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January 21, 2019

Fix your digestive issues with Tamara Freuman

Do you suffer from a bloated belly, IBS, diarrhea, or another digestive issue? Our guest today, Tamara Freuman has the answers in her new book, The Bloated Belly Whisperer.

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  • Judy Murphy

Thank you!

Allan (1:00): Tamara, welcome to 40+ Fitness.

Tamara Freuman (1:04): Thank you.

Allan (1:05): Your book is called The Bloated Belly Whisperer. I know from reading the book why you now have that, for a lack of a better word, nickname, but thats also what youve called your book. Can you give us a little bit of the backstory on that?

Tamara Freuman (1:20): Sure. I am a dietician and I work in a gastroenterologists office in New York City. And pretty much from day one when I started working there, patient after patient would come to me complaining of bloating. Early in my career I really had no idea what this thing was. Its not something you read about in your textbooks when youre learning in dietitian school. I just had to ask a ton of questions and understand what was going on, and it became very clear to me very quickly that not all of these people were talking about the same experience or the same problem. As my practice progressed and as my career progressed, I understood that bloating really meant many different things, but there were about 10 causes that I kept seeing over and over again, and they started to look very familiar. It got to a point where within the first 10 minutes of talking to someone who was bloated, by asking certain questions and gathering certain information, they were clues that would lead me very quickly to the right cause and therefore the right treatment. Once I figured out how to figure it out, I thought Id better put this down in writing so that other people can really benefit from this knowledge.

Allan (2:30): And thats what I think is really cool. Having written my own book, I think as a writer youre like, Gosh, I really do hope they read this first chapter”, because this first chapter is really critical. I know so many people are going to say, I have constipation so Im just going to flip to that chapter and get to the rub of what I need to do. But you start off the book with a quiz. The reason I like the quiz is, its looking for those other signs that someone might be missing because they have the most significant symptom in mind, versus they might actually have two of these things going on at the same time and the quiz is actually going to help them do that. You kind of define how you started developing this quiz, but can you tell us about the quiz, how it works and why its valuable for the reader to take some time to go through it?

Tamara Freuman (3:28): The reason I developed this quiz is because the way that it works when a patient comes into my office is I have an hour to sit with you and ask you a million questions. And I do – I ask everything, and youll answer something, and that will lead me to another question. Theres sort of this brain algorithm thing going on that leads me into this Choose your own adventure decision tree, and then I land at the answer. I cant do that in a written book, so what I had to do is come up with the next best thing, and this quiz really is that. Its, how do I distill that very complex diagnostic back-and-forth into something that you can take by yourself at home and that will lead you to, if not the most accurate answer, the top three. And then maybe you can pick from the top two or three things that you sound like and recognize your own experience. So the quiz is the best chance that I have to approximate an in-person patient consultation with a reader sitting in their own home.

Allan (4:24): I really enjoyed going through the quiz and looking at the questions and the potential of what I would have answered at certain times in my life. I have the great fortune right now – Im very clean with what I eat, so I dont tend to suffer from bloating much. But I can say in my past, I definitely have had multiple symptoms of bloating, constipation and those types of things. I recognize the nature of it, so it was really cool to go through and say, Yeah, thats what I felt. Thats how that was. That wouldve been my diagnosis at that point in time. I do want to go through what I think are some of the more common ones that I hear from friends and family and sometimes from clients. The first one that got my attention, and I have a couple of questions as we dive into it, is indigestion.

Tamara Freuman (5:18): Yes.

Allan (5:20): I see commercial after commercial after commercial of, Take this pill, take that pill. This is quick; thats going to take forever, but that lasts forever. And go back and forth. Can you talk about the symptoms someone would have and then what some of the treatments are that they can do?

Tamara Freuman (5:37): Sure. Indigestion, the way I talk about it in the book, is the sour stomach bloat. And thats really any kind of acid-related malady. This is one of the more common types of bloating that originate in the stomach. One thing I try to do in the book is really separate bloating that originates in the stomach, which is its own beast and it has its own remedies, versus bloating that originates in the intestines, which has other causes and other remedies. So, of the types of bloating that originate in the stomach, indigestion, acid-related issues are a problem. And whats tricky about them is they can be very situational. Patients have a really hard time identifying whats going on and whether there are food triggers, because theyll say, Sometimes I eat this food and Im fine. And then another time I eat that food and Im miserable. Am I intolerant to that food or not? Whats going on? And the issue is, our stomachs reaction to food is very contextual. It depends when we last ate. Has it been five, six, seven hours since we last ate and we are empty in acid? Or did we just eat three hours ago a big giant fatty meal and were still a little bit full from that meal? You could eat the same food in either of those contexts and have a really different reaction, versus youre on a normal meal schedule, its been about four hours since youve eaten, youre a little bit hungry – not over hungry, not over full. You eat that meal and you have a third reaction. And so, this idea that your body can overreact with acid, or you could have a loss of pressure in that muscle that separates your stomach and your esophagus, because you ate a lot of fat or you had some alcohol with the meal and that meal is refluxing on you. The trick to classic indigestion is really understanding the foods that trigger it, the contextual triggers of it in terms of your hunger level or fullness level, and therefore how to manage it with food choices, with supplements, with medications.

