, it is. You know, I think for me, one of the things I keep hearing is from patients I've worked with in the past and people today is that they notice the difference when they start working on their collagen You know, whether it be they're taking supplements that support their body's own collagen production or a collagen supplement or just drinking bone broth, which was really the first thing that I started to do that I had my patients do in the past that, you know, I've recommended so many supplements and super foods over the years, but the one that people kept coming back to me saying, wow, I noticed a dramatic difference in my health really, really had to be collagen. Now there are other things as well. I think there are certain herbs and spices and vegetables and probiotics that, and sometimes Omega3. So there are things that people can notice a big difference with. But for me personally, in my own gut health and joint health, I noticed a really big difference in collagen so I'm always excited to talk about collagen you know, I wrote a book on the topic but you know, I'd love to talk about today. Anything related to, you know, how collagen or you know, collagen, but also those other superfoods that support collagen production, how they can help our health.

Allan: 03:20 Absolutely. My wife has been having some issues with her knees and so she's been dealing with the doctors and doing the basic things that I think people our age over 50 anyway, start to do with their knees as you know, you get it scoped and then you, you go back in and they're going to do the little shots. And then she went this last time and the doctor gave her the prescription or not prescription so much. He gave her some collagen sold her collagen and said, you know, you need to be using this now. She felt it helped. She hasn't been on it long term I think going on now two and a half months. But it's, so she's taking it, having a little less, little less problems, but just the other benefits that she's getting from the collagen, she said my hair is growing and feeling so much better. My fingernails are growing, my skin. They're just so much healthier now than they were before I started this protocol.

Dr. Axe: 04:08 Yeah, it's amazing. You know, my, I've noticed the same thing. My wife and I joke around how fast and our fingernails grown, how thick and strong our hair is right now. My wife is pregnant. She's due here in April.

Allan: 04:22 Congratulations!

Dr. Axe: 04:22 Oh Hey, thanks so much. Yeah. And so we were just talking last night, but she was just saying, I mean even through pregnancy, I mean, she just feels really, really good and both of us eat a really good diet. But when she started taking collagen and consuming bone broth and these collagen superfoods, I mean she really noticed a difference in her skin, hair and nails. I mean, it is the number one ingredient if somebody is looking to improve their overall beauty as well. You know, a lot of times people today are using these sort of outside in products. You know, it's maybe it's hyleronic acid for the skin or moisturizers, essential oils and I recommend all those things and think they're fantastic.

Dr. Axe: 05:00 But at the same time, if somebody really wants to see the biggest difference, they possibly, or maximize the difference they see in their beauty, collagen is definitely the number one supplement. You know, this is kind of a shocking statistic. Once you reached the age of 25 years old, your body produces less collagen every year by the time people are in their 50s their own body produces 75% less collagen in their fifties than they did in their twenties and so that's why it's even more important because our own body is producing less. It's so important that we supplement collagen into our diet. And I had, somebody asked me recently on this,and said, Hey, it's collagen a fad. And I said, collagen isn't really a fad. It's one of the oldest superfoods that we were getting in our diet. Think about this. Our ancient ancestors all consume bone broth, which is 90% collagen. It's pure collagen that's what bone broth is and we aren't getting bone broth in our diet and therefore we're essentially missing a macro nutrient.

Dr. Axe: 06:00 And think about this. There actually are no essential carbohydrates. There are essential fatty acids and there are essential amino acids. There's also something called a conditionally essential amino acids. Now the amino acid you're going to find in collagen are considered more conditionally essential. They're not always considered. But this being said though, they are essential. We need them to be healthy. And the big thing to think about with this, if you're missing in your diet, a macronutrient, okay? Like for instance, protein. If somebody doesn't have enough protein in their diet, they can get thermogenesis Their muscles can waste. It causes major nerve trend issues. I had a patient one time, Allan came in who actually, this is interesting, he was my first patient ever when I was in student clinic and his doctor put him on a no fat diet for his cholesterol, which first we know today, anybody who keeps up with the medical research, that's crazy. But he was taking, consuming no fat and his hair was thinning and his nerves were degenerating. He was losing his memory, lose it.

Dr. Axe: 07:07 I mean he in a matter of three months, his entire body started wasting away from not eating fat. Now think about this. Collagen is a macro nutrient. It is a protein. We are completely missing this protein in our diet. So again, it's one thing, Hey, if you're a little bit deficient and a mineral, like it will affect your body. But if your, which is a micronutrient, but if you're completely deficient in a macro nutrient, your health is really going to suffer. And I think today a lot of people are suffering from conditions like leaky gut syndrome, chronic joint pain, thinning hair, chronic inflammation. They're struggling with these issues because they're not getting collagen in their diet. And when somebody starts consuming more bone broth, taking a multi collagen protein, supplement, consuming herbs and superfoods that support your body's own collagen, they really start to notice a big difference in their body when that happens.

Allan: 08:01 Now let's take a step back cause you're saying macro. And I think people know that basically we know the three macros are protein, carbs, and fat, but as we kind of go through that, we know it's a much more complex formula that there's an essential, amino acids, there's essential fatty acids. That's that we need. Like I said, there is no essential carbs, although we do generally have to make sure we're getting enough energy to support body functions. So we do eat a proportion of those. The way we break them down, whether we go keto or otherwise, we make some decisions on how we're going to allocate those, those macros rather than we're making decision to make the decision or we're just not making decisions. We're eating what we want. We're still making the decision of what we put in our body. But how is collagen, how is it that you're seeing your collagen is maybe a fourth macronutrient if we will, but what is collagen and why is it so important?

Dr. Axe: 08:51 Well, collagen is so important because it makes up one third of all of the protein in your body. Okay, so one third of it. Now I want to say this as well. If you think about if one third, so, so like our muscles, those are made up of more muscle building proteins like branch chain amino acids and mathiolene. Okay. That's what makes up our muscles. What makes up our ligaments, tendons, fascia, connective tissue, our skin, our hair, our nails, our bones, our discs, our gut lining, our arterial walls. If a pregnant mother has a placenta, their body's creating that's made up of collagen so all of those areas I just mentioned are made up of more than 90% collagen for the most part. And here's another interesting fact. Listen to this. There is more collagen in your bones then calcium and all other minerals combined, and so we don't think about these things, but collagen is so critical for us to be healthy.

