Let's Say Hello

[00:03:19.230] – Allan

Hello, Ras.

[00:03:20.690] – Rachel

Hey, Allan, how are you today?

[00:03:22.760] – Allan

Well, I'm juggling. Juggling episodes. Juggling traveling. Well, we had a guest, and her episode is supposed to go live when this episode goes live. So probably last week you had heard me say such and such will be on this week, and this ain't that episode. Well, her book got delayed, and so we shifted things around. So we may have a couple of episodes in the near future where there's not a hello episode. Hello part of the episode. And I apologize for that. Well, I may play it anyway, but if you're like well, he's already there, and now he's talking about going there. If that gets confusing, I'm sorry. We're time travelers here, and we're this in the future. It is what it is. I want to make sure that I help the authors the best I can when I can. So this episode was not the one I promised you last week. It's a new one. So that plus, yeah, I'm traveling. We're currently in Ashborough, North Carolina, which was the county I was born in, the city I was born in. My mother lives here. My sister lives here. We're visiting her before we go over to Asheville, which is where my daughter's getting married.

[00:04:27.570] – Allan

So when you're listening to this, our daughter would have gotten married on Saturday, so you're listening to us on Tuesday. Normally we're not that tight. Normally we're two or three weeks out, but right on that. So if the next couple of weeks sound weird, was like, yeah, I'm planning this trip. I'm about to go. I went and I got there.

[00:04:45.850] – Rachel

Time has no meaning.

[00:04:49.210] – Allan

Yeah. Message from future.

[00:04:51.370] – Rachel

Time has no meeting anymore.

[00:04:53.710] – Allan

How are things up there?

[00:04:55.020] – Rachel

Beautiful. We have spring. The trees are budding, and tonight is actually run club night for me. And I cannot wait to get down to the trail because the turtles that we have in the river should be starting to do their nesting. And so I can't wait to see what kind of wildlife we'll have pretty soon. So looking forward to seeing my turtles tonight.

[00:05:14.090] – Allan

Cool, because now they're going to listen to a future episode, and it's like she just said it was freezing a turtle.

[00:05:20.590] – Rachel

Well, today's a spring. You never know. It's Michigan.

[00:05:25.190] – Allan

So are you ready to talk to Kashif?

[00:05:27.880] – Rachel

Sure.

Interview

[00:06:08.700] – Allan

Kashif, welcome to 40+ Fitness.

[00:06:11.280] – Kashif

Good to be here, man. Very good pleasure. Happy to be here.

[00:06:14.500] – Allan

Yeah. Now your book is called The DNA Way: Unlock the Secrets of Your Genes to Reverse Disease, Slow Aging, and Achieve Optimal wWellness. In reading the book, it was very interesting because as you went, you went through great examples of different people, including yourself, and how their genetics were driving their outcomes, their health outcomes, sometimes without them even knowing it. Obviously mostly without them knowing it. It was there and it was real. By the time you started writing the book, it was about 7000 profiles of people that were out there. So I do have to ask this quick question, is have you figured out the perfect genetic profile yet?

[00:06:54.050] – Kashif

I wouldn't say perfect, but there is one gentleman who we met with who was the founder of a four M, the anti aging conference. And this guy's in the Guinness Book of all the records for like, 13,000 sit ups and some number of thousands of push ups, and his genetics were almost flawless. He's so healthy that he's recovering while he's pushing himself, and that's why he can do the 13,000 sit ups. I think his name was Robert Goldman. But other than that, everybody has a red flag for the most part. He's literally the only person we've seen that's wired like this. He's a genetic freak. But everybody has something, whether they know it or not, that needs support.

[00:07:28.980] – Allan

And that's why we're here, because I know I'm far from perfect and I need support, a whole lot of support. Now, you used a term in the book. It's the first time I've actually seen this term in a book. And that's why it really caught my attention, because it was just one of those it stops you for a second when you're reading. You're like, Wait a minute. That's really important. And the term was informed choice. If we know what the answer is, if we know the right choice, we have a choice. We have the opportunity. Can you talk a little bit about informed choice, what that is and what it means for us?

[00:08:03.800] – Kashif

Yeah. So in this context, what we're saying is we are constantly making choices when it comes to health or wellness, even if we don't think we are. Every time you decide to eat, to breathe, to expose yourself to anything, it's a choice towards health or a choice away from health. Literally every choice you make. And most of the time, we're not even consciously aware of that. It's outside of our awareness. And so once you start to develop the habits of understanding that your choices do equal your health outcome, when it comes to chronic disease, aging, the way you perform, the way you sleep, and it truly is in your control that a lot of these things that we think are, oh, yeah, there's diabetes in my family. There's breast cancer in my family. No, there's some underlying genetics of optimality that drives that thing to thrive. And if you understood what that root cause was and you started to make the right choices, then you can decide whether or not you have disease. You can decide at what pace you actually age. You can decide how much energy you have. And this is one thing I learned about myself.

[00:09:02.480] – Kashif

I sit here in front of you, perfectly healthy. When I used to have five chronic conditions, which I really thought I had, that I didn't realize until later, I developed through the wrong choices.

[00:09:11.060] – Allan

Now, one of the interesting things that we got into this was there's what we would call, I guess people just call common truths. It's like we all believe this is the right way to do this. And if you're doing this, you're doing the right thing. And generally 80 20 rule is probably working out. But there is some counterintuitiveness to this whole genetic makeup. You had a buddy who was golfing four times a week, and I think most people would say, well, that's awesome. That's a good amount of walking. Even if you're in a cart, you're still doing a good amount of walking and exercise and getting outside. But this was actually detrimental to him. Could you explain that?

[00:09:45.320] – Kashif

You nailed it. The reason why he did the golfing was for the walking because he had a cholesterol issue. And this guy, a dear friend of mine, 38 years old when this happened, and he was a pharmacist, so he, on the medical side, understood himself. Right. He had been trained, but that number kept going up and his dosage kept going up, and he couldn't understand, what am I doing wrong? So the walking was part of his therapeutic plan. Let me walk this off. Right. What was actually happening was he was missing some of the key detox genes that instruct Glutathione utilization in the body. So your body's ability to bind onto toxins, send them to deliver, to metabolize and clear and so in missing them when he was walking on that golf course and breathing in. And by the way, this is in Canada, where the regulation on what chemicals are allowed to be used in golf courses are a little lax just because we have a long winter in most provinces. And so they allow more stuff to be used. And he's breathing these things in for three, 4 hours at a time, four days a week, which is not typical human capacity, even with the best detox system.

[00:10:48.670] – Kashif

And he had the worst. So what happens when you have toxins in your body? They cause inflammation. Your cellular structure was not designed to cope with these types of toxic insults. And so when the endothelium or the inner lining of the blood vessel, the wall that the blood actually touches, gets exposed to toxins, it gets inflamed. And your body will then use cholesterol as a hormone to reduce the inflammation. That's why it's actually sent to that location so if you don't deal with the underlying root cause, which is I have no detox system and I'm consistently exposing myself to toxins that are causing inflammation. But instead you wait to treat the disease that comes out of it, which is what we call cholesterolemia. All you're going to ever going to do is it's like a boat with a hole and you're just throwing buckets of cholesterolemia while the water is still coming in. Why not plug the holes? And that's what we were able to do with him. And guess what? He's not on a prescription anymore. No more pills.

[00:11:40.210] – Allan

That's awesome. That's awesome. But so counterintuitive that okay, play golf a little less and choose a different golf course.

[00:11:47.170] – Kashif

Well, it was a couple of dials to turn. It was that it was adopt new habits. But it was also now that we know that your body doesn't do this job well, how can we supplement it? So there's two dials to turn, get rid of the exposure. That's not always easy. Let's also support your body's biological function. We made a cocktail form as a friend. I made him some supplements that supported detoxification of the body cellular resiliency, mitochondrial function. And then his cells started to behave as if he did have the good version of the genes.

[00:12:18.960] – Allan

Awesome. So now you brought up something in the book, I think with onslaught of diabetes and you have some experience in your family and you're up with this. Is that some point everybody's going to have insulin resistance and diabetes even if they not have a genetic preference. But can you talk about how genetics drives insulin resistance?

[00:12:37.850] – Kashif

Yeah. So right now, the United States is presumably 95% metabolically unhealthy. This is coming from the CDC. They're saying only 5% of Americans actually have good metabolic health. And that's mostly driven by our food supply. The high carb, low fat myth that was completely wrong and the road we went down and where we're now at. And so the actual straight out insulin response is genetically driven. There's a gene called TCF seven L two, which determines how efficiently you actually manage your insulin levels and how do you respond to glucose in the bloodstream. And are you bouncing up and down or is it more even keel? And if you're not doing well, there a big red flag. Points to diabetes. AMY1 is a gene that helps you break down starches and metabolize them and use them as fuel. Some people do really well there and we don't tell them you need to go on a low carb diet. They actually thrive on carbs. A lot more people, however, don't do so well there. Then there's also fat metabolism. I can't tell you how many people we have to tell them that the reason they don't feel good is because they're on a keto diet.

[00:13:40.050] – Kashif

And I'm not saying not go on a keto diet for the person who's wired for it. There's nothing that will make them feel better and healthier than that thing. But for the person who's not wired for it, who has the suboptimal version of the ap2 gene, as it's called, they may feel good in the first two or three weeks because ketones start firing. The brain feels good, you're using fat as fuel. But five, six weeks into it, you start to get sluggish. And you don't blame it on the keto because you felt so good in the first two, three weeks. So you start looking for other problems. Right. And a lot of people, we've had to unwind and change their diet. So all of these things equal metabolic dysfunction, which then lead to insulin resistance, which then lead to a whole scope of problems, from cardiovascular disease to cancers, to diabetes to dementia and Alzheimer's. We need metabolic health as a baseline foundation for other chronic diseases to not set in.

[00:14:30.040] – Allan

And I think this kind of speaks to the whole idea that, well, it worked for him, it should work for me. I watched them do this way of eating, and it works, and they're just in brilliant health and I want some of that, and then I eat that way, and my results are just not even close to that. Can you dive a little deeper into how our genotype affects the nutrition that our body needs?

[00:14:54.990] – Kashif

Yeah. So this is a big challenge in today where information is so easy to access. And so you go to YouTube or you go to a podcast like this, for example, and you hear something that the person speaking says, this changed my life. And they're probably correct. But if you ask them how they got there, it was probably five, six, seven years of trial and error. And that's why exactly,

[00:15:20.440] – Allan

you got me eight years.

[00:15:22.550] – Kashif

But, yeah, eight years of like, this sucks, this sucks. I'm like, oh, wow, I feel incredible. And you feel so good that you want to scream for the rooftops and tell everybody, and that's why you have this incredible podcast. Right. But the pain it took to get there, we don't talk about. And all we're saying is that, yes, it works for you. If a genetic you comes along, it will also work for them. If they're not wired like you, they're going to say, this doesn't work. This guy doesn't know what he's talking about. Right. So all we're saying is, day one, there's an instruction manual in each one of your 50 trillion cells that's telling your cells how to do their jobs. And those manuals are not the same for us. So when it comes to nutrition, like you just asked, if we aren't precise in terms of what our bodies need, yes, you can trial and error it until you figure out what feels good, and then eventually you'll be great. That takes years, typically. Or you can go straight to the genes that direct all these processes, starting with the brain. When it comes to diet, nutrition, the first thing we usually look at is how do you even perceive food?

[00:16:21.900] – Kashif

There's genes around satisfaction of the palate and people that need to binge and snack because they can't get satisfied. I need my doritos, I need my cookies. Right? Then there's genes around satiety of the gut and your ability to actually feel full. And that signal from the gut to the brain is just sometimes slower for people. And so we have to structure their food. Then there's people that can't experience pleasure as efficiently as others. Their dopamine pathway is broken, so they become addictive or they become bingers, and they use food as coping mechanism because their emotional pathways are off. So decoding the brain step one is really important in terms of decoding how to eat the way you want because you may think you're doing it, but depending on the day and what you're exposed to, you probably aren't.

[00:17:02.410] – Allan

Yeah, so this is talking about our relationship with food and satiety and how we approach it. It's talking about how we metabolize the different macronutrients and it even gets as deep as how we deal with the micronutrients and how we balance that out. I haven't done mine. I will. I promise. I'm on it. Back to the States. I'm a spit in the tube, but I have a problem with low sodium and low potassium and I have to kind of manage and make sure that I'm getting a sufficient amount of that in my diet. I only know that from the error that happened.

[00:17:35.920] – Kashif

Right.

[00:17:36.280] – Allan

And every time I go get blood test, I have seen that it's low. And I'm guessing there's probably a profile in my genetics that is putting me at a predisposition for that.

[00:17:46.700] – Kashif

Yeah, likely the ability to actually metabolize. So there's different steps to using nutrients. There's getting it in the blood, which is what we measure, but there's also using it. So there's a big difference between understanding how much is in the blood and how much is in the cell where your body actually needs it. And genes that drive those steps are unique and separate. And so we can get really precise, especially when it comes to vitamin D. It's a really complex pathway. But vitamin D is probably the most important micronutrient that you need out of the 22,000 genes that make up your Genome 2000. So almost 10% of your human biology requires vitamin D at the adequate right level to express your genes properly. Meaning that for your genes to do their jobs, whether it's hormones, brain, bone, skin, whatever, if you don't have the right amount of vitamin D, you're not doing those jobs well. And vitamin D has a complex pathway because if you think of our ancestral traits, they were out in the sun. Here's you and me indoors on a zoom call, right. That was not the reality of what worked. Like 200 years ago and then go beyond many thousands of years.

[00:18:52.800] – Kashif

So we now have this ability to mitigate and reduce our vitamin D utilization, which doesn't fit our current lifestyle. Step one, there's a gene that takes vitamin D from D Two from the sun and converts it to D Three. So how efficiently do you do that? Step two, there's a gene that then transports it to the cell where it's actually used. How efficiently do you do that? Step three, there's a gene that binds it and actually gets it into the cell. And how efficiently do you do that? So now not only do we know how much vitamin do you need, but maybe how frequently. If you don't transport and bind it, the first dose, you might only use 20% of what you put in. So you need to take two or three doses in a day. That one thing. I can't tell you how many problems we fix just by fixing this. From anxiety to bone issues to I can't get out of bed with depression and issues. So much get fixed just with this one thing.

[00:19:44.330] – Allan

And I think that's why a lot of people notice when they start eating right, they start feeling better. These feelings and emotions, all this stuff, it's like, well, food is not supposed to help me with depression, but yes, it does if you eat the right food.

[00:19:57.230] – Kashif

Yeah, there was a report that just came out that if you take the best antidepressant drug and then you compare it to exercise, exercise is a 50% better outcome than the number one antidepressant drug, which, by the way, only works 40% of the time because it's just masking the symptom and hiding the fact that there's biological dysfunction. And it usually has to do with gut and body, like not moving your body and not supporting your gut, which both equal brain problems, neural inflammation, disconnect in general. So yeah, food and exercise will resolve most mood issues.

[00:20:34.170] – Allan

So let's do that. Let's jump into fitness and talk about how our genotype drives the type of fitness that we should be doing. Because I know some people sit there and say, well, you can look at this person and they're long and lean and they do yoga. Well, yoga didn't make them long and lean. They're good at yoga because they're long and lean. Or you can look at a sprinter or you can look at a marathoner and say, okay, two totally different body types that make them better at their sport. But when we look at training, though, there's still training that's best for us. How does that all work?

[00:21:05.640] – Kashif

So that's a big thing that we talk to parents about because you can imagine the five, six, seven year old child where it's like, hey, I want my kid to play football. I want my kid to be a hockey player. Do you know what they're going to look like when they're 15 and imagine all the effort you're going to put into this to see them fail because you didn't pick the right path, when guess what? Their hormones tell us exactly what they're going to become. And that's also true for you and me, the 40 plus crowd, right? We understand exactly why we've been challenged and why we hit plateaus. So take me, for example. I produce a lot of testosterone. My genes say that very clear, but I also clear it very quickly. So I have this use it or lose it type hormone profile, where if I do actively go to the gym regularly, which I do, I can fairly easily maintain the physique I want. But as soon as I stop, it all comes crumbling down, right? I can't get big and I can't deadlift 400 pounds because I don't make enough estrogen, which is there's a myth that strength and weight comes from testosterone actually is driven by estrogen.

[00:22:08.340] – Kashif

So I don't make enough estrogen to get the mass. I'm more of a Captain America and less of a Dwayne Johnson, let's say. Right? If I do everything right, there's a certain body type that my hormones are already dictating, and that helps me determine how I need to work out. For example, I used to do four or five sets of everything and I was over training, and my recovery didn't facilitate that. Well, now I do two sets, and every single trainer I talk to says, that's not how you work out. Well, guess what? I'm in the best shape of my life and I'm able to go to the gym more often. And I feel better mentally because that's exactly what my body needed. And yes, it's unique, but great, that's what I need. It doesn't matter to me what works for everyone else, right?

[00:22:50.600] – Allan

Yeah, exactly. And so by getting your genetic profile done, you're going to have some ideas, okay, how's my body going to respond to exercise? What am I going to get the most benefit from? How is my recovery work? Which is going to also then help you understand, okay, what volume should I put on myself? And so many people just think more is better, but that's not the case.

[00:23:11.630] – Kashif

Since I reduced it, I have far better outcome. So recovery, the word you use, is very important. So we're in Toronto and we work with a lot of NHL hockey players. It's like a mecca of hockey training up here, right? So in the offseason, they're all here, and recovery is always a question mark. So we work with a lot of players and we have to show them that their regimen is the problem, it's not the recovery. They're just over training. And when we reduce their training to align with their mitochondrial resilience so we can actually determine how efficiently the mitochondria functions, which then determines how quickly they recover. So, again, we turn both dials, we supplement them to help their mitochondria and to help them recover faster, but we also adjust the load to make it align with what they're designed for. And all of a sudden, again, they thrive. They actually don't need to train as much, but a guy like me, I need to train consistently, meaning every day, but a small load per day, right. There's some guys that we tell them, you got to go three days a week and you got to go heavy.

[00:24:09.460] – Kashif

Right. There's some days people that got to go heavy every single day. So it depends on who you are and how you're wired. And all of a sudden, when it's aligned and personalized, you get the best outcome.

[00:24:18.220] – Allan

Yeah, and that's so hard for people because they just say, okay, well, this person's working so hard, especially a professional athlete, but just everyday people, you go in the gym and you see someone working really hard, and they built this body, and it's like, oh, wow, well, I want that body. Genetically, that body might not be possible, but beyond that, you have to put in the right kind of work, the right amount of work, and at the right times to make this all work out. And a good genetic profile like what your company does, will give us that information to help us understand our fitness and recovery better.

[00:24:50.160] – Kashif

And the other big area is the delineation between male and female training. So most of what we know and understand is based on, how do I take a 20 year old guy and make him a weightlifting champion? Right? That's where everything comes from because that's the industry. It's competitive training is at a youthful age, and it's around men. It's recently become a phenomenon with women, with TikTok and all these videos and everything. So everyone wants to look like everybody else now, right? So women, whereas men have a daily hormone cycle, and your genes will determine sort of little nuances in that cycle for a man. We have a menstrual cycle every day. Men have a hormone cycle, right? Sorry, I should say a Manstrual cycle. Women have a menstrual cycle. They do it every month. So the exact same thing that we do every day, women do it on a monthly basis. So it's stretched, meaning it's not, here's what I do every day, or here's what my week looks like. What does my month look like? Because the hormone levels in week one are here, and then they're down here, and then they're back up here.

[00:25:51.540] – Kashif

It's a roller coaster. So your body whereas in the beginning, for a woman, it's more akin to weight training and putting on muscle. Then in the following week and your estrogens go crazy. You're more prone to injuries. You want to get off the heavy weights. Right? Then in the following week, your body wants to get into recovery mode and start prepping for that lining release. So if you understand the cycle, which we map out a lot. And you understand. Are you more estrogen dominant, more testosterone dominant? Do you make toxic hormones, which then causes inflammation, which you need to reduce? Then you can be really particular on how to make that ideal month. And then women get unstuck, let's say. They really feel stuck all the time.

[00:26:31.840] – Allan

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

[00:26:41.260] – Kashif

So I would say the big sleeper that gets ignored isn't spoken of is environmental health. So the thousands of people that we reviewed, the one thing that consistently was a drip of toxic insult that was outside of their awareness was what's in their environment? What are they breathing? The chemicals on their desk, the pesticides that make their lawn so beautiful, the Teflon coated frying pan could be something that your neighbor sprayed in their garden. So the toxic chemical burden that we have versus what we're wired for, giant misalignment, huge problem and is the root cause of a lot of problems. Right. So I would say that's the number one thing to look out for, number two is to understand that we walking on this planet, have genes, an instruction manual on our body that is approximately 200 to 250,000 years old. We haven't changed since then. Now, our current reality is a post 1950s reality. So compare that to 250,000 years, a tiny, tiny blip in time in terms of food, stress, sleep, chemicals, everything. Right. We are not designed for how we live, which is why we have a $4 trillion health care budget, of which 90% truly is spent on chronic disease, all of which is preventable.

[00:27:54.670] – Kashif

So $3.6 trillion a year the United States spends on treating things that never needed to happen in the first place. Right. So just understand that in order to truly be healthy, this thing that you're walking around in is not ready for the environment you're walking around in and the food you're eating and for the stress you're having and for the lack of sleep and all. So you need to work on all of those things. Try and be more like your cavemen ancestors if you can. Right. Number three thing I would say is consistency. And I've learned this from myself, in myself, trying to be better and eliminating five chronic diseases. I don't have any of them anymore, and I haven't had them for years. When I had five years ago, all five of them at the same time. Things can come back. We get sort of comfortable. Right. And consistency is key. You can never stop doing the work. You have two choices. You either do the work now or you pay for it later. And you can pick one. You cannot do anything. Fine, then, okay. Enjoy the medical system, which is, I will do whatever I want.

[00:28:57.160] – Kashif

And when I break myself, it's the doctor's job to fix me that's one way or I could understand what might break and prevent that from happening and go into my 90s, riding my bicycle and playing with my grandchildren. That's a very different way to live than the American dream right now, which is the last 15 years or spent in treatment. That's actually the average. So that becomes a choice. In order to maintain that choice, you have to be consistent. It's not a task, it's a lifestyle. It's every day you wake up, you're working on your health.

[00:29:24.080] – Allan

Excellent. Now your company, the DNA company, is going to give the listeners of the 40+ Fitness podcast a 10% discount on the DNA workup. You go to thednacompany.com/40plus. So the discount code is 40 P L U S. You can go there and get a 10% discount off of the test. Is there somewhere else that you'd like me to send them, Kashif?

[00:29:46.240] – Kashif

Sure, I mean, anyone that's interested in learning more the book, which was big news for us, is coming out right around the corner. So if you go to thednaway.com, you'll be able to be connected to a retailer that can supply the book. But this was really exciting for us because one of our patients was a CEO of a publishing company and when he heard what we're doing he's like, well, you guys need a book out there because everyone needs to know that this tool should be part of their toolkit. And most people don't. Most people don't know that they can prevent and reverse and read their human instruction manual. And so I spent late nights for a good year writing this book. It wasn't my intention to be an author, but when I started I couldn't stop. It was a really pleasurable thing to do and so it's now finally being released and our mission is that we can bring personalization to health and wellness. Even just by reading the book, you can understand my journey and how I fixed myself, which allows you to start thinking about yourself in a different way. So again, that's thednaway.com, and it's launching May 16.

[00:30:47.790] – Allan

Great. And that was what was really cool was that you took the time to walk us through your DNA and how that's changed your lifestyle choices. So it's a really good practical way to demonstrate the benefits of how this all works, plus lots of opportunities shared with different people that you've worked with and how you've helped them set their course. Thank you for that. Kashif, thank you so much for being a part of 40+ Fitness.

[00:31:10.850] – Kashif

It was a pleasure. Amazing talking to you.

Post Show/Recap

[00:31:14.010] – Allan

Welcome back, Ras.

[00:31:15.650] – Rachel

Hey, Allan. I always love talking about DNA and it is still on my list of things to get done. But now I've got something to think about because my hospital network can do some genetic testing. They also accept genetic testing through another outside platform. But then it sounds like Kashif has a different company, the DNA company, that might be even more thorough. So now I kind of got to compare to see apples to apples what I can get out of this DNA testing.

[00:31:46.570] – Allan

Yeah, it's pretty fascinating, the testing that they do. Everything's a step change as things go, and technology changes, and the costs come down on some things, always going to go up on other things. But as they come down on these technologies, they're able to do more. As they learn things, they're able to do more. One of the interesting things about his company is at this point, they've served 7000 people. And that doesn't maybe not sound like, but that's a nice size sample of looking at people and their situation and then looking at the lifestyle changes that those individuals make and what it means in their life. So when you kind of take it from that context, it's like, this is a pretty cool deal. The 23 AND ME was kind of like the first one out the gate doing this stuff. And when they did it, they tried to tell you things like, you have a propensity for Alzheimer's or not, you're probably going to be lactose intolerant or not, you're going to be bald or not. They could do that, and they could also then start telling you about your heritage and where you're from.

[00:32:54.820] – Allan

Now, they got in a little bit of trouble at the beginning because the FDA is like, you're diagnosing diseases. So there was a whole lot of fighting infighting things that was going on between the government and that company. Fortunately, they got past a lot of that stuff. So while your DNA cannot diagnose an illness, it can tell you a lot about the way that you do things in your body that can give you the information to make better choices. Okay. And where that's valuable is if you say, okay, well, I like fruit, and it's like, great, you like fruit, but your body doesn't process fruit the same way as someone else. So you can have some fruit, but just not as much fruit as you might be eating today. So I know everybody's like, well, it's natural food. Yes, it is natural food, but your body might not process fructose as well as somebody else, and you have to take that into account or not. I mean, it's your choice. That's why I wanted to start I started that conversation with him about informed choice about that, because if you have the information, then you can make those choices.

[00:34:02.450] – Allan

And there are privacy concerns. Who has access to your genetic information, and how can that be used in the future? Right now, nobody knows. But it could be, and it's something to think about, because if someone has your genetic information and decides they don't want to write an insurance policy for you, that could be a big deal. So there are some concerns. There some things for you to think about, but here's a way, and mine's been tested, so if they want to clone me, please go right ahead. Nobody wants to clone me, but if you want some information, some data that's going to help you, this is the way to go.

[00:34:44.680] – Rachel

Well, the interesting thing that you touched on briefly is about cholesterol. I think it was his friend that had high cholesterol and was trying to go golfing and walking and being outside and wasn't helping his cholesterol. And then maybe he got this DNA testing and found out, well, there's other problems to how he was attempting to resolve a high cholesterol. I know that with menopause, my cholesterol is expected to raise. My dad's got high cholesterol. It could be a genetic factor, but it would be interesting to know, well, if I should be on statins, or if statins won't work, it should be nice to know that. Or like when you talked about choosing different diets, maybe I should try a Mediterranean diet or vegan. But I sure would like to know whether my body would respond as well to that or another. I mean, it just would be nice to cut through the chase and instead of experimenting with all these different things to try and control my cholesterol. What can I learn from this data and implement a lot faster?

[00:35:48.110] – Allan

Yeah, well, again, you can go to 40plusfitnesspodcast.com/dna that'll take you to the page. And they run discounts, they do different things, but it's not out of reach for most people to make this investment and kind of know those things with his friend, kind of the scenario was that his friend was an avid golfer and he was out on the golf course all the time. Now they're up in Toronto, so their golf season is like, over the day it starts. It's pretty short to keep the grass going and to keep everything they used a lot of chemicals and everything to keep the grass growing all the way through the winter and have it ready for the season. And so it was just really that exposures to toxins that this guy was not his body was not equipped to do very well. And so daily, almost daily, like four times a week, exposure to toxins was causing some issues. Now it's one of the weird things of traveling up to North Carolina. Our days down in Panama are twelve and twelve. I mean, like literally 6:30 6:30 daylight period. We're up here now. Last night we're like, walking around at 8:30 and it's still daylight.

[00:36:56.680] – Allan

We're like, this is insane. Up in Toronto, it's even more insane. Like I said, up in Canada, their days, so he can get off work at 05:00 and play a whole round of golf before it even starts to get dark walking. And so this guy's out there playing golf, and he's getting some good walking in. He feels like he's taking care of himself and his body's just not dealing with the toxins, and that's just causing all kinds of problems in his body. And so nobody would know that. They'd be like, this was a healthy guy. He played golf four times a week. Why is he having a heart attack? Nobody would know that. And he thought he was doing everything right and it wasn't working out. So it's just kind of one of those things. This technology right now is available to you, which is what's important to take away from this call. Eventually, this information will be a part of how your doctor cares for you. Your doctor is going to say, Well, I know, okay, there's eight statins on the market right now, and I know you're not going to tolerate any of them.

[00:37:57.930] – Rachel

Right.

[00:37:59.530] – Allan

What we're going to do is we're going to prescribe this other medication, and we're not going to make you go through the grief of struggling with the statins. And so you think about that, where instead of a practice with this trial and error stuff, with all the different drugs, they'll literally know this is the drug that's most likely to help you right now, based on what we know about your genetic profile and what will work for you. And when we get to that level of personalized medicine, then our life expectancies can go astronomical, because you're not going to waste a whole lot of time trying to treat something the wrong way.