Allan (7:33): Okay. I like how in the book youre very clear with, Lets start with the How and what we eat. You went through a process of saying if you suffer from indigestion, youre going to want to eat more regularly, smaller meals, those kinds of things. And if that doesnt quite solve all the problems, then there are some medical things we can do, as far as over-the-counter and prescription stuff. Can you walk through the food choices, the size and timing of meals, and then some of the other treatments?

Tamara Freuman (8:08): Definitely. As a dietician, the way that I would typically approach people with acid indigestion is Im looking for foods that empty the stomach rather expeditiously. The way I describe it is your stomach is basically a food blender. Its main job is to liquify your meal, so that that liquid meal can trickle out of the stomach and move on into the digestive journey. I tell my patients, Envision how much stomach acid does your stomach need to secrete, and how much time and churning does your stomach blender have to churn in order to liquify a giant kale salad versus to liquify a kale smoothie. Same food, same ingredients, very different physical properties. So, you can envision what type of work and what kind of time and what level of acid will be required to liquify certain textures of foods, certain volumes of foods as compared to others. So the first thing that Im really looking at with my patients is how much volume do we eat in a sitting and what are the physical properties of that meal? Can we tame the texture? Can we tame the volume? Break it up – instead of having a big lunch at 12:00 and then nothing again until dinner at 7:00, can we have a small lunch at 12:00 and then the second part of your lunch at 3:30 or 4:00, and then another small meal at 7:00, so that youre never too hungry and overeating and then never too empty and starving, so youre going to overeat because youre starving. So, thats one thing that I do. The second thing as a dietitian that I care about is fat. Fat really does have an effect on the sphincter muscle that keeps your stomach contents in the stomach and prevents them from refluxing into the esophagus. Really high fat meals can relax that pressure so that food is more likely to reflux. So for a patient who does have that classic indigestion, Im looking at fat, Im looking at frequency of meals, volume of meals, and texture. For many, many patients, that gets them really far in terms of symptom control, even without any medications.

Allan (10:20): You also threw alcohol in there, because that can be symptomatic as well, right?

Tamara Freuman (10:25): Absolutely. Alcohol has a very similar effect as fat in terms of relaxing that muscle, and that can make reflux more likely.

Allan (10:35): Most of the medications that are on the market actually reduce the stomach acid at some level. But Ive read, and maybe its wrong and Im misreading something here, that sometimes we would have some of these symptoms because our stomachs not producing enough acid.

Tamara Freuman (10:54): Thats a really common Internet misconception thats out there. I know that there are a lot of beliefs that we’re not having enough stomach acid and we should take apple cider vinegar or other things to acidify the stomach, or even supplements. Theres one called Betaine HCL that I see people use a lot. Theres really no evidence to support any of this; in fact, there is some pretty strong evidence to support the contrary. Frankly, if you ask any person who has suffered from chronic acid indigestion or more serious chronic acid reflux disease, they feel better when they take a TUMS, they feel better with acid reducers. So, I havent really seen any evidence to support this idea that not enough stomach acid would cause acid indigestion.

Allan (11:41): Thank you for that. Like I said, that kind of confused me when I was reading through. I thought we were supposed to go away from the TUMS and go towards taking HCL to push our stomachs to do the digestion faster, if you will. But I guess not. Thank you. The next one I want to talk about, which I think is also very common and actually very uncomfortable for a lot of folks because it makes it sometimes difficult for them to feel comfortable leaving the house, is constipation.