Dr. Axe: 09:56 It's like, well, why do we think calcium is the most important thing for bones? Because the dairy companies found it was the top mineral in your bones. But there's also magnesium, there's phosphorus, there's all these other things. But because of marketing, that's why we feel like it's so important. But really today, if we were looking at your bones and what's most important, it's actually collagen. So all that being said, collagen is so important for so many areas of your body. Think about this for your arteries to be, you want them to be elastic and not hard. When you hear something like calcification of your arteries, that's hardening of your arteries. You don't want that. You want to have soft, supple arteries, which are made of collagen when they're healthy. So all of these areas are just, it's so important. And collagen also will spare muscle.

Dr. Axe: 10:45 It supports your metabolism. So for fat burning and weight loss, it's important. But just in general, like it's important for, it's kind of like the glue that holds your body together. So if you want to be healthy, especially your joints and ligaments and tendons to be healthy as you age. Like I had a grandfather who was 96 years old and just passed away last year. But up until he was 96 he had joint pain. None of his muscles hurt though, but his joints hurt. And that's because he really, for the good part of his life, up until the last couple of years when I had him start taking it, he really never took collagen. And so again, I think for us it's the biggest thing we're missing in our diet. And I think if people start using it or consuming a diet and listen, it's not just taking a collagen supplements more than that, it's consuming vitamin C, which is necessary for collagen production, not just any vitamin C, an absorbable vitamin C that comes from super fruits like Camou-Camou, ascelroa cherry, amla berry or certain foods, broccoli, citrus fruits, also like red bell peppers, you know, so there are certain foods and then we get into, there are other foods that support collagen production that helped boost cells in the body.

Dr. Axe: 11:54 And those are really unique types of adaptogenic herbs. And the other thing you want to do, not to keep going in this, but you want to protect your body's own collagen production and there are certain herbs that help you do that. Matcha green tea, tumeric powder is amazing for this resveratrol found in the skin of blueberries and grapes, but again, collagen is just really important for us because over 30% of all of the protein in our body is made up of collagen. And if you don't get it, think about this. Imagine trying to build muscle like a bodybuilder or trying to put on muscle without eating protein. It's hard to do like they're not really not going to see results versus it's the same thing if you're trying to heal your joints, if you're trying to have a healthy gut and digestive system, if you're trying to have beautiful skin and you're trying to do it without collagen, it's going to be very difficult.

Allan: 12:43 And so the, the basis of this is, you know, if we're, if we're just eating standard protein sources of muscle meat, maybe some eggs and things like that, we are getting a lot of the amino acids, we're just not getting the right mix of amino acids to optimize our, the collagen production opportunities in our body because we're just not giving it the natural resource to do what it's supposed to do. Well, if we're not getting the right amino acids, because the collagen is basically just built out of select amino acids like glycine and others. And so with those amino acids, if we're making sure we're getting those in our diet, we're giving our body the natural resources that it needs to build the body that we have.

Dr. Axe: 13:23 100%.

Allan: 13:25 And then if we're getting those other nutrient and we're getting those other nutrients, like you said, vitamin C and some of the other things that are basically kind of the, the things that make it all happen so that our body optimizes that production.

Dr. Axe: 13:36 Exactly.

Allan: 13:37 Okay. Now the interesting thing was I thought of collagen as just a thing. And you know, I as a one singular thing, you can talk about the different types of proteins. We know if we get plant proteins or we get protein from meat or protein from eggs or a protein from say whey or case in that they're, they're different mixes of amino acids or different structures of them. And so they're, they're all a little different in a, you know, well we'd all we call because we're getting all the essential amino acids, you know, we, we call it the perfect protein, but there are multiple types of collagen that I was not actually familiar with. So could you take a little bit of time to talk about the different types and in particular the ones that you call kind of the five or I guess is six key ones.

Dr. Axe: 14:20 Yeah, so I would say when we're talking collagen, I think five in particular, type one, two, three, five and 10 those are the most important types of collagen we should be getting into our diet. Now I'm going to bring this up to say there was a principle in ancient Chinese medicine and that is if you eat the organ of an animal, it supports your organs. Or if you eat a food that looks like an organ or a system in your body, it actually supports that system. Let me give you an example. A Walnut looks like a hemisphere of your brain. Beets are red and actually look like blood and we know by the way, walnuts are full of Omega threes and colene and all these amazing nutrients that really support brain health. We know beets actually boost nitric oxide in your body, which is super nourishing to your blood.

Dr. Axe: 15:04 We know that certain things like carrots, you cut in half, it looks like an eye and we know according to thousands of clinical studies, carrots and beta carotene and vitamin a support eye health, reishi mushrooms like identity to your kidneys and your adrenal glands so they support your adrenal health. All. That being said, there is a principle that when you eat a certain area of a body or or so like if you eat a chicken breast, it supports muscle meat because that's the area, that's what it is of a chicken. It's pure muscle. It's going to support our muscles. So with different types of collagen type one and three collagen make up, primarily your skin, hair, nails, bones, discs, and then some of your gut lining. Type two collagen makes up your ligaments, your tendons, your connective tissue, and all of your facia. Type five and 10 collagen really helps support areas like your cardiovascular system and your veins and arteries.