[00:38:36.200] – Rachel

That would be so wonderful. That's what I love about this DNA, just the science. And like I said, cutting to the chase sure would save a lot of time and money and effort instead of the trial and error things that we do right now.

[00:38:49.600] – Allan

Yeah, if you're interested in all this, you can go to their website, 40plusfitnesspodcast.com/DNA, and that'll take you to the website. And I don't think they gave me a discount code, but there are different codes out there you can use if you want to book one of these. Maybe 40plus.

[00:39:06.260] – Rachel

40plus.

[00:39:07.090] – Allan

40plus. Okay, I wrote it. Okay. Yeah, use the discount. 40plus, they'll give you a discount. They might be offering one. That's better. That's fine. Take the discount if it's better, but get some money off of it. Again, if you want to act on data and you want to kind of go to the next level with how you approach your health and fitness, this is not a bad tool to have.

[00:39:29.260] – Rachel

Yeah, that's really cool. Well, thanks.

[00:39:31.560] – Allan

All right, well, Rachel, I'll talk to you next week.

[00:39:34.310] – Rachel

Sounds good. Take care.

[00:39:35.850] – Allan

You too.

[00:39:36.730] – Rachel

Thank you. Bye bye.

Music by Dave Gerhart

Patreons

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– Anne Lynch	– Ken McQuade	– Melissa Ball
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Another episode you may enjoy

Clean those dirty genes with Dr. Ben Lynch

Less...

Let's Say Hello

[00:02:38.130] – Coach Allan

Hey, Ras. How are things?

[00:02:40.310] – Coach Rachel

Good, Allan. How are you today?

[00:02:42.480] – Coach Allan

I'm doing okay. We're having a water issue again, so I don't want to get into all that because it's just going to frustrate me again.

[00:02:50.040] – Coach Rachel

Oh, jeez.

[00:02:50.750] – Coach Allan

But we're working on it. But no, I'm happy to announce that I have a few things that I told last week. I started interviewing on different podcasts, and so some of those podcasts have come out now, and I wanted to share a few of them. I was on Paul Hanton's podcast called The Healthy Fit Life. You can find that one at 40plusfitnesspodcast.com/paul.

I was on Natural Health Matters with David Sandstrom. You can find that one at 40plusfitnesspodcast.com/david.

And then I was on Jillian Lockditch, which we had her on last week. I was on her podcast. Growing Older, living Younger with Jillian Lockditch. And that's at 40plusfitnesspodcast.com/gill. And that's Jill spelled G-I-L-L. Like from Jillian, but Gill and you can find that one.

So Paul, David, and Jill, I was on each of their podcasts. And so 40 Plusfitnesspodcast.com and then those names Paul, David or Jill. And you can catch those episodes there.

[00:04:01.180] – Coach Rachel

Awesome. That's exciting. I can't wait to give a listen to those.

[00:04:04.900] – Coach Allan

Yeah, it's interesting to be on the other side of the interview. Sure. Because even if we've discussed kind of what we want to talk about, I don't have a script. I don't go in this like, this is how I say these things. I listen to a question and then I say, okay, this is the best way to answer that. So it's a lot more off the cuff than a lot of the things that I do when I'm interviewing a guest on my podcast. I've read their book and I have specific things I want to discuss here. I go at it not necessarily knowing what they're going to ask me. So it can be kind of interesting. So, yeah, go check those out.

[00:04:46.960] – Coach Rachel

Awesome. That sounds fun.

[00:04:48.730] – Coach Allan

How are things up there?

[00:04:50.180] – Coach Rachel

Good. I just wanted to share with you and our listeners real quick. My doctor just told me some pretty important news the other day. I'm post menopausal. Yay, I made it. I made it. And kind of related to that, my thyroid is finally tanked out, so I'll be starting some thyroid medicine. I'm hypothyroid, which is now the reason why I've been so darn fatigued lately, just because my thyroid has not been functioning quite as well. And it's kind of funny because as an ultra marathoner, fatigue is kind of the name of my game to begin with. But now I really know why I'm actually as tired as I am, so I'll be starting that pretty soon.

[00:05:33.370] – Coach Allan

Man, you're going to be blowing out your PRS like nobody's business.

[00:05:36.350] – Coach Rachel

I'm hoping. I'm hoping to get some of my energy back, but I just wanted to share real quick as I learn more about what this means for me as a woman. And by the way, I'm 51, and I didn't know that 51 is the actual average age that women hit menopause. So yay, I'm textbook.

[00:05:57.890] – Coach Allan

I thought it was closer to 53, but yeah, okay, textbook.

[00:06:02.350] – Coach Rachel

Yeah. So as I figure some of this stuff out, I'd be happy to share my story with our listeners. But just for right now, I've got official notice I'm menopausal, and we'll see what happens.

[00:06:15.350] – Coach Allan

Basically, the way that I understand that they diagnose this is if you go without a period for a year, then they consider you in menopause.

[00:06:25.540] – Coach Rachel

Yeah, well, it gets kind of tricky because I had an Ablation done, so I haven't had a normal period in a couple of years. So that makes it a little difficult to figure that out. And I've had a lot of symptoms. The heat flashes during the day, night sweats at night, a little bit of moodiness. But again, those are kind of normal. And for pretty much any woman that actually either has a period or is going through the perimenopause and apparently now in post menopause. So it's important to know that some of these symptoms can get worse. My thyroid is probably in the mix with all these hormone fluctuations and changes, but it's important to spend time with your doctor as well. I go to my annual physical every year. I see a high risk breast cancer doctor, and now I see a women's health specialist who specializes in menopause and can give me a whole ton of information, but they did the right test at the right time. And now I know for sure what's happening with my hormones. And it's going to be very helpful as I navigate all these symptoms moving forward.

[00:07:38.760] – Coach Allan

We're good. I mean, you know, at least once a year I try to have a woman's health expert on. We're typically going to talk about perimenopause and menopause and that type of thing at least once per year, sometimes more. So I've had several episodes on, so there's lots of material out there. But this is going to be good because I'm going to have a pro on my side next time I do interview. That's right. Yeah. We can approach that one a little bit different, but cool. All right, well, are you ready to get into our episode about victimhood?

[00:08:12.420] – Coach Rachel

Sounds great.

Interview

You are not a victim. That's what I'm calling this episode. And it relates to kind of a cultural trend that I've been seeing out there lately where victimhood is being kind of almost touted like a virtue. And I'm here to tell you that if you're trying to improve your health and fitness, if you're trying to lose weight particularly, you're going to really struggle if you have this state of mind, this victimhood state of mind. So I'm going to go through some statements. These are statements that I've heard people say I've heard people or seen people post them on Facebook and or on Twitter. And it's so common that it was easy for me to find several different ways that this shows up. So the first one is I want something I don't have, therefore I'm a victim. So if someone has something you don't have, obviously you're a victim. The next one is, I struggle more than other people, therefore I'm a victim. And so this goes on, the idea that your life is harder than theirs and therefore you're a victim because you have to struggle so much harder to do the basic things that everyone else is doing or that you believe other people are doing to get their success.

Now, this is a very common one, particularly in weight loss areas. I'm addicted to sugar and carbs, therefore I'm a victim. And this one's really, really common. I see it a lot. Now, don't get me wrong, sugar and carb addiction is kind of a thing. But the reality of it is it's not as hard to break as some other addictions might be. And there are steps to take. You are not a victim. You chose to eat sugar and carbs, or at least you ate them when you were given them and you've continued to eat them and buy them. So having sugar and carbs around you is the same thing as maybe sending an alcoholic to a bar. It's just something you wouldn't do if you're trying to beat alcoholism and if you're trying to lose weight, being around sugar and carbs might make that very difficult for you, particularly if you believe you're a victim. I don't have the energy to work out. I love this one, therefore I'm a victim. Okay? I don't have the energy to work out. Now, there's this little known thing in our body that causes us to actually get hormones and endorphins feel good stuff in our brain when we work out, that gives us more energy.

When we build strength and endurance, we have more energy. So the not having energy to work out is really just an excuse to not get started, okay? Other people sabotage me, therefore I'm a victim. Now, don't get me wrong, there are plenty of people out there willing to sabotage you if you let them. But again, you're choosing victimhood. In this case, they're choosing to do what they do. They're choosing to try to take you off track in some cases. Sometimes they're not. Sometimes they actually think they're doing something nice for you. But if you feel like other people are your problem, you are the problem. You are not a victim. But you'll say you're a victim because those other people, well, they're in your way. And then I've tried everything, and nothing works. Therefore, I'm a victim. And again, this is just that concept that you've really given everything the best shot possible. You really worked your way through it, and all these failures have just become an evidence of your limitations. So we're going to talk about that a little bit about what victimhood is. Now, victimhood fits in the mindset frame of being a fixed mindset.

And this is a psychological concept that was developed by psychologist Carol Dweck. And so what she talks about in her writings and in her studies is that you either have a fixed mindset or a growth mindset. And guess what? Those aren't fixed. You can have the one that you choose to have. And there's a reason why these fixed mindsets are a problem. And one of the main things is that people with a fixed mindset, people who believe they're victims, they avoid challenges. And anytime there's a failure, even a little failure, you're more likely to see that as evidence of your limitations, okay? And so what that does is that creates fear of failure in yourself and you're not willing to take risks. So the signing up for a gym membership or hiring a coach or buying the food service that's going to be delivered to you, you don't want to take that step because if you fail, it's just more evidence that you're limited, that you're a victim, that you have a problem. And then another tendency that fixed mindset people have is to compare themselves to others. Now, in some cases, this is to seek external achievements so they can say, okay, well, at least I'm not as heavy as that person.

But they also end up with the negative and the limiting beliefs that they see someone else and they don't think they'll ever make it to that same spot. So these external comparisons are really holding them back on both sides. One is, well, I'm actually kind of normal. When I look at everybody else, they're all overweight. I'm overweight, therefore this is just the way it is. We're all victims, okay, and you're not. But that's a fixed mindset. Now, in contrast, a growth mindset refers to your belief in your ability and your intelligence that that can be developed, that you can improve yourself over time with hard work, dedication and perseverance. So the question you have to ask yourself is, do I believe that challenges and failures are opportunities for me to learn and grow rather than an indication that I'm going to fail? And if I fail, therefore I'm broke, therefore I have these limitations. So with a growth mindset, you always give yourself the best opportunity because you're willing to take the risk. You're willing to hire that coach, you're willing to join the gym, you're willing to try a diet or a way of eating or exercise program.

Again, even if you know everything else failed, you're going to go at it again. And you're going to go at it with the idea that these things that happen are teaching you something. They're giving you an opportunity to improve. And that's where the importance of this is. If you feel like you're a victim, you don't have control. But when you take on a growth mindset, you're suddenly taking on this idea that I am not limited by the mistakes and problems I've had in the past. Yes, I had problems with these donuts, and yes, I struggled when these things happened and yeah, with the stress of my job or the amount of time I was traveling, all those things, I could use those as excuses or I could try to find ways to improve my life despite those problems. And that's where the difference in these two come from. So to break away as a victim, there's a few things that you need to ask yourself, and these are important. So if you're not driving or running or doing something and you can get a pen out, this is a good time for you to write down these questions and really spend some time thinking about it.

Okay? This is not something you're just going to answer while you're listening to this podcast. So the first one is, are your actions consistent with your values? And here's what I mean by that. Let's say you want to be the best mother or the best father you can be or the best grandparent you can be. Okay. Are you living in a way that allows you to do that? You may say, I want to make sure that I'm there for my spouse, I'm there for my children. I want to be that person. Are you? Are you living in a way that makes that possible? Are you living in a way where you're going to be there for one and that you're going to be capable of doing the things that you want to do? How do you want to live the rest of your life? What are the values that you want to carry on? I've talked about it several times. I want to be there for my wife. I want to be there for my children. I want to be there for my grandchildren. I want to be there to run the bed and breakfast, to do the things.

I want to be able to physically train people for a long, long time. And I want to be independent my whole life. I do not want someone to have to take care of me. Those are my values. So then looking at your actions, ask yourself, are your actions consistent with your values? Because this can help you break through this. This can help you take that next step I'm going to talk about in a minute. Okay, the next question. Are you able to learn from mistakes or do you see them as evidence you're broken or flawed? So you go out for dinner and they bring around the dessert tray and it all looks awesome. And so you tell yourself, well, I'll just get a little bit of chocolate. I did go to the gym this morning, so I'm just going to go ahead and get a little bit of that chocolate death by chocolate thing. And they bring out this 32 ounce chocolate menagerie on your plate and you go digging into it. Now, the next day, how are you going to look back at that? Are you going to say, oh, my God, I failed, I'm a failure?

Well, no, you're not. That's an opportunity for you to learn. So ask yourself, do you really think you're broken when you do those things? And the short answer has to be no. That's an opportunity for you to see where you made a mistake. So you could just tell the waiter after you've gotten your meal, please do not bring that dessert tray by here. And if you're in the United States and you're listening to this, you can be very clear. If you bring that dessert tray by here, you will not get a tip from me, okay? Guess what that waiter or waitress is not going to do when you say something like that. They are not going to bring that dessert tray because they do not want to jeopardize their tip. So you just tell them, if you bring that dessert tray by here, I will not tip you. And guess what? You're going to get past that. So that's the second question. The third question is, are you willing to push outside your comfort zone? And this is a big one because most people want easy. They want the easy button. Tell me the diet.

Tell me what to eat. Tell me what not to eat. Tell me how to move. Tell me how to lose my gut. I just want to lose the belly fat. I don't care about anything else. I just want to lose the belly fat. They want the easy they want the thing that's inside their comfort zone. So they teach us. And when we go to coaching for our business, and they say, tell them that you can do X-Y-Z without them having to do this other thing. So you can tell them lose £20 without exercise or diet. And because people want to stay in their comfort zone, they don't want to exercise. They don't want to change the way they're eating. That sounds very appealing to a victim mindset person, to a fixed mindset person. So if I'm talking to you and you're feeling that way, are you willing to get outside your comfort zone? Because that's where the magic happens. The good things in your life do not happen in your comfort zone. Change does not happen in your comfort zone. You've got to be willing to push outside the comfort zone if you want to grow.

So again, the third question, are you willing to push outside your comfort zone? So those are three really important questions that you should be asking yourself over and over again to make sure that you're keeping a growth mindset, that you're not falling into that victimhood virtue thing, okay? So this can be very scary. Don't get me wrong. I know change is hard, okay? It's easier for you to stay in your comfort zone. That's where most people are today. Most people are very comfortable foods everywhere. Good. I'm never hungry. I'll never be hungry. I'll never try to be hungry. I'll never let myself get to a point where I'm hungry because food is readily available. But getting outside your comfort zone, saying, maybe I'm going to let myself get a little hungry from time to time. How about that? I'm going to feel what this feels like. I'm going to get out of it because I'm not starving. The words we say, I'm starving, but you're not starving. Starving takes days. Starving takes weeks. And so if you're a little hungry, you're not starving. And so, so many people are in that comfort zone that that's where we want to be.

The safety was safety with numbers, okay? And that's not where you need to be. You cannot be in your comfort zone and be successful. The other thing that makes change hard is it's so easy to compare yourself with others. I mean, look, 67% of Americans are overweight. Okay? What does that mean? Well, that means if you're overweight, you're in the majority. You're winning that vote. 40% of Americans are approaching obesity. So when you start looking at this, the vast majority of people out there are overweight and obese. And so you just look at that, well, I'm not as heavy as that person is, and, oh, look, I'm at the grocery store, and I'm actually maybe not the weakest person here. Maybe I'm not the fattest person here. And we justify where we are. So that's, again, that's a push against change, because staying where we are means we're just like everybody else, okay? And then change is really, really hard if you just decide that you want to change. And the reason is decision is really not a strong enough way to approach this. See, if you have a growth mindset, you're going to commit to this.

You're going to take that risk, and you're going to go all in. You're going to get outside your comfort zone, and you're going to make sure this happens. But that takes commitment. That takes that step, that daring, that knowing that, okay, I'm going to do this, but I'm not going to die. I'm going to get better, because I'm just going to keep pushing. I'm just going to be persistent. I'm going to do the hard work. I'm going to be dedicated, and I'm going to make this happen. Okay? That takes commitment.

Now, the one thing I'd like to leave you with on this is, yes, change can be scary, and change can be hard, and change is something that is not natural for a lot of us. But you're not alone. We have a wonderful Facebook community. You go to 40plusfitnesspodcast.com/group, and you can join our Facebook community. I do challenges. We're all there. If you want to share something, you need accountability, whatever you think you need. I have a group environment that's very caring, and we're not doing a bunch of that Flex Friday stuff and not trying to make others feel bad because we look good.

This is an environment where you can feel safe, and it's a private Facebook group, so it's not out on the interwebs for everybody to read. This is just for us to share and to support each other. I'm out there all the time, so I'll be answering questions if you have them. So you can go to 40plusfitnesspodcast.com/group to join us there. And if you're really ready to commit to this, I'd encourage you to get in touch with me. I coach people to lose weight. I coach people to get more fit. I only coach people over the age of 40. And I look to help people develop a growth mindset, so they learn from their mistakes. They get better, they get more comfortable being outside their comfort zone, and they change and they grow and they get better. And I know you can, too. It just takes that scary thing. You got to do that scary thing. And if you need help, I'm here to help you.

Post Show/Recap

[00:23:54.000] – Coach Allan

Welcome back, Ras.

[00:23:56.540] – Coach Rachel

Hey, Alan. Well, that was a lot that was a lot of good information. And as a fellow coach, I have encountered some people with a fixed mindset and just the absolute I can't run because or I can't work out because, I can't lose weight because fill in the blank. I've heard some of those things. And it's hard as a coach to go back to that person and say, well, wait a second, what can we do? If you've got a problem, what do we need to do to solve it?

[00:24:27.510] – Coach Allan

Well, I've definitely had clients that I would say didn't have a growth mindset to start with, but they had to at some point or else they wouldn't succeed. The reality is, if you have a fixed mindset, you're not going to get outside your comfort zone. If you don't get outside your comfort zone, nothing's going to change for you, and you're going to be right where you are. So it's the Harry Ford quote. If you think you can't or think you can, you're right. You have to have the mindset that you're going to get it done. For some of us, that might just be the commitment. For a lot of other people, it's a health scare. And so something has to shake you out of being a victim. Someone comes screaming, and they slap them in the face. I mean, kind of the whole thing is the people are panicking, and you just slap them in the face to get their attention, and it's like, calm down. You're not accomplishing anything. And so I think people sometimes need that slap in the face to make this happen. But if you're listening to this podcast, then you want something to happen, then you just need to transition that over to a commitment, not just a decision.

[00:25:53.810] – Coach Rachel

Right.

[00:25:56.050] – Coach Allan

And I can tell you that if you're not willing to deal with setbacks, which this is where the victims really struggle, is that if you do something, maybe you're doing something and it's working, and, you know, okay, well, I've lost this same £20 over and over again. And then you get to the lose the £20, and then something happens. You have a bad day, and you go do something you didn't want to do. You ate some things you didn't want to eat, and now you're going to blow off your whole weekend because, well, it's kind of screwed up Friday night. And then it becomes this thing, and then you start seeing the scale move back up. So you just stop stepping on the scale. And then yeah, you find yourself six weeks later right back where you were, if not heavier. You start running, and you feel a little bit of a tweak in your ankle or a little bit of tweak in your foot. You're like, oh, no, I can't run anymore. Instead of trying to do the things that are necessary to rehabilitate that, so you can start running again, doing the things you can do.

[00:27:02.380] – Coach Allan

So I can pedal a bike, I can get an elliptical, so I can keep my stamina up. But that takes this idea that you have a choice. This is not put on you. You are not a victim, right? And until you get past that, you're not going to be there. And so most of my clients that come in with this growth mindset, they're fed up, and they're like, hey, this is it. I'm doing it. I'm doing it. I'm doing it now, okay? And once that light clicks on, it's like, this is too easy. This is actually not that hard. It was scary, and it never worked before, but it's different this time. And it's different because now they're looking at this and saying, okay, I don't have to be perfect, right? I don't have to worry about if I make a mistake. I can always course correct that's, right? And it just keeps them on task, and they're like, okay. And then they get a win, and then they get another one. So just even just this last week or so, one of my clients, he had gone to this thing, it was like a government thing, and he was just really talking about how if you guys, if, you know, is wearing a tie, he couldn't button his top button in his shirt, okay?

[00:28:25.220] – Coach Allan

And so he was like, that was part of what his self and that was affecting his self image, and he was unhappy with it. And then he's three weeks into my program, and he's like, I had to wear that suit again, and I could button the collar, the neck. And he's lost £10. And he's feeling great, and he's doing more and more now. He's getting ready for some exciting things, like 100 miles, bike ride. This is the way it works. Another client was a very similar situation. She got called in for an interview. She wasn't really thinking so much about doing work, but she heard about this position. She puts in her name, and they call her, and then it's this panic. How am I going to look in my clothes when I go in for this interview now? Because we have a kind of a weird self image sometimes of ourselves. She didn't recognize that she had lost a good bit of weight and that she was smaller. So she puts on those clothes and they fit perfect, and that boosts her confidence. And she goes in and. Aces that interview and pretty sure she's going to get that job.

[00:29:39.930] – Coach Allan

Okay. That's growth. That's a growth mindset. And sometimes we're not always 100% behind ourselves or we don't see it happening for ourselves, but we just stick with it.

[00:29:52.900] – Coach Rachel

Yeah.

[00:29:53.490] – Coach Allan

And the good things are happening.

[00:29:55.250] – Coach Rachel

It does. And the benefit to having a coach or like the run club groups that I have is that you get to see these types of examples. It is possible. And maybe when you get to see examples like with your clients, that other people are losing weight at a later age or under these difficult circumstances, it's possible for you, too. And if you just pause for a second and reevaluate your situation, you might be able to think through what you need to do next, whether it's hire a coach or not or join a run club or not. But you do have options, and sometimes you just need to think a little bit outside the box to see what might work for you. But that's the great thing about hearing stories, like with your clients. And as I see my runners develop in the run clubs I participate with, it's totally possible. It just shakes what your norms are.

[00:30:48.110] – Coach Allan

Well, if someone had first told you when you first started running that you were going to be doing ultras oh.

[00:30:53.350] – Coach Rachel

My gosh, I would have laughed.

[00:30:55.870] – Coach Allan

Yeah.

[00:30:56.850] – Coach Rachel

Or running 50 miles right before I turned 50, I would have laughed. It's just inconceivable for me.

[00:31:03.350] – Coach Allan

I remember you sitting up on a couch with your foot in a cast, and you were so upset, and you're like, and I'm losing it, and I'm losing it. And that was a very down time for you.

[00:31:15.520] – Coach Rachel

It was.

[00:31:16.250] – Coach Allan

But as soon as the doctor cleared you, you started working your way back up and way past where you were. You just blew that away after you got yourself healed. And so it's just understanding where we are and saying, okay, I can't make that up in a day.

[00:31:36.080] – Coach Rachel

Right.

[00:31:37.010] – Coach Allan

But I'm going to grind it out. I'm going to do it and then see what happens. And that growth mindset that you had going back into your training, training smarter. You don't do it again.

[00:31:49.970] – Coach Rachel

Yes.

[00:31:51.970] – Coach Allan

That's made all the difference.

[00:31:53.620] – Coach Rachel

All the difference, yeah. For sure.

[00:31:57.030] – Coach Allan

All right, well, Rachel, I will talk to you next week.

[00:32:00.950] – Coach Rachel

Awesome. Take care, Alan.

[00:32:02.620] – Coach Allan

You too. Bye.

[00:32:03.710] – Coach Rachel

Thank you. Bye bye.

Music by Dave Gerhart

Patreons

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

– Anne Lynch	– Ken McQuade	– Melissa Ball
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Thank you!

Another episode you may enjoy

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Let's Say Hello

[00:02:40.370] – Allan

Hey, Ras, how are you doing?

[00:02:42.180] – Rachel

Good, Allan. How are you today?

[00:02:44.550] – Allan

Well, it's been kind of a rough week. We had to say goodbye to angel. Her nerve issues in her back and then the hip dysplasia. She pretty much declined pretty quickly and was not able to walk on her own, couldn't stand up on her own. So we would stand her up and sometimes she could move around a little, but she was so hobbled, and you could just see it on her face how miserable she was about the fact that she couldn't get out and do things. And seeing Buster go off and run around and do his thing. And Mama's going to walk Buster, and Daddy's going to walk Angel. She wanted to be with them. That's what they did. They go for their walks together. And it just got to a point where she couldn't and she knew it. And she was starting to see you could see it on her face that she just was not where she needed to be. And laying around all day long, it was causing other health issues for her, so we had to help her pass on. First time I've ever had to dig a grave for a pet.

[00:03:45.630] – Rachel

Oh, wow.

[00:03:47.050] – Allan

Well, I can say it's a pretty good workout.

[00:03:49.380] – Rachel

I can imagine.

[00:03:50.450] – Allan

Especially when you have to dig through two and a half feet of clay. So I was a little sore for a couple of days after that. Not just sore outside, but sore all the way through. So it was a tough week, but we're recovering and mourning and moving on.

[00:04:11.720] – Rachel

I'm so sorry. So sorry for your loss. It is hard to lose a loved pet. Someone's been in your family for so long. I'm sure the house has been a little bit quiet this week without her there, and my heart goes out to you.

[00:04:27.430] – Allan

Well, Buster is making sure that we stay entertained.

[00:04:31.150] – Rachel

Good.

[00:04:32.790] – Allan

He's a good dog.

[00:04:34.200] – Rachel

Good. Well, I'm glad to hear that.

[00:04:36.350] – Allan

How are things up there?

[00:04:37.840] – Rachel

Good. We have spring at least today. The weather has been great. And I had mentioned a couple of weeks ago that I was tapering for my big race, which last week I ran my big race, and now I'm in a reverse taper. I'm just taking my time getting back to running, which is wonderful. Now that the weather is turning, it's really easy just to go out there on a beautiful day like today and just get a mile or two in. I'm just taking my time and enjoying the run and the weather until I feel strong enough to get a few extra miles in at a time.

[00:05:13.680] – Allan

Awesome. Well, congratulations on that run. I know you got a PR and all that. Now you got to do the recovery, right?

[00:05:21.000] – Rachel

That's right. Yeah. Taking my time.

[00:05:23.430] – Allan

All right, well, are you ready to talk to Tom Hine?

[00:05:27.390] – Rachel

Sure.

Interview

[00:06:16.810] – Allan

Tom. Welcome to 40+ Fitness.

[00:06:19.710] – Tom

Thank you, Allan. Welcome. And I'm glad to be here with you and your audience.

[00:06:24.020] – Allan

The book is called The Balanced Wealth Approach: Secrets to Living Long and Living Rich. And I think I was growing up in college and everything. I went to college for accounting, became a CPA, worked in that. And it was always the thing of you don't want to outlive your money. Most of us today don't actually have that problem. We have the other problem of not living long enough to enjoy our money. And so that's kind of what this book talks about, is finding that balance of saying, okay, build wealth so that you have what you need when you're older, but at the same time build health so you're actually able to enjoy those years. It was always kind of, I guess, a trope, if you will, where people would live, they'd work to 65, they would retire and die at 67. And I think now with with longevity happening the way it is, better medical care to keep us alive, not necessarily keep us healthy, we're living longer. And again, from someone from the financial planning, you're basically probably telling your clients you can't expect to die at 67 like people did 40 years ago.

[00:07:30.370] – Allan

You've got to expect to live to 90 or 100, and you want your money to last that long, but you want to be able to enjoy those years as well.

[00:07:37.720] – Tom

Correct. Yeah, it's about values clarification. I like to say these markets will heal, recessions come and go, but when your money recovers, will you be there to enjoy it? And there's a big talk today, as you know, about lifespan versus health span, right? It's how long you live, but how long do you live healthy? And one of my messages to my clients and your audience is you really want your health span to equal your lifespan. Right? We don't want the last ten or 15 years to be hooked to tubes and running from doctor to doctor. Not to say that doctors don't help us, but like you've said, so many other podcasts, we want to be proactive. We want to be CEO of our own health so that we try to do the best we can before the doctors have to intervene with more severe measures. So, yeah, I'd love to have people balance it. And also, more importantly, if you look at longevity and what's going on today, I heard on one of your other podcasts about Alzheimer's is type three diabetes, right? We talked about the MCT oil. We know so many more things today than ten years ago that those of us can take advantage of or at least bounce those ideas off our physicians and medical people to say, is this something I should consider for my own longevity?

[00:08:53.930] – Allan

I was having a conversation with Ras, who is my co host, so we have some conversations around these. And when I said this next statement, I got a visceral response from her, which I think is actually brilliant. It's a seven figure portfolio. Doesn't really matter if you're six foot under but you said a little differently in the book. But it's that concept of, okay, you did this great thing, you built this great portfolio, there's your big chipstack, and then you're out of the game. And the concept I wanted to take out of that was, okay, if you were running a seven figure business, you would want to run it well, meaning that the business is operating well. It's a healthy balance sheet in addition to a healthy business. So your relationships with everything and everybody you work with. And so the concept you brought up in the book was being the CEO of your own health. Could you jump into that concept a little bit? Because I've talked about being an advocate before, but I think the way you put it was really on point.