Tamara Freuman (12:12): Yes, constipation is a big one. Its really common, and also I think a lot of people who are constipated don’t recognize that theyre constipated. I have a lot of patients who will come to me and theyre complaining of bloating, and when I go through my little back-and-forth algorithm in my brain, it sounds very much like what I call backed up bloating, or being full of stool. And theyll say, No, no, no, Im not constipated. I go to the bathroom every day. Theres this idea that if you move your bowels every day, you couldnt possibly be constipated. And thats not true at all. You could move your bowels, but move them incompletely, and still move your bowels every day and wind up having a very high stool burden or a very large backlog of stool hanging out in your colon thats unable to really be passed. And so, sometimes people can be constipated and they dont even know it.

Allan (13:02): Okay. So how would someone know the difference between normal constipation and something where theyre not completely getting rid of all the poo?

Tamara Freuman (13:12): The classic constipation, what most people recognize as constipation is, I dont go every day. I might skip a day, I might skip two days. My stools are really hard. There are these hard little balls, or I have to strain incredibly much to go. And when I go, I feel like I didnt get it all out. Thats the typical experience of constipation that most people who have that will recognize that theyre constipated. But there could be people who have extremely high fiber diets, for example. Theyre putting a lot of stuff into the pipeline and they go to the bathroom once a day. And its like a smallish to medium, formed normal size stool – in other words, putting more stuff in than is coming out. Someone on a really, really high fiber diet might need to go to the bathroom three or four times a day to keep up with the input. Sometimes if youre just going one time a day with a very high fiber diet, and its not an incredibly large amount of stool, you might be falling behind. Thats something people might not recognize is going on and then they dont understand why theyre so bloated.

Allan (14:17): Thats because the fibers picking up extra water and making up some girth to what youre digesting, versus not.

Tamara Freuman (14:27): Right. Fiber by definition is indigestible, so fiber that goes in must come out. We cannot break it down, we cannot absorb it. With fiber, what goes in must come out, and if a lot is going in and not a lot is coming out, then you might be outpacing your ability to eliminate it, which could happen for a variety of reasons. Maybe you have a slow colon, which can happen. Maybe your pelvic floor muscles arent working optimally and youre unable to pass large amounts of stool. There are lots of reasons that could happen.

Allan (15:01): I actually had a green smoothie yesterday for lunch, and Ive already gone twice today. So, I think the fiber is working its way through me quite quickly.

Tamara Freuman (15:13): It is. And I love that were at a place in our relationship where we can share these things with each other. Thats so great!

Allan (15:21): Its funny, because actually theres another author that Im interviewing and hes pretty heavy into the fiber stuff. Even though I do the keto, Im going to work a little bit more on getting my greens in, particularly the leafy greens with the fibers. I did do a fruit smoothie yesterday, Im going to do a smoothie today and see how that works for me.

Tamara Freuman (15:43): Excellent.

Allan (15:44): Alright. So, someone comes to you and they are in fact constipated. What can they do now to help themselves?

Tamara Freuman (15:53): The trick with constipation is, its really important to understand, if you can, the nature of the constipation. You can be constipated for more than one reason, as I alluded to before. For example, one thing is you just dont eat enough fiber. Thats the low hanging fruit – nothing in, nothing out – so, thats a more straightforward fix. Some people are constipated, like I said, because their colons are really, really slow; it takes a really long time for stuff to move through them. And the longer waste spends in your colon, the more dried out it can become, so that can be a cause for constipation. Some people, their motility is fine. Things move through them at a proper pace, at a normal pace, but the muscles involved with defecation arent coordinating properly – they cant relax and let the stool out, or their muscles are too weak and they cant propel enough force to get the stool out. There are all sorts of reasons that someone could be constipated and typically a dietician or a doctor will start with some of the more likely causes. Theyll look at the fiber, they might do a little bit of an-over-the-counter laxative thing and see if that does the trick. And for many people with a slow transit constipation or inadequate fiber, that is a really quick and easy fix. But if youre someone that is on a high fiber diet and youve taken magnesium supplements or MiraLAX or a senna tea or something – those low level laxatives, and literally they havent done a thing for you – then we have to start wondering whether your musculature can really support healthy defecation, and maybe get an evaluation from a gastroenterologist of your pelvic floor function to see, because all the laxatives in the world and all the fiber in the world aren’t going to help if there is some faulty plumbing and things cant get out.

Allan (17:47): Okay. Typically Ill have some coffee in the morning, and that seems to be a stimulant that gets my whole digestive system working rather quickly. So, that is something they could also consider – some caffeine in the morning?