Dr. Axe: 16:02 And so this is also why when people are buying collagen as a supplement, it should always say multi first. That's going to be the highest quality. They should be buying a multi collagen protein, because if you're only getting one type of collagen, you're not necessarily as strongly possibly supporting all the areas of your body you should. So I really think that, again, when you're doing collagen, like chicken broth contains mostly type two collagen beef and fish collagen contain mostly type one and three and eggs contain a little bit of collagen or the egg shell membrane, the inner part of the egg egg shell that contains type five and type 10 collagen. And so all that being said, I think ideally we're getting multiple types of collagen because they are subtly going to support other areas. And I will say this type one and three collagen different types of collagen can definitely still be used to create other types or areas of collagen in the body. And it's a misnomer for people to think when I consume collagen and literally just goes to that area and becomes collagen in my body. What happens when you take a collagen supplement, your body breaks down that collagen into individual amino acids like proline, hydroxy, proline, glycine, and then it works with things like vitamin C and hyleronic acid and glucosamine and chondroitin, and it works with those things to create new collagen within your own body. That's kinda how that works.

Allan: 17:27 Okay. Yeah, that was actually kind of surprising to me because in the past, you know, I would pride myself on being the guy who cooks the Turkey for Thanksgiving at my mom's. And so every year I'll buy a grass fed pastured. I mean, you know, grass pastured Turkey, organic Turkey for for dinner and now I'll cook the Turkey and I'll take all the bones and I'd make a bone broth. And then when that wasn't available to me, and I'll, and I'll admit I wasn't getting my servings a day, but I would have bone broth every once in a while. And then when that would run out, I then go to the market and I, you know, the farmer's market and I buy chicken feet, you know, I'd make again make some bone broth. I didn't realize though that I, I was actually only touching on a small portion of the, of the collagen benefits that I could've gotten and that I should have also probably been buying some beef bones as well to make some beef broth, a bone broth as well. I didn't realize that I was still missing out on opportunity, just not having that full understanding and appreciation of the different types of collagen.

Dr. Axe: 18:23 Yeah. You know, it really is crazy how, I'll just say this, you know, I like I, I've taken so many supplements and I've eaten very, very healthy for a long time, but I could still notice a difference when I started this collagen diet. You know, when I started doing all the research and reading up on these ancient like ancient diets. And if you look at Japan today, they have one of the most simple diets in Okinawa. Japan, the top foods they consume on a regular basis are fish broth, rice and fish. They consume a lot of green tea as another one. But, but those are three other top top foods. It's fish and fish broth, it's rice and it's green tea. And I want to mention to, you know what's so amazing about fish broth? It's loaded with collagen and fish, is full of Omega, you know, has these healthy fats like the amegas.

Dr. Axe: 19:13 And then you've got matcha, which is one of the most protective herbs on the planet. And they just consume a lot of herbs, also consumed seaweed, which also is good for collagen production. So sometimes people wonder, I don't know if you've heard people talk about this. I have a friend of mine who is, he is Asian. And he talks about how all his relatives, like even when they're, you know, his grandfather is a 70 and he's like, he looks like he's 40 like very, very young. And I said, you know, a lot of times people will say, sometimes Asians look younger than other nationalities. And he said, well, I think the biggest reason is their diet. He said in the Asian diet today, especially in Japan, he said, you know, the amount of bone broth, the amount of matcha green tea, seaweed, these collagen boosting supplements they consume every day is a very, very high. So I know it might be other things as well, but I just thought that was interesting. In Asia, the amount of, that's what I, as I did all my research, they probably consume the diet that is friendliest to collagen production in college and protection than any diet they're on the planet. And so anyways, I I think that if somebody is looking to see a big turnaround in their health following a full on collagen diet is really going to help.

Allan: 20:24 Yeah. And I, and I think the other thing to go back to what you said is that the Okinawans are probably eating so much more like their ancestors than the American is today relative to our ancestors.

Dr. Axe: 20:37 Exactly. It's an ancestral diet. It's one of the closest, if not the closest that I can think, give, you know, when you look at the blue zone diets, if you've ever read any of the articles or books there, it's interesting because really that's what I would say sets them apart as cultures is they're eating as close as close to their ancestors and listen, not all their diets are the same. You know, their diets are different. The one common denominator is they're all eating real food and they're all active, they're moving, they also practice a lot of spiritual or sort of faith. Like it might be a different faith, but they're also practicing things that are faith based, community based. It's really amazing when you look at what supports lifespan. But those are, you know, those are all factors.

Allan: 21:16 Now in a book an, we've talked about this a little bit here, there are other nutrients that we would want to consume just to make sure we're setting our body, priming our body to have what it needs to be successful in building the collagen and using the collagen that we're taking or eating. Can you talk about some of those, I mean, you've talked about macha tea and some others can. Can you talk about those and how they're helping this process.

Dr. Axe: 21:38 Yeah, so for starters, let me hit on three categories. We have foods that protect collagen. We have foods that boost collagen, and we have foods that just generally help your body create new and healthy tissues. So first, the foods that protect collagen, these are going to be high foods that reduce oxidation. And so it's going to be antioxidant rich foods. I'm talking berries to start blueberries, raspberries. Blackberries will be very high on the list. One of my super favorite super fruits. Goji berries will be high on that list, asaii Berry Maki Berry, but doing berries are going to be fantastic for protecting your body against collagen degradation. I talked about matcha green tea and other forms of green tea, matcha, very high in antioxidants. It also contains a compound called an EGCG, which has the anticancer properties but matcha really high up on that list. I'm also going to throw in that list foods that tend to be like dark blue, dark purple, dark green, so even like spinach and chard, green leafy vegetables, they're going to help protect your body, but I wouldn't say those antioxidant rich foods, especially herbal teas and berries are going to be the ones that you can just do on a regular basis. So for breakfast, maybe you do a collagen smoothie with one cup of berries, one scoop of a multi collagen protein, a little bit of almond milk or coconut milk.