[00:09:55.040] – Tom

Yeah, thank you, and I will. One of the famous quotes that jumps out to me from doing the research was, and you'll appreciate this is, a healthy man has a thousand dreams, but a sick man only has one. Right? So the idea is, while you're building this seven figure portfolio or business, we like to say and doctors have shared this with me there's what we call acceptable level of optimization. There's an acceptable level, and there's an optimized level. So if you think about it from a business standpoint, you could have the auditors look over your books and records and cash flow and say, hey, things are going well, but these are the things you want to do to optimize your company. Whether it's R and D tax credits from my end, it's helping clients save money, convert to a Roth IRA, whatever it is in the financial planning end, when you make that parallel to health and wellness about being CEO of your own health, it's don't just go once a year to your own primary care. That's a great starting point. But add those extra measures that you would learn from podcasters like yourself.

[00:10:56.560] – Tom

Be proactive. Why? Because we know that diet, sleep, exercise, and stress reduction, those are some of the key pillars that every doctor will tell you we have to manage better. And then you add into that, what are people doing on a daily basis? I wear my oura ring all the time. That's one of the things I talk about, actually. I'm actually wearing the whoops wrap, too. I'm trying to compare one versus the other because they have different metrics. And then in addition to that, what can you do with diet, sleep, exercise? We have a lot more control, as you know, Allan, over what we eat today, right. How we exercise. I just attended a great seminar on grounding and red light therapy and EMF. I mean, that's a whole another generation of research, but we know so much more how to take care of ourselves, and yet some of us get so busy, we actually don't tender the store. And so that's what I want to remind the listener, is you actually have a lot more control today over what you eat, how you sleep, how you track it. And then don't let yourself get so busy building that mega company that you neglect your own health and end up spending all that money to recuperate the very health that you were trying to preserve.

[00:12:06.770] – Allan

Yeah, you may not know a lot about my story, but I had made it up to C suite at 39 years old as a top auditor of the company, had all the trappings of success. I had the money, the stock options, the restricted stock, the 401k, all of it. And I'm going through this process of realizing I'm completely miserable and unhealthy. I spent eight years trying to find balance in all of this, and it finally came about when I was willing to do some of the things you talked about in the book, about your own story, about how I flipped it and said I've got to spend more time on my health. And so at that point, for me, it was diet and exercise. And then once I kind of got that built up, then it was okay. Next thing is sleep, and I kind of got that zeroed in. But I felt as long as I was the C suite executive of a large company, standard Porsche 500, I was never going to hit that fourth pillar of stress management. So by good fortune or bad fortune, however you want to look at it, I got laid off.

[00:13:18.660] – Tom

Right.

[00:13:19.500] – Allan

And I made the decision at that point to not go back into corporate because I said this fourth pillar of my health is more important than me adding more to my wealth. And so, in a sense, I did my scorecard and I began to weigh the health side a lot more than the wealth side.

[00:13:44.380] – Tom

And congratulations, Allan. You're exactly right. And the challenge we all have, I just had it happen to a client six months ago. They had saved up all their money without getting the details and doing a review and dies of a heart attack. And now the spouse has all this money and no one to enjoy with the grandkids. It's nice, but not her spouse. And so you're right. But here's the thing. It's often tough. As I said in the book, mine was in the go go 1980s when they told me to quit martial arts and burn the midnight oil. And I said, luckily for me, I can't do that. It would be against the grain and against my values clarification. But it took that moment for me to realize I had to go left or I had to go right. And like you, I said, I'm going to take the turn that enriches and nourishes me. Looking back, I never regret a day. In fact, many of my peers did work themselves, ultimately either to an early grave or more importantly, to unhappiness. And at the end, that wasn't the journey they would have wanted either.

[00:14:44.060] – Tom

So congratulations to you on that.

[00:14:45.920] – Allan

Well, it took me a couple more decades than it took you to draw that conclusion, but I did eventually get there. But you have a tool that you put in your book. It's called the balanced wealth scorecard. And I know you now use this with your clients that you're counseling or advising on their wealth strategies, but you're having this additional conversation with them of what else about your health? How are you going to live well and retire well? Can you talk about your balanced wealth scorecard? Not so much. I mean, we can talk about the financial side a little bit, just so they know what's in it. But obviously this is a health and fitness podcast, so I'm not going to give them financial advice on this show other than they might want to reach out to you if they've got some money they need to manage. But beyond that, can you talk about your balanced wealth scorecard and how that's used?

[00:15:42.260] – Tom

Yeah. Thank you, Alan. And it's a joy for me because the scorecard and first of all, my disclaimer, I always tell even my clients that know me, I say, I'm not a doctor. I play one on TV and they laugh. But nothing is proprietary. Nothing violates HIPAA. They're not sharing any medical information. The scorecard is subjective, so the input comes from the user or the client. What I like to do is ask them. There's four topics on finance, which we don't really have to get into in detail, but the other four are on health, right? Hence the term balance. What I asked them is, if you were looking back over three years from now, one year from now, five years, looking back, what would you like to achieve in that space that would put you further along the line of health and wellness? And a lot of times, the first thing is, nobody's ever asked me that from a financial planning end. But what I just got an email yesterday from a client out in the Midwest, which I love. This client said, I finally got why you kept asking me about an oura ring, which she finally ordered one.

[00:16:41.870] – Tom

She said, I understand now why I said, I don't get any benefit, but it may help you and your journey on tracking, exercise and sleep. So the scorecard is designed to have them input on a score of, let's say, zero to eight or twelve on a scale on where they feel they fall. Obviously, the lower numbers mean they've not spent much time thinking about diet, sleep, exercise. The higher numbers mean, yeah, I've spent some time, but I haven't systematized it. And you and I know, based on all your great work, too, on podcast, once you create a system, it's easier to follow it, and then you can always insert something new. And so typically about twice a year, at the end of a regular review of their portfolio or their tax situation, I'll say, let's take out that scorecard. And what would you I asked them, what would you like to talk about next? One client recently got rated on his life insurance because his A1C is too high. So I said, okay. Great. What's your primary care telling you? And then what are his next steps? So that he knows, as a reminder, I'm there to coach him on, to encourage him on that step if he wants to share that.

[00:17:48.230] – Tom

So we typically use it as an accountability partner. And then for those people, Allan, that really want to do a deep dive, obviously, I have doctors that I've worked with that I can always refer them to. There's no finders fees. They can go right to these doctors and inquire and like many of your great podcasts, these people are experts in a deep dive, whether it's Alzheimer's, brain research, Parkinson's, I mean, you name it, they've all done their homework and they've got peer reviewed work in that area. But that's if somebody needs to do a deep dive more than the traditional. So it's an accountability partner, we like to review it. And more importantly, I love it when the spouses or their partner weighs in, because I like it to be where it can be a couple's thing. And as you know, when couples are both on the same page, the goals, the odds of reaching a goal are multiplied when you've got someone there cheering you on. So that's a big part of it, too.

[00:18:42.260] – Allan

Yeah, well, beyond cheering you on, it's the whole concept of, okay, if this is a lady and her husband doesn't want to eat the foods that she's eating and she's trying to commit to increasing or improving herself in this area, she's going to need his support at some level. Otherwise it's going to be a struggle. And it's not that he has to eat the way that she's eating, but at least at that point, if he's on board to help her reach these goals and understands that these are important to her, which includes she has to communicate these things to him. If you're doing that, if you're doing that, if you're communicating this, look, I've done this scorecard, and these are the things that are now kind of my priorities. They're my values. They're what I want to be. You can take that scorecard to your doctor. You can take that scorecard to your spouse or significant other. You can even share that because most of us are in our 40s. Our kids are going to be old enough 40s and 50s. Our kids are going to be old enough to understand that we want to be healthy and be there for eventually their kids having those conversations,

[00:19:44.500] – Allan

This is a really good tool to say, okay, I want to be financially secure. I want to be healthy. And so these are my priorities going into this next quarter, next year, however we want to approach it. But that gives you a great tool. And you mentioned something else that I think is really important is I don't like to talk bad about doctors. So I'm not talking bad about doctors. Please don't hit me up and say you're not listening to your doctor. Well, look, there are doctors that are in the current process that follow standard of care. They know the basics. They had the education that was necessary for them to be a doctor and do what they do, which is great. There are other doctors and very smart people who are on the other side of this. And look at this more from a well care perspective and they've raised the bar well above the sick care that most of our doctors currently have to practice. There are people out there, there are these experts, if you will, in the way that you can deal with nutrition. There's experts in the way that you can deal with supplementation.

[00:20:50.580] – Allan

There are tests that you can do that only these doctors are going to do. Because your doctor isn't going to necessarily say, just because your A1C is high, we should do a genome test so we understand if there's some genetic predispositions for that, or whether this is just something that's based on the fact that you're eating McDonald's every day and should just cut it out. Your doctor is just going to say eat better. And that's about all they're going to say. And then you got to figure that out. And then again, I'm a nutrition coach, I'm a fitness coach. And so there's people like me. I know what an ETF is, I know what stock is, I know what bonds are, I know about what is it? Diversification. I even know a lot about cryptocurrency and all those other things. Now, a lot of people don't. So they come to someone like you who's an expert to get advice so that they can optimize, so that they can do better than they could do on their own. Can you talk about how someone should go about picking an expert, knowing it, finding an expert, picking an expert and then working with one?

[00:21:55.510] – Tom

Yeah. Thank you. And also I'll give the analogy, which you'll certainly appreciate, health and wellness, just as I say in the book, when you diversify your portfolio, stocks, bonds, cash, real estate, I also mentioned diversify your health care, right. If you've been a good saver, maybe you don't just have primary care. Maybe you have a massage therapist or I say a chiropractor approved by an orthopedic surgeon. Maybe you have these other people in the background because we know that there are many different experts that can weigh in and you don't have to have pay a king's ransom for all this. I mean, a lot of these great health practitioners aren't always at the very highest end, but they have really great knowledge. But to answer the question, we believe the basis of everything should be a financial plan, right? Just the way that Chatbot, GPT and OpenAI have taken the world by storm. A financial planning software that's robust, literally incorporates long term care, Social Security, Medicaid planning, estate planning, roth IRA conversion, all the things that are important. And I often tell clients, ten years ago the software wasn't that advanced or what they call in fintech.

[00:23:04.110] – Tom

Well, now we literally get updates from the companies every week on we've changed this module because Secure Act 2.0 was passed last December, right? Or we've changed it. So number one, the basis of everything should be a financial plan, number two, and that's easy to do. But the second thing is the plan should be reviewed a couple of times a year when life conditions change. And that's where we add that balanced wealth questionnaire at the end or what do they want to do on that. But the third thing to remember is along the way, the government is really forcing people through this Secure Act 2.0. They want people to take more money out and get taxed now because we know the government sadly, is broke, right, the deficits, and I'm not blaming one party over the other, they both contributed to it. So our government is going to be reaching into your pocket, Allan, and your listeners and my pocket. Not that we don't want to help the government to protect us and there's some good things the government can do, but there's also some inefficiencies, right? And I tell my clients, if you don't do the right tax and financial planning, you're volunteering to give more money to the government rather than doing the right amount for your fair share.

[00:24:12.240] – Tom

So financial plan, a review on top of that. And ultimately, even though people are in their 40s and 50s and relatively young, I still want them to get a Will durable power attorney. I've had too many stories and I know you probably have known people who died unexpectedly and all of a sudden their spouse or their kids are left with a situation where you got to go through probate, which is basically salt in the wound of that. So we believe that's part of a traditional financial plan as well.

[00:24:40.560] – Allan

Yeah, well, I live in Panama country on an island. So yeah, when people pass here, it's fun. It's fun. And so one of the things I wanted to bring up, because you are a financial planner and coach, but the health savings accounts, I think what a lot of people think is, well, this is when I go to my doctor and I have to pay the deductible, I can use that against my health savings account. If he gives me a prescription and I have to pay for part of that, that goes against that. Certain other things that I would buy for my health would be in that. But what about things like coaches and nutritionists and things like that? Those are included in that whole model as well, aren't they?

[00:25:25.540] – Tom

They are. And the key thing about it I'm glad you brought that up, a lot of people don't know they've got, I'll never say free money, but money set aside for coaches and people like that, absolutely, it's allowed. And I suspect even more. This is where people really want to get in the nitty gritty of their planning. If you're smart about your own 401k, and we can't get into details here, but what they call Roth conversions and all, you can generate tax free money and retirement that can also be used to pay for these services. So a lot of people, if you're listening and you're over the age of 60, you might think it's too late. No, it's not necessarily too late in your 40s and 50s and still adding the HSA accounts are absolutely one way to do it. To allocate to that. It's a smart move

[00:26:09.910] – Allan

because I had a client and she's like, I need you to do these jump through these little hoops for me, and I can claim this on my HSA. And I was like, cool. And it saves her some tax money, too.

[00:26:22.170] – Tom

Yeah. And I would also share Allan, although I'm not a tax expert, but this is something for your audience, because a lot of times a little bit of research goes a long way. One of the reasons why I enjoyed writing the book for my current and future clients is I am and my accountant blessed that I'm able to expense this healthcare R and D research, because it's not just about me, it is for the benefit of my current and future clients. So I cleared it with him before the book even got published, and he said, it's your line of business. So for your audience, if people love what you do and others, and you can make it part of your business and integrate it, then you have the ability to ethically and legally deduct these expenses as part of R and D and all, whether it's for you or your training clients or your coaching clients. That's certainly within the purview of what's allowable under the IRS law.

[00:27:11.610] – Allan

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

[00:27:21.150] – Tom

So the three that I like to focus on, and the big one is sleep, right? There's no question every book's been written about it. There's some great ones about sleep. And again, whether you use your Apple Watch, I like to use the oura ring. I have no investments in these companies. I'm just sharing what works. But I love to be able to track the deep sleep, the REM sleep, your HRV, all these critical aspects of it. And if. You don't know all the details. There's plenty of websites. I know some of your podcasts have covered that. So number one, and I just listened to, by the way, a very well known military expert give a talk on another webinar and they asked him regarding all of the challenges in school violence and all that stuff like what's the one thing people can do to take advantage of being alert and responsive and healthy every day? And this is a military person. He said sleep. Sleep is the thing that people really need to focus on. So that thought that was fascinating coming from a lieutenant colonel. The second thing, clearly I would add, and I've done more of this work out in the last month, is this idea of circadian rhythm, sunlight, grounding.

[00:28:28.630] – Tom

The fact is, a lot of the way we evolved over 10,000 years and more was a lot of our artificial light. Today we're in buildings a lot. The research has clearly shown that if we get back to nature and where you are is a perfect place to get back to nature, right? And they said the blue zones, a lot of people in the blue zones around the world, guess what? Outside, near the beach, near the ocean, near the sand. So I think a second one is just be mindful of how many hours you spend indoors versus the natural sunlight and the circadian rhythm. I'm learning a lot more about that for me. So when I have my travels and I think the third thing is, for me, it's been again, I'm not a nutritious like you, but clearly the keto diet has been I didn't come into my program a lot of overweight. But I dropped a lot of weight doing the fasting and keto diet, and I realized I could live on a lot less calories and have the energy. The key thing is, as you know, is training your body to burn to that glucose before you get to the ketosis stage.

[00:29:30.960] – Tom

And a lot of people never can get over that hump because there's social challenges. I'm sure you know this, friends and family and people stop in and you're like you can't tell everyone that you're fasting all the time, right, because you got to eat meals. But I found that if you can work around that, those are the three things that have helped me now. A year from now, I may change them up a bit. But those are the three that I found that keep me on a mindset of health and wellness and more importantly, allow me to be CEO of my own health and not sit there and be frustrated by schedule changes, airline delays, or whatever's going on in the world.

[00:30:06.930] – Allan

Well, Tom, the book is called The Balanced Wealth Approach: Secrets to Living Long and Living Rich. If someone wanted to learn more about the book, more about you and what you're doing, where would you like for me to send them.

[00:30:19.100] – Tom

Thank you. Yeah, it's thebalancedwealthapproach.com. It's literally the title of the book.com. And they can learn about the book. There's a questionnaire, there a scorecard they can fill in, and then that can begin their journey, as we like to say, we can bring you to the door of health and wellness. We can open the door, but they have to walk through that door. And the great work that you've done, listen to people and the experts that you have on. And I'll continue to gather information from my clients because I think this is just the first inning of what's going to be a great long term run for all of us.

[00:30:53.730] – Allan

Great. Well, you can find that episode at 40plusfitnesspodcast.com/587. Tom, thank you so much for being a part of 40+ Fitness.

[00:31:03.870] – Tom

Thank you, Allan. And thank you very much for sharing some time with me. I enjoyed it immensely.

Post Show/Recap

[00:31:17.370] – Allan

Welcome back, Ras.

[00:31:19.010] – Rachel

Hey, Allan. This is a topic that we've talked about a little bit lately. It's so important to just like Tom said, be the CEO of your own health. I mean, when you prepare for retirement, there's more to retirement than just having enough money to live on. You need to have the health to take you through those retirement years.

[00:31:39.330] – Allan

Yeah, that whole live part.

[00:31:41.490] – Rachel

Yes. That's pretty key.

[00:31:46.450] – Allan

Yeah. I think a lot of people look at retirement and they're like, okay, did I save enough money to last? And how long am I going to be here? We started it years ago, probably most of us. Put a little bit away in your 401k, do a little bit here, do a little bit there. And then as you start getting into your forty s and fifty s, you really start thinking about socking away a little bit more, pushing up that amount so that you're kind of building this portfolio. But so few people think about their health and fitness in a similar light of, what am I investing today for my health and fitness? And it's time. It's effort and sometimes money when you need that assistance and accountability. And so few people are doing it, they're sort of just coasting along and it's like, ho hum. And it's sort of like, I guess I'm going to work for the rest of my life kind of mindset. But that won't be nearly as long as you think if you're not taking care of your health and fitness.

[00:32:48.560] – Rachel

Oh, that's so true. Just to play devil's advocate here, I can tell you that in my 20s, I was also focused on my career and didn't have to think too much about my health. In my 30s, when I was having kids and raising young children, my time and attention was focused on them, and my husband Mike was focused on his career. So it's like years tick by before we really even needed to think too hard about our health. And then before it's too late, you want to get into that. It's just important to maintain that focus. And it's better in your younger years. It's easier to start a running regimen or a weightlifting regimen or any sort of program when you're younger and healthier and you can bounce back faster.

[00:33:37.040] – Allan

It is easier to be fit and stay fit. So maintenance is an easier way than starting later in life. But the point being is you can. It's the whole point. They'll tell you it's like, don't think you've lost it. You can still be putting money away for your retirement now, whatever you can. And it's sort of the same thing with fitness. It's like what you can with what you have right now, because every little thing you do, every little investment chips away and puts a little bit in that bank to make you healthier and make you more fit. And so as you start looking at not just how you want to live that other part of your life, the second half or the rest of it, however you want to line that up, basically, what quality of life do you want to have? What do you want to do and enjoy? You know, I've talked about my grandfather, 80 years old, had to quit playing golf because he couldn't. And he kept living. He kept living, and he lost the most important thing in his life, which was golf, and he lost it, and he lived for another 15 years.

[00:34:45.610] – Allan

As you kind of look at this and say, I want the life and I want my retirement money to last as long as I live. But you should also want your health span to last as long as you live.

[00:34:57.920] – Rachel

Oh, gosh, yeah.

[00:34:59.220] – Allan

Because I can't even imagine sitting there and withering away.

[00:35:06.320] – Rachel

Oh, yeah.

[00:35:07.250] – Allan

As an older, frail person losing independence, looking at that jar of pickles I bought that I can't open and waiting for someone to come by and open it for me, not being able to take care of myself. I can't even imagine spending years, potentially years and years of my life in that state. But if you're not doing something today, you're setting yourself up for stuff just like that.

[00:35:35.040] – Rachel

Oh, for sure. It's so easy to get busy and focus on our careers. But what's going to happen when you don't work anymore, when you actually quit work to be retired, and you've got all this time on your hands, and what are you going to do?

[00:35:50.510] – Allan

We're going to go to the Mediterranean and do these hikes, and we're going to go to Machu Picchu and do that thing, and we're going to do all those things right, but then we're not doing anything now. So it's like you get to 65 and it's like, wow, I can't walk up the stairs without getting winded. There's no way. And then, yeah, you go on that cruise. But leaving the cruise ship. Someone's got to drive me to the top of the volcano because I can't walk there. So now it's not the same experience, it's not the same as what you thought. And it just becomes harder and harder because you're just not doing the things necessary to be ready for those. So if there's something about your retirement that excites you, start working on it right now. Yeah, it's the whole thing. It's like, yeah, I'd love to do these cruises and do this thing. Well, you got to save the money for it, right? Well, it's the same way you've got to build your stamina and your energy and your strength to be able to do those things and enjoy the life that you are meant to enjoy.

[00:36:49.760] – Allan

You worked hard, you worked hard your whole life to save for that retirement. And as you said, seven figure portfolio and you're 6ft under is not the plan. So you got to start doing things on both sides. But health and fitness is probably an area where many of us might have be falling short. We're probably saving plenty of money in our 40s and 50s because we know it's coming. We a little bit behind the curve on this stuff, but we're doing it. And this is the same way. Start investing the time and the effort and in some cases money to get where you want to be.

[00:37:24.880] – Rachel

Yeah, for sure. That sounds great.

[00:37:27.630] – Allan

All right, well, Ras, I will talk to you next week.

[00:37:31.410] – Rachel

Great. Take care, Allan.

[00:37:32.950] – Allan

You too.

[00:37:33.880] – Rachel

Thank you.

Music by Dave Gerhart

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Less...

Let's Say Hello

[00:02:48.870] – Allan

Hey, Ras. How are you?

[00:02:50.700] – Rachel

Good, Allan. How are you today?

[00:02:52.810] – Allan

I'm doing okay. Got some news. I've been really quiet about this over the last 20 plus weeks. In my meantime, when I'm not doing anything else

[00:03:06.090] – Rachel

when is that, by the way?

[00:03:08.910] – Allan

I set up to take the Precision nutrition level two on my way to being a Master Health coach. But I I passed my final last week for my level two.

[00:03:20.100] – Rachel

Congratulations.

[00:03:21.160] – Allan

I basically been so I was for the last 21 weeks, I've been spending about 8 hours per week on this course. It's pretty intense. I would basically kind of put it up there and say I was taking multiple college courses at the same time to do this because it was pretty deep. I printed out their text just from the lectures. It was 180,000 words.

[00:03:48.490] – Rachel

My gosh.

[00:03:50.650] – Allan

Just to kind of give you an idea of how much content was in this. And then it was a final 100 multiple choice questions that you go through. So I passed that test, and by the time you're listening to this episode, I'll have my level two and be working towards my Master health coach with precision nutrition. So I'm pretty excited that that's over.

[00:04:15.410] – Rachel

Yeah. Wow. Well, that's fantastic. Congratulations. That's really huge.

[00:04:20.600] – Allan

Thank you. And it basically ups my game a lot, because from that coaching perspective, it kind of gives me the it's not so much the credentials, it's just the things I learned during that 20 weeks and how I can apply that for my clients and get them even better results. That's what I'm excited about. I know when I'm doing my coaching that I'm doing kind of that highest level of coaching that I can possibly do, because there's nothing harder. I mean, there's nothing higher, like getting to that point where it's okay, I'm the most credentialed I can be as a health coach, so health and fitness coach. So that's pretty exciting. Put all the tools in place for me.

[00:05:06.370] – Rachel

That's wonderful. Congratulations.

[00:05:08.550] – Allan

All right. How are things up there?

[00:05:10.370] – Rachel

Good. I mentioned last week that I was going to be running an ultra, and I did. It was 34 miles, and I had a great run. Earned first place in my age group. Set a two minute thank you. Got myself a two minute PR on this course. This is my fourth time running this course, and it was a great day with really terrible conditions. We got rained on at the beginning, and then it only got colder from there. You had snow in the afternoon, so it was kind of a muddy mess, but it was wonderful. Painful, but wonderful. It was a good run.

[00:05:49.870] – Allan

Yeah. You add the poor weather and the PR, that's pretty impressive. You you must have trained really hard for this one.

[00:06:00.070] – Rachel

You would think so, but not nearly as hard as when I trained to run this the first time. But it's been four or five years since my initial PR on this course, so it's not so much the training as the wisdom from the last few years. I really know what I'm doing, so I can persist through some uncomfortable conditions. And truthfully, this kind of gets me a little bit fired up for pushing my limits on a good weather day. I mean, if everything went better, then how much faster could I have been? There's just a lot of room there to ponder that, so I'm pretty excited about whatever might come next. I have no plans, but I am definitely thinking about something.

[00:06:48.660] – Allan

Good. I saw Mike had post a picture of your prep and then his prep. I think he had a PR too.

[00:06:58.600] – Rachel

Yeah, that was a good picture. Yeah. I've got a lot of gear to run 34 miles. I need quite a bit of food. And I had a couple of wardrobe changes because I knew that it was going to get rained on and they provide drop bags. So I had a change of clothes as needed on the course and everything. And Mike had all the celebratory beer ready, so his prep was a little different than mine.

[00:07:24.370] – Allan

Some of it was left when you got done.

[00:07:26.370] – Rachel

At least I got a beer out of it. Yeah.

[00:07:28.160] – Allan

Okay.

[00:07:30.370] – Rachel

Well deserved.

[00:07:31.850] – Allan

All right. Well, are you ready to have this conversation with Dr. Hood and Dr. Price?

[00:07:37.860] – Rachel

Sure.

Interview

[00:08:29.570] – Allan

Lee, Nathan. Welcome to 40+ Fitness.

[00:08:33.100] – Dr. Price

Thanks, Allan.

[00:08:33.740] – Dr. Hood

Great to be here.

[00:08:35.000] – Allan

Yeah. Your book is called The Age of Scientific Wellness. And as I was going through the book, I just had a whole lot of thoughts. And what I liked about it was I would be thinking something like, well, what about what about what? And then here you guys go and answer that question. So you answered a lot of my questions about health care and well care and kind of the direction some of this stuff is going or very much could go. And even though it sometimes has a feel of science fiction, I see enough around me otherwise to say that you guys are probably spot on. That change is coming fast, and it's going to be kind of interesting how the next, I would say one or two decades shapes up as far as how our visits to our doctors go and how we personally can step in and make some changes for ourselves. So I appreciate this book because it's a lot of food for thought and it covers a few things that I really want to get deeper on. But this is a really good book.

[00:09:42.170] – Dr. Hood

Thank you.

[00:09:44.570] – Allan

Now, in the book, you compared and contrasted health care, which is what we have pretty much today, which is get sick, have a symptom, go to the doctor, take a medication, usually for the symptom, not always for the cure, and then rest and repeat. Literally, we just keep going back and then for a lot of us over the age of 40, it's counting how many pills you have to take in a day. And then we sit down and start having those conversations. Well, I'm on seven, I'm on eight. My doctor changed this one and put me on these two, and this one gave me that, so I took that. And it just seems like a case of whack a mole, if you will, and you go into that and then the look forward of what we could have is what you call wellness care, which speaks to wellness, the transition, and then disease. Can you kind of talk through that and why that different paradigm can completely flip the way we look at medicine?

[00:10:52.990] – Dr. Hood

I think the fundamental idea is that health care in the future is going to be data driven. And the idea that we will follow each individual on a regular basis every three months or every six months, and we'll assess blood analytes and the gut microbiome and do digital health measurements. And these measurements will let us assess the three different features of health. So I see your health trajectory as made up of three components. So most of us start in wellness, whatever that means. Then often we will go through a transition to disease that will progress and then reverse itself and take us back to wellness. So the data driven transitions we can assess are wellness are the transitions and disease itself. And what's exciting about data driven approaches is they let us optimize health for each of those three phases. For wellness, typically, we would guess that ordinary person, even appearing well, would have maybe 30% of the potential wellness. And there are many actionable possibilities that come from data driven wellness that can further optimize that. And a very interesting question is it's up to you and how far are you going to go in being well?

[00:12:36.770] – Dr. Hood

The second point that's really fascinating is because we can detect in the blood transitions that occur years before you get the clinical disease, there is now the opportunity to think about reversing disease when it's simple at its earliest stage, so that you never get to the disease. And a really attractive idea of data driven wellness is we can deal with many, if not most, chronic diseases in this fashion. And then, of course, for disease itself, the enormous data density gives us fundamental new insights into how to deal with disease more effectively. And many people are doing that. But the whole idea is, in the future we will follow you, whether it be with fitbits and aura rings and things like that, and or with blood and your microbiome analyses. And they will give us the power to optimize your health.

[00:13:47.190] – Allan

So, Lee, on a simple basis, just to kind of walk us through this, can you go at a high level and say, okay, we know that there's a transition that occurs that puts us into diabetes. We've identified it now as prediabetes. But can you kind of talk through that line of how that would work for someone who's maybe going in that direction and how that transition would appear?

[00:14:09.320] – Dr. Hood

Nathan, do you want to take that one?

