August 22, 2023

How to properly manage your medications with Dr. Hedva Barenholtz Levy

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With many of us taking several medications each day it is hard to know that we aren't taking unnecessary drugs or dealing with adverse reactions when we don't have to. In her book, Maybe It's Your Medications, Dr. Hedva Barenholtz Levy shows us how to best manage our medications as we age.


Let's Say Hello

[00:01:26.690] – Allan

Hey, Ras, how are things?

[00:01:28.300] – Rachel

Good, Allan. How are you today?

[00:01:30.320] – Allan

I'm doing all right. I'm doing all right. We're getting closer to my vacation.

[00:01:34.570] – Rachel


[00:01:36.830] – Allan

And so a couple of big things. One is I won't be taking new clients during September. So today's the 22nd. You got about a week. If you go to 40plusfitness.com/discovery, you can book a call with me and we can go ahead and get you going. If you don't hit me this week, then I'm going to be closed for September. I'll still service my existing clients, I'll still do the podcast, and I got a special little surprise I'm going to talk about in a minute that I am going to do, but I'm not going to take on new clients during that period of time. So if you're not in the door before I get on the ferry to leave this island on September 1, I can't talk to you. I won't bring you on until October, probably October 2. Based on what my wife has shown me, my itinerary is because she's doing all that, I'm just tagging along.

[00:02:26.510] – Rachel

Nice, that sounds awesome.

[00:02:28.400] – Allan

So if you want to work with me, this is the time you could email me or you can go into 40plusfitness.com/discovery. That's a direct link to my calendar. Literally. You see days on there that are available to book. That's the days I'm available to book. So go check it out. Also, I want to do something a little fun in September. I want to play health and fitness bingo.

[00:02:52.510] – Rachel

Oh, boy.

[00:02:53.990] – Allan

Okay, so I'm going to roll out the first of hopefully many 40+ Fitness Bingo games. Okay. And the way we're going to play this is it's going to be in the Facebook group, but you can go to 40plusfitness.com/bingo to get the details, but you basically will get a bingo card with some health and fitness activities, that you can do during the month of September. So it's going to run for 30 days. There's three levels of game and prizes at each level, it'll be drawn off of people who complete that level. So there's going to be, of course, the straight line, the way you normally play bingo. There's going to be the x, the middle space is a free space, and then there's also going to be a blackout. And so the prizes will be relative to how far you make it through your bingo card of whether you get a line, an x, or a blackout. And I'll have some prizes available for that and we'll finish that up in September. So just a little heads up, there are 25 squares in a bingo card and there are 30 days in September.

[00:04:05.000] – Rachel

Oh, cool. This sounds so fun.

[00:04:08.270] – Allan

This isn't like you're going to have to do this all the time, but the rule is it's one per day, so you can't fill multiple squares in the same day. This isn't like I go out there one week and just bust all this stuff out and say, well, yeah, of course I got my protein and I had 30 grams of protein on this day. I'll check both. That's not how it works. Each day you score something on the card. And this is based on an honor system, but it still can be fun because there'll be things that you wouldn't maybe necessarily have really focused on. So it's going to maybe take you outside your space a little bit. If you're not doing resistance training, you know there's going to be a square for resistance training. You absolutely know it's going to be in there if you're not moving much, if you're sedentary. Yeah. There's going to be park your car at the back end of the parking lot instead of at the front, and it's going to be the little things like that, but I think it's doable by just about everybody. But you can find your line.

[00:05:02.960] – Allan

You can find your line. If you just can do a line, then that's great. It's better, maybe better than what we've done or an x or a blackout. But there'll be prizes involved, so I'm hoping to get some folks involved. You can go to 40plusfitness.com/bingo.

[00:05:17.270] – Rachel

Sounds awesome. What a great challenge.

[00:05:20.880] – Allan


[00:05:21.830] – Allan

All right. Well, how are things up there, Rachel?

[00:05:24.210] – Rachel

Oh, wonderful. Getting ready for a camp out this weekend. We're taking the camper out to a park up here in Michigan and just looking for weekend of peace and quiet.

[00:05:33.760] – Rachel

Getting away.

[00:05:34.760] – Allan

Yeah. You got about another month and a half.