Dr. Axe: 22:59 That's a perfect anti-aging smoothie to have in the morning where you're going to get some of those super foods and then maybe a glass of green tea in the morning as well. That's going to help. Now, some of the foods that are going to help your body in protecting collagen are going to be those foods that reduce inflammation as well. So tumeric is going to be very high on that list. Tumeric contains a compound called curcumin, which reduces inflammation. Interestingly as well. It also can support collagen production because it has a compound called tumor own which support your body and creating more STEM cells. Now along with that, some of my other aunt favorite anti-inflammatories that can help will be, Rosemary also contains Rosemaric acid, which is great. Ginger root, another fantastic one, another one that's great. CBD oil. CBD oil also has anti-inflammatory properties and then any food that's going to have Omega3s, wild caught salmon, other fish like mackerel and tuna, grass fed beef, chia seeds, flax seeds, hemp seeds, but those omegas along with those anti-inflammatory herbals, those are going to really help with reducing inflammation and preventing collagen degradation and breakdown.

Dr. Axe: 24:10 And last but not least is this this category of super herbs and foods that support your body and creating STEM cells and that tends to be the ones that really are known also as adrenal tonics and that lower stress hormones. Reishi mushroom is amazing. Ashwagandha, which was an Ayurvedic herb that's used today especially to treat hypothyroidism really is incredible. I'll also throw out there herbs like astragalus Rhodiola Rosea, but at the top of the list I would put Rishi mushroom and ashwagandha. Those two in particular help lower lower stress hormones. They support STEM cell production and two of the best out there are reishi and ashwagandha for STEM cell production

Allan: 24:53 Now, so we get these nutrients and we kinda sorta, we're changing this, we're getting this as a part like so we have our our smoothie in the morning or we're, we're now going to incorporate some of these other foods in our daily repertoire, our daily menu and you have meal plans. I think that's one of the cool things about your book is that it, it doesn't just say here's the information, go fourth and do it. You actually have meal plans and some ways that we can do this, but what are some basic ways that we can just ensure that we're getting enough collagen each day?

Dr. Axe: 25:22 Yeah, so I would say for starters, to make sure you're getting enough collagen every single day, one take a collagen supplement or a bone broth protein supplement, you want to supplement with it. So for myself, Hey, maybe if I'm having a big bowl of chicken broth that day, you know, maybe you don't need to know. I still do. And in fact, I recently talked to Dr. Joseph Mercola, who's a, who's a friend of mine and he's a him and myself run two of the largest natural health websites in the world. And I asked him, I said, dr Joe, how much collagen do you consume a day? And he said, I consume 60 grams. That's the equivalent of three to six servings every single day. And so that being said, I consume at least two. So I consume about 30 to 40 grams a day myself. So I'm getting collagen every day.

Dr. Axe: 26:08 And I want you to think about this. If one third of the protein in your body is made up of collagen, if you're like, I'll share for myself, actually I consume about 40 grams a day and so with that, like I consume about 120 grams of protein a day myself. One third of all my protein intake is collagen and that's what it should be. Just like people have heard this balance of Omega three and Omega six fats, you know like you're supposed to have about between a one to one and one to four ratio of Omega three to Omega six fats to have healthy levels. This same goes for collagen, building proteins to muscle building proteins. You need a balance. So that being said, every person on the planet should be consuming. If you're not consuming bone broth, a large serving every single day, you should be getting collagen protein.

Dr. Axe: 26:56 And what I do is I do one scoop of a bone broth protein. The reason I do bone broth protein in addition to a collagen protein is bone broth protein contains it's bone broth in powder form and it also has hyleronic acid, glucosamine chondroitin. These are compounds that support collagen production in our own bodies and so I think they're critical for that reason. So I do one scoop of bone broth protein, one scoop of a multi collagen protein, and that's what I use to get my collagen every day. Now, in addition to that, like this a, yesterday I made a big bowl of what I call immunity soup and what I put in there was two big jars, probably about 30, 30 grams or so, probably equivalent to like six cups of bone broth. I put in some chicken thighs. I did a big bag of kale, I did cauliflower, I did Shataki mushrooms and I did a miso. So I did this chick pea miso I put in there and sometimes I'll do also, I'll put in some garlic, a little bit of sea salt and some, sometimes some white beans and I did this big bowl of immunity soup.

Dr. Axe: 27:59 Anyways, all that being said, it tastes amazing, but I'm also getting chicken broth in that meal as well. So I think everybody, the best place to get collagen, number one is going to be just as a supplement because a lot of us are just not getting it daily. Number two is do it as a chicken broth or a bone broth, like a real homemade chicken vegetable soup. And I would do a combination of a multi collagen protein in your smoothies and your coffee and your tea. It's, it's very close to like, it's pretty much a tasteless powder. And in addition to that, getting just chicken broth and beef broth, but those are the, those are the best places to, to be getting collagen.

Allan: 28:37 Well this is, this is definitely the time of year to be eating immunity soup because flus or anything else is going around. I just met with a business colleague and he was he was coughing at the table and I'm like, Oh man, I gotta, I gotta go do something here. So I don't take it with me, but yeah, so definitely this is good. And that recipe is in the book, by the way, so you can check that out. So we take the soups. We do that now. I'll tell you, you actually convinced me. I actually went out and bought a couple of things. I have collagen powder to take back with me to Panama and I will definitely be looking for opportunities to make more broth, bone broth. We have some limited resources with some of the things that are available to us on the Island, but I'm, I'm going to step it up a good bit. Absolutely. 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. Axe: 29:27 Oh wow. Well I think people want to take care of their body, their mind and their spirit. So I'm going to start off here. One of the things, ways I start every day for myself is doing what I call my spiritual triathlon. And so I wake up in the morning and I spend time just getting grateful saying I'm grateful for. And I know everybody pres a different religious background, but for me like I just praise God. That's how I start my morning and say what I'm grateful for. Number two, I read a book to help me grow. And so this year I'm reading a lot on leadership. I'm reading a lot on spiritual growth. And so I read either my Bible or like a John Maxwell book or Simon Sineck, some book on leadership. And then I'll spend some time, the next little bit and all visualize and I'll meditate or pray.