[00:14:11.390] – Dr. Price

Sure, I'd be happy to. One of the ways that diabetes is a great example because it's probably where we've worked this out the best just in medicine today, because there is at least a diagnosis that you can make or an evaluation of prediabetes and that relates to the ability for us to control insulin. So to look at controlling sugar via the secretion of insulin primarily. And so when you look at that, you can transition from waiting to some late stage disease and late stage diabetes care is pretty horrific, right? It's foot amputations. They're up like 40% in the United States over the last decade or something like that, which is just terrible. But if you're looking at prevention and earliest on, you can deploy new kinds of devices. So continuous glucose monitors, for example. You can wear a device on your arm, you can go in it's painless for a course of two weeks, and you can monitor how your body's response to sugar is being managed. You can get a sense for how good are you at that. You can actually look at exercises and changing your diet or even some supplements or drugs or different things like that that can have an effect on trying to blunt or get yourself to be better at controlling glucose.

[00:15:29.010] – Dr. Price

And as you improve that metabolic health, as you focus on wellness, that then reduces the likelihood that you would transition to diabetes. Now, if you want to broaden out from that and this is some of the things that we get into in the book. So we did a paper for the Proceedings of National Academy of Sciences a few years ago, and we looked at the genetic risk for 54 different diseases and conditions. And what you find is that even if you look in asymptomatic people, you can identify differences that manifest themselves as a function of being at high or low risk for a disease decades before the disease manifests. And in many of these cases, they relate to mechanisms that are happening early in the process that might be reversible. Just to give one example, we looked in the blood of people and stratified them by risk for coronary artery disease. Turned out there was only one protein whose concentration of the blood was correlated with that strength of genetic risk. In this case, that was PCSK nine. Well antipcsk nine drugs are the biggest that's the biggest blockbuster drug in that space in the last decade.

[00:16:37.810] – Dr. Price

And you could see that, and it's the only signal when you look early. And traditionally in medical research, we're always looking late. And you have these hundreds of changes, maybe thousands of changes that you're trying to suss through to figure out what matters but you're seeing a very complex picture at the end when you look early and you have more of a movie where you're starting from wellness to the early transition. The number of signals is small and the interventions are easy. So going back to diabetes, late stage can be loss of pain sensitivity, and all the problems that come with that early is fixing your diet, eating more fiber, things that are very simple. And that's kind of the whole paradigm, which is to shift healthcare much more towards understanding these fundamental processes and how good we are at them, like the control of glucose. But it could be combating oxidative radicals. How good are you at how well is your DNA repair happening? Are your telomeres shortening faster than they should, et cetera, et cetera, et cetera, aimed towards how do you live as long and healthy a life as possible?

[00:17:43.910] – Allan

Now, the term scientific wellness actually appeals to me a lot because we've seen a lot of things, I think, over the last few years and through nutrition my whole life. That really wasn't science. It was marketing, if you will. But that said, in looking at scientific wellness and you talked about data driven, which I think is important, there are three bits that you got into. One being the genome, which is just basically our genetic makeup. The phenome, which is the first time I've heard that term, actually. My spell check on my computer doesn't even know that word. I guess I'm not that dumb. And then digital measurements of health, which I think you brought up a little bit, was the fitbit or the continuous glucose monitor, those types of things. Can you go into those and how that data is going to because it sounds like a lot of data.

[00:18:45.910] – Dr. Hood

Sure, I can start on scientific wellness. The idea there is that humans are terribly complicated. And if you want to be able to assess that complexity, the best single approach is this belief that blood is a window into health and disease. Because blood bathes all your organs. They secrete molecules, be they proteins, or metabolites into the blood. And if you can learn to read the quantification of those analytes, you can assess the health of at least 25 different organs in the human being. So the idea then, with scientific wellness is we can look at proteins and we can look at metabolites that give us deep insights into how biological networks in different organs and for different physiologic functions actually operate in what state they're in. And we can begin in a scientific fashion to ask, are there ways that we can cure this kind of deficiency? And simple example of that was when I had my analytes analyzed. I found I was incredibly low on vitamin D. And vitamin D is really an essential vitamin for preventing diabetes and cancer and cardiovascular disease and aging, a whole variety of things. And what I was shocked at is when I used the normal doses on a regular basis of 1000 international units to bring me back to normal, it didn't phase my blood levels at all.

[00:20:45.620] – Dr. Hood

And it turned out that in addition to low vitamin D in the blood, I had two genetic variants that blocked the uptake of vitamin D. And the one effective way of getting around that was to use very large doses, 15,000 international units. And that brought me up to normal. And then I had to use more than normal to maintain that kind of level. And those are all beautiful examples of how we assess assay blood analytes and could change the dimension of wellness in a single individual. And in fact, in our initial studies for scientific wellness, we were able to correlate six different types of data and come up with 2500 correlations. And going to the literature with some of the correlations between those various combinations led to actionable possibilities that could be then given to individuals. And if they did them, they improve wellness in a voided disease. But the ability to quantitatively assess the blood and draw inferences about general functions and specific organ states, I think is a very important idea. Nathan, did you want to continue with the rest of the question?

[00:22:20.110] – Dr. Price

Sure. So there's many things that you can get into that I think really guide a person as they're trying to implement something like this in their life or have an impact. So one of the really interesting elements that came out of analyzing these data and it does bring together genetics and the blood measures was when we looked at people who were going through a program aimed at improving their wellness, this scientific wellness program that we were running as we did that, what we found was that you can take a genetic prediction, let's say, of something like LDL cholesterol in your blood. Right.

[00:22:54.730] – Dr. Price

Millions of people are on statins to control this. And so when we looked at that, it turned out that you could predict in advance who was able to lower, for example, their LDL cholesterol by lifestyle interventions. And the key variable turned out to be that if your genome predicted that you could be low but you were high. In other words, if there was a gap, you could change it. And if your genome predicted high and you were high, there wasn't a gap, you couldn't. Now, one of the things that's really fascinating is that if you think about medicine, and something as common as that is in our healthcare system today, essentially no doctor uses the genetic information about what the genes say about your level of LDL cholesterol. It's everyone is treated the same, and it turns out that their responses are totally different. That's also true for HDL cholesterol, so called good cholesterol you're trying to raise. It's true for things like hemoglobin, A1C, for the transition to diabetes, because there are genes that predict the residence time of red blood cells, for example. So the average is 120 days. But some people will be more at 110 or 130.

[00:24:05.460] – Dr. Price

Totally predictable by genetics. So the main diabetes marker is hemoglobin, A1C, which is a molecule that's circulating, and it accumulates these sugars, essentially, that go onto the edges. And the amount of time you have makes a difference in how long that accumulates. So based on different genetics, a person could have the same readout and be at high risk for transition to diabetes, and another person could have the same readout and be at relatively low risk for transition to diabetes. Totally predictable by genetics and so forth. So there's many, many things that you could get into.

[00:24:38.810] – Allan

Now, Lee, you came up with the concept of 4 P medicine. Could you walk us through that? Because I think this is where the rubber hits the road. This is where we actually start getting this stuff done.

[00:24:53.390] – Dr. Hood

I agree with you completely. Back in the early 2000s, when we were just starting the Institute for Systems Biology, and the mission of that institute was to take a systems or global holistic approach toward both wellness and toward disease. We also took a systems approach to thinking about health care in what are the most fundamental elements of health care we need that are absolutely necessary. And we came up with the four P's. So prediction, the ability to predict whether or not you might be susceptible to a disease, and if so, the second P was prevention. How can we deal with that disease and maybe deal with it before it ever manifests itself as a clinical entity? The third one was personalization because it was clear from day one that humans are a unit of biological organization and health had to be focused at individuals because different individuals differ in every way, and their genetic and their genetics, their behavior, their environment and so forth. So these first three PS, prediction, prevention and personalization, really are the scientific meat of what this data driven health care is all about. We think after the Air Veil program, where we, over a four year period, brought 5000 people to scientific wellness and accumulated data clouds, we think we understand very well how to approach the science end of things.

[00:26:48.500] – Dr. Hood

But the fourth P is participatory, and the question there is, how do you get the system to change? How do you persuade patients to actually have the initiative to participate in scientific wellness? How do you persuade physicians to take advantage of it? Many have skepticism about it, they don't see it as real science or I think others are actually intimidated by the fact, namely genetics, that it entails a lot of things they don't understand and they're very hesitant to get involved. How do we persuade the physicians, how do we persuade the healthcare leaders? How do we persuade pharma and the technology companies that this is going to be the future and get them to focus on wellness and prevention rather than just on disease by itself. How do we get those that are the FDA, that are Adjudicating drugs and all of these things? And how do we get the whole educational system? The training of MD's has to change in a really radical way. When I went to medical school many, many years ago, I was appalled later to learn I never had a course in genetics. Fortunately, I was an undergraduate at Caltech and I had a good background, but I never had a course on diet or the gut or any of these kinds of things, or I never had any kind of course that ever mentioned the word wellness.

[00:28:28.860] – Dr. Hood

And frankly, I think a lot of things I was taught then is what our students are getting taught today. And there is enormous resistance in the medical schools to say, well, we're all filled up. We have all these courses because we have all these requirements and we don't have time to think about anything new. So anyway, how do we get the senators, representatives, the executive to realize that if you spend money today on prevention and wellness, tomorrow you'll have enormous savings and strikingly increased quality of health care? So those are the challenges of the four P, science on the one hand, but sociology and economics and psychology and so forth, on the other hand. So how do you get a system that's embedded in paying doctors according to how many times they touch the patient to change to one that's value based, where the doctors get paid on how well they keep all of their patients? And these are the challenges that come with data driven health.

[00:29:49.950] – Allan

Well, kind of. One of the things I took away from it was this is proactive rather than reactive. This is an opportunity to get out in front of everything and just tap it out before it becomes a fire. There's a hot spot and just tap it out now. Don't let it become a wildfire later. And I think the last P is really the answer. And the thing is, we have to participate. We have to be our own advocates in the way that we're taking care of ourselves and the things we're doing. And I think as tools become available to the patient, then the patient is really the one that has the best opportunity to drive a lot of this because generation before mine would have gone and the doctor says, okay, we're going to have to amputate your foot. It's like, okay, which one? And then you weren't going to say no. You were going to say, can I get a second opinion? You weren't going to question it. It's like, well, the doctor said so, therefore we are. And it's the jump, how high kind of mindset. And now we are a lot more likely to question things and do that.

[00:31:06.540] – Allan

But it goes back to the doing because if your doctor does come to you and says, okay, look, you have these analytes and this biology, this genome that's going to basically says that if you don't do something you're going to get diabetes. And for most of us that that's happening to, we know someone in our family that went down that aging curve and it's not pretty.

[00:31:36.510] – Dr. Hood

No, the other thing I would say, I think a big part of fourth P is education and we have really focused on that in very important ways. One, Nathan and I with others have written a textbook on systems biology and systems medicine and it's an ideal textbook for medical students and graduate students of various kinds to take up. It's written for someone who doesn't understand all the intricacies of biology. A second thing we've done with an education group I started more than 20 years ago at ISB now is we've created from the systems biology text on the systems Medicine chapter, a 20 module course for high school students that gives them deep insight into systems medicine and P four, healthcare. And I'll argue that and we'll be starting to use that course this year and be able to distribute it to many schools. I'll argue that that course will train students who will know more than 95% of physicians about the future of medicine and really where it's going to go. A third thing that we've done is the book that we're here talking about. And a fourth thing is that I've persuaded an Italian film director to make a 90-minute documentary on wellness over the last 5000 years.

[00:33:18.030] – Dr. Hood

That in a general sense talk about how our perceptions of wellness has evolved and where we are today with data driven health and what it means for you and in an artistic fashion try to appeal to people to activate this fourth P. That is I will participate in this kind of process. So we have lots of things going on that I think will be important in the educational process. But diving in and getting done these transformations is what we're all about. And I'm doing it from an academic side and Nathan obviously is doing it from the side of a wonderful company that's trying to bring health and wellness and prevention to people in small bits and pieces, which is one very effective way of doing it.

[00:34:24.290] – Allan

I want to thank you guys as I was going through your stories and what you guys have done to date is exceptional. But when that video comes out, when that's a documentary, when they get that done and they're ready to publish, that get me back in the loop. I'd love to have everyone back on the podcast and we can talk about that documentary because I think that's going to be extremely valuable and I'd like to help spread the word.

[00:34:53.310] – Dr. Hood

Okay, we'll take advantage of it. Thank you very much.

[00:34:58.590] – Dr. Price

Yeah, maybe if I can just add a little bit on that participatory piece, then, because one of the things that I could imagine listeners may be thinking, or if you start to encounter scientific wellness, I think you can see a lot of promise in it. But there might be questions of how do I easily implement this right? How do I make that something that's real in my life, that affects my wellness, my health, all those kind of things? And I think that so much of the onus of dealing with complexity of the kind we're talking about, really has to fall on the side of those of us who are working on the algorithms, the products, so forth, to try to make this as simple as possible. And so that's one of the areas that I think we're really focused on, on trying to deliver that out to people. And so some of the elements can also just be very minor, practical. I'll just share one example. So microbiome testing, lee and I are both big believers in microbiome and its future, and it's turning out to be important for so many health issues that people are getting into.

[00:36:04.980] – Dr. Price

But the process of getting a sample, for example, is not typically the greatest, right? So listeners that aren't thinking, what do. You have to do?

[00:36:16.710] – Dr. Price

You get a bucket or a piece of paper, poop on the bucket,

[00:36:20.510] – Allan

plastic bag,

[00:36:21.890] – Dr. Price

take a little shovel. You got to dig it up. You got to put it in a little bile. You got to close it. Some of the tests require freezing. I don't know what you keep in your freezer, but I tend to keep food there, so it's not like the greatest spot, et cetera. So just to give an example, then. So that's an issue. So one of the things that we sat around and this was some work that we did at Thorne but basically to just say, well, what's the easiest way we could do a microbiome sample? Which led to the invention of something that we call the microbiome wipe, which is basically what it sounds like. It's basically toilet paper made out of a special polymer. So you wipe like normal. You throw it in a vial, you shake the vial, within 10 seconds, it dissolves away. So what that was was a way to get, like, the easiest way we could possibly think of to get a sample. Now, what that does is that lowers the barrier to people doing it. And we saw a big uptake. In fact, on another podcast, Sarah Godfrey was interviewed. She's a prominent physician and she's treating a bunch of NBA players.

[00:37:24.260] – Dr. Price

And she shared this anecdote that the NBA players would never do the microbiome samples for the reason we just talked about. Because it's gross, I guess. Or they didn't want to do it, but when switching to the wipe, they all did it and it was like, not a problem. So, anyway, not to get too bogged down by that, but ways that we can make the blood sampling easier so we can do this now, fairly painlessly at home. You can get your microbiome sample. You can wear a CGM, you can wear your wearables of all the various kinds you've got. There's so much of an ecosystem that's growing up around this where a person has to take ownership of their own health. But the number of companies and groups that are working to try to take so much of this science and make it available to people and give them things that are science backed and easily accessible is just growing immensely. So there's a whole enterprise on the discovery side that we're talking about. And also on the delivery side in.

[00:38:32.390] – Allan

The book you brought up Flexner's report, and this was a report basically on the medical system way back when. Nathan, what would your thoughts be of something like that actually happening today? That there be someone just sit down and say, okay, we're going to look at this holistically to make a change because I just see so much opportunity for pushback. And you even mentioned that in the book. Pharmaceutical companies are not going to want to make 24 different types of medication for an item when they know, okay, this is only going to work for one of 24 people, and each of those other 24 people are going to need a different medication. They'd rather just sell 24 and then have those people that it didn't work, switch to something else and work their way through it.

[00:39:19.010] – Dr. Hood

The simple extrapolation from that is just to say we have to fundamentally change how pharma discovers drugs and we have to do it at a different scale and with different selective processes that can generate drugs extremely rapidly and make it well within the cost structure of the rare disease genes, which is one in 200,000 people. We want to be able to treat them. So I think that's one really important thing that we have to think about.

[00:39:54.750] – Dr. Price

Yeah, and the point you bring up is really important because there are so many entrenched interests that are centered around our current healthcare system, which is totally focused on disease. And I was on a panel right before the pandemic with former chair of Harvard Medical School and I really like the way he said this and he said that healthcare is the only industry that does not study its own gold standard, which is wellness. And that's really what we're talking about. But because that has been set up the way that it is, you do, you have billions and well, it's healthcare, right? You have $4 trillion in the US alone set up around that kind of process. So trying to change it is an incredible enterprise and undertaking. So we have to do both. Try to advocate because as individuals, there's no doubt that a healthcare system centered on wellness is better. Like if anyone could make the trade off between a drug that slightly improves your decline during Alzheimer's versus never getting it as a person. Any of us would take never getting it right. I mean, the value prop there is incredibly simple, but getting there is very hard.

[00:41:11.100] – Dr. Price

So there are certain things you can do within the context of the certain system. Lee was alluding to this in terms of you can help drug companies have much higher hit rates on getting favorable drugs. One interesting thing that people are waking up to now is the microbiome metabolizes away about 13% of drugs. So you could be taking a drug and it's never even getting to you. Your microbiome changes, it eats it, and it doesn't get to you. And it depends on the kind of species you have in your microbiome. That's like one small example. There's all the others that we've gone through in genetics and so forth. So it does help the drug companies upstream if they have drugs that are failing for these unknown causes. You're exactly right on the market segmentation, which segments their market, so they're not financially incentivized towards that. And so we get into a number of these things in the book. But this was also partly the point of writing this book, honestly from Lee and my perspective, where we're trying to advocate for a lot of this change in how medicine is done. Part of that is that we have to create a movement of individuals, of the patients and individuals themselves that basically demand a health care system that does much better for them.

[00:42:31.360] – Dr. Price

And we're so much in the situation in healthcare of a very uneven power dynamic between, say, the physician and you as a patient, and there's an element of trust there, and there's an element that's happening. But it does put you in this situation of if you really want to take advantage of the revolutions that are happening right now in medical science, in delivery, in ways that we can optimize our health spans and all these things, you do have to be an active participant and sort of seek that out. And then as more and more people are seeking that out and demanding that, that changes the underlying economics, and then that is what will really drive the top, so to speak, of the medical hierarchy to have to pay attention to this. I don't think it's going to be a top down driven revolution. It really has to be bottom up. I don't see there's any other way.

[00:43:24.690] – Dr. Hood

You know, the other thing I'd add to this, Nathan, is another way of looking at it is data driven health really is going to achieve two things. One is enormous increase in quality of individual health care, and we need it as the top 20 developed nations, we're right near the bottom, even though we spend much more than anyone else. But the second really important point for converting the system to a health and prevention mantra is the idea that we can save the health care system enormous amounts of money. And I would say if you take the five major cost driving things that we have to deal with today, they are one, the quality of health care. Two, the aging population. Three, the explosion of chronic diseases for the inequity that arises from data being generated only in the Caucasian race for the most part so far. And then five, this impossibly escalating crease of cost. But on the quality, scientific wellness is going to be transformational. On the aging, we now have a metric for aging that not only tells you your biological age, the age your body says you are, its metrics actually tell you how you can optimize your aging process.

[00:45:02.930] – Dr. Hood

And more than that, the ability to prevent chronic diseases before they get started could be a transformational event in cutting down the frequency of those kind of things. And of course, with big new programs, we're going to balance up the equity equation, which is utterly critical because different races have really strikingly different genetic consequences for disease and so forth. And our feeling is, with these things together, you're talking about saving trillions of dollars, especially because chronic diseases alone cost 86% of our health care dollars. And suppose we cut to very small fractions of major chronic diseases and things like that. So that's going to appeal to the payers. And in many ways, the payers could really be the catalyst for driving a transformation from a sick health care to a wellness and prevention health care.

[00:46:08.310] – Allan

So a relatively small investment today is going to pay off big time for us in the future.

[00:46:13.380] – Dr. Hood

Big time for us. Absolutely.

[00:46:16.410] – Allan

Now, I have this question I ask all of my guests after reading your book. I'm so super excited to ask you gentlemen these questions because you've seen the data, you've seen more data than just about anybody else that I've ever asked this question. So, Lee, I define wellness as being the healthiest fittest and happiest you can be. What are three strategies or tactics to get and stay well?

[00:46:46.450] – Dr. Hood

Well, I would say that one strategy to go after wellness is scientific wellness. We now have what will be an exponentially increasing analysis of wellness trajectories and they'll lead to actionable possibilities. From the era Fail 5000, we had perhaps 200 actionable possibilities that we validated by taking correlations and going to the literature and verifying them with the data that we're proposing to do. We're putting forth the idea that we should do a million person project with a genome phenome analysis, and in a sense, it's a second genome project. Do it over ten years, we'd have all the validation we need for everything I said about quality improvement and decrease in cost and things like that. I'm arguing that we'll have tens of thousands of new actionable possibilities that will have to be delivered by AI to do two things to physicians. One, explain what it is and what's necessary. But two, give the validation in a simple way they can understand and of course they then can bring these things to their patients. I think a second thing that's absolutely key is aging is absolutely the strongest correlation with all chronic diseases. If we can cut down aging, we can cut down strikingly the transition to chronic diseases.

[00:48:30.170] – Dr. Hood

So, I mean, not only will you keep yourself younger and healthy, you can begin to imagine that many people could go into their 90s or hundreds and be mentally agile and physically active. And we'll have to redefine what retirement means. We'll have to redefine how many jobs you have during your lifetime and so forth. And of course, the data driven part will deal with the racial inequalities and data that exist out there. And the million person project could formally prove in very powerful ways literally trillions of dollars we could imagine saving in health care. I think scientific wellness, I think optimizing aging process. I think avoiding the chronic diseases and dealing with the racial diversity. Because to give you a simple example, japanese are three to four times as likely to get Alzheimer's if they have two copies of a bad gene called ApoA four than Caucasians do. If you look at Latinos, they have almost no probability of getting Alzheimer's from two bad copies of that gene. So that shows you the striking differences that we must take into account for health for individuals of different origins.

[00:50:07.170] – Allan

Nathan, I'll ask you the same question. I define wellness as being the healthiest fittest and happiest you can be. What are three strategies or tactics to get and stay well?

[00:50:20.150] – Dr. Price

Yeah, so I'm just going to put aside at the moment like the three big obvious ones that we all know about physical exercise pretty much every day, sleep 8 hours every night and eat a nutritious diet. But then I want to give three that are more focused towards the kind of things we're talking about. So one is get a genetic profile so that you understand the probabilities of what are the most likely factors that might inhibit your health. The second is to measure the dynamics around especially blood and the microbiome that can be interpreted in the context of those genetics. And then by those comparisons, we've got to make this easier for people. But those comparisons make a huge difference in understanding where you're at relative to your potential and where you're at in the manifestation of the things that are likely to be the biggest problems for you. That gives you a personalized map for a return on your health effort investment, roughly. So where do you put your time and effort? That kind of a map lets you navigate around the most likely issues that would end in you're not having the long healthy life that you really want to.

[00:51:41.400] – Dr. Price

And then finally, I'm going to reiterate something that Lee talked about, which is do everything you can to reduce the pace of aging. And there's a lot of interest in this right now. And this involves both things like the various lifestyle things that we've talked about, but also there's a lot of interesting compounds that are available now that have the kind of evidence that they extend lifespan in a bunch of different animals. And we know they functionally hit very conserved pathways in humans. We're not far enough along to where we know for sure that this is going to have an impact on human longevity, but we won't know that until it's sort of too late to be useful for some of us because it just takes a while. But there are a lot of these that are coming out. And so if you look at all these different hallmarks of aging, if you want to try to control senescent cells, well, there's data that shows that quercetin and dosatinib can kill senescent cells. Like, that's an interesting one. NAD right. There's different molecules. NR disclosure Thorn sells that one, or NMN or things like this that you can use to try to increase NAD well, that's an important element of aging.

[00:52:57.670] – Dr. Price

Metformin is an interesting one because there's a big trial going on, the Tame trial nerve. Barcelona at New York is leading that to look at its effects on aging. So if I'm in this space, you want to keep yourself educated and look at the data as it emerges. But there are a lot of possibilities, including things like intermittent fasting and so forth, to think about how do I slow down that clock. And because of different biological age measures, and there are multiple of those, there's the epigenetic ages that are probably the most famous now. We do one based on clinical labs that I think just gives more actionable possibilities right now. But there's a lot of these abilities to monitor that and just track that over time and try to stay biologically as young as you can as that science is moving quickly, and it's not there to where we kind of where we would like to get to in a Sci-Fi type future. But you can do things that materially reduce your risk of dying. And that's the definition of aging that I'm using here, which is just what's the likelihood and give any given year that you will die.

[00:54:06.050] – Dr. Price

And that goes up as you get older. And so if you can just flatten that curve, it makes the likelihood of a long, healthy life much higher. And so those are the three things I'd focus on.

[00:54:17.170] – Allan

Well, gentlemen, I agree with your conclusion and your book The Age of Scientific Wellness that we're right on the cusp of something exceptional happening. You've convinced me. If someone wanted to learn more about you and learn more about your book The Age of Scientific Wellness, where would you like for me to send them?

[00:54:39.610] – Dr. Price

Yeah, so for me, obviously, just pick up a copy of The Age of Scientific Wellness wherever you get books. In terms of my work on trying to drive product development to make scientific wellness accessible, thorne.com thorne.com is where you'd find that.

[00:54:59.150] – Dr. Hood

For me, I would just say that I think our book really is the best place to see what we've done in the last 15 years in terms of pushing this idea of scientific wellness and so forth. But I can be reached at lhood@phenomehealth.com.

[00:55:22.230] – Allan

Gentlemen, thank you so much for being a part of 40 Plus Fitness.

[00:55:27.370] – Dr. Price

Thanks so much, Allan. Great to be here.

[00:55:28.990] – Dr. Hood

It was a pleasure. Enjoyed your questions.

Post Show/Recap

[00:55:33.850] – Allan

Welcome back, Ras.

[00:55:35.490] – Rachel

Hey, Allan. That was a great interview. And I probably could have listened for another 20 30 minutes. I love listening about genetics and the potential that it could deliver in our existing health care system. I actually prefer the word wellness care, like they had mentioned in the beginning. I mean, there's just so much potential for getting patients healthier earlier with a personalized insight into their genetics and other data.

[00:56:06.070] – Allan

Yeah, I actually had another question on the plan, but we've gone so far. It would have probably gone another 20 30 minutes if I'd ask my final question. So it was what it was. But, yeah, this was really interesting because the technology with AI and data and knowing the genome and all the other data points that we can collect now relatively inexpensively with a watch or a phone or ring, there's a ton of opportunity here for us to do something. And kind of what was really interesting we didn't go deep on this, but Flexner's report was back before there were really good medical schools, there were medical schools. And for the time they were what they were. He did a tour around the country looking at all of our medical schools, and he tore them a big one. He ripped them up in some bad situations. Like, he went into one and he asked to see their lab. See what lab? The lab. And the guy says, Well, I can bring it to you. And he carried in one piece of equipment. This is for a major medical school. Not like a no name medical school either.

[00:57:22.820] – Allan

Like one of the better ones. People thought it was the better one at the time, and they didn't have a medical lab, which means all of the doctors that they were graduating had no idea how these labs were run. They had no idea how to read the results because they had not been trained to do these things. So he wrote this report, and it changed the way medicine worked across the country and the way medical schools were set up. But like most things, you solve one problem, you kind of create another one. And so now we have standard of care and we have all these rules, and so our doctors have to follow these things. And it really kind of hand holds them to say they see a problem, the symptom solve the problem. The symptom it's the symptom based sick care. That's binary. Are you sick or are you well? And it never really looks at as a continuum to say you're well, but you're moving maybe towards getting sick. If we catch it early, we can reverse this. So it's the difference between catching it when it's stage one cancer or even before that.

[00:58:27.810] – Allan

I mean, once there's like, the environment for cancer to form and they know that's happening, reversing that environment versus catching it when it's stage three or four when symptoms finally start showing up.

[00:58:43.620] – Rachel

I love that concept. Early detection, especially in terms of cancer, is so important. Everybody knows that. But they also mentioned we know pre diabetes. That's the exact same thing. And we're trending towards pre not we, you and I, but people are trending towards pre diabetes. But what if we could even go earlier than that to make some other assessments of our blood sugar levels? And not even just diabetes. There's the cholesterol situation.

[00:59:15.800] – Allan

Well, I picked diabetes because it was the perfect example that everybody can understand. You go into your doctor and you're like, okay, you're watching your A1C tick up each time you get this blood test. And the doctor is like, don't worry about it. Don't worry. It's ticking up. Don't worry about it. Until it hits 5.2, we don't care. Well, the fact that it went from four six to five, you should care. Something's going on. Your blood sugar is not being cleared as effectively as it was before. Something's changing. That's that thing, that's that transition where your body is starting to get to a disease state.

[00:59:54.910] – Rachel

But I want to sit on that for a second because I think I only have I'm 51, and I think I only have two, maybe three years of an A1C, because I don't remember how early you can be for them to take that test or to test for that. What if I could have had it when I was 40? What if I could have had it when I was in my 30s? And it's not even that. It's the cholesterol numbers and iron numbers and my thyroid situation. And there's just so much information if I had known it earlier.

[01:00:27.280] – Allan

That's the cool thing, is that data and the ability to get those tests is becoming more and more available. And so someone in their 30s can have this test. If you have children in their 20s, you can say, hey, for Christmas or for your birthday, I'm going to pay for this blood panel. And they're like, oh, thanks.