[00:05:37.850] – Rachel

I know, I know I'm losing to be. I gotta enjoy as much as I can outside before it starts snowing.

[00:05:48.040] – Allan


[00:05:48.610] – Rachel

Not that I'll not go outside because, you know I do.

[00:05:51.390] – Allan

But you will. But you won't be camping.

[00:05:53.430] – Rachel

No. Yep.

[00:05:55.770] – Allan

Mike will be ice fishing in a few months.

[00:05:57.510] – Rachel

Oh, for sure but let's let's just wait. I'm not ready for summer to go away.

[00:06:02.130] – Allan

Yeah, I'm not either. All right, well, are you ready to have a conversation with Dr. Levy?

[00:06:08.600] – Rachel

Sure. Sounds great.


[00:06:34.510] – Allan

Dr. Levy. Welcome to 40+ Fitness.

[00:06:37.630] – Dr. Levy

Thanks so much, Allan. Glad to be here.

[00:06:39.780] – Allan

Now, the name of your book is Maybe It's Your Medications: How to Avoid Unnecessary Drug Therapy and Adverse Reactions. And I think everybody wants to avoid adverse reactions, but I like the word you used therapy.

[00:06:54.230] – Dr. Levy


[00:06:55.430] – Allan

Because we don't have a drug deficiency. This is meant to get us over a period of time when we can actually fix ourselves versus just deal with the symptoms. So I love that you use the word therapy, and I love that you use the concept of that health is a team sport, because I think too many times we just think, well, there's the doctor, he's the coach and the quarterback, and I'm just doing my part. I'm an offensive lineman. It's thankless I just take my pills, and I go on with my life. Right.

[00:07:27.360] – Dr. Levy

And it's a little bit more than that, right?

[00:07:29.060] – Allan


[00:07:29.760] – Dr. Levy

So I definitely talk about the concept of your healthcare team, and I think that's maybe an important thing. We could start off with that understanding. Of course, we think about the main players the physicians, the pharmacists, the nurse. But there's occupational therapists, physical therapists. When I was talking to a group of older adults, someone mentioned the dentist. Right. These are all part of our healthcare team, but the most important person on that team is you, the patient, the consumer, the one who's taking those medications. And I think all too often, people don't recognize that they are an important part of their team. They have a voice, and they're actually in the game, as you said. Right. Using that analogy. So that's an important thing. And then if you start with that premise that I have a voice, my opinions matter, my preferences matter, what I'm experiencing when I take medications matter, then you're at a different starting place, I think, with the drug therapy and that's talk about that phrase again, too. Medication we can talk about medications we can talk about pharmacotherapy is another term for drug therapy, and I never really thought twice about it, so I appreciate you bringing that up.

[00:08:28.740] – Dr. Levy

But it's drug therapy. It's another approach to managing our health, and it's one aspect of managing our overall health. And the link with healthy aging, I think, is so important, which is where this book came about. Too often, we continue taking medicines as we get older, and they may not be helping us age in the most healthy manner if they're unnecessary or causing problems.

[00:08:52.170] – Allan

Now, I came from an accounting background, so when you give me a number and a list someone called it a listicle once, but when you give me a list of things, it's like I'm kind of drawn to that. I kind of like that idea of a list. And so you identified five characteristics that increase the risk of adverse drug events. Like I said, I think most of us want to avoid that. Can you talk about each of those briefly and why they're important?

[00:09:15.730] – Dr. Levy

Yeah, sure. So I present these five characteristics as when you look at them together, it's kind of unique for the older adult population. And in medicine, we talk about age 65 and olders is the cut off of sorts. And so those five points, the first one is taking multiple medications puts you at increased risk of having an adverse drug event. And that kind of makes sense. The more medicines you're exposed to, the greater the chances are of having a problem from them. Why does this happen? Lots of reasons, but one is we have more chronic conditions as we get older, and that leads to the need often for at least one medicine, but sometimes two or three, depending on the condition. Right. We think about diabetes and even heart failure and other conditions where you need several medicines. The other characteristic is or the second characteristic is the involvement of multiple physicians on your care team. So think about how our healthcare today is a little bit divided. We have specialists all over the place. The number of older adults who are seeing specialists has almost doubled in the last 20 years. So that's something to think about.