Dr. Axe: 30:08 Okay? So that's what I do. I do my spiritual triathlon and it's, it's gratefulness, it's reading. And then it's spending some time in prayer and meditation. And I'll tell you when I do that Allan, I just, it really changes my day. Like I'll read something about love, then I'll think, how can I love others better? And love is sacrificing yourself. It's serving others. It's giving something. But how can I serve and be kind. And so that's how I start my day every day. And the second thing they can do, and I want to challenge everybody to do this, is a lot of times people try and change everything at once. Here's what I would say. If you want to be successful in your health and you, so this is something everybody can do. Just change breakfast. Think about this. If you just change breakfast, you're changing one third of your diet.

Dr. Axe: 30:52 That is a huge step and if you can do that all year, you're going to see a transformation in your health and I recommend that everybody do what I do for breakfast and that's do a collagen boosting smoothie, three simple ingredients, one cup of berries, one scoop of multi collagen protein and one cup of coconut milk or almond milk. That's what I do, Allan every morning for breakfast and I feel incredible. I've had people follow that recipe and they've said no other meal that they've ever changed to have they noticed that big of a difference in their health. Three easy ingredients. Now, Hey, if you want to spice it up and add some other things all add in some cinnamon sometimes or pumpkin pie spice. I'll add in a handful of spinach to get some greens or a green superfood powder. Sometimes I'll add in other things, but that being said, three simple ingredients, berries, collagen, almond milk.

Dr. Axe: 31:44 That's it. And so if people can make that change, that's going to be huge. So eat a good, clean, healthy breakfast. And number two, I would say change your mindset to Food is medicine. This is the message I have preached for years almost since the beginning of my career, is that if you think about when you're eating, not what's going to satisfy your immediate desire, but what is going to be as a medicine to your body. And listen, this can be different for different people. In fact, Ellen, I don't believe that there's one diet for everybody. I do believe though that most people generally speaking, are collagen deficient. We're missing collagen in our diet. And I think if people can follow the diet plan that I have in my new book, the collagen diet where I outline [inaudible], how to eat collagen, pancakes, collagen chocolate chip cookies, collagen brownies, you know, but I, these recipes are made with things like almond flour, coconut flour, simple homemade ingredients.

Dr. Axe: 32:42 They're going to help people heal. I think that would go a long way as well. So I would say again, if people want to change work on your spiritual and mental health through doing that spiritual triathlon number two, just change breakfast to that college and boosting smoothie. And number three, change your mind to focusing on food being your form of medicine. And what I found too, Alan is that you know what, like I'm not taking any foods from you. I think if you have the mindset of like in my book I teach people, it's not that you can't have cookies, it's you just need to use a different type of flour. It's not that you can't use oil, I'm just going to recommend avocado oil, coconut oil,G and olive oil or grass fed butter. Like those are what I'm going to recommend. And so I teach people how to make easy swaps to collagen, boosting foods, to healing foods that help them live longer, happier lives. And so I would say those would be the three takeaways that I would take action on.

Allan: 33:34 Thank you. So dr Axe, if someone wanted to learn more about you, learn more about this book, The Collagen Diet or the other books that you have, where would you like for me to send them?

Dr. Axe: 33:44 You know, Hey, I encourage everybody to check out my Instagram page. It is a doctor Josh Axe on Instagram. Also my website, dr axe.com you can just go to [inaudible] dot com and you can also just search my name on Google, start searching Dr Axe Collagen Diet. You can go to amazon.com as well. I just wrote a new book, check out the new book there. But yeah, I would just search my name on Amazon, search my name on, on Google and I think you'll find a lot of exciting things on both of those resources along with Instagram and Facebook.

Allan: 34:15 And I'll have a link to that on our website, 40plusfitnesspodcast.com/419. Dr. Axe, thank you so much for being a part of 40 plus fitness.

Dr. Axe: 34:27 Hey Allen, thanks for having me.

All right. We are a whole month into the year 2020 kind of crazy how fast this first month of January just flew by, but now it's February and I'm happy to announce that I'm opening up three slots for one-on-one clients at 40+ Fitness. So you can go to 40plusfitnesspodcast.com/apply and that'll send a message to me to let me know that you're interested and we can have a conversation about rather one-on-one trainings for you with one-on-one training. You get everything that you would get from a personal trainer except counting the reps and that makes it very cost effective. I have an app, so you'll have workouts that'll give be given to you through your app. You'll have constant contact with me with the messaging and email through the app. So again, go to 40 plusfitnesspodcast.com/apply to learn more about working with me at 40+ Fitness.

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January 27, 2020

Heart health with Dr. Jignesh Shah

At some point in our lives, we're all going to deal with heart disease in one way or another. In his book, Hearth Health, Dr. Jignesh Shah explains the various tests and treatments and when they're the right thing to do. 

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

Dr. Shah: 01:04 Thank you. Thank you for having me on the show.

Allan: 01:06 Now I really enjoyed reading your book, the book we're going to talk about today, Heart Health: a Guide to the Tests and Treatments You Really Need. Part of the reason is, you know, being in my fifties, this is kind of the time when a lot of the conditions that have us thinking about our heart start popping up, you know, heart attacks, and all the other things that can go wrong with your heart, stokes and things like that. We're reaching that age where we're seeing it happened to our friends and family that were right around this age. And in some cases people lost their parents around this age. So we start to think about, well, how healthy am I? You know, you would just think, well, I'll just go in and get these tests done every once in a while and then I'll know I'm good. But that isn't always the case.

Dr. Shah: 01:53 Absolutely. And that is one of the key points of the book that just because we get a test done and the test says you're fine, doesn't necessarily mean that nothing will go wrong. We have progressed quite a lot in that understanding of heart diseases. However, there are things that we can predict and things that we cannot and even after a normal test, people can have problems. And on the other side I would say just because you have a normal test doesn't mean that you are looking at an impending doom and gloom. You have a lot more control, you have lots more time and you've got to use it effectively to gather all the information before reacting to it.