[01:00:50.190] – Rachel

Yes.

[01:00:51.710] – Allan

But the whole point is to say, yeah, I'm going to pay for this blood panel because I want you to have what you need to be next. I'm interviewing this guy now, and he's actually a financial planner, but he's looking at health and he's saying, a lot of my clients, they build up a seven figure portfolio, and then they drop dead before they even retire. He's like, so they care about the return on their investment every year. And so he's talking about in terms of what we talk about, generational wealth, how can I give this money to my children? Well, how can I give health to my children? How can I find health for myself and give health to others in my family, people I care about? And it's like, give them a blood panel. At least at that point they have data, and it's like, well, what does this data mean? Well, your A1C is already over five, and you're 31 years old or you're 40 years old. It's like, okay, we don't know what it was before, but that's a number to look out for and to tell your doctor the next time you see them, which should be soon, my A1C is already over five.

[01:01:53.940] – Allan

It's like, okay, you're approaching pre-diabetes. Don't worry about it. That's what the doctor is going to say, because the standard care says that's not a problem. It's not a problem until it gets over 5.6, then you're in pre-diabetes, and now we have a problem.

[01:02:08.650] – Rachel

That's the frustrating part, right? It is

[01:02:12.750] – Allan

but I don't think there's going to be a Flexner's report now, just based on the way culture of medicine is done, there won't be someone to step back and say, let's redo all this. What this has to happen. And the reason I kind of press down on the participatory part of the four P medicine is this is on you. This is on you to make decisions for yourself and to say, I would really like to know what my genome says. I would really like to know what my blood panel says and if my doctor is not asking for it. But I kind of know there's a family history of diabetes or I kind of know there's a family history of kidney problems or heart disease or this or that. Go get your calcium score. Go check out your cholesterol. Check out your blood pressure on a regular basis. It doesn't have to be perfect, but finding the data points that you think are important based on what you know about your family history. And unfortunately, I have a friend that was adopted. He didn't know any of that at the time, and so he went and got a genetic test and went on ancestry and things like that and found family has found his siblings and his mother.

[01:03:27.880] – Allan

And so not that that's what it's for, but I guess it is what it's for because that's what they're using it for. I have all these fourth cousins all over the world, everybody's my fourth cousin, I guess, thousands of them, hundreds, millions of them. But anyway, the point being is this data can be your friend, and there are some ethical concerns about how the data is going to be used by businesses and this and that. But right now I would just poo poo that. And I'd say, look, being afraid and cowering and not doing something for yourself just doesn't make sense in my mind. Take a moment. Get the data that you know might be important to you based on what you know. It doesn't have to be everything. You don't have to go do the genetics things if you don't want to, but at least go get a blood test, check your blood pressure, have a blood pressure monitor at home, almost nothing. A blood sugar monitor at home, almost nothing to invest in these little pieces of equipment. Test your blood sugar. If it's over 100 much after a meal, after you had some cake, it's going to go over 100.

[01:04:38.170] – Allan

But if it doesn't fall right back down, that's a warning flag. If your blood sugar, you wake up in the morning and you haven't had anything to eat and it's over 100, that's a problem. That's the transition to disease.

[01:04:51.910] – Rachel

Yeah. And it sure would be good to know that catching it early. I mean, we talked about early detection. The earlier you can figure this out, the better you can make the changes in your lifestyle to adapt or get earlier medical care, if that was really necessary.

[01:05:08.460] – Allan

And for some of these, we just know, okay, yes, if I exercised more, I am because I'm sedentary, or if I stop eating the crap and drinking the beer and doing all the things I'm doing, smoking or whatever else, you know, quitting, that is going to improve your blood panel. You just know it. So get the low hanging fruit out of the way. But then if you really want to start optimizing your health so you're here for your grandchildren and maybe your great grandchildren and you want to live the last half of your life well, then start working on making the easy changes, the ones you know about.

[01:05:48.740] – Rachel

Sure.

[01:05:49.200] – Allan

Get the blood panels, get the data, and then really start working on refining this. And it's not that you're going to be running ultramarathons or working out 6 hours every day, but it's just knowing the little things that you can do that are going to improve your health outcome. And I'm not going to say it's not medicine because there are some medications like metformin that have shown real promise. Vitamin D supplementation. Again, like our guest said, sometimes just a little bit of a supplement isn't enough. But you don't know if you need vitamin D until you get a blood test and you check, you see your blood levels are low, your iron level is low, your vitamin D is low, then supplementation might be the right thing to do.

[01:06:34.030] – Rachel

Sure.

[01:06:34.740] – Allan

And I mean, I'm not a doctor, so I can't tell you that it is the right thing to do. But I can say it might be. The right thing to do. Get the blood work to check, the blood work to check, and then talk to your doctor, and your doctor can say, yeah, supplement, and then we'll get it checked again in about three months. And then you might find, yeah, there's a reason why that supplement is not absorbing the way that it should. I need to maybe do more or look at this from a different perspective. And so having the data lets you make better decisions.

[01:07:04.480] – Rachel

It does. At the very end of your conversation, you talked about being more proactive than reactive. And if you can act early and faster to the results of your blood work, then it will save you a lot of time and money in the outcome. Later on in life, you don't have to sit and wait for heart disease or diabetes to come get you. You can be more proactive and make changes right now so that you don't have to get there.

[01:07:30.560] – Allan

And I would say every single one of us knows what that low hanging fruit is in front of us. Yeah, if you need help doing that, get help doing that for sure. Get the low hanging fruit out of the way. Movement, nutrition, it's not rocket science. It's simple, simple stuff that's hard to do. But once you start doing it, you feel better. Once you start feeling better, you have more energy. Everything feeds on itself. It's a self fulfilling loop that just gets better and better if you're doing it right. And then the fine tuning and the knowing that, okay, I can be super healthy, but still drop of a heart attack. Well, get your calcium score, talk. If your family has a history, then understand that history. Get your genetics. If you need to look at your blood work, do those things so you have the data to make the right decisions for yourself.

[01:08:26.480] – Rachel

Yeah. Allan, I've been wanting to do genetic testing for a long time. It's been a little bit expensive, and no doctor, I think would give me a calcium score at this point. But paying for that out of pocket might actually be worth the investment just to have this data at this particular age that I'm at. So I mean, I know that insurance doesn't cover all this stuff for sure, and even doctors may not be willing to write up a prescription for certain blood work, but if you're willing to pay out of pocket for it, I bet different labs can help you with that.

[01:09:03.170] – Allan

They can. They absolutely can. And there are labs. I have some relationships with one or two. So if you're thinking about you want some labs, just message me and I can hook you up with one. They have doctors on site. Doctors will write up the lab request. Sometimes you can just go to your local Quest drawing center or some of them actually, they ship it and you have the test at home. If you want for some of these tests, not all of them, but if you want a panel, you can get a panel. If you want a calcium test, you can pay for one. You just have to go out there and get one done, something I'm going to be doing. And so the question I asked is, okay, so you have $1,000 in your bank. Great. And then you have a heart attack. Guess how much that's going to cost? And so it's an investment now to basically say, I'm not paying my deductibles and my 20% of everything for hundreds of thousands of dollars in medical bills ten years from now. What they call it? Pennywise, pound foolish.

[01:10:02.260] – Rachel

Yeah.

[01:10:03.330] – Allan

In many cases it is. If you're not willing to make the investment in your health, then you won't keep it. And that's time, money and effort, all those if you're not doing the work, if you're not putting in the time, and in many cases, getting the things done that you need it done and spending the money where you need to spend it, then you could be pennywise and pound foolish.

[01:10:25.500] – Rachel

Yeah.

[01:10:26.150] – Allan

And that's kind of sad, but nobody's going to do it for you.

[01:10:30.720] – Rachel

Right. It's definitely a hard decision, but I think that it's worth it in the long run, especially if you have plans to live long.

[01:10:40.270] – Allan

I do 105 wiping my own butt. I'm there.

[01:10:45.470] – Rachel

Yeah. I got goals.

[01:10:47.670] – Allan

I got goals. All right, well, Ras, I'll talk to you next week.

[01:10:55.200] – Rachel

Great. Take care, Allan.

[01:10:56.440] – Allan

You too. Bye.

[01:10:57.260] – Rachel

Thank you. Bye bye.

Music by Dave Gerhart

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Let's Say Hello

[00:02:46.790] – Allan

Hey, Ras.

[00:02:47.770] – Rachel

Hey, Allan.

[00:02:48.990] – Allan

How's the last few minutes of your life been?

[00:02:51.460] – Rachel

Pretty quiet.

[00:02:52.690] – Rachel

It's nice to be holed up here in my office.

[00:02:56.150] – Allan

Yeah, our hello section. We're doing two episodes at the same time, so nothing's changed other than a few minutes on the clock since we did the last one. But just thought we'd take a moment to have our little hello session anyway. So, Ras, are you ready to have a conversation with Juliet and Kelly Starrett?

[00:03:13.750] – Rachel

Sure.

Interview

[00:04:13.650] – Allan

Juliet, Kelly, welcome to 40+ Fitness.

[00:04:16.940] – Juliet

Thanks so much for having us, Allan.

[00:04:18.590] – Kelly

Thank you.

[00:04:19.140] – Allan

Now, your book is called Built to Move: the Ten Essential Habits to Help You Move Freely and Live Fully. And the interesting thing was when Becoming a Supple Leopard came out, loved the book. When the second edition of it came out, I bought it again and gave the first edition away. And then when Deskbound came out, I bought that. Those are both sitting on my bookshelf over here. And then this one comes out and I'm like, how did you write a better book than the best books that are already out there? And you guys did it. You did it.

[00:04:52.720] – Juliet

Thank you so much. Thank you so much. We're really excited about it.

[00:04:56.480] – Kelly

Well, I think what you can see is some evolution in our thinking that we maybe have been very keen on our roots are high performance, that's where we came from. But as we've progressed and gotten a little bit more old or mature or wise or our lives have gotten up, we're looking around and seeing that we had to have a slightly different conversation because some of the things that we were talking about ten years ago really haven't come to pass. And if we were going to take a crack, honestly, at saying, hey, fitness and wellness has left a lot of people behind, what does that look like to us and what's important to us now as we start to crest 50? And it turns out that all of that experience has been integrated into this book. And if we were going to be honest, something that Juliet I talked about is that those other books really lacked this blueprint, this daily manual about how to go about your life. That was what was missing from our writing.

[00:05:47.910] – Juliet

In some ways we think of this book almost as a prequel to Supple Leopard because this is sort of again, we think of them as base camp practices and Supple Leopard is sort of like the advanced class.

[00:05:59.890] – Allan

Yeah, well, I always talk to my clients and we talk on this podcast that fitness is not CrossFit. I mean, CrossFit is great. I love CrossFit, but they call that the fittest person on the earth when they do their competitions. And that's great. But for us, fitness is fit for task. So it's being the best grandmother you can be. It's being out with your friends and feeling confident and comfortable that you can play tennis or pickleball. It's being late for the bus and having to take a little sprint there to catch the bus stop before the bus pulls away. It's the things we do in our everyday life that is what real fitness is about. And I've always also said there's not a user manual for us, but built to move. Well, there it is. You've basically given us the user's manual for how to move our bodies. And if our bodies are not moving the way they're supposed to, we can evaluate and then we can do something about it. And that's the beautiful part of this. It's not just saying, here's your diagnosis, good luck. Your doctor says eat less and move more, then you're like, okay, but you guys are actually giving us more of a manual of how to do it and how to actually improve it and if it's already working, how to keep it going, which again, I just think it's brilliant. Thank you.

[00:07:14.350] – Juliet

Well, and I really love how you're framing the idea of fitness. And one of the things we really wanted to do with this book is make it as accessible as possible. And one of the ways we frame fitness in our own minds is just simply being able to do the things you want to do physically for as long as you want to be able to do them. And that is really wide ranging, as you said. I mean, that can be just having the stamina to walk 25,000 steps with your grandchildren at Disneyland or that can be you want to be a 65 year old triathlete. I mean, it's very wide ranging. But I do think we've overly narrowed the definition of fitness to people think it is sort of like the CrossFit body or whatever that means. But to us it's really much broader. And I think that's how our own thinking has evolved over the years.

[00:07:58.760] – Kelly

And let me say that one of the things that we know was the truth about some of our earlier work was that we had objective measures. And our objective measures were your native range of motion. That's the underpinning of sort of our old work. What is it that everyone agrees the shoulder should be able to do? How can we get you back to those positions? And then the proof was in the output, the wattage, the poundage. And one of the things that we realized was that we hadn't given people clear objective measures or vital signs, physical vital signs, around some of the other features of our behaviors, whether it's nutrition or sleep or walking or moving. So what we've done here is recognize that if anyone can know what decent blood pressure is 120 over 80. That's not great blood pressure, but it knows it's a range where you're saying, hey, I need to pay attention, or I need to make a change. And what we've tried to do in Bolton move is give people objective vital signs where you can say, hey, I have a newborn, or I'm on a deadline and my sleep is awful, but I'm just below the vital sign line right now.

[00:08:57.790] – Kelly

This objective measure, and it gives you a place to say, I should pay attention to that or helps to inform you about some blind spots, because, frankly, people are working. They're crazy. They're working hard and have complicated lives, and we need to show them that it's not all or nothing.

[00:09:12.380] – Allan

Yeah. And to kind of give folks an idea, what we're talking about from a range is you guys saw that commercial with the old man trying to lift up his granddaughter. I ball every time I watch.

[00:09:23.650] – Juliet

Me, too. I watch it, like three times a year and just cry my eyes out.

[00:09:26.790] – Allan

I cry every time I see it. And you've got that. So the guy's just trying to lift up his granddaughter to put a star on the tree that he bought for her, and it's just that moment he's been training for. And to go as far as Juliet, your father, who's out there rafting and hiking and doing these things with his kids and keeping up with them, yeah, it's hard, but he's doing it because he's at that level. This is a wide range of fitness that we get ourselves into at this age group, and so it's right for all of us. So I think that's what's really beautiful is this is not just something if you have bad movement patterns. This is a great book. Even if you do, this is how you keep having those patterns and you keep moving. Well, yeah.

[00:10:07.540] – Kelly

One of the things that Julian and I are fortunate enough to be in is a world of high performance sport, and we get to work with alongside a lot of superhumans men and women and really complicated, amazing teams. And what we've realized is that our grounding is in this high performance, but that only is important because it informs us what good practice looks like. And part of what Juliet and I have been trying to do is say, hey, if sport and high performance environments is a laboratory, and that's how we've kind of always viewed them, that if we don't actually apply that science to society and transform our communities, then that stuff is less important to the both of us. It's more hate circus and entertainment. And so we're really trying to sort of conjoin those behaviors. And one of the questions that we regularly ask and you're pointing out is, how is it going? Are we being served by our current lab results? And it turns out that just about anything you care about probably is trending in the wrong direction globally or even nationally, from obesity to being overweight to depression, substance abuse, pain.

[00:11:16.260] – Kelly

And one of the things that we have come to realize is that the underpinnings of any high performance environment is this book. And it's not diet and exercise. And what we're seeing is if we are going to in fact be 100 plus years old, which we're definitely trending towards more and more with science and drugs and surgeries and all the things that are coming, we better think differently about how we're living our lives because the environment person sort of interaction is becoming a little bit more convoluted and complicated.

[00:11:45.990] – Juliet

And one thing I would add to that too is it is a myth that all of these high performers actually are checking all the boxes as well. I think it's easy for those of us who are weekend warrior types to think, okay, well the Starretts work with these elite athletes and they've checked every single box. And in some ways because I think we have gotten so much more sophisticated in training, so much more knowledge is widely available thanks to the Internet. We have this explosion of technology that can be applied to fitness that there's an assumption that all these high performers are getting the basics right, but in some ways they're not. In fact, because of all this, Sophistication they too have forgotten to focus on the basics. And so I think it's important for your listeners to know that the things that we are prescribing to do for weekend warriors everyday movers are the exact same things we are actually prescribing for the highest performers to be doing as well.

[00:12:41.750] – Allan

Yeah. Now there was one thing that you brought up in the book that I think is really important because if you go into any bookstore and you start looking for fitness books that relate to people over 50, you're going to find the stretching books because we've lost a lot of flexibility, we lost a lot of mobility. And so when you bring up mobilization or mobility training, which I bring up a lot, they default to this oh well, I already stretch before I do my workout and I stretch after my workout, therefore I'm covered. Can you kind of compare and contrast what is the difference between mobilization and stretching?

[00:13:18.630] – Kelly

May I, should I take a swing at this?

[00:13:19.720] – Juliet

oh yeah.

[00:13:23.090] – Kelly

When people say stretching, it really is sort of a nebulous term. If I said diet, that could include traditional diets, paleo juice, cleanse keto. It's a really nonspecific idea. And one of the things that we're trying to say with mobilizations that we're prescribing is that you are a complex, amazing, systems based human being. If you just feel tension in a muscle or a tissue that's not necessarily making changes in that muscle or tissue. Because I think when what's happened is we've all known, hey, we should stretch, but we all don't know why. To what end? What is enough? And is it working? Because remember, the goal here is to restore our native range of motion. In fact, what we want everyone to be thinking about here is that your range of motion and ability to move freely has nothing to do with your age. It's the one aspect of your movement that sort of is age independent and age proof that it's more difficult to heal as you get a little bit older. We slow down, but we still heal, but it's slower. It's harder to keep muscle mass on. We know it's harder to change body composition, to lose those stubborn few pounds.

[00:14:34.850] – Kelly

But your range of motion, that's a really stable system. And what we know is that as we get older, maintaining our range of motion allows us to maintain movement options. Movement solutions. Your balance will improve if you have better ankle range of motion. You are more likely to have fewer aches and pains if your hips do what hips are supposed to do. So what we're talking about in the mobilizations are saying, hey, here are some targeted techniques that we actually call in house position transfer exercises. We're doing this slightly different variation on restoring what your tissue should do to a specific aim of restoring a range of motion you should already have. So you might stretch because it feels good, right? Like you just move your neck around. But we can think about stretching. If someone said, hey, I go to yoga, isn't that enough? Well, yoga is a movement practice, and you may feel tension in your musculature and tissues while you do that, but that may be an incomplete way of addressing a range of motion. So what we're trying to do with these mobilizations are introduce some other techniques like contract, relax, and some other sort of key concepts to help people be able to return to their native range of motion in a specific way.

[00:15:49.890] – Kelly

So this is more akin to an exercise that restores your range of motion than, hey, I'm passively pulling on something because someone told me this is good for me at one point in my life.

[00:15:59.590] – Allan

Yeah, and it's sort of that concept. We do the stretching because we want it to prevent us from hurting ourselves. But the reality is it's mobilization and being able to move through the full range of motion that allows our body to do the things it's supposed to do so we don't get injured.

[00:16:15.530] – Kelly

And what you're bringing up is a really important thing. Oftentimes when people come I think when we were working with younger populations and we were earlier in our careers, 15 20 years ago, we were using these sets of mobilizations and ideas of restoring to how your tissues slide and glide and what your joints do. We were using them to restore positions so that our athletes could go out and win world championships. That's great. But that has nothing to do with me as a 50 year old man. And what it turns out is that those same mobilizations oftentimes can be employed to return my, again, native range of motion. What is it my body should be able to do? Everyone agrees that this is what your shoulder should be able to do. Every physical therapist, every doctor, every surgeon, there are these native ranges to every human, not gymnast ranges. I'm not talking about that would be nice, but that's not the reality. What we saw was that when people had pain or stiffness, one of the easiest things we could do was do something to change their physiology. So by getting some input into the tissues that was different than just tension stretching, we saw that sometimes that was enough to restore or change how their brain was thinking about the tissue.

[00:17:25.430] – Kelly

So suddenly that pain didn't mean I was injured. My body was throwing up an error message. And immobilization was a simple way of turning that message off. By changing some aspect of my tissue or by mobilizing, I was able to return or change or improve my range of motion. And my brain thought that was different. So we ended up realizing that we had this sort of spinning coin. And on one side was, let's return your positions so that you can do what you want to do. On the other side was, hey, I'm in pain. Well, what can I do about it? I can restore my positions and own my shapes and own how my tissues move. And that may be enough to get me out of pain or change how my brain is perceiving what's going on in my body.

[00:18:05.260] – Juliet

And one of the things we're really trying to change the perception about in this book, and I think this is particularly relevant for those of us over 40 who do suffer from aches and pains because we're trying to use and move our bodies, is that and Kelly alluded to this a little bit, but pain doesn't necessarily mean you're injured. And I think that's where people often go in their minds, like, oh, I have knee pain. I'm injured. And one of the things we're trying to be evangelist about is, hey, before you take time off work and get seven MRIs and go see twelve chiropractors and physical therapists, you really can take a crack at some basic soft tissue and mobility work and really potentially affect change in your own body. And I'll give you an example. I can't tell you how many people we've had come to Kelly saying, oh my God, I have knee pain. Should I go get an MRI? And I should probably go see the orthopedist

[00:18:59.840] – Kelly

we call this the pain spiral. And it's very common,

[00:19:02.240] – Juliet

and it sort of leads to this medical intervention situation that often ends in a physician not seeing anything on an MRI and instead just telling that person, well, you should stop doing what's hurting. So you may love running, it may bring you joy, but you definitely should stop doing that, which is not what people want to hear. Instead, we're able to say, hey, look, your knee is a system connected above and below with muscles and tons of soft tissue and connective tissue. And I can't tell you how many people we've said, hey, you need to spend seven days doing soft tissue work on your quads and your calves, ten minutes a day that are connected to your knee. And people are blown away like they don't believe us at first that it's going to make a change in their knee pain because they think for sure they're injured. And so one of the things we're trying to do, and we do have some sort of pain toolkits in this book, is to try to reframe thinking a little bit, such that if you do have aches and pains in your joints and shoulders, there obviously will be a time at which it's totally appropriate to go see a physician.

[00:20:05.820] – Juliet

But maybe that shouldn't be your first course of action. Maybe you take ten minutes for a few days to just see if you can make change. Because the amount of people we've been able to see who can is astounding.

[00:20:16.990] – Kelly

And if I may just jump in there. The other side of that is that people fail to appreciate that the environment, the lifestyle decisions we make influence how regular and how tough and durable our tissues are and how our brains perceive what's happening in our bodies. So one of the first conversations we have with anyone when we're dealing with an acute injury or chronic injury or persistent pain is we actually look at their sleep. And then what we know is that if you're a stressed person who's getting less than 7 hours of sleep a night, we know that that is not helping you sort of calm this ringing bell down and that if you want to heal, change your body composition, grow, put on muscle, get skinnier. Whatever your goal is, it turns out eight is a really magic number. So the rest of the book it seems like, and this is what's really confusing, I think, about how we presented fitness and wellness to people is that we are a system and that my moving during the day affects my sleep and my sleep quality and sleep density. But if I can sleep more, I can oftentimes heal more effectively or even just get my brain to stop being so twitchy and freaked out and perceive my body as a threat.

[00:21:29.030] – Kelly

So if pain is a request for change, we want to sort of expand what that means. Well, hey, we can work locally and change some aspect of your tissue or get some different input. But also let's look at these other things that may be contributing to a system that sort of has a blanket.

[00:21:43.250] – Allan

and in the book, you kind of identify basically as that. It's like, okay, here are some things, and you have ten vital signs, is what you call them vital signs, but they're basically checks to kind of do that, check in with yourself, how am I doing with this? How am I doing with that? And it's not subjective. In some cases, it's a little subjective, but in a general sense, you've put measurements. You said, okay, let's try to do this and see how you do. And then from there, we kind of have an assessment of where we stand. And that's always a good thing, because when we talk about goals, you got to have a measurement. You got to know when you're successful, all those different things that go into writing a really good goal. This is the perfect start, the perfect benchmark, and then the tool that makes that stuff happen. So we sound complicated when we start talking about tissue and moving and this and that, and, okay, if it's my knees hurting, how could it actually be my hips that's causing this? And so that's the hard part that you guys have worked out, is you do these assessments, you have a better understanding of where you stand.

[00:22:44.320] – Allan

You do the exercises, the pain goes away, your movement improves. And all of these things, all ten of them, they literally build on each other to form a platform for you to be a better human, to move better, to live that life fully that we talked about all the way through the century mark. And so can you go through just briefly and kind of talk about each of the ten vital signs you have in the book? A little bit about why they're important, each of them is important, and then a little bit about how we could kind of maybe assess them and understand where our weaknesses and strengths are, and then just kind of how to put it all together.

[00:23:20.210] – Kelly

Before we jump into that. I just want to appreciate that the most important part of the book is something that Juliet and I came to work and understand, working with people who are very busy. So if we went to the Marine Aviation Weapons Tactical School, which is a very intense program where they're teaching marine aviation advanced techniques, no one is sleeping. So if we walked in and said, sleep more, that's not a solution. And if we had busy working parents with young people, and we said, hey, we need you to spend an hour a day at the end of your day doing this checklist of things, we also saw that that was impossible for people. And so Juliet and I spent better part of the last decade coming up with something we called a 24 hours duty cycle. And this is important in context, because what I want everyone to understand is you don't have to run this perfect checklist. We've really started to conceive that behavior change starts, when are you going to have some control and agency? When are you going to fit this into your life? So it's yet not another thing you've got to get done.

[00:24:21.280] – Kelly

And our motto around the house is, let's be consistent before we're heroic. And if we don't help people conceptualize where they can sort of layer or feather these things into their lives, it's not going to make a change. So that's the first thing I want people to understand about the book, is that it's a really easy starting place to begin to make fundamental changes. And let me give you an example. If we look at the first vital sign of getting up and down off the floor without your hands, it's really a sneaky vital sign about looking at hip flexion and what your hips should be able to do. But the easiest expression of that is, can you sit cross legged and get up and down off the floor without using your hands or putting your knee down? And that's not a strength issue, and it's definitely not a big range of motion I need to be a gymnast to sit crisscross applesauce. But one of the easiest ways to begin to change that is to say, hey, I'm going to watch TV tonight and sit on the ground for ten minutes while I'm watching TV.

[00:25:15.050] – Kelly

And every time I get uncomfortable, I'm going to fidget. So if most of us are watching TV in the evenings, which we are, right, watching news, we're getting caught up, we're self regulating, we're calming down. All we need you to do is get onto the floor and lean up against your couch and you've already begun to change your behavior, which is putting range of motion into your hips. You're changing shapes, and you're going to have to get up and down off the floor before you go to bed or get that snack or something else.

[00:25:41.140] – Allan

Or just sleep, right there.

[00:25:44.030] – Kelly

We've constrained the environment. We've shaped a behavior without having to make another choice. And that's one of the things we're really trying to do here.

[00:25:51.760] – Juliet

And one interesting note from a data perspective on this particular vital sign, which is get up off the floor. And it's the first one we put in the book, in part because it's kind of a fun test to do and you can get your whole family involved, and I think you learn really quickly where you are when you do that test. But one of the things we know is that in countries where people sleep and toilet on the floor, they suffer from much fewer low back pain orthopedic injuries, hip replacements, knee replacements, and fall risk. Fall risk, which everybody knows once you fall, especially as an elderly person, that's sort of the beginning of the end. And so there's some really interesting data behind it. But what we love about this particular vital sign is that it is so easy to immediately get some information about how your body's working. And then it's also the practices that we have around it, one of which literally is sitting on the floor more often while you watch television. And we know also from data that everybody is watching quite a bit of television a day. It's just an easy way to fit it into literally any busy life.

[00:26:54.120] – Juliet

And just to add a little bit of further context to what Kelly said, and I think it's important on these vital signs, I mean, we spent a lot of years thinking about which ones we did and did not want to include in this book. And the ultimate question for us is what do we do? We are users, we are busy parents of two kids and we work full time jobs and we are like normal people. We're not fitness people that spend 24 hours a day making Instagram videos about our abs like that's not what our life is like.

[00:27:24.180] – Kelly

I would like to have making 24.

[00:27:26.050] – Juliet

Hours, but we are users and these are the basic practices, all ten of these vital signs that we actually are focused on implementing in our own lives. And so getting off the floor is the first one.

[00:27:39.720] – Juliet

I believe our second vital sign is breathing. And people have started to, I think, get some concept of the importance of a breath practice. People have heard of Wim HOF cold therapy plus breathing. But interestingly as people may or may not know, kelly's a physical therapist. And when he has a client come in, especially a client that is complaining of low back pain, which is a very common problem, and I'm sure many of your listeners have or have had the first order of business Kelly does with them is work on their breathing. And we find it to be so critical in terms of how your body functions and also how your brain can think about and manage things like pain.

[00:28:23.280] – Kelly

What's interesting is, again, instead of saying, okay, now here's another practice that you have to do, what are you going to kick out? You're going to kick out making breakfast for your kids so you can do a breathing practice? What we are trying to say is we've got something called a blood oxygen level test, the Bolt test in there and it was popularized by a really brilliant thinker named Patrick McCone, and he is oxygen advantage. And it's a simple idea of understanding how CO2 tolerant we are. So hang on in there everyone. Remember that Juliet and I are really obsessed with being old and maintaining the things that we love to do as long as we can. But the other side of that is that we realize that we never have to have a compromise between being durable and longevity and performance. When we focus on helping the body do what it should do and improve its capacities, it turns out you can play more pickleball and you can do that spin class or whatever it is you like to do more effectively. And one of the things that I think is misunderstood about sort of some of our breathing traditions like yoga or meditation is sometimes we didn't always appreciate the impacts on the physiology.