[00:10:19.910] – Dr. Levy

When physicians are prescribing their own medicines for you, are they communicating with each other? Do those medicines interact? Does one physician know everything that you're taking? So that's where some of those other risk factors come in, when you have more prescribers involved.

[00:10:35.210] – Allan

I worked in a pharmacy when I was in college, and I can tell you the pharmacists back there, yeah, they've got the little computers, but they are so slammed to just keep turning pills out because the retail environment is just they will do a consult with you. But it's even hard for them if they're just seeing a script unless the computer tells them there's a definite deal. But this goes even further to say, okay, because two doctors talking to each other, pharmacists looking at you could get your stuff filled in the same place. And it doesn't necessarily mean it's being reviewed and covered off.

[00:11:11.880] – Dr. Levy

And there's some safeguards in place. I don't want to scare people, but definitely not all of the information is at the pharmacy system. And we can go into how to know what medication is the right choice, the right drug for a person. We have to have some of that medical information, the health background, which pharmacy systems don't have. So, yeah, that's another concern. Right. We can only do so much checking at that community retail dispensing setting. So clearly, the more doctors involved, studies have shown that there's an increased risk of having an adverse drug event occurring. The next two reasons kind of go together. And they're big words, but I do introduce them in the book. I think it's important for people to at least know these terms are there and then talk about them in more easy word with easier words, pharmacokinetics and pharmacodynamics. And this simply refers to pharmacokinetics, is how our body handles medications. And as we get older, our body handles medications differently. Our kidney function changes, our liver function changes, and that impacts how our bodies process and get those medications out of our system. Some medications can have a much longer duration in the body because of these pharmacokinetic changes, if you will.

[00:12:23.810] – Dr. Levy

So suddenly, as we get older, we might need lower doses or we might need to avoid certain medications because our bodies are handling medicines differently. So that piece is another that's a third characteristic that's really important. And then the fourth one I mentioned, pharmacodynamics, another big word, but that simply refers to how the drug affects our body. And the most simple way to address this for older adults to understand how our bodies change and deal with these medicines differently, is our bodies are more sensitive to the effects of medications as we get older. And that's the pharmacodynamic piece. But that really means maybe smaller doses will be just as good for older adults. It means that there's certain drug classes that we might want to avoid as we get older because we're more susceptible to having a serious, more significant side effect, like Drowsiness. Dizziness, that fall risk, things like that. And then the fifth characteristic I include is the fact that older adults are not enrolled in clinical trials as much as the younger population, those under 65 years old. And that's because it's hard to study a drug, its effectiveness, if a person is taking many other medications and has many other health conditions.

[00:13:33.550] – Dr. Levy

So it's not as clean, if you will. But we cannot know how a drug will affect an older person or an older person with different health conditions unless we study or have it exposed in someone with those conditions. So that means when a drug is newly available on the market after it's been approved by the FDA, we may or may not know exactly how the safety and effectiveness in an older individual. So those five characteristics, putting them together, kind of make that older adult a little more unique situation and at higher risk of having an adverse drug event.

[00:14:10.270] – Allan

Yeah, and I think that's easy to see. There's nothing inherently wrong with any one of these things. It's just a part of the way the system works. They want to get a market, a drug to market quickly. If they can't get enough older adults in there and one of the things I would say is it's probably chronological age, biological age, two different things. So you might not be 65, but you might be in a 65 year old body. And so drugs would affect you. If your liver or kidney is not functioning the way that it's supposed to, then you might have the wrong drug, you may have too much of the right drug and all that. So I think one of the keys to me is if you start a new drug, you need to have that conversation is to know, okay, what does this drug do? Why is this doing it? What are the potential risks? Because there are no wholly safe, fully effective drugs out there.

[00:15:04.740] – Dr. Levy


[00:15:05.400] – Allan

Okay. Something could go wrong, and in fact, it goes wrong a lot more often than we would hope. And you listed the stats in the book, which, again, it's scary stuff. If you're on multiple medications, it is something that you definitely want to pay attention to. And you identified that as medical related problems or MRPs. So we won't keep saying medical related, medication related. Now, poor Frances, in