Tamara Freuman (18:05): Its actually not the caffeine. Its the coffee. Theres a compound called chlorogenic acid that is in regular coffee and also in decaf coffee, and that is what stimulates the colon to kind of perk up and move along. You could get that benefit from both a regular coffee and a decaf coffee. Whereas even a caffeinated tea will not have as strong of an effect because it doesnt have the chlorogenic acid. I know a lot of people don’t drink coffee because they say, Im caffeine sensitive. The caffeine doesnt agree with me, so I cant drink coffee and therefore I cant benefit from the gut stimulating properties of coffee. And I always tell them decaf works too. If you enjoy the taste of coffee and youre willing to have a decaf, get on that because it will help.

Allan (18:51): Cool. That was in the book; I just actually forgot about it. I guess the other question that came up as I was reading through, because I had a guest on once that swore by coffee enemas. I know enemas are a way to help with constipation from time to time. What are your thoughts on coffee enemas?

Tamara Freuman (19:11): Enemas in general will promote emptying. Ive had patients who’ve needed to use enemas regularly because their pelvic floor muscles dont work well or because they have extremely pathologically slow transit, and enemas on a regular basis are the only way that theyre able to get some relief from their bloating – enemas, whether its coffee or water or salient or whatever. My understanding for the few patients Ive had that have done coffee enemas – it was really about an alternative delivery system of caffeine, because they were not able to tolerate coffee by mouth. Once I had a patient who had these terrible migraines and caffeine really helped her with her migraines, but she couldnt drink coffee; it gave her this awful, awful acid reflux. So, she happened upon the solution of coffee enemas as a delivery system for caffeine, and that seemed to work for her. So my understanding of a coffee enema in terms of constipation relief – it probably has much more to do with the enema and probably a lot less to do with the coffee.

Allan (20:12): Okay. Any other thoughts if someones going through constipation that they can do besides the changing and making sure theyre getting plenty of fiber, maybe taking some of the soft laxative formula or perhaps enemas, that we could consider if were looking for treatment options?

Tamara Freuman (20:32): What I would say about the fiber question is, if you are someone who does have a pelvic floor function disorder, eating less fiber until your pelvic floor muscles have been rehabilitated through treatment might actually make it better, not worse. The fiber is a little bit tricky, which again comes back to this idea of, if more fiber doesnt feel better, there may be a reason for that. And for some people less fiber may be better. Theres another thing that is a little bit underrecognized with constipation, and that is position on the toilet. There is something out there called a Squatty Potty, which is basically an overpriced stepstool that you put in front of your toilet and it raises your knees so that when youre sitting in a toilet, youre in a more squatting position. That is our bodys more preferred natural position for pooping. The pelvic floor muscles are optimally aligned when we are in a squatting position. Particularly for people who have pelvic floor problems, getting those knees up with a stepstool of some sort while youre going to the bathroom can really make a difference.

Allan (21:34): I should reiterate, because I think a lot of people stop their squat real early. So just being seated is not necessarily the squat position. Were talking about your bottom being a little lower, so that the hip crease is below your knees. And yes, the Squatty Potties put you into that natural position while youre on the toilet if you are having some issues. That’s actually why the guy invented Squatty Potty. I think he said his mother was having some issues and thats why he came up with it. Its cool, but it is just a stool. And then I guess the last area I really want to get into, as far as some of the things that we would deal with that I see from time to time, is carbohydrate intolerance. Can you get into that a little bit?

Tamara Freuman (22:23): Sure. Carbohydrate intolerance is any time that you have digestive distress because of a poorly absorbed carbohydrate. There are these different families of carbohydrates that human beings may be inclined for one reason or another not to absorb very well. And I think the one that most people are familiar with is lactose intolerance. I think its pretty common knowledge at this point that for a large segment of the population, once were out of our teenage years or out of our 20s, we start producing less of the digestive enzyme lactase that we need to absorb milk, sugar or lactose. As a result, when we have too much dairy, especially high lactose dairy, we can get really gassy, we could get bloated, we can have diarrhea. Thats one that were very familiar with, but there are other carbohydrates that we could also be intolerant to. Another one is fructose. There are these special transporters in our gut that are supposed to take fructose out of the gut and some people have more of them than others. So if you have a really high load of fructose and you dont have enough transporters to take it out of your gut, youre going to have very similar symptoms as lactose intolerance. And the trick to some of these carbohydrate intolerances is the symptoms dont onset immediately after the lactose or the fructose or the offending carbohydrate. It takes at least four hours and typically closer to six to eight hours, because the symptoms of malabsorption dont happen until that sugar or carbohydrate makes it all the way to your colon, and that takes a while. So what can happen is someone might experience the onset of gas at 3:00 p.m. and theyll look and be like, What did I just eat? But really what they should be looking at is what did they eat for breakfast? And there are other carbohydrate intolerances that Im seeing more and more of as well, especially with some of the special diets and the new products coming out that are sugar-free, low carb. Theres a lot of use now of sugar alcohols – things like sorbitol, erythritol, xylitol. People like them a lot because theyre natural or naturally derived. They have no calories, they dont raise your blood sugar, and so youre seeing them in a lot of sugar-free, low carb, even some keto products. The problem is when you have a lot of them in your diet, they can exert a very similar effect as a lactose intolerance or a fructose tolerance because human beings dont absorb them well. So, those too can produce gas, bloating, diarrhea, things like that. There are these different families of carbohydrates that can produce those symptoms.