Allan: 02:49 Yeah. I think that's really kind of where that when you start talking about heart disease and particularly when it's happening in the moment, it is really hard to kind of take that step back and think about it objective. Because everybody just knows when the last beat of your heart is the last beat maybe. And so people tend to want to fix it now versus taking that step back and thinking about it. And that's what's really cool about the book. As you had stories in there of individuals that were, we're going through different things and then different protocols were promoted and they either did it or they didn't. But some of them were rushed into decisions and some, you know, had the wherewithal to get the second opinion. So if I go into the doctor and the doctor tells me there's some problems and they want to do a procedure, it could be, you know, putting in a stent or do even a bypass, we should get a second opinion. Right.

Dr. Shah: 03:45 So you started off really good you said you go into a doctor's office and that is a critical thing to remember. You went walking into the doctor's office, that's a different scenario and he pointed out to be a good place that you have enough time to get a second opinion. Now if you went into the emergency with chest pain and the EKG show or showed that you have, you're having an active heart attack, that is not a time for us. So that's the book tries to give you the new one's version of it, but you're absolutely right. You go to the doctor's office, tell them, you know, I've been having chest pain when I walk but I'm under a lot of stress and the doctor says, let's go ahead and do a stress test it's a noninvasive test. They're not going to poke inside your body. They're not going to put gas.

Dr. Shah: 04:49 Very good test to start. However, even in this situation, we're trying to get a second opinion and slow down the crane. In some cases, you know, I have known 40-year-olds who have been running five, seven miles a day, no problems at all, and then they started a different exercise and now they're having chesting pain the rest to a stress test and that patient the same stress test may not be necessary. However, somebody who does not exercise that much and starts exercising and starts noticing chest pain with exercise stress test may be necessary so in either case you have enough time to get a second opinion.

Allan: 05:38 Yeah. One of the things I think that was was really important as I started going through the book and you stress this time and time again is if, if a procedure is recommended, you really want, you want one or two things to happen as a result of that procedure. You either want to know that because of this procedure I'm going to live or and or that I'm going to have a better quality of life. Can you talk a little bit about that?

Dr. Shah: 06:03 Yes. Thank you for giving me these two very critical things. As a doctor, there are only two things that we can do for you. We can either prolong your life or make the quality of life of your life better. So no matter how bad the pictures are how fabulous the technology is. As a patient, you really have to know does it need one of these two end goods live longer or live better? Then so if you went into the doctor for what I would call a well baby checkup, annual physical or a wellness check, meaning thereby you do not have any symptoms, any tests that is being recommended you really have to ask, is this going to make me live longer? Because remember, if you do not have symptoms so the patient can, the physician cannot make the quality of your life better, but if we can improve the quantity of your life, meaning that they are longevity, then you don't want to undergo that test.

Dr. Shah: 07:18 That test is not going to make a difference. You really have to question, no matter how fabulous the technology is, how convincing the logic is. If you do this, then this happens, then this happens and this happened. All of that becomes more and more farfetched at the bottom of the day. You want to know does this make me live longer and if you are having symptoms, will this take away my symptoms? Is it likely, particularly my symptoms and only then you want to undergo that and you know, I would say even with that, you do want to ask the physician is there a simpler way to accomplish the same thing and you would be surprised how often a more simpler approach can sometimes accomplish exactly the same thing. We know from studies of the studies now that in majority of the cases, medications accomplish exactly the same as a bypass surgery with medication. You know, so you always will, ask the physician, is there a simpler way to accomplish the same group?

Allan: 08:28 Right. So, you know, being older, you know, I do go in for wellness checks and if my doctor had recommended to me, Hey, you know, you're over 50 now, let's, let's do a stress test. And no, I haven't had any symptoms. I haven't had any problems. I only had one incident where I thought I had a problem, but it turned out to be basically my sodium got too low and I went into the emergency room with chest pains. And that was really because I had had an episode of a seizure. And then during that seizure kind of strained my chest. And so to me it was, you know, I was feeling really bad because my sodium was low and as soon as I went in and you say the word chest pains, it leads to a whole, a whole set of protocols.

Allan: 09:11 You're taken straight to the back. You're given a nitroglycerin and they're putting you on a drip there. They're checking your heart rate. They've got you on a machine like that. And so it turned out it was just, it was dehydration and low sodium combined was what mine was. Now had they told me after that you probably should go do a stress test. I wouldn't have known any different. I would just said, okay, well my doctor said I need to do a stress test. So I think it's important to know that, you know, do you have symptoms that are okay? There are some of the heart attack symptoms, but if I have to agree, okay. The doctor says, okay, you should go get a stress test. And I agree. Tell me about what, what does a stress test entail? You know, what does it like and what's it going to tell us in the end?

Dr. Shah: 09:52 Right. So a stress test is performed to increase the activity of the heart, so as to increase the oxygen requirement of the heart itself. And under that stressful situation, if the heart muscles which are now requiring increased oxygenation do not hold up, then it indicates to us that there are some blockages to the blood flow. To the heart itself and the way to accomplish that is ideally to walk the patient on the treadmill, well connected to the EKG machine and look at how the EKG or ECG changes take place. And if there are some changes then that is concerning. However, if the patient is able to walk 10, 11 minutes and has no chest pain whatsoever, the EKG does not show any abnormality. Then they know that their heart is able to work under this stressful situation. Beach indirectly tells us that there are no blockages.

Dr. Shah: 11:05 So the idea of stress test is where you would maybe walk on the treadmill with EKG connected to you and somebody's observing the EKG or blood pressure and your heart rate. Sometimes there are additional testing added on to it where you get injected with radio active dye which is injected when you are at the peak of your exercise and then you're put under a camera where the emission from the radioactive dye is picked up and it hurts us. Understand if there are parts of the heart that are not receiving blood supply. Once again, that indirectly tells us that may be blockages in the heart artery. That's the typical stress that is performed and it is performed to figure out if there is a chance that you have blockages in the heart artery.

Allan: 12:02 A lot of times if someone's had an issue in the past or a doctor just feels uncomfortable and you're going to go in for a surgery for something entirely unrelated, they may make you required once you to do a stress test. Should you try to get a second opinion, should you try to talk them out of it if you've had no symptoms or is this something that maybe you just want to go ahead and do?