[00:29:33.580] – Kelly

And that when I could get someone to breathe and do some breath practices. One of the things that we know, for example, is that you can strip off more oxygen off of the hemoglobin. Remember that blood is carrying oxygen, but the mechanism by which that oxygen comes off that blood cell is actually driven by your CO2 levels, the carbon dioxide gas. And so the more I can get my brain comfortable with having higher CO2 levels in the bloodstream because the CO2 is what triggers me to breathe. Suddenly, what we see is that you can actually access more oxygen, which means it's easier to go upstairs, which means if I have pneumonia or emphysema or I'm dealing with a chronic condition or I want to hike more effectively, and destroy the people in my hiking club or my bike group. I'm talking about this is the conversation we've had with our elite Tour de France cyclists. That this same idea of, hey, let's improve the efficiency of the system ends up going a long ways, but it also improves how well your rib cage moves, and it improves how well you can take a big breath, which changes your Vo2 max and makes it easier for you to move and balance and put your arms over your head.

[00:30:43.150] – Kelly

So when we start to see breathing not as a meditation alone practice, but as a mechanical practice, it's shocking the impacts that it has downstream.

[00:30:52.850] – Juliet

And just a note on the practices in our breathing chapter. And again, because our whole focus has been how can we fit this into our lives without adding another hour long breathing meditation practice? We recommend, and we are inspired, of course, by Jacob Nester's amazing book Breathe that one of our future chapters that we can discuss is walking More. And so we don't have a separate breathing practice. We suggest that while you're walking more, you actually just practice nose only breathing. Or one of the things we do a lot in our own practices whenever we're exercising, part of our warm up is just to work on a little bit of breath practice during our warm up. So again, it's not an added new practice. It's something that we're conscious of, we know the importance of, but we're figuring out how to just layer it into other things we're already doing and just bring an awareness to it. So we obviously are huge fans of walking and adding in generally more movement in the day. And so the time when I practice most of my nose only mouth closed conscious breathing is while I'm walking.

[00:31:51.340] – Kelly

What you can start to see in the book is that almost the book is split into sort of two categories. One of them, for example, and another vital sign is extend your hips. We're really trying to look at hip extension, which is my ability to walk and bring my knee behind my butt like I was in a lunge position. Because of the amount of time we're spending sitting, because of just the nature of being a human in today's world. We've seen that this inability or loss of capacity or loss of freedom to put the hip behind us ends up with a phenomenon called tail wagging the dog, where as soon as my leg starts to come behind me, it ends up taking my pelvis with it just because I'm a little bit stiff in that lunge position. And if you look at any of our movement traditions like Pilates or yoga, they are obsessed with hip extension. If you look at our sprinting and some of those practices, they're obsessed with hip extension. So I'd like to be known as the knees behind butt guy. And the idea is that we find that when we're managing again, restoring what the body can do.

[00:32:51.320] – Kelly

And we have something in a test called the couch stretch, which, if you follow our work, you know, is the arch nemesis of every human being. But the idea is it's just, hey, let's take this leg into some extension and challenge the tissues here. And what we find is that ironically, just by improving the shape, we often see commensurate changes in pain around the knee or people's low back starts to feel better and they can go up the stairs, run, get into lunges more effectively, have more movement choice. And again, what we're seeing is part of the book is saying here are some objective measures, like putting your arms over your head, being able to sort of take a breath, looking at balance, and then some end up being very much around the behaviors that make a robust person. Like nutrition, like sleep, like not sitting too much. And so I think what ends up happening in these vital signs, so we don't just kill people with boredom over all the ten, is you take the ones that were maybe a blind spot for you and we can see. Was that sort of a behavior or was that a movement behavior?

[00:33:53.030] – Kelly

Was that a way I was living my life? Or hey, I didn't realize this is something I didn't have access to?

[00:33:57.420] – Juliet

And just one quick backstory on that. I mean, we really backed into what we call sort of these lifestyle conversations. And, you know, from reading our other book, Deskbound, we never set out to be like the standing desk people or the walking people. It's not that sexy, it's way sexier to say that we work with the 49ers or something. But we've really backed into these lifestyle practices. Again, seeing that we've really just missed these base behaviors. People are in our neighborhood, moms and dads are saying, hey, should I be keto? Should I be taking what supplements should I be taking? And what we always go back to is the basics. We say, okay, wait a second. Before you embark on some diet or start taking a bunch of supplements or buy some kind of pod that you sleep in at night, like, are you sleeping? Are you eating fruits and vegetables? Are you moving enough throughout your day? Can you move your body into the shapes that allow you to be able to do the things you want to do? If that's pickleball, great. And so we really did sort of back into the lifestyle side of this book.

[00:34:57.100] – Juliet

And again, also because these are the things that we've realized in order to feel good and be able to move the way we want to do, those are the things we have to prioritize in our own life.

[00:35:06.310] – Allan

Yeah, and I think you said something that's really important there is you stack this stuff, which is really good about when you go through your 21 day challenge, you stack this stuff and you say, okay, we're going to talk about walking. But at the same time you're walking, there's a breathing technique and there's some things you can do to mix both. I think everyone can relate to the fact that there's kind of this running joke amongst people that I know I'm not getting on the floor until I have a plan to get back up. And so if you relate to that, then there's something in this book for you. The breathing, I think, is kind of an interesting thing because a lot of us can relate to going up a flight of stairs and getting a little winded. I'm carrying luggage and talking to my guests at our bed and breakfast. Sometimes when you're carrying about 50 60 lbs of luggage and you're going up a flight of stairs and you're talking, you get to the top and you're kind of like, wow, I'm a little winded. But instead of me going out there and saying, you know, what I need to do is get up in the morning and run these stairs about 20 times so that I build up this endurance to do this stuff.

[00:36:06.680] – Allan

A breathing technique of just getting my body used to taking in just a little bit more and holding carbon dioxide and being a little more comfortable with that is going to allow my body to use oxygen more efficiently and I'm less likely to get winded walking up the stairs talking. And then for me, mobility has always been a struggle. And it's really a struggle because you spend the first 40 years of your life doing everything wrong. If you're a bodybuilder,

[00:36:32.130] – Kelly

well, you can do whatever you want. Let's be honest, that's the magic, right?

[00:36:35.760] – Allan

But the thing is, you're training as a bodybuilder and it's like full extension is not what they teach you to do. They teach you to do tight and stay tight. So lengthening your hips, because you sit all day, those types of things. As you kind of go through this, I think you're going to go through every vital sign and say, wow, that's important. Oh, that one's important too. Oh, I'm not eating like I'm going to live forever. I'm eating like Twinkies are going to go out, and I'm not going to get another one.

[00:37:02.390] – Kelly

Well, you brought up something, I think that's really great here one is we're talking about a movement practice, or essentially is, can you be useful? Can you do what you want to do? Do you feel like, hey, I'm afraid to ride this bike, or I'm having a hard time skiing because my hips are getting stiff? We have all these conversations. They're all on a continuum. The next question is, okay, what do I do about that? And the next question is, okay, when do I do that? And then how do I get consistent? That right. Well, if I schedule yoga and I go yoga every two weeks, that's probably an incomplete solution. We think that that's great. Go do yoga.

[00:37:37.580] – Kelly

Go it's a movement practice. Breath. It's fantastic. Tons of end range Isometrics built in there. But what we'd rather you do is spend the last ten minutes of the day when you actually have some control in your life or in the evening towards the end of the day, getting on the ground or working on a tissue or working on a position. And what we found clinically was that if we said, okay, take off your shoes, hike up your dress at work, get on the ground in the office, no one's doing that. That's crazy. But if I said, hey, once you're down, shifted a little bit at home, put the roller or a ball next to the TV, next to your coffee table, and let's spend and ask ourselves, what feels stiff? What feels tight? What haven't I done? Where did I work today? What's kind of barking at me a little bit? And now we've connected a soft tissue mobilization practice with what's really happened with someone in the day, and we've done it in a way that they can be really consistent at it. Because we saw that ten minutes ended up being a really sort of critical mark.

[00:38:33.810] – Kelly

If I said 15 minutes or 20 minutes out the door, I'm out. But ten minutes, everyone has ten minutes. And you can do a lot of other things while you're doing that. You could do a breath practice. You could just zone out and watch TV. But if you spent that ten minutes and you aggregated that five or seven days a week, a month, two, it's pretty transformational. So you really brought up this important idea of, hey, I need some additional inputs. Why? To maintain my range of motion. And if something is good, then I don't need to work on it because I've sort of above the minimum, but some other area where I've sort of contest myself or see what's going on or even ask what's sore or what wasn't I able to do today? What we found is that when people made that commitment to just ten minutes with a simple set of tools like a foam pool tool noodle. Or roll on a ball of wine, whatever it is you need to do, we saw that we could actually impact how they felt and impact how they move. Another thing we have around the shop is athletes that feel better, perform better, human beings that feel better, have better lives.

[00:39:32.860] – Kelly

So I think that's a really important piece that you bring up there.

[00:39:35.750] – Juliet

And one of the things we do on this, encouraging people to actually do these things which are difficult to do again, because we all have busy lives and sometimes that one thing is just one too many things is we do this thing called Peppering Our Environment which we are huge fans of this idea. And if you came over to our house and saw our living room because we love TV and we often end our night by sitting down and actually watching TV for an hour, like it's a nice transition for us. And so if you look at our TV room you will see that it is littered with lacrosse balls, foam rollers, different mobility tools. I recently bought these little kind of yoga mats that you can sit on because we do a lot of sitting on the floor and I realized that our floor was super uncomfortable and that was limiting the amount of time I wanted to sit on the floor. So I'm trying to take all these little micro steps to make these habits as easy as possible for me to actually do.

[00:40:30.620] – Kelly

We want you to spend your willpower and doing really hard things.

[00:40:34.240] – Juliet

I just wanted to not take care of your body. One of the other vital signs we think is so important is underlooked. I think overall is balance and it's one of the first things to go as people age. In fact, as we're cresting into 50 we're actually starting to have more and more friends who are reporting feeling that their balance is starting to go even as early as 50. And again, nobody is going to say okay, let's go to a balance class for an hour. Nobody is going to do that. One of the things we do is pepper our environment. We have these little portable slack lines we keep around our kitchen called a slack block. And we have little balance tools in our garage, like an endo board. And we just have little tools around our house and at our desks at work so that we can incorporate things like a really simple balance practice into our day. Again, without adding on, having to go somewhere, go to a class, add on a new behavior. It's just another stacking behavior.

[00:41:29.970] – Kelly

Even the test is a great daily practice that you don't have to do anything. And if you haven't ever seen the old man test, one of our friends, Chris Henshaw, came up with this, and he was an elite triathlete who was trying to come up with a task that he could beat his kids at. And they were such good athletes. And literally is stand on one leg, don't put your other leg down. And put your socks and shoes on. Then stand on the other leg without ever touching the ground again. Put your socks and shoes on. And if you just did that every day, if you just practiced in a year, you would spend hours working on your dynamic balance, trying to balance on one foot, you're going to do it.

[00:42:07.830] – Kelly

So let's just work this in. And now we've just taken that off the table. Holy crap.

[00:42:13.650] – Juliet

And the other thing we've tried to do is make it fun, because I think that's another thing that we've done a horrible job of in the fitness business is we've made it just so like drudgery, where you've got to go to the gym and check these boxes. It's not fun. And just these little balance tools we have around the house are very playful and fun and sitting on the ground with your kids at night and working on your mobility and practicing your balance. And we've just been in our living room with our own kids doing the old man test, and it's hilarious and fun and we don't always make it. And so we've just sort of tried to add like, an element of fun and play to this. Because, again, our thinking here is that a lot of what's out there in this space is about restriction. How can I restrict my diet and restrict the things I'm doing? And we want this book to be about expansion. In our nutrition chapter, for example, there's no restriction. Our nutrition suggestions are appropriate for any diet anyone follows, whether you're vegan or carnivore.

[00:43:10.410] – Kelly

But hold on, I challenge you to hit those two benchmarks. Good luck with it.

[00:43:16.190] – Juliet

What people need is some expansion and less restriction. And in our nutrition chapter, we're just saying, hey, you actually probably need to eat more fruits and vegetables

[00:43:26.540] – Kelly

and you're not getting enough protein that's it.

[00:43:30.370] – Juliet

We're just trying to make it fun and accessible for people.

[00:43:33.360] – Kelly

And one of the things you heard Juliet say was fun and accessibility, that happens in the functional unit of change or health, which is your home. So the second we bring in a physical therapist or a physician or some third party, that really removes our agency and our control. And what we know is that it doesn't work. It's not sufficient enough. Unless your physician and your dietitian and your physical therapist lives in your house, it's not going to happen. And so we see that this functional unit of change is the home we call it that's like a hyper local object, hyper local phenomenon. And that if you have a garage and a kitchen and you put your shoes on and suddenly you realize that your control around feeling better actually happens in your time, under your demands and under sort of your watch. It's not an external piece. And that really feels like a revolution for people.

[00:44:24.130] – Allan

Because it makes it accessible. You're not having to pay those bills. Go to the masseuse, go to the physical therapist, go to the orthopedic guy and get them to do what they do or chiropractor, and you're not going to their place. Limited time, limited exposure, limited attention. Get this done. They give you the homework. It's a piece of paper with some pictures on it. And 99% of the time, they never look at that picture again. They never look at that paper again. The interesting thing that you've said, and it's kind of what brought this full circle for me, is I have this joke. It's not really a joke, it's actually real, but I say, I want to be able to wipe my own butt when I'm 105. And people right, but people think and then it starts to hit him. It's like, wait, so he wants to live to 105. He wants to be able to move and be independent and do these things. He wants to be able to do a squat. He wants to have the mobility and dexterity to do the paperwork. He wants to be able to just go and not worry about whether he's going to make it or not.

[00:45:20.060] – Allan

So there's a lot built into that little sentence. But the cool thing about what you guys have here, and again, that's why I love it so much, is this is going to give you benefits today, and it's going to give you those benefits in the future, because a lot of people will tell me it's, hey, Allan, you're 7, so you're talking 50 years from now. You want to be able to do these things. It's just hard for me to wrap my mind around doing something for 50 years from now. I want to do something that's going to stop my back pain or knee pain. Right now I want to be fit now. I don't want to be fit in a 50 years, but this does both. And I think that's what's so wonderful about the way you guys have approached this is you're looking at it and saying, okay, here's the thing to know how you're doing, to gauge yourself, here's a practice or a few practices that you stack together. You fit them in with what you're already doing. You can stand on 1ft. Close your eyes while you're brushing your teeth. Go for a minute, brushing your teeth at 1ft with your eyes closed.

[00:46:15.420] – Allan

And then the ding goes off. You switch feet. The second minute you're supposed to be brushing your teeth for two minutes, you're on your other foot for that whole time, or like you said, putting your shoe on the old man test socks and shoes. It's extremely hard because I've tried it. It is really, really hard.

[00:46:29.840] – Juliet

It's really hard. Well, I think you bring up a thing that I think a lot about, and I think you're right, it's got to be both. I think very few of us are inspired by, okay, I want to be able to do these things when I'm 100 years old, short game and long game is but, yeah, I think you're exactly right in terms of the short game and the long game. And one of the things I like to point out is that we are all so comfortable with this idea of setting goals either in our home lives or definitely in our businesses. Everybody is aware that you've got to save for retirement and sets financial goals around that. So I would challenge everybody to set some short term and long term physical goals. Because again, I think what happens to a lot of people is they turn 70, 75 and they haven't set those goals. And all of a sudden they've lost the ability to do the things they want to do again, whether that's just play with their grandchildren or go for a hike or whatever. And so there's so many things in this book that can make people feel better, move more freely right now.

[00:47:28.320] – Juliet

And I think this is like your 401k for movement when you're older, because nobody's goal is going to be, I hope I'm stuck in my Lazy Boy or in a skilled nursing facility when I'm 80. That goal is for zero people. So everybody wants to be able to move in some capacity and move freely now and into the future. This book is sort 401k of the movement.

[00:47:52.930] – Kelly

And let me say that that is completely in line with when we come into professional organizations, premier national teams, choose some big crazy organization in sports, on TV. We've been there and working with them. We start with a goal and we literally work backwards into what does it that look like today? What does that look like in a week? And chunk that out might be in three months chunks, might be six month chunks. So Juliet really brings up this important point. No one, or very few of us have actually said that my goal is to be independent, be able to toilet and transfer them 105. Then you can really work backwards and say, what does that look like? Well, it looks like I need to walk today and manage my sleep to the best of my ability. So you've nailed the idea. The other thing that I want people to understand is that these practices create buffer zones. They allow you because as you get older, bad things are going to happen. You're going to fall, you're going to injure yourself. You may have been injured from high school soccer whatever it is, or you may have a disease problem coming down the pathway.

[00:48:52.290] – Kelly

And so we talk about our own experiences in the book here, but understand that sometimes what looks like miraculous outcomes when people are confronted with cancer or a big surgery or trauma, it just turns out maybe they had a little bit more resilience and tolerance built into the system. And so what we're doing here is saying, hey, look, it's going to be unlikely that you get out of the next 50 years completely unscathed without having to go to the doctor. But how you show up for that event is going to definitely impact its outcome. And we're not trying to scare anyone here. Again, our focus is we think you can feel better and move better and do all the bad stuff, but it turns out these things are what is essential about being a functional, durable human.

[00:49:35.740] – Allan

Before I let you go, I think there's going to be one big question. People are like, well, wait a minute, wait a minute. Juliet, Kelly, you can't write a fitness book and not talk about weightlifting and running. You talked a little bit about yoga. Where does exercise fit on all of this?

[00:49:51.840] – Juliet

Well, I will start by saying not including it as one of our ten practices was a very conscious decision, in part because we feel like everybody is fire hosed with information about particularly diet and exercise in this sort of moment in time in our fitness space. And what we realized is, ultimately, we are totally exercise agnostic. You'd think we wouldn't be? We owned a CrossFit gym for 17 years. We've worked with elite athletes. We both have certain ways that we like to train. But one of our own evolutions over the last ten or 15 years is becoming exercise agnostic. Those of your listeners who read the book, you will see we do pay homage to the fact that we both do love to exercise. Exercising is a huge part of our life. It's how we both probably manage our mental health. It's what we like to do. It's our hobby. We used to both be professional athletes. So, yes, we are huge believers in exercise. We believe people should do it. But we really wanted to not write an exercise book. We didn't want to put a stake in the ground about what exercise is or isn't the best.

[00:50:58.150] – Juliet

And our philosophy has really become so reasonable that we are of the mind that, yes, people should exercise.

[00:51:06.600] – Kelly

And we can define that as you should probably breathe hard and you should lift a weight.

[00:51:09.980] – Juliet

You should be under breathe hard and lift a weight. But how you do that, man, the sky's the limit. Because what we've seen over the years is people will do what they enjoy. And what people enjoy is wide ranging. I mean, whether that's pickleball or zumba or CrossFit or orange theory or triathlons or you name it, right. When people are told to do something that they don't enjoy, they don't do it. Period, end. If you don't enjoy doing it, you will not do it. And so we do think it's critical. Anyone who follows us online knows that we do exercise and we love exercising, but we really wanted to sort of stay out of that lane and say, yes, we think you should breathe hard and lift a weight, and how you do that is really up to you. Anything to add to that?

[00:51:56.740] – Kelly

I think Supple Leopard comes out ten years ago in a month, and if you'd asked me then, I would have been like, yes, you should have a double body weight deadlift, and you should be able to write.

[00:52:07.770] – Juliet

That was 39 year old Kelly.

[00:52:11.460] – Kelly

What I will say is one of the things that's nice about this book is that you can actually use it as a diagnostic tool, and that if you enjoy some exercise and you think you're doing it, come in and take some of our tests and see how well your exercise regime is actually supporting your native movement. And ultimately, one of the things we'd like to see is that you can hit some of these things and conjoin some of these things. If you're doing good strength conditioning, you're working on balance, you probably don't need to do lots of extra balance. You can work it in. You're working on breathing in there. But ultimately what we've realized is watching the world expand in sort of hyper technicality, the confusion that is the internet with exercise is that that message isn't getting there. And that if we told people to exercise more and here are more COVID body weight pump shred exercises you can do in your living room with a therapy and a book, that message hasn't changed the range of motions or capacitives of someone. So I think if everyone had a kettlebell and a jump rope or a kettlebell in their kitchen and a hill, I mean, there's an old Russian coach, I think, or he was an Eastern block throws coach, and someone asked him, what should you do for cardio?

[00:53:24.760] – Kelly

And he's like, you should go run or walk a steep hill. And they were like, what if you don't have a steep hill? He's like, I don't know what to tell you. But it was that simple of an idea that go walk up and down the hill until you breathe hard, you feel like you've had enough. And that's a pretty elegant message. I think the fact that we have seen that you can buy bumper plates and Olympic lifting shoes and kettlebells at Kmart and at Walmart means that those tools are available to us. And as Juliet saying, how much is enough? Well, that depends on your goals. I think what's happened is we've taken diet and exercise and made it all about, do I look good naked? Is this about body composition, ego not what am I training for? And I think when we come back to that goal setting that Juliet said suddenly then we can ask, well, are you doing the kinds of training that really does make you a better runner or better at skiing or better at playing pickleball? Then that's a different conversation. But ultimately what we're shouting at people is, hey, let's use this to burn calories because that's the only thing that matters and that's really the wrong conversation.

[00:54:28.460] – Allan

So I asked for three of these and I usually would ask both guests and so I'll give you the option, you guys can alternate and just give me three or you can each give me your three. It's cool. So, Juliet and Kelly, I define wellness as being the healthiest, fittest and happiest you can be. What are three strategies or tactics to get and stay well?

[00:54:48.120] – Kelly

Watch this. We're going to say most important thing and we haven't talked unison. One, two, three. Sleep.

[00:54:53.880] – Juliet

Sleep.

[00:54:56.430] – Allan

Vital sign number three. I mean, number ten.

[00:54:59.470] – Juliet

Exactly.

[00:55:00.670] – Kelly

What would you take next, J, in your own kind of life around those three things?

[00:55:04.880] – Juliet

I would just say I would say sleep and then general movement and movement throughout the day. Again, I'm a fan of exercise, I do it very regularly.

[00:55:14.960] – Juliet

But for me I feel the best when I've added in plenty of non exercise activity type of movement. So that's making sure I'm walking enough in the day, moving around during the day, either standing while I'm working or making sure I'm getting up and down quite a bit if I'm sitting while I'm working. So for me it would be sleep and plenty of movement, especially in the form of non exercise activity. And eating a vegetable. That would be my third thing, eating a vegetable.

[00:55:43.540] – Kelly

We'll leave it there.

[00:55:44.660] – Allan

Okay, cool. Kelly and Juliet, if someone wanted to learn more about you, learn more about your book, Built to Move, and of course the other awesome books you guys have. Where would you like for me to send them?

[00:55:56.450] – Juliet

Sure. Folks can check out. Built to move at builttomove.com you can learn more about the book. Of course, it is available at every bookstore and every online book retailer. You can follow us on Instagram at @thereadystate and all of the other socials as well, twitter, Facebook, @thereadystate.

[00:56:15.170] – Kelly

And I want to shout out to our Juliet and our amazing staff at builttomove.com. We have a 21-day-follow along challenge. It's free. You just need to put your email in. And we've got an email video course, supplemental to the book. It'll really useful to have the book, but we know that sometimes, hey, if I can follow along and get a little sort of nudge and some support, we can go a little bit further. So we've created a whole back end, gorgeous little sort of experiential platform that goes along with the book. And again, just go to builttomove.com. You can sign right up for it. And there's a 20-day sort of follow along challenge that mirrors the book. You'll get some daily reminders and some videos of us showing you what it actually looks like.

[00:57:00.140] – Allan

That's an awesome resource. So, yeah, go check that out. You can go to 40plusfitnesspodcast.com/584, and I'll be sure to have the link there. Kelly, Juliet, thank you so much for being a part of 40+ Fitness.

[00:57:13.570] – Kelly

Thank you.

[00:57:14.090] – Juliet

Thank you so much for having us.

Post Show/Recap

[00:57:24.730] – Allan

Welcome back. Ras.

[00:57:26.030] – Rachel

Hey, Allan. I probably could have listened to you guys chat for probably another hour. There is a lot you guys talked about with the book, Built to Move. I don't even know where to start. There was a lot to go over.

[00:57:36.680] – Allan

Yeah. The interesting thing is Jill from the last week, Kelly and Juliet, and then another interview that's going to be coming up in a few weeks. Katie Bowman they're all movement specialists. That's what they do. They're into how the body moves, how to breathe, how to optimize the movement of your body. They do work with extreme athletes. They work with normal, everyday people. And it's really what it's all about is using the human body the way it was designed to be used. And so a lot of times we talk about performance and you might think, well, I'm not an athlete. I'm not trying to make the Olympics or NFL team or this or that. But what you are is an athlete from the perspective of the movement patterns that you need to do to be who you need to be, that could be a caretaker. So your ability to help someone get up off the floor when they fall, your ability to get yourself up off the floor when you fall, your ability to play with your grandchildren, your ability to keep up with them, your ability to do all these different things, and all of them are fundamentally built around your ability to move.

[00:58:46.630] – Allan

And a lot of people get into their forty s and fifty s, and they start talking about this ache and that pain and this joint I can't and the doctor said don't, and the only reason doctor is telling you don't is because he knows or she knows that it's going to hurt. And he and she knows maybe you're just not going to do anything to improve your performance, and therefore it's always going to hurt.

[00:59:12.520] – Rachel

Right.

[00:59:13.280] – Allan

We create these situations, but if we start moving our body more and we start moving it the right ways, and we start paying attention to how our body was designed to move, then it just makes it a lot easier. I get on the floor all the time to pet my dogs.

[00:59:30.220] – Rachel

Oh, good.

[00:59:31.050] – Allan

When I have grandchildren, that's never going to be a problem. I don't even think about it. I get on the floor, I get back up, and I can keep doing that. And if I wanted to do a cardio workout in my home, that's exactly what I would do. I'll get on the floor and get back up. Get on the floor, get back up. Try doing that for about three minutes. That's a workout.

[00:59:49.940] – Rachel

It would be, yeah.

[00:59:50.880] – Allan

Okay. But just try sitting on the floor and you'll find you squirm a bit, move a bit. The Starretts watch TV with their family sitting on the floor. They're not sitting on standard furniture. Katie, who we'll be talking about too in a few weeks, she's even more extreme. She's conditioned herself to not even need a mattress or a pillow when she sleeps.

[01:00:09.210] – Rachel

Oh my God.

[01:00:10.690] – Allan

Which I've done the last time I talked to her, which about five years ago. I did that for a while. And it will literally change the way you move, the way you feel, because your body adapts and builds capacity that wasn't there. We wear padded shoes, thinking that's protecting our knees. In reality, it's weakening our feet and ankles. And so when we go barefoot, it's really, really hard because our feet hurt because they're not used to being strong enough to support our body weight without that padding. And so as you start thinking about movement, in particular with their books, the Starrett's books, because he did The Supple Leopard, and then there was a second volume of that, and then they did Deskbound, and now they have this book. This book is sort of like, I'm not going to say a step change better, but it's an evolution. He was originally thinking about how athletes could move and should be. So it was a really good book, but it is mostly adapted to athletes. And then he did Desk Bound, which was more of the person who is sitting at a desk or sedentary a lot, not through choice, but just where you are.

[01:01:17.370] – Allan

This one balances it all out and says, what can normal people do to live better? And it gives you all of it in this one book. So I love their books, I love what they do. They're amongst the best books on the market. They're always going to be in my perennial favorites, and this one's no different.

[01:01:36.080] – Rachel

That's awesome. One of the light bulb moments that I had listening to the interview was somebody mentioned about nobody has a goal of sitting in a Lazy Boy for the rest of their life. And I love that, it's so true. But let's think about that for a second. My grandfather was probably in his 70s, so retired, and he loved to play golf. He did a lot of golfing, which is great. He would walk or take a cart, but he'd be out there hitting the balls all the time. Well, his shoulder started paying him and I was too young. I don't know what his shoulder injury was, but then his doctor said, you should give up golf if it hurts when you golf, give up golf. And that's what he did. And it's not that he actually sat in his Lazy Boy for the rest of the life. I'm sure he didn't. But when you're thinking about these later stages, when you retire from work, don't you want to be active? Don't you want to go and do things and play the sports you enjoy playing or travel to the places you want to travel?

[01:02:32.680] – Rachel

So between then and then, between these ages, these decades, even, you can think about, well, what can you do to maintain the range of motion or the endurance of the activity that you want to do, whether you want to do nine holes or 18 on a golf course? And it's just something that I always thought about. He was in his prime of his retirement and then became more or less couldn't do the things that he loved to do. And so watching your range of motions and like they mentioned, peppering your environment with all the tools, the foam rollers and the weights or whatever you want to do, if you have it near you, you're more likely to use it and get benefit from it and like you getting up and down off the floor. These are all activities that will help you stay fit for task as you age with each decade.