Allan (24:51): Thats going to be a function of doing a food log and looking at symptoms and trying to find that connection.

Tamara Freuman (25:01): Definitely. What I tell people is a food and symptom journal for a week, 10 days, where you record the time of what you eat, everything, and the time of onset of symptoms. And what youre going to want to do is look back at four to eight hours before your symptom onset, because very often thats where it originates. Thats especially so for carbohydrate intolerance. Not necessarily for other types of bloating, but for a carbohydrate intolerance a food and symptom journal is terrific. It really provides the data. You need to figure it out.

Allan (25:33): In the book you went through several supplements that we can use to help our digestive system do the things its intended to do so we dont have these plumbing issues, for a lack of a better word. Do you mind going through a few of your favorites that would benefit most of us to consider having as part of our diet?

Tamara Freuman (25:57): Definitely. Im not a big pill pusher, Im not a huge supplement pusher. Ill start there.

Allan (26:03): Im not either, but Ill tell you, I get more questions about what supplements they should be taking. I tell them, whole foods first.

Tamara Freuman (26:11): Definitely.

Allan (26:13): And if there are some other issues and you want to optimize, thats when you can start looking to these things.

Tamara Freuman (26:18): Absolutely. If I had to pick the top two that I recommend the absolute most often and the top two that give the most of my patients… If I could only have two supplements to recommend for the rest of my life, which two would they be? They would probably be magnesium and soluble fiber. Starting with magnesium – its an electrolyte, its a mineral, our bodies have a need for it. Its something that we need anyway, but when we take it in higher doses of 350 milligrams or more, it has what we call an osmotic laxative effect. Thats a fancy way of saying it draws more water into the bowel and speeds up bowel transit so that people who tend to be on the slower, more sluggish side, people who tend to have harder stools that are difficult to pass, its magical for them. You take it at bedtime, usually in a dose of 400-500 milligrams, sometimes a little bit higher if needed, and the next morning, it really helps regulate bowels for people who are constipated. And its really safe, its really cheap, its really available. Its something that I recommend a lot, and its just a lot of bang for your buck.

Allan (27:29): I use a ZMA supplement from time to time, but I would caution folks with magnesium. Walk your way into it. You might wake up in the middle of the night and have a “hurry, go” kind of situation. But I do use a ZMA occasionally. The other thing Ive noticed about the ZMA is it gives me these really cool lucid dreams from time to time. I just dream better, and I think probably Im sleeping better with the ZMA. It is also relaxing and helps you sleep.

Tamara Freuman (28:01): Interesting. I dont have all that much experience with it, so its really interesting to get that feedback. I would say that the other supplement that I use a lot is for people with the opposite problem – diarrhea; people who are really prone to diarrhea and this pattern of running back and forth to the bathroom four or five times every morning where they feel like they cant get out of the house. For that, a soluble fiber supplement in the mass market – things like Citrucel and Benefiber; in the more natural market youre looking at things like acacia fiber, Heathers Tummy fiber, things like that. Taking that in the evening at bedtime can really regulate the bowels in the morning, calm down that spasmodic back-and-forth, consolidate all these little pieces that arent coming out at once into one or two complete, calm, normal formed stools that you get out easily and you get on your way. I have to say that for my patients with irritable bowel syndrome that are diarrhea-prone and spasmodic – soluble fiber is just magical for them; they do so well with it. So, I rely heavily on that in my practice.

Allan (29:08): Okay. I define wellness as being the healthiest, fittest and happiest you can be. What are three strategies or tactics to get and stay well?