Dr. Shah: 12:21 No, I think I'm American college of cardiology and American heart association is very clear about the fact that in rare high-risk surgery you need a cardiac clearance and a stress test prior to that. Outside of those rare surgeries for 90 to 95% of surgeries, you do not need a stress test, to undergo orthopedic surgery or a back surgery or what have you. And so for majority of the cases you do not need a stress test. And I would strongly urge you to get a second opinion before you undergo that stress test because the chances of that stress test veering you away from what you really require, which is that surgery, it will just point to a different direction. And as you've read in the book, it will lead you down a path that you will not want to go. And that is why American college of cardiology is very clear about the fact that majority, I mean the overwhelming majority, 90 to 95% of surgeries do not require a stress test prior to undergoing the surgery.

Allan: 13:37 Yeah. You had a story in the book where a woman had torn a ligament in her knee and as a result, she wasn't able to be active like she wanted to be. And obviously if you're not active, you a trophy and, and so she couldn't, she couldn't walk with her friends. So she was missing the social aspects and the fitness aspects of it because she failed a stress test.

Allan: 13:58 Then they were like, okay, well, you know, I think she went on for other procedures and, but she had to wait a year before she could come get that surgery. That's, you know, a year of, of inactivity. Scary. And so that was definitely not going to extend her life or improve the quality of her life. It was really of cause the exact opposite.

Dr. Shah: 14:17 Exactly. I mean, she been for a stress test that was not acquired then she had, she was asked to undergo this cardiac catheterization and she had complications from that. And from that point forward it just went into this cascade of negative events where she was not able to get surgery that she required for almost a year and had she not gone through stress test like it is recommended by the American college of cardiology. She would have gotten the ligament surgery and went on to be active back again, which would have done more good than all this additional testing.

Allan: 15:01 Yeah, so if I go through as far as stress test and the doctor finds something abnormal and they say, okay, we need to do this next procedure. As the cardiac catheterization you spoke about, can you talk about what that is and how they do it and what we can find out from it?

Dr. Shah: 15:15 Yes. A catherization test is an invasive procedure, meaning that the doctor is going to get inside the body, they will number the area around the groin where one of the major artery is, sometimes they can use the major artery in the arm. And once they get access into the artery, they put a catheter, a small, tiny long plastic tube that goes into the heart artery and they inject dye into it by taking pictures of the flow of the dye under the camera. And by getting several pictures we understand where the blockages in the heart arteries, based on where the blockages are we can further prescribe the right type of medicine or discuss the possibility of stints or discuss the possibility by-pass surgery, depending on the pump or not the blockages it tells us a lot about the blockages in the heart.

Allan: 16:25 And again, it's one of the things I really like about your book is after you've had that, you know, that initial test or you know, then the second follow up the catheterization test, your book goes on to say, okay, here are some of the options that you might be presented. There's medication, sometimes there's bypass with medication and it gives you the questions to ask your doctor. So as you're facing these things, I think your book's an awesome resource for someone because it answers a lot of questions very, very easily. And then you can ask your doctor the right questions, you can get your second opinions and you can make sure you're doing the right thing to increase your longevity and quality of life.

Dr. Shah: 17:02 Absolutely. And thank you for bringing that up because on the web, what I notice is that there are a lot of generic questions which may or may not apply to your specific situation. So I have wanted to equip my readers with very specific questions for that particular procedure, which is pertinent so that the patient in the position exists, that willing to be an active process. You are willing to be part of the healthcare team and not just a passive sit here.

Allan: 17:36 And let's hope, again that's your physician is a, is a main role to you having that and being a part of that team. Cause if that physician is not you, you might need to find that another physician.

Dr. Shah: 17:47 Absolutely. I agree with you completely.

Allan: 17:49 Now you, you, you kind of mentioned Dr. Google, you know, people love to go on dr Google and self-diagnose. We also love, love, love to wear these tools to measure everything. You know, so the Apple watch and some of the other things that are out there, you can know how well you sleep. You can know how many steps you take in a day. You can know your heart rate every single day, including, now I guess Apple watch does an EKG for you. If someone has one of these watches on and they start noticing and an abnormal rhythm or you know, something going on and their watch is kind of, is that something they just definitely need to walk into the doctor and start having some conversations or is it something that they should just sorta say, okay, I get it. I don't have any other symptoms but the watch is telling me there's something amiss.

Dr. Shah: 18:38 Yes. So there are a few aspects to it. I will mention. So if you are having symptoms and it correlates with the EKG section or the heart rate section of your wearable device showing abnormality, if those two concur, then there is good reason to go to the doctor and get checked out. Secondly, there is a condition called atrial fibrillation. Unfortunately, as we age, a lot of us become familiar with that term atrial fibrillation. And what we know is that people who have atrial fibrillation have an increased risk of stroke. And so if the Apple watch is talking about the possibility of atrial fibrillation based on the EKG, then you do need to get checked by a physician. Maybe get another monitoring gadget that they can look at and figure out if it is indeed interpolation. And if so, how does it need to be treated because of the increased risk of stroke.

Dr. Shah: 19:54 There are things that we can do to decrease your risk of stroke. So from that standpoint of is critical. However, the other aspect I would also say is that people don't need, to me these variable devices, the source of their anxiety. Please know that nature has given you one of the best gadgets to assess how your body's feeling and that is your own self, your own understanding of your body. If you notice that every day you've been able to walk five months and for the past two weeks at two miles, you're just getting by tells you're huffing and puffing. That is enough reason. That is more of reason to be concerned well and beyond what the Apple watch tells you. I think we understand some of the technology, we understand some aspects of how the heart functions and how our body functions, but it is all in combination.

Dr. Shah: 21:05 Just the heart rate by itself doesn't tell you the complete story. Just the EKG by itself doesn't tell you the story. That is where physicians can put things together for you and say, is this critical or is this not critical to be addressed. And sometimes the treatment can be worse than the disease itself. And I want the listeners and the readers to be open to a conversation that isn't something that is so bad that the treatment will make it better. Is if six or one and a half dozen of another well was treatment as well.