[01:03:19.450] – Allan

Well, and that's what I tore my rotator cuff, and I very easily could have gone to a normal doctor, and the doctor would have said, well, okay, stop doing these things, stop lifting these heavy weights, and stop doing these obstacle course races and stop moving. And that was never an option. When I went and looked for the surgeon, I found the surgeon that worked with athletes at the university. I found the physical therapist that worked with athletes at a Division One level school, and those were my team. I brought the best team for recovery for me to get back to being an athlete, if you will. That was my whole goal with the team. And I did the homework when I went in for the surgery. I still could do just about everything except press. And we went in. We're going to get the surgery done. I got the surgery done on Thursday. I was in physical therapy on Monday.

[01:04:21.130] – Rachel

Wow, that's awesome.

[01:04:23.490] – Allan

And like I said, I had one of the best physical therapists. He worked with the football team at the local university for a while. And I went in and I said, no, I don't want to just recover. I said, I want to be back to 100% of what I was before. Let's make that happen. And I did everything he told me to do. I did every bit of homework, and I actually didn't do more than what he told me to do. So there was no rushing it, if you will, to say, no, I've got to recover faster, and doing more is going to be better. It was really just this seasoned approach of saying, this is what's necessary. Get it done and don't injure yourself further by doing something silly.

[01:05:07.880] – Rachel

That's great that you had a team that was not interested so much as fixing you and reducing the pain, but helping you prepare for continued activity. There's kind of a difference in perspective there.

[01:05:19.770] – Allan

There is. If I had been your grandfather and they said, you can't play golf, and I'm like bull, right? I'm not a big golfer, so no, I mean, but realizing if if that was something that was one of the most important things in my life, fix me, what do we do so I can play golf? If the doctor said it, I'm like, I'm going to have to fire you. You're not a team player.

[01:05:44.130] – Rachel

Right. And I'd like to think that at least some of the doctors that I work with, I mentioned, okay, these are my goals in life. This is what I want to achieve, and what do I need to do to get there healthily? I have been injured myself, and I looked for doctors that would be willing to get me back on my feet to running and not just a sedentary lifestyle again.

[01:06:02.900] – Allan

Yeah. So imagine if someone said, Rachel, you broke your foot a second time. You got to stop running.

[01:06:08.220] – Rachel

Yeah, I'd laugh. We all laugh at these things. I need to find another doctor.

[01:06:15.740] – Allan

I'm sorry I got to fire you. I'm not a team player. You're not trying to help me. I'm going to run. You just got to make it happen. And so it's just a part of this has been thinking about where you want to go, and movement is the key for all of it because you're not I mean, who doesn't like sitting in a Lazy Boy watching movies?

[01:06:35.390] – Rachel

Yeah, once in a while, but not retirement.

[01:06:38.650] – Allan

That's not where I want to live for 40 years. And so it's just kind of one of those things is saying, no, get yourself moving the right way. And then books like this are going to start you in a very good way. They're going to teach you the right way and very simple, easy to start. And I think that's one of the values here is it's not like you got to be working out seven days a week. They're not even talking about that. Exercise is the sort of the cherry on top of this thing that we're not even talking about exercise. They're just talking about general day to day movements, patterns that you should be able to do safely and without pain. And if you're doing it right, you're less likely to injure yourself and feel pain. That's part of it, too.

[01:07:21.780] – Rachel

Awesome. Fun interview.

[01:07:23.730] – Allan

All right, well, I'll talk to you next week.

[01:07:25.870] – Rachel

Sure. Take care.

[01:07:27.140] – Allan

You too.

Music by Dave Gerhart

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How to improve your running form | chris mcdougall and eric orton

Less...

Let's Say Hello

[00:02:39.730] – Allan

Hello, Ras.

[00:02:40.920] – Rachel

Hey, Allan, how are you today?

[00:02:42.820] – Allan

Doing all right. Just very busy.

[00:02:46.080] – Rachel

Yeah, well, busy is good.

[00:02:47.980] – Allan

Busy is good. Busy is good. We're still sort of in busy season for Lula's. Tammy took the weekend off and went to Jazz Fest and we got some very demanding guests over the course of the weekend. Lots of moving parts, and then I'm actually doing some live training. I was wanting to do it. That's why I was going to launch the retreat, which is now happening. And I was like, okay, I still want to train people in person some. So I went ahead and solicited out to get some new clients. So I'm bringing in new clients to train in person in my studio. And I also now relaunched my program because I realized my normal program, my Be fit for Task program was great for people that wanted to work on fitness, but it wasn't as great for people that wanted to lose weight. The program was twelve weeks and then I condensed it to six weeks. So it's working very, very well for people that want to get more fit. So my Be Fit for Task program works really good for that but it's not so good for the folks that want to lose weight.

[00:03:45.100] – Allan

So I decided to go ahead and launch a new twelve week program that focuses on weight loss.

[00:03:50.470] – Rachel

Nice.

[00:03:51.070] – Allan

And so it has to be twelve weeks because it's just the way the math works in our human body. You can change some things but when you look at really a month and a half you're just really getting into the meat of it and you haven't really had any struggles or any issues happen yet. So it's hard to say how would we manage when this happens. You can write all of the SOPs for yourself that you want to have, but when stuff really happens then you find out. So twelve weeks tends to work a lot better for that. So I just relaunched that program, I'm calling it the Shed program and I just got that going and so I'm starting to onboard clients for all that. We're capping it at twelve like I do with most of my things. I'm not going to have more than that many clients because that's how many I can handle. But it's going pretty good. We're having the kickoff calls and people are getting excited. We're starting some plans and getting going.

[00:04:44.890] – Rachel

That's exciting. I love to hear that. I love to hear people making changes. That's great.

[00:04:49.340] – Allan

They are. All right. How are things up there?

[00:04:51.630] – Rachel

Good. I think it might be spring. At least this last batch of snow has melted so that's wonderful.

[00:04:59.130] – Rachel

But yeah, weather's turn

[00:05:00.600] – Allan

we used to call it. There was a fake spring. You just think it's there. You start pulling out your bathing suits and all your stuff and getting ready and then there's another little cold snap and then same thing for the end of the year. You start going into fall, you're like, oh it's cooling off, it's great. And then you have an Indian summer. It's just another two weeks of really hot weather in September.

[00:05:18.490] – Rachel

Yeah, it's like the weather just can't get it together. They don't know what season to be in quite yet. But as we get to the end of March, beginning of April, then I can kind of feel like I can believe spring is actually coming. Then I kind of feel a little more confident in the weather changes. Yes. In March you can't be fooled. Don't be fooled.

[00:05:39.090] – Allan

Don't be fooled. It can snow as late as April.

[00:05:42.020] – Rachel

Yeah, but it's nice.

[00:05:43.490] – Allan

Well good. All right, well are you ready to have a conversation with Jill?

[00:05:47.400] – Rachel

Sure. Great.

Interview

[00:06:59.500] – Allan

Jill, welcome to 40+ Fitness.

[00:07:01.980] – Jill

Well, thank you for having me. I fit into that demographic, so I'm excited to be here.

[00:07:05.860] – Allan

Well, good. Yeah, there's a lot of us these days. More and more people in the fitness space are in this area. I know when I first started trying to fix myself years ago that there was nobody here. Everybody was 20 25 30, and then, well, then you're just supposed to just cast off and we never saw you again. So it's good that more and more of us are actually understanding that taking care of ourselves is a lifelong thing. And there's more and more of us that are in our forty s and fifty s that are out there trying to get these messages out there. Now, one of the ways you're doing it now, this is not your first book, but your new book is called Body by Breath: the Science and Practice of Physical and Emotional Resilience. If I'd had this book five years ago, it would have been so valuable to me. It still is. But five years ago, I just really felt like I was losing the battle for resilience. And I really felt like, okay, stress was beating me up so bad that even when I could get my fitness together, or maybe my health together, I was never whole, if you will.

[00:08:08.570] – Allan

And what I really liked about your book was that it sort of took that whole concept of you're one being and how you take care of your body, it's all connected, and your breath is everything. It's where life and everything happens. And so as you got into this and I'll just say I've read a lot of anatomy books, as you might imagine, as a personal trainer and everything else, and I've read a lot of books about the systems of the body. This is a master class. If you're interested in learning more about your body, this is the book for you.

[00:08:41.830] – Jill

Oh, I'm going to take you on the road with me, Allan, can you do my intros everywhere? That's really awesome. Thank you so much for connecting with it in that way. And just last night I was checking this is coming out after the book is out, but we're in our final four days of prior to publication right now as we record this, and last night it was number one in medical anatomy and anatomy on Amazon. I certainly never, ever in my wildest dream, by the way, my dad's a doctor, so he is like, finally my doctor. But she could have been. Would have been. And not to scare people, the Anonymous is done in, I think, a very accessible way. Those were illustrations that my goodness, I think there's probably five to seven drafts on many of them to just keep finding what's essential, what's going to be able to connect off the page and into people's bodies, because that's really the translation that I want. I want people to have a sense of embodiment through the visual tour of the book. So I'm really glad that that landed with you.

[00:09:45.560] – Allan

It did, because as I was getting into it, I would ask myself the question, I'm like, do we need to go this deep into the anatomy? And then once you started talking about the why this works, we needed that. We needed that basis. And part of what I like about it is there's beauty in the complexity. And what I mean by that is so many people want an easy button. Just tell me how to breathe. And it's like, well, your body actually already knows how to do most of it.

[00:10:14.530] – Jill

We've gotten, in our own way, of being able to have efficient breathing in so many ways. And just to your point about, well, I just want it to be easy, my mother doesn't have easy breathing. My mother is asthmatic. She's been a lifelong asthmatic, chronic asthma. It wasn't until her mid 60s that she even knew how to locate her diaphragm, and it was because I was on a show. My friend Kelly Starrett, the founder of the Ready State, formerly Mobility Wad, he had me come onto a broadcast that he did through a platform called Creative Live. He had me come in and do a seminar for him on fascia and an hour long seminar on breath. This was really revolutionary more than ten years ago. These were topics that really were, I guess, not that hot yet. Although fascia was definitely trending, I showed the participants how to palpate their diaphragm, which is really simple. In fact, you can do it right now as you're listening. You just take your little paws, your little hands and you swing them around the bottom of your rib cage where you can get in you can't get into your ribcage easily all around it, but at the Costa margin, where you have that kind of teardrop shape on the right and left sides of your abdomen.

[00:11:25.120] – Jill

You can get your fingers underneath there. And if you kind of slump over, your fingers can piano play up against all the muscles you're touching, which is obviously your skin, some of the fatty layer of your abdomen, your rectus abdominals, your obliques, your transverse abdominals. But behind all that is your respiratory diaphragm. And then you take a breath in. If you breathe into your hands, you breathe in towards your gut, you'll actually feel the diaphragm contract and try to push your fingers out. So I taught them that process. And I get off stage and there is an enthusiastic message from my mother and she's ecstatic and weeping and so intense, and she says, oh my God, I just felt my diaphragm for the first time in my life. So this is an asthmatic who has lived with lifelong problems and pain and so many other impacts from her breathing posture and from the strain of breathing. But no doctor had ever told her about the primary muscle of respiration. This is also echoed in the very front of the book where I have an incredible yoga professional, a fitness professional, lewis Jackson, he wrote The Ford.

[00:12:30.760] – Jill

He was a lifelong asthmatic and he walked into one of my seminars in his mid 40s, and he had the exact same revelation why didn't anybody teach the asthmatic kid about the diaphragm? He had been dependent on inhalers. It had created a ton of shame for him around at parties, around friends. He was like hiding it all the time. Didn't want to be seen as that sickly, asthmatic kid. But nobody had even in his all his yoga training, nobody had actually described or help him map out the muscles of respiration and what that meant to his whole body. So anyway, so I really do think that just enough anatomy and there's a little bit more than enough, as you mentioned. But it really helps you to map yourself, connect to your core. The lining of your life are your breathing muscles. And why should we over focus on our quads and our biceps? My opinion, the diaphragm is the most important muscle of the body. I mean, I'm saying that above the heart. All right? So that's where I'm coming from here.

[00:13:33.840] – Allan

Well, they're definitely first cousins. They're close.

[00:13:38.630] – Jill

Yes. Well, the diaphragm happens to be a mattress for the heart. The heart sits directly on top of it, and the diaphragm is like humidam Humi dumb. Look how I'm massaging you, Mr. Hart.

[00:13:48.240] – Allan

Above me right now. One of the reasons why I got really excited about the breathing and the body and this whole conversation was because I've always thought of breathing as related to stress. That's when I noticed my breathing. That's when I felt like I had to start paying attention to my breathing, was in those moments of acute stress and then realizing I'm not breathing the way I'm supposed to when I'm in periods of chronic stress. That was me working in the corporate world and realizing I've sat here all day long and I'm actually not breathing most of the day. By not breathing, I mean actually not taking in deep breaths, getting oxygenated, just literally almost in a coma, sitting there and this shallow, almost like panting little dog breath, if you will. And I see it. We've got pets, and whenever they're distressed, they immediately go into that low breathe. And I'm like, that was me 25 years of my life. My days were that kind of breathing. How does breathing and stress resilience pull that together for us so we can understand not just that it's affected, but how we can use it to affect our stress?

[00:15:00.660] – Jill

Sure. Breathing is one of the greatest switches that you can use in your body to be able to pull yourself literally from state to state. You can breathe in such a way that you are up regulated, you're hyper, you're hyped, you're pumped. You can also breathe in ways that calm you down, that pull you out of high stress states. Because breathing is one of these amazing functions in the autonomic nervous system that isn't just autonomic, it's not just automatic. You can actually regulate it. And that's what makes breathing as a health tool so profound. Because healing doesn't take place in a sympathetic, upregulated high pipe state. Healing actually takes place in the rest, digest and recovery. And if we're dampening our ability to enter into parasympathetically, relaxed, rest recover states, then allostatic load the sum total of our stresses, just the pie chart of that is out of proportion. And eventually those lead to stress related diseases. And Ailments, the global indices of disease are all pointing towards that. All cause mortality is increasing due to anxiety related and depression related issues. And so it's important for us as a species to pay attention to what are the levers that this levers is one of the things I think Kelly talks about.

[00:16:24.110] – Jill

What are the levers that we can play around with to see if we can foster a habitat in our body that is okay with that other side of the stress spectrum? That other side of the stress spectrum is our rest, digest, recover, recuperate. So the book while the book is called Body by Breath, the word body is also in there. It's not just breath as the only tool. There are many ways that the book outlines how to use your body and also use some tools to augment a parasympathetic or a relaxation response. And breath is one of the major tools that is used. But the whole body stress is a body wide experience. It's not just in your head. And you know that because you get these really tight shoulder muscles. Your jaw clenches, your sleep starts to be disturbed. We have this body wide expression of stress. So typically one of the easiest and simplest ways to adjust your breath rhythm is to try to put more gas and more duration into your exhales. So long exhale breaths. And this is just a very simple thing. You just think about blowing out more candles on the birthday cake than you already have.

[00:17:37.200] – Jill

So maybe you inhale a certain quantity of air. It doesn't matter how much it is, but you just want to make sure that your exhale is longer than your inhale just to start to grow your capacity. That comfort of getting out of a stress breath, which is more that panting breath or a very shallow breath.

[00:17:55.430] – Allan

Yeah, you used the term in the book and it kind of clicked in my head as I figured something this would but what it was, was you said turning your off switch on. Okay. I would go through my whole day on switches on and you would think, okay then. Now what I'm trying to do is I'm driving home from work and also still in a stressful situation, but I'm trying to then turn off. I never thought of it as other than like if my boss called me up to his office, I would start doing box breathing in the elevator just so I wouldn't do a fight or flight in front of him because I couldn't I had to go face him. But it was just interesting that you put this concept in there because it was just something it was a tool. When I was working in corporate, I just didn't have can you talk a little bit about turning your off switch on?

[00:19:02.620] – Jill

Yeah, in the book I call it turn on your off switch. Thank you so much for asking me about that little lingo statement because it really does summarize the whole book. The book is about recovery, and the off switch in this case is the parasympathetic nervous system. So when we're in a highly stressed state, our sympathetics are basically running rampant and we're responding to that mostly unconsciously. How to take control of that excessive on is to actually try to stimulate a specific nerve called the vagus nerve, which is really the governor of the parasympathetic nervous system. So the ways that we go into the mellow are, one, by turning the on off, but turning the off on. And I know that's very confusing, but it's a little bit of neuroanatomy. So we want to do things that stimulate our vagus nerve because once the vagus nerve starts to come online and we can do this in many different ways and I outline this throughout the book, what happens is the arousal of the parasympathetic nervous system, it down regulates the sympathetic nervous system. So there is a switcheroo happening in terms of what effects start to happen from the brain to the body and also from the body to the brain.

[00:20:28.690] – Jill

So in the book I outline a five phase or five specific things to think about if you're trying to turn on your off switch. And I call this the five P's, and I think it's a very easy formula for people to get comfortable with. It's a five P's of the parasympathetic nervous system. It's a process. It brings you Ps. Lots of p's in there. But here are the five P's. The first P is perspective. Perspective has to deal with a mindset. It's very helpful if you're going to try to flip your stress switch that you bring in your adult brain. You bring in a host that allows your body based experience to occur, because once you start to decrease the speed that's happening in the sympathetic nervous system, you're going to start to have a lot of feelings. The adrenaline and the acceleration in our sympathetic nervous system blunts us to a lot of the subtler senses in our body. This brings me on a quick sidebar into our physiological sensing system is called interoception. And I highlight this in a big way within the book. But basically, these subtle senses are the physiology of your body speaking to you.

[00:21:50.690] – Jill

And so it's helpful to have a mindset that welcomes those feelings to occur, because sometimes those feelings are a physical feeling and other time those feelings are emotions. So we want to be a welcome host to our experience. So in a mindset in that perspective chunk, you would want to say things to yourself that are positive, like, all of me is welcome here or I embody my body. So you're going to welcome your experience.

[00:22:16.600] – Jill

The Second P is place. The place is not always ideal, right? You're in the elevator on the way to speak with your boss. You're in line at an airport, just hoping you can get off the standby list. So place is not always ideal. It can be cacophonous, it can be loud, it can be bright, it can be hostile. But in an ideal setting let me talk about the ideal setting for the parasympathetic nervous system, we're in a place that is warm, that is dark. Those are some of the things that the parasympathetic nervous system really likes. And if you can't be in those places, maybe if you're in a loud, clangy, bright place, you can pretend fantasize.

[00:22:55.790] – Jill

So maybe cast, if it's safe to do so, cast yourself in an imaginary space. It is very helpful. All right, so place.

[00:23:03.550] – Jill

The third P is position. Typically, for position, we want to get grounded. We want to get low to the ground. You could do this by reclining on a bed or a sofa or lying back in a chair. But to really maximize position, especially for the vagus nerve, we actually want to try to get our head lower than our heart, lower than our pelvis. And what this looks like, if you're in a reclined position is just elevating your pelvis up a few inches. I like to elevate my pelvis on my tool. It's called a gorgeous ball. But you can put your pelvis on a stack of books. Body by Breath is a very thick book. You can always put your pelvis on the Body by Breath book. Or a yoga block. We love those. Or a rolled up pillow or everybody's got something they can stick their tush on top of. And what that gentle slope does is it takes advantage of a neural feedback loop called the baroceptor reflex. And what the baroceptor reflex is, is there are nerve sensors in the sides of your neck and the carotid artery that are vaguely mediated.

[00:24:04.330] – Jill

And when your body starts to sense due to gravity that too much blood is flowing towards your brain, your brain can't afford that. Your body can't afford that. And so these stretch sensors in these arteries send a very quick feedback loop through the vagus nerve to the brain and suddenly there's a state shift. Your stroke rate will slow down so your heart will slow down and your breath pace will slow down and all the arteries within your body constrict. And this is to minimize blood flow to the brain so that you maintain your blood barrier, your blood brain barrier. But the consequence of that, the result of that is a mellowing. You get chill by doing this gentle slope.

[00:24:41.830] – Jill

The fourth P is what most people think the book is going to be entirely about is pace of breath. And I already mentioned to you the pace of breath. You typically want to have exhales that are longer than inhales. Although there are paradoxical breathing patterns that are reversed that can be very effective too, but for the most part exhales longer than inhales.

[00:25:01.720] – Jill

And then the fifth P has been my specialty for a very long time palpation. And then in this case, palpation, I teach self massage strategies that down regulate the sympathetics and up regulate the parasympathetic nervous system through gentle touch, through gentle motion and through depth of pressure, comfortable depth of pressure, especially into certain regions of the body where the vagus nerve is available. So we can affect the vagus nerve through manual or through mechanical means through pressure.

[00:25:33.350] – Allan

So as we work through this and we could do it as a stress resilience or we can just do it for an overall resilience perspective, sure, I like that. There's some tools out there I like whenever there's something that makes it to where someone can beyond just knowing that I feel less stressed, I'm sleeping better, those types of things. We can actually measure our performance, if you will, as far as if we're trying to do this. And one of the ways but interestingly enough, it was athletes where I've heard this from, they want to make sure that they are recovered enough to go into training because they train so hard. They use heart rate variability to measure basically their recovery. But it's a tool we could use if we're really stressed out. We're in a high stress job, and we want to make sure we're doing the right things and we're not overstressing ourselves. Because I've had some clients that are, like, wanting to train harder and harder, and I'm like, okay, you're already in a chronically stressful environment. Adding this extra stress of a harder workout to your workload, that's a load. That's a stress load.

[00:26:41.410] – Allan

We call it allostatic load. It just adds up. And workouts can be good hormetic. They can be good for you, but they can also be a part of the problem. Can you tell us a little bit about heart rate variability and what that's measuring and how we could use it as a tool to understand our stress management?

[00:27:01.260] – Jill

Sure. Well, I don't wear tech. My husband does, so I get to collect data. But I don't know. I'm very old fashioned. I want as few rays near me as possible, and I tend to do my own heart rate analysis through interoception. So I'll do different heart rate tests by sensing my pulse and also checking my heart rate. So I just wanted to put that out there because I know a lot of people are checking their reads. Okay, what heart rate variability is the beat to beat changes within your heart. So your heart actually, when you're amplified, your heart has a very regular beat threshold. So let's say when you're running, maybe you're at 120 to 130 beats per minute, right? It's very rhythmical. It's very on. And that's because the excitation within the body subdues or prevents the vagus nerve from firing upon the heart. When you're in a relaxed state, when you're not in an amplified stress state, the vagus nerve should be firing upon the heart, and that creates a sympathetic parasympathetic toggle within the heart itself. But when we are in sympathetic states, it dampens the strength of the vagus nerve signaling to the heart.

[00:28:27.620] – Jill

And so we get the steady, steady, steady state heart rate. When people are so they're psyched, like, oh my God, it was 130 beats per minute, but you're in high stress state, which we need for output and for exercise. But after that stress state, you should be able to come down. And the faster you come down, of course, without crashing, but you should be able to come down and that your heart then goes back to its normal between 60 and 80 beats per minute. Much of this is dependent on so many different factors, but the reason we have these beats to beat changes is because of the effect of the vagus upon the heart. When you have very highly trained athletes that also do a lot of recovery work, their resting heart rate can be lower than 60, and they're extremely healthy. And that is a signal. It's a sign of good vagal tone, meaning that when their body doesn't need to be amped up, it's not sympathetic. They have their parasympathetic resilience in place, helping them. To recover, rest and regenerate.

[00:29:28.550] – Allan

And the value of that, when you start thinking about it from a historical perspective, is you're walking through the jungle or through the woods or through the field. You're just calm, everything's cool, and then something happens. You need to be able to respond quickly. But we're not supposed to stay there. We're supposed to then get back to that rest and recover. Because if we spend too much time and we're not recovering well enough, there's going to be a time we don't get away because we didn't recover well enough to perform well enough when it was time to do that. And unfortunately, most of us are spending so much time in a chronic stress state that, like you said in the book, I think turning on that off switch is kind of an important thing that we've forgotten how to do.

[00:30:16.390] – Jill

Yeah, I think that I would like to see people engage in recovery based practices that really do impact the body and its structure in very therapeutic ways so that it builds what I call their endurance. For parasympathetic tolerance, I do tend to find that people, many people, not all the people that come into my studio, but many of the people that come to work with me, have been so conditioned to upregulation that when they enter into parasympathetic states, their body feels unsettled, it feels threatening, it feels scary. And for these people, meditation, like stillness, meditation, has been abysmal and really is something that is uncomfortable, causes the wiggles, causes the fidgets. And what I try to do is help those high anxiety individuals to find recovery based practices that aren't triggering another sympathetic response. I think some of the there's a chapter in the book around the vagus nerve, and I also highlight the work of Dr. Stephen Porges, who has a theory called Polyvagal theory, which is, please read the book so you can understand polyvagal theory. It's a little difficult to explain in short, shrift on a podcast, but incidentally, he was the first person to quantify HRV.

[00:31:40.570] – Jill

The many things that Dr porsche talks about is the evolution of the vagus nerve and how our bodies, as humans, have appropriated it from reptilian all the way up to primate and mammal and primate to help us identify these body based feelings and, I guess, harness the impact that the vagus nerve can have on our overall health and well being.

[00:32:09.130] – Allan

Yeah, well, the key of it to me is and it's one of the reasons why I think your book is so valuable, is it really does kind of explain we're not just this physical thing, we're not just this emotional thing. And it's really hard to talk about one without talking about the other if you really understand how it all works, because your emotions affect your physicality and your physicality affects your emotions. And all the trauma and all the history and everything that you've had, it's all a part of this jumble of what we become as a person. And if we want to be healthier, it's important for us to just understand how all that works and to find the right ways for us to turn off when we need to be off and turn on when we need to be on. And having these tools, I think, is extremely valuable. Now, in the book, you do share all of these exercises and that was really when the rubber hit the road. So the lessons that you get in the front half of the book are really important. Take your time, go through those. It's a reference manual for how your body works and all of this, then the exercises are excellent and very well photographed and set up so you understand exactly what's being done.

[00:33:25.890] – Allan

And now you know why you're doing it. Which for a lot of people looking at exercises, like, why does she have her hips way up on that and her feet way up on the wall? And that looks uncomfortable. You're not staying there forever. You're just staying there long enough to let a few things happen and settle within your body. But again, as we start looking at these exercises, you had one set and I was like, okay, this is important. I don't know that I'll be able to get my wife to do these exercises. But anyone that's struggling with sleep, I think, has found themselves and their brain is racing and they're suddenly in this almost a fight or flight mode. 02:00 in the morning. And how can they turn it off? Because because they might not be able to completely get up and do a whole workout at 02:00 in the morning. But you do have one. You call it Let sleep. I don't know if you know the full workout, but can you talk about a few things that people can do to help their body just go back into a rest state and go back to sleep easier?

[00:34:27.190] – Jill

Yes. So for that acute wake up, I feel for you. I mean, I feel for all the over 40 fitness people, especially females, that are waking up. Hormone changes are no joke. And as a woman in my perimenopausal years right now, I was absolutely astonished at how radical perimenopause changed sleep for me. So I will say, on a global level, one of the ways that I've dealt with the problematic early morning waking for myself is I've adjusted my bedtime. Because no matter what time I would go to bed, I'd wake up right around 04:00 a.m. And so I decided no more 10:00 p.m. Night time. I go to bed at 8:30. Now, with my kids, that's really helped.

[00:35:22.000] – Allan

Me that's my normal bedtime is 8:30 9:00.

[00:35:26.410] – Jill

If my body wants to wake up at four and my acute practices aren't helping me get back to sleep, then I just need to listen to this bigger sort of chronological change that's happening and work with it rather than against it. But that being said, I do have a few things that I do if I have other wakings during the night, and breathing is very helpful. Here's what I'll say first. Gosh, there's so much I want to say about sleep because I think one of the biggest things we miss, or our bodies miss, is that there is a natural melatonin wave that just comes up in your body right? In the morning we have our cortisol wave, and at night we have melatonin wave. And if you push past that melatonin wave because you really want to finish the episode, or you really want to finish reading the chapter, or you've got to send five more emails or you haven't finished with your food prep, you're going to have a rocky sleep. So it is very critical to attune yourself to interceptively. So this brings us back to interception physiological listening, to be able to pick up on that wave and know that that wave has something to say to you, which is lights out.

[00:36:46.920] – Jill

And so if we miss the wave, it's going to jank up our sleep. So that's one, don't miss the wave. If you miss the wave and you are having fitful sleep, there are a couple of different breath practices that have been proven to be an anxiety reliever and a parasympathetic inducer. And this just came out recently in oh, gosh, I can't remember. OD, I think it was in cell. And it was a study done by Melissa Balaban, David Spiegel and Dr. Andrew Hooverman up at Stanford, and they compared a few different breathing strategies against mindfulness meditation. And I'm bringing this into the sleep realm. The breathing practice is called cyclic sighing. And in cyclic sighing, what you would do just stay in bed. You don't need to move position, you don't need to do anything fancy. What you do is you take a big inhale, pause the inhale for a moment, and then take a second inhale on top of that so you're completely full, and then exhale slowly out through your nose or mouth in body by breath. I call this a chocolate chip breath or chocolate chip cookie breath. And this was a breath I designed in an acute way for my six year old, who started to get panic attacks within months of the pandemic happening and was frightening to watch her go through the inability to breathe and was really struggling.

[00:38:20.120] – Jill

And she doesn't have asthma, there's no other. It was all stress and emotion related due to the changes in the pandemic. And so what I had her do is take a gigantic sniff of warm chocolate chip cookies, try to just fill her body with that chocolate chip cookie scent, pause for a moment and then take an extra kind of cheat sniff, get more scent in, and then exhale slowly and let it go. And so the cyclic sighing breath, you don't have to imagine chocolate chip cookies because that might be too arousing for you in bed. But know that it's a two part inhale followed by a long extended exhalation. And this triggers a reflex in the brain stem of a certain area of the brain stem called the parafacial nucleus. That was discovered by Dr. Jack Feldman, who is a respiratory neuroscientist. But this also is a stoker of our parasympathetic nervous system. So you wake up, your mind is spinning, you start to fidget, start doing these cyclic thighs. Don't count them, just keep doing them and you might find yourself drifting off to sleep. So that's one that's very helpful. There's another breath strategy.

[00:39:31.030] – Jill

Here's the other thing. If you have a partner in bed, there's a little stress there because you start to realize that you can hear your breath go through your nose. So maybe don't let them sleep with you so you can do your breath practice and not wake them up. The other breath strategy I like to do is in the book also, it's called Psychic Alternate Nostril Breathing. This is the one that works for me. It's called an Anolum Vilom. And Anolum Vilom, you imagine the breath alternating from nostril to opposite brain hemisphere and then moving to the other side of the brain and then out the opposite nostril. So you're basically creating a little loop de loop of imagined air pattern or imagined airflow. And I don't know why it works for me, but it does. Ultimately, there are about 23 different breath strategies in the book. You might find one that works for you. So even though I'm saying, oh, well, science said cyclic size are the thing that's going to help coax you down, it may not be true for you because you might have a paradoxical reaction to any of these breath strategies.

[00:40:37.920] – Jill

That's one of the things that makes this so interesting. The other thing I would say is prior to sleep is to get in during the day some recovery based practices because there is a build up over time of your ability to click into that parasympathetic mode. So I think it's a good idea to start to build your tolerance for relaxation earlier in the day. And then you might find that there's a carryover at night. There's other individuals that I work with that find doing the fascia facial work. So in body by breath, there's some head, neck and face rollouts to help massage and stimulate different vagally mediated muscles of the face, neck and head. And so doing really gentle work on the jaw, the temples, even deep into the sides of the neck near the carotid, these can be things that, again, down regulate, sympathetics up regulate parasympathetics and help you nod off. And if you're a jaw clencher, it's very helpful to do the jaw massage close to bedtime to just change the resting tone of those muscles.

[00:41:49.650] – Allan

Yeah, I bring up sleep a lot because I do believe it's critical. It's just one of those big things. And I know that a lot of us over 40, particularly women, struggle with sleep. I'm the guy who's falling asleep each time I've taken yoga, and they use the non sleep. What is it called? Yeah, I'm out.

[00:42:14.250] – Jill

So that's interesting, too. That's a whole other chapter. So there's four tools. The tools are breath, breathe, roll, move, non sleep deep breast, also known as yoga nidra. And there is that category, or there is that segment of the population that when they go into non sleep deep breaths, they actually bypass the focus and they just pass out. And so that would be like an excessive vagal dominance, the non sleep deep breath. From where I'm coming from, if you need to sleep, you should sleep. I mean, that really is an indicator to me of absolute exhaustion. But ultimately, with non sleep deep breaths, we wouldn't be able to train ourselves to maintain attention, to maintain focus on our physiology in this interesting liminal state. And I detailed that in the chapters.

[00:43:00.230] – Allan

Yeah, it was one of those things where if it was a calm yoga session, because I did have one that was like combat yoga, and that one I didn't I was bruised up. I was beat up by the time that one was over. But, yeah, it was kind of interesting. But most of them because it's just this relaxing the breathing, this and I'm laying flat on my back. I'm like, out.

[00:43:24.530] – Jill

Yeah.

[00:43:27.730] – Allan

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

[00:43:40.230] – Jill

Number one, I'd say become aware of your breathing and which zone of respiration you tend to live in. So those zones of respiration I detail in the book, we have three zones the gut, the rib cage, and the stuff above the rib cage. And depending on becoming aware of where you're breathing is really step one towards adjusting yourself into, I think, a healthier, happier place. Number two would be help your body move and find something that commands your curiosity and focus within the movement. And so that could be body parts that you're interested in, or it could be a phenomenon outside of yourself, like a goal of being able to play with your grandchildren for the rest of your life. And then number three for being healthy, happy, and well is use self massage to regulate your emotions and help yourself physically.

[00:44:42.410] – Allan

And your book, Body by Breath details most of that, particularly the massage and the movements and everything else. So, Jill, if someone wanted to learn more about you or learn more about your book, Body by Breath, where would you like for me to send them?

[00:44:58.510] – Jill

We have a really helpful website, bodybybreath.com, that is everything about the book. My company is tuneupfitness.com, so people can also head to the website and check out the offerings there. We have filmed all hundred exercises within the book and those will be going up on the website eventually. I know we're in post production on that. I have lots of programs that also detail fascia and rolling. I have partner programs with my dear friend Kelly Starrett, also Tom Myers, who is one of the godfathers of functional fascia understanding, and then my friend Katie Bowman. We have a program called Walking Well. So there's lots of offerings and classes on the website and then there's lots of free stuff on YouTube, so cost is a barrier. I have so many free videos on YouTube that explain in very digestible chunks of the work. And you can find me on Instagram @thejillmiller. That's where I'm most active. But there's also teachers all over the planet. We have about 500 tune up fitness teachers that teach yoga, tune up, role model and body by breath methods. So you can find them by heading to the website of tuneupfitness.com and putting in your zip code.

[00:46:11.270] – Jill

And you can actually work one on one or in groups with our teachers.

[00:46:16.770] – Allan

Great. You can go to 40plusfitnesspodcast.com/583, and I'll be sure to have the links there. Jill, thank you so much for being a part of 40+ Fitness.

[00:46:28.430] – Jill

I'm so happy to connect with you. Thank you so much for welcoming me and for your deep interest in my book. I really appreciate it.

Post Show/Recap

[00:46:45.490] – Allan

Welcome back, Ras.

[00:46:47.080] – Rachel

Hey, Allan. Every time I think I've heard everything about breathing, you have an interview with somebody that introduces yet another thing I haven't thought about. And it was just really interesting because in this discussion there was a moment where you were talking about having a longer exhale than the inhale. That was one thing that I just never thought too much about. But I was on a run over the weekend, running uphill, my heart's pounding because it was a challenging run. I was on on this trail and I'm like, okay, I'm going to try this. And I started to take some longer exhales and sharper inhales and I don't know, it was a hard run anyway, but I feel like at least it gave me something to focus on. And I did feel better. I felt a lot better once I was done with the hill. But it was an interesting practice that I actually used from your interview. So that was super cool.

[00:47:41.670] – Allan

Yeah. Key takeaway, kids, practice what you're going to do in the race. Don't just do it in the race.

[00:47:48.090] – Rachel

That's right. That is right.

[00:47:51.590] – Allan

All right. So it worked out pretty well with you breathing.

[00:47:55.750] – Rachel

It really does. And especially for runners, we have all these different conditions and whether you're running calm and in an easy pace or you're charging up hills or even windmilling down the hills, which is really fun, there's different moments where breathing in different patterns can have a real huge benefit while you're running or walking or doing whatever. So, yeah, it's always fun to listen to these different techniques and to put them into action to actually try them.

[00:48:24.390] – Allan

Well, what I really liked about this was that Jill's book was really just practical. Breath is a part of movement. Breath is a part of relaxation. Breath is a part of huge sleep. It's a part of everything. So the better you breathe, the better you're going to do in all of those things. And when you get that all kind of balanced out and you're breathing right the way your body was designed to breathe, using your diaphragm and using it correctly, then your body has what it needs as part of that whole, okay, I've got plenty of oxygen, I've got rid of enough of the carbon dioxide. My body doesn't have to feel like it's about to die. I can just relax a little bit more. And again, that's one of the keys. One of the keys for people who are really good at running is that they get adequate oxygen in and carbon dioxide, they get a right balance and they keep that right balance at what is basically a very low level of exertion for them. But they're moving really quick. So there's this disability. But then the other side of it is, well, they are going to put up with a whole lot of pain for that duration of that run.

[00:49:40.970] – Allan

But the breathing is the big piece because most of these runners, their resting heart rate is in the 40s when they're really pushing themselves, they might get their heart rate up to 150, whereas an average person, I get 150 just jogging down the street. But it's one of those things where breath is really a part of movement. It's part of all of it. There are some good exercises in here for you to go through and understand how to breathe better. And that's going to make everything else better.

[00:50:21.430] – Rachel

Oh, absolutely. And you just mentioned relaxation. And in every aspect of life when you've had a really tough day at work or you're frustrated with the kids or something is stressing you out. Really taking that time to practice some relaxation technique type of breathing. It sends your body into such a relaxed state so that your mind can actually think better and then you can problem solve a little better and not be so anxious about what's going on but actually have the wherewithal to deal with it properly. And I think few people just take you hear it all the time, just take a second, calm down. But if you actually did it, don't ever tell your wife to calm down. I'm just saying. But when you actually do take a second, take a deep breath, then it actually does put you in such a relaxed state that you can deal with troubles so much better. And I think that's missed on a lot of people.

[00:51:17.160] – Allan

Yeah, I agree.

[00:51:18.970] – Rachel

Great interview.

[00:51:20.230] – Allan

Thank you. Well, you'll talk next week, then?

[00:51:22.480] – Rachel

You betcha. Thanks.

Music by Dave Gerhart

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Another episode you may enjoy

How breath-work can improve your life with Stuart Sandeman

Less...

Let's Say Hello

[00:02:33.080] – Allan

Hey, Ras.

[00:02:36.260] – Rachel

Hey, Allan. How are you today?

[00:02:38.100] – Allan

I'm doing all right. Good weather, busy season at Lula's. Daughters getting married soon. So we're starting to book that trip. Tammy and I are talking about it because we want to see family. When you have family that's in their upper 70s and 80s and you start saying, Okay, I got to get got to make the point because you can't just say, I'll do it next year. So we're going to stay a little bit longer in May than we thought we would just to get all that in. But we've been talking through how to do that. And I'm a weirdo, but you already knew that. I just prefer to arrive in one location and get a rental car and just hook it on in the car. You can throw your bags in there once and you just go. And it just makes things so much easier, in my opinion. Now, yeah, you do spend more time because you got to drive. But if you think about flying to a location, getting a rental car for a day or two, and then going back to an airport and flying again, actually got to turn in that car and fly again, pick up another car, yeah, it's faster, but there's so many moving parts.

[00:03:55.470] – Allan

So a late plane and I missed this. And now you're not getting into your hotel when you planned on it. And then you got to try to get that done. So there are still a lot of moving parts because I have to get my CPR. The last one I got was online because COVID. I need to get it done in person this time. That would be nice. They might let me get away with another year of online, but I don't live in the state, so I don't have them here. I have to get them when I'm in the state. So this year, going into the states, mine is going to… I think it actually is going to be close to expiring about the time I get there. So I want people to dillydally or get in there and get it done. And so I'm trying to slide that in there. Oh, and there's the wedding.

[00:04:43.700] – Rachel

Yes, the whole reason you're coming up here.

[00:04:45.380] – Allan

I was like, Hey, I could do this on Saturday. What time is that wedding? I was like, You are not. No.

[00:04:53.700] – Rachel

Oh, my goodness. What a trip.

[00:04:56.440] – Allan

Yeah. So yeah, we're probably going to be flying into Miami, spend some time with family there, drive up to North Carolina, spend some time with family there, go to the wedding, and then drive on over, I think, to Kentucky, spend some time with family there, and then head back out. Awesome. Yeah, but it'll be a lot of driving, not as much driving as we usually do, and not for nearly as long as we usually would, and not normally when we would. But all those things all considered, we'll make the best of the trip we can and get it all done. But how are things up there?

[00:05:27.980] – Rachel

Good. Today's a good day. We have blue skies today. We're in the thought.

[00:05:33.560] – Allan

The numbers I was seeing about power outages and stuff like that.

[00:05:38.300] – Rachel

Yeah, it was brutal. In fact, there's still a lot of people out of power. We lost it briefly just for a few hours. Thank goodness. But one of my cousins was out for four and a half days. Yeah, it was just brutal. And there's still people that are out and we are expecting another pretty serious weather event happening to be determined whether it's going to be more ice or more snow, but yeah, we're still recouping from that last storm.

[00:06:05.440] – Allan

Do you guys have a generator?

[00:06:07.020] – Rachel

We do. This house has a generator that will run our furnace and we have a well, so it'll run water for us. So it does, it works just fine. It's really funny. We lived in Florida for seven years, Allan, and the first thing we did when we moved there was we bought a generator because it's hurricanes down there. Never once needed to use it in Florida. And up here, we've used the generator, I think, in every house that we've been in since we moved back and several times per year. So yeah, I'm glad we have it.

[00:06:40.560] – Allan

Lula's had a generator, but it's this old little beater, and I don't even know if it worked. I haven't tried to start it. And then I brought one down. I had a Honda that I used for tailgating, but we put it away. I haven't pulled it out. And so the power goes out regularly. Oh, no. At least once a month, we have an unplanned power outage. And then probably about once a month, we have a planned power outage. But I haven't pulled them out. And it's just one of those things you have a whole list of things you really should do. And then you just don't do them because there's other things you'd rather do like watch Netflix or go for a walk or anything else.

[00:07:22.780] – Allan

So yeah, I should really get that generator out and get it serviced.

[00:07:26.390] – Rachel

It could be handy. But if you've never needed it, though.

[00:07:29.380] – Allan

But you do. No, because when the power goes out, we don't have water. We have a pump that pumps the water through our house and without that pressure, there's no water. So we tell people, if we know the power is going to go out, it's like you got one flush and done, so make it matter. But if we don't know the power is going out, that's when it can get a little bit dicey.

[00:07:50.440] – Rachel

Yeah, that could be helpful to have. Yeah, it's good to have one here because same thing in the middle of winter, it's not fun to lose power for an extended period of time. In the summer, we can manage, but it's a little harder in the winter.

[00:08:04.950] – Allan

Yeah. All right. Are you ready to talk about vein health?

[00:08:08.500] – Rachel

Sure.

Interview

[00:08:56.920] – Allan

Dr. Mandy, welcome to 40+ Fitness.

[00:09:00.690] – Dr. Mandy

Thank you. Thank you for having me on.

[00:09:04.160] – Allan

When I was working corporate, I traveled a lot and I spent a lot of time on airplanes. In fact, I did one time did the Newark to Singapore flight, which was over 18 hours. So I spent a lot of time. And so at that point, you're reading a lot about get up and move around, wear these compression socks, do these things because you really don't want this deep vein trombosis. And so I would do the basic stuff when I was on a plane that long, moving around, doing what I needed to. But I guess I never really wrapped my mind around the fact that all of this from the spider veins and Varicose veins that I remember ladies at the lunch line had with all their compression socks to this is really just a continuum, if you will, of the same issue of vein disease.

[00:10:01.440] – Dr. Mandy

That's exactly right. That's the perfect way to put it. It's all a continuum of the same disease. And flying is such a big risk because it's a microcosm of all the risk factors for blood clots, like you mentioned, DVT, as well as vein disease in general. So anytime you're sitting in one place or standing in one place and your blood is not really pumping and moving like it should, it just sits there in the veins and isn't really circulating the way it should be. And so that can lead to blood clots in the deep veins. And it can also lead to a lot of pressure on the veins underneath the skin. And that pressure causes those veins to overstretch and allows blood to actually flow backwards. Normally, blood should only be flowing up in the veins in your legs. But due to a variety of things, being in one position for a long time, having genetic predisposition, having multiple pregnancies, variety of things like that, those veins can be overstretched and that causes blood to flow backwards, which can lead to all the things you discussed earlier, the bulging vericose veins, the pain and symptoms and swelling, and in some cases, severe cases, blood clots as well.

[00:11:14.240] – Allan

Okay, so let's walk through a few of these just so folks know what we're talking about here. So spider veins are what exactly?

[00:11:23.700] – Dr. Mandy

So spider veins are the small… They can be a purple color, light pink color. They're those little tiny, wispy veins right on the surface of your skin. They're usually very small and they usually don't bulge out. So meaning they're just flat underneath the skin, so you can't feel them. And that's the most minor form of vein disease or most minor sign of vein disease.

[00:11:45.040] – Allan

Okay. So those are just a discoloration that you see because the blood is not flowing through those little veins the way it needs to.

[00:11:51.840] – Dr. Mandy

Exactly right. Normally, those veins are so tiny, you'd never be able to see them with the naked eye. But because they've been under a lot of pressure, they're several times bigger than they should be. Even though when we look at them, they appear very small, they actually should be much, much smaller than they are. And so it's all, again, like you said, it's all part of the same process. So those veins overstretch and becoming bigger than they should be.

[00:12:13.040] – Allan

Now, Varicose veins, they actually are a little bit worse because they're bigger and a lot of people suffer from pain from these. Can you talk a little bit about what Varicose veins are? Exactly.

[00:12:23.570] – Dr. Mandy

So Varicose veins, typically are those big bulging veins that you see some people have. Maybe you mentioned your grandparents. So you could see them bulging out. They could be very large like that. They don't necessarily have to be that dramatic, though. Any vein that bulges out from the surface of the skin is a Varicose vein. So sometimes they're actually quite small, and they're those giant ropey looking veins. But if they bulge out and you can feel the vein when you rub your hands over the surface of the skin, that's a Varicose vein. And those can be more dangerous because those can lead to bleeding. Sometimes the bleeding spontaneously, or in worst case scenario, they'll actually clot and those can lead to TBTs and other problems associated with that.

[00:13:09.050] – Allan

Okay. Now, chronic venous insufficiency is the next stage along this continuum. Can you get a little bit into what that is? Right.

[00:13:17.290] – Dr. Mandy

So chronic venous insufficiency is where the big, we call the trunkle veins underneath the skin, have become too large and the little valves that pump the blood up the leg against gravity have become broken. And so instead of keeping the blood moving up, a lot of it is going backwards. And that ultimately is what causes Varicose veins in many of the spider veins you see. The root is really those bigger veins deeper inside the skin that you can't see that are allowing blood to back up into those Varicose veins and spider veins. So one way to think of an analogy I tell a lot of the patients that we see is the big veins that are deeper are like the trunk of the tree. We literally call them trunk of veins because they're like the trunk of the tree. And then those bulging varicose veins are like big branches on the tree. And then the little spider veins are like little leaves on the tree. And so the trunk is where the problem is. So when the trunk goes bad, blood just backs up into the branches and the leaves. And that's what causes all the visible veins and those big varicose veins that you can see.

[00:14:20.120] – Allan

Okay. And then, like I said, when I was on an airplane, you can get into this pretty quickly versus over a series of years, but you could still get there. Deep vein thrombosis is actually now we're starting to get into some really dangerous stuff here. Exactly right.

[00:14:36.320] – Dr. Mandy

Yeah. So like you said, that can happen for a variety of reasons. It can be, in your case, your example of being on an airplane, that's where you can get a little dehydrated on a plane, the blood just sits in those veins. And anytime the blood sits and doesn't move, it can clot. What keeps the blood from just clotting throughout your body? Part of it is the motion of the blood constantly moving. And so if it's sitting in one place, there's a much bigger risk of it clotting. So an 18 hour flight from Newark to Singapore, where you're not doing a lot of moving, you're just sitting in one place, that blood is not really moving effectively. And that's why people can get clots on airplanes.

[00:15:14.040] – Allan

And it's not really… I mean, it is the clot in the leg, but it's the clot that moves that's the dangerous one. And that causes a thing called pulmonary embolism. Can you talk about what's going on there?

[00:15:25.780] – Dr. Mandy

That's exactly right. So blood clots in the legs themselves can be painful and can cause swelling and all those things. But the really feared complication of that is an emboli, which is where part of that blood clot or embolism, which is where part of that blood clot breaks off from the leg and travels up the veins in your body to your heart and ultimately your lungs. That can cause anything from shortness of breath. Sometimes people don't even notice them. Worst case scenario, they can be life threatening and be a true surgical emergency. So those are extreme cases. That doesn't happen with most people, but it can. And it can and does happen occasionally.

[00:16:02.200] – Allan

Now, we talked a little bit about being on an airplane in the period of time that you're sitting still, and you talked a little bit about dehydration, but what are some things that we might be doing to ourselves that are causing a higher risk of these complications happening to us?

[00:16:18.680] – Dr. Mandy

Yeah. So any sedentary lifestyle, especially over a period of years. So any prolonged sitting, especially obesity, certainly smoking, those are all major risk factors for BVT. And the reason is they all injure the lining of the veins, and that can lead to clot formation and things like that. So being active, getting up and walking, moving, and being able to prevents clots. Obviously, maintaining a healthy lifestyle in terms of diet and being physical and not being overweight, all that helps prevent blood clots as well. And certainly avoiding smoking. So there are some things that are just genetic and can't be really prevented, but those are some major risk factors that can be prevented.

[00:17:05.760] – Allan

So for a lot of us, if we start seeing more of that little outward signs like the spider veins or the Varicose veins, that could very much be an indicator that we want to go get checked out and make sure this isn't something worse.

[00:17:20.150] – Dr. Mandy

Absolutely. Yeah. Especially Varicose veins, but spider veins as well can be a sign of wors vein disease, especially if they're around the feet. If you see a sudden increase in the number of small veins around the feet and the ankle, that can be a sign of pretty significant vein disease.

[00:17:37.010] – Allan

Okay. So if we notice some of that, we're going to come in to one of your clinics, the Metro Vein centers. What's going to happen and what are some of the treatments that would potentially be available to us, given where we are in this continuum?

[00:17:50.500] – Dr. Mandy

Yeah. So the first thing we do is I talk to everybody who comes in, we go through their symptoms and the problems that they're having, and we do a thorough look at what could be causing these. And then the objective test that we do is an ultrasound of the legs. So an ultrasound is very similar to when pregnant women have an ultrasound of their abdomen to look at the fetus and the growing baby. We do the same thing just on the legs. And what we look for when we look at the veins is the size of the veins as well as the direction of the blood flow. So the veins should be fairly small, only one, two, maybe three millimeters at the largest, and the blood should only be flowing up. But in the disease veins, the veins can be many times bigger than that, and the direction of the flow is actually backwards. And when those two things are there, the veins being too large and the blood flowing backwards, we know there's a disease and that needs to be treated.

[00:18:44.480] – Allan

What are some of the treatments that we could go through to make sure that just to fix it? Obviously, I'm always going to be a proponent of lifestyle, but sometimes our lifestyle can't reverse this. So what are some of the treatment options that would be available?

[00:18:55.760] – Dr. Mandy

Well, thankfully. The treatment is usually very easy. So it used to be in the past, there was a major surgery to treat these veins called vein stripping and some similar type procedures. And those oftentimes while staying in the hospital, major cuts on the leg can be very painful, high blood loss. And now we treat them in the office, usually takes 10 minutes or less to treat one vein. There's no cutting, no stitches, no surgery. People usually walk in and out on their own, go back to work a lot of times. And there are different types of treatments we can do based on where the vein is, how big it is, what the patient's goals are. And one of those is injecting a medicine into the vein, which causes the vein to shrink. Another one is called radio frequency ablation, where we use radio frequency, not radiation, but radio frequency to shrink the vein. And another one is where we inject a medicine that seals the vein called VenaSeal. And the goal of that is to prevent the blood from flowing backwards. But they're all very quick, easy procedures that insurance pays for.

[00:20:01.440] – Allan

And you want to basically, as soon as you start noticing some of the outward signs of this, you want to get in as quickly as you can, right?

[00:20:08.180] – Dr. Mandy

Exactly right. Unfortunately, veins only get worse over time. So once they go bad, there's nothing you can really do in terms of lifestyle or behavioral changes or medication that's going to reverse that. So all you can do is treat the veins to prevent that backflow of blood. And that's what we do in our office. So it's good to maintain a healthy lifestyle and do all those things. But once the veins go bad, they only get worse over time.

[00:20:33.270] – Allan

Still going to encourage you to quit smoking if you're doing that. And I'm going to encourage you to move around because that's still good for you to do. But then yeah, get in and see a specialist on this. Now, your clinics are located in New York, New Jersey, Connecticut, and Michigan. Last time I checked, you're still in those places, right?

[00:20:52.900] – Dr. Mandy

We're still in those places and we're continuing to look for new locations as well. So hopefully in the future, we'll be expanding beyond that.

[00:21:00.980] – Allan

Yeah, we're down here in Panama if you're looking for a satellite office.

[00:21:05.390] – Dr. Mandy

Sounds good to me. Yeah. Looking out my window in 25 degree weather, Panama sounds really nice.

[00:21:11.690] – Allan

It was 25 today Celsius.

[00:21:18.170] – Allan

Dr. Mandy, if someone wanted to learn more about you, learn more about the Metro vein centers and all that you do there, where would you like for me to send them?

[00:21:27.100] – Dr. Mandy

Well, they can visit our website at metroveincenters.com, and we have a wealth of information on there. It gives the locations of our offices how to contact us, but also just a lot of good information on vein disease. We try to make it as user friendly as possible. And I think people would get a lot of valuable information from that. You can also follow us on social media or on Instagram and TikTok and all those things. So we try to provide information on things on that as well.

[00:21:55.120] – Allan

I learned quite a bit reading your blog, so I do appreciate the information and the time you took to put that out there because it is very clear and easy to follow and understand what these are and how they relate to our health and fitness. And again, it can seem like it's just an unsightly thing, but when it gives you an idea that it's a bigger thing than that, you've got to take a moment and figure it out. And I'm glad you guys are out there helping provide this information and the treatments.

[00:22:25.360] – Dr. Mandy

Thank you. Yeah, it affects a lot of people. Some people estimate 20 to 30% of people in the United States. And it's one of those things, even when I went to medical school, a lot of my professors would say, it's just people get older, they get veins. And like glue it off is not a really important problem. But it is an important problem and it can cause significant lifestyle disabilities in terms of being able to exercise and enjoy normal walks in the park, even because of the heaviness and discomfort. And so thankfully, we can help treat that now very easily. And so that's not something you just have to live with. Just because you see some big veins, we can take care of all those things.

[00:23:04.620] – Allan

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

[00:23:08.840] – Dr. Mandy

Thank you very much for having me. I really appreciate it.

Post Show/Recap

[00:23:21.420] – Allan

Welcome back, Ras.

[00:23:22.660] – Rachel

Hey, Allan. It's been a really long time since I even gave any thought to vein health, Varicose veins, or any of those things. I remember my grandparents used to have problems. I said, I think it was the Varicose veins that were very painful for them, and so they would go to the doctor and have them treated. But yeah, it's just something that hadn't been on my radar for a long time. But it's pretty important.

[00:23:48.140] – Allan

Yeah. And growing up, there's the different types of jobs I had. I worked in a library, so a lot of the librarians would have them. And I worked in a pharmacy. And so the pharmacists and clerks that work that were on their feet all day, every day, they would have them. And then, of course, then I got into travel and I'm on an airplane for up to 18 hours or more. And you just know you've got to do some things to take care of yourself. So I have the compression socks. I made a point of getting them. I was trying to stay hydrated, all those different things. But if you start to notice that you have problems, this is the one thing I didn't know before I got into this, this is progressive. If you start noticing a problem, it could be indicative of something worse happening later. So it's worth going in and getting it looked at just to make sure there's no long term problems. You can get it treated. You can start making some lifestyle changes, and that's definitely going to help.

[00:24:48.740] – Rachel

Yeah, my goodness. I didn't realize the extent of how dangerous it could be to have the veins and to pay attention when they do show up, those little tiny ones before they get into the bigger vericose or the deep vein thrombosis. That's pretty serious stuff.

[00:25:06.110] – Allan

Yeah. It doesn't happen that often. So it's not like people are just all over the place. But just something to be aware of, if you have Varicose veins or you have the spider veins and you're going to go on a long trip, do the self care. If you can talk to a doctor first just to make sure I've got these condition, how am I going to do with this trip? Because we don't take international travel on just a whim. You usually have some time and that you know it's going to happen. So it's worth it. You can go in and see a doctor, see if you can get it treated or at least know what preventative care. I still own my compression socks. I don't know that I'll ever need them to go because I think the longest flight we even take out of here is four hours. So I don't know that I'll need them again like I did when I was traveling all the time. But I had them. And so it's like, just take precautions if you think you're going to put yourself at risk because it can be pretty serious.

[00:26:05.570] – Rachel

Yeah. Interesting. It was really interesting to hear that and to be reminded. Good interview.

[00:26:10.970] – Allan

It is something I haven't talked about. And I just thought, I know this was a health problem that I knew older people got. And Tammy's mother has some leg vein problems. So it is something that you just… It's out there. It's just not super common. But enough so that if you start noticing you have a problem, go get it fixed.

[00:26:34.160] – Rachel

Yeah, that sounds good.

[00:26:36.320] – Allan

All right, talk to you next week.

[00:26:37.780] – Rachel

Take care, Allan.

[00:26:39.040] – Allan

You too. Bye.

[00:26:40.050] – Rachel

Thanks. Bye.

Music by Dave Gerhart

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