Tamara Freuman (29:19): I love that definition of wellness and I think its so similar to my own. One thing I see that I think undermines a lot of peoples ability to achieve that definition that you’ve described, is theres a real dogmatism about diet. We kind of adopt these dogmas that, This is bad, this is good. You should eat this way. We all should eat that way, because so-and-so told me that and so-and-so eats that way. Theres this black and white thinking as if all human beings have to eat the exact same diet. I like to really encourage people to step back and take a more global perspective, which is, there are populations all over this big planet of ours who have extremely healthy lives that live into their 100s without chronic disease very, very well, and they eat really different diets. Theres not one diet that all human beings have to eat. And one diet that works for you or for your personal trainer or for your aunt or for your best friend might wreak havoc on you, in terms of digestively, or might be miserable for you because it makes you gassy or you hate the foods on it or its inconvenient for you. There are a lot of reasons why we dont all have to eat the same diet, and I think allowing yourself and opening yourself to the possibility that you could have a very healthy diet and I could have a really healthy diet, and we could have completely different diets, and that is not a conflict. I think thats so important. So thats the one thing, to be a little bit less dogmatic about diet and really be open to the possibility of different paths to good health.

Theres another thing I see a lot that really has a negative impact on peoples relationship with food and eating, which I think impairs wellness. Its this real emphasis on what to avoid, what to eliminate, whats toxic, whats bad, and placing foods into these categories of dietary demons and defining your diet based on what you dont eat. What Ill say is Ill have a patient who could come to me and say they follow a vegan diet or a plant-based diet. That doesnt tell me anything about whether its a healthy diet, because potato chips are vegan, apple juice is vegan. So, defining your diet and good health by what you dont eat, I think is a lot less useful than defining your diet and its helpfulness based on what you do eat. Whats actually going in your mouth? I dont care if youre a vegan, Mediterranean, keto, whatever kind of dietary pattern you follow. Its less about what you avoid and more about what you do eat. You could avoid 50 things in the world that are supposed to be terrible for you, but if youre not eating any vegetables or youre not eating anything with vitamins, your diets not going to be healthy. And so really focusing on putting good stuff in your mouth rather than being so fearful of being poisoned by something that might not be perfect going in your mouth, is I think a really healthy, constructive way to look at your diet.

I think the third one is the importance of routine. We think about diet as being this main key to health, but I think we also forget that sleep plays a really big role. Movement and activity play a really big role. And ultimately for optimal health, our bodies want us to be in a rhythm of consistent meal times, adequate rest, regular movement. When any one of those three pieces of the puzzle are missing, its going to be really hard to have true and complete health and wellness. We talk a lot about diet, but then we stay up too late, messing around on YouTube, and then we get five hours of sleep. Or we skip meals some days and then try to compensate by eating a super healthy lunch, but we didnt have breakfast. I think the best way to really be kind to our bodies and give our bodies what they need is to pay attention to consistent rhythms, routines, meal times, sleep times. Our bodies thrive, I think, when we have these set schedules and our organs know what to expect and have that predictability.

Allan (33:26): Tamara, those were excellent. I love all of those, so thank you for that. If someone wanted to learn more about you, learn more about the book The Bloated Belly Whisperer, where would you like for me to send them?

Tamara Freuman (33:39): I have a website – TheBloatedBellyWhisperer.com. Theres information about the book. I have a lot of my old newsletters, where I sound off on things that are on my mind and important to me. There are links to things that Ive written. I write a lot online for U.S. News and for Self, and so links to a lot of those articles are on my website. So I think my websites a great place to start.

Allan (34:01): Excellent. You can go to 40PlusFitnessPodcast.com/365, and Ill be sure to have a link there. Tamara, thank you so much for being a part of 40+ Fitness.

Tamara Freuman (34:13): Thank you for having me. It was so fun.

 If you've been struggling with gastrointestinal issues, you know its a big pain. Now Tamara in her book has given you a quiz thats going to help you have the right conversations with your doctor to get this taken care of once and for all. So, I do hope that youll go out and check out that book if you have any issues with your stomach at all.

Also, Ive been telling you this past couple of weeks, during the month of January, I am offering to sell you a signed copy of The Wellness Roadmap. You can go to 40PlusFitnessPodcast.com/Hardbound to get a hardbound edition of the book, or you can go to 40PlusFitnessPodcast.com/Paperback to get a paperback edition of the book, a signed copy mailed directly to you. I can only do this during the month of January because in February Im moving to Panama, so hurry up while supplies last, because I did get a shipment of books in and Id like to get them in your hands if youre interested in having a signed copy. So, go to 40PlusFitnessPodcast.com/Hardbound or 40PlusFitnessPodcast.com/Paperback. Thank you.

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