Allan: 21:46 You know another interesting thing that comes out of these wearables, it's a conversation I've had with one of my clients. He has a resting heart rate in the low 50s and I have a resting heart rate in the high 70s. And so, you know, if we go and we look at that formula where our bodies, and our watches are saying, you know, stay in this zone. He can't, he can't get to the zone. He can go 100%. His perceived effort level is 100% and his heart rate just will not get up to pass one 41 50. It just, just won't mine, I could get my heart rate up pretty quickly, but I also don't feel full exertion at 177 or 180. I can actually exert past that for a sustained period of time. And, and I try to, you know, I try to explain to folks, it's like, okay, this is a formula that works for a lot of people, but not everybody. So can you talk about where this max heart rate thing came from and how it kind of blew up into this,fitness craze of people thinking that they have to be in this magical zone all the time?

Dr. Shah: 22:48 Absolutely. so that is a very interesting story. You know, in the 1930s and 40s, doctors have promoted this idea that any kind of activity is bad for your heart. Patients with heart condition used to be told you need to rest. You can't exert yourself too much. You can't have too much stress. You can't argue with people and so on. And then as time went on in the 50s, the people started realizing that people are actually doing better when they're exercising. So the world promotion of exercise came into be a jogging was promoted and so on. And at that point in time, burning question in the physician community and cardiologist community specifically was what other heart patients who have had surgery for the heart condition, what kind of exercise can be recommend safely. So that was a burning question that was brought up time and time again.

Dr. Shah: 23:54 And the health services department knew that they would be asked this question during a certain meeting. And so at that point in time, what they did was the junior colleague was asked to collect some data regarding that. So he took into consideration 10 papers written about cardiac patients, young heart patients who had undergone heart surgery and what was the safe level of exercise and when they assessed this data in a very preliminary manner. They said, you know, there is this easy formula that we can come up with. It is 220 minus the age,based on what they observed. And so they went and spoke at the conference and when they were as expected as how much exercise can somebody do. Yeah. After having had heart surgery after having had heart disease, they said it seems that the safe level is to get to a heart rate of 220 minus age.

Dr. Shah: 25:00 Now even the people who were recommending this knew that even among the heart patients, people who had undergone heart surgery, this was a wide range. This was just a general guidance given. Just like what is an average human height. And we would say in the US it is 5'9″ or 5'8″. That doesn't mean that if I'm 5'7″ I need to get looked up about it. We immediately recognize that. And so then the experts assume that this would be recognized that this is not hard. And it's true. And this was the data only for patients who had a hand be at a young age. Father had significant heart disease. But as it happens, numbers are attractive. You know? So it just took a life of its own. So people put up posters in the fitness centers and gymnasiums and so on.

Dr. Shah: 26:07 And then there was wearable device made and show enough that industry has just exploded. So the drum beats of measurement and quantifying has just taken on a life of its own. Though this was never meant specifically for, this was never meant for the general population. So it is good to have a general guidance. However, do not let yourself be restricted just because of this. As I mentioned, nature has given us a much parameter, which is how do you feel? Are you feeling alright? Then go for it. Exert yourself a little more. If you're not feeling alright, it doesn't matter at what heart rate you are. That's body's way, nature's way of telling you that maybe there's something amiss and you need to stop.

Allan: 27:01 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. Shah: 27:11 Number one I would say look at home care more than healthcare to make you healthier. And what I mean by that is regular exercise, quitting smoking, and eating a healthy diet. That would be the first and foremost thing that you can do at home to get the most bang for the buck. Now step number two would be to get a good assessment and control of your blood pressure and if you're a diabetic, of your blood sugar. That would be my step two. And step three would be to practice optimism, mindfulness and graditude. And I see all these three based on solid research evidence, which has shown that all these three things, to give you a much healthier heart, much healthier heart than otherwise. There has been tremendous research on optimism, gratitude and mindfulness and then to live 5 to 10 years longer and happier life compared to the pessimists. So I would strongly recommend your audience to consider these home care steps before approaching the healthcare system.

Allan: 28:52 Those, those were really cool. Thank you for that. If someone wanted to learn more about you, learn more about the book, Heart Health: a guide to the tests and treatments you really need, where would you like for me to send them?

Dr. Shah: 29:04 So my book is available anywhere books are sold. Amazon.Com, Barnes and Noble, Booka a million, etc. If you want to learn more about heart and all these tests and treatments, want to explore it a little more. Want to know a little bit more about me or want to communicate with me. I have a website called JShahmd.com where I have lot of information about heart conditions, pictures with videos and even if you're being advised for procedure, you're we have videos and written material that is not difficult to understand and so it could be worth looking.

Allan: 29:57 Okay, this is episode 418 so you can go to 40plusfitnesspodcast.com/418 and I'll be sure to have those links there. So Dr. Shaw, thank you so much for being a part of 40+ Fitness.

Dr. Shah: 30:09 Thank you very much for having me. Really appreciate it.

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

– Tim Alexander– Judy Murphy– Melissa Ball
– Barbara Costello– Debbie Ralston– Leigh Tanner
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– Wendy Selman– Jeff Baiocco

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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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Patreons

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

– Tim Alexander– Judy Murphy– Melissa Ball
– Barbara Costello– Debbie Ralston– Leigh Tanner
– John Somsky– Anne Lynch– Bill Gioftsidis
– Wendy Selman– Jeff Baiocco

Thank you!

Another episode you may enjoy

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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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Another episode you may enjoy

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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
– John Somski– Ann Lynch– Bill Gioftsidis
– Wendy Selman– Jeff Baiocco

Thank you!

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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.

More...

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
– Randy Goode– Debbie Ralston
– John Somsky– Ann Lynch
– Wendy Selman– Jeff Baiocco
– Bill Gioftsidis

Thank you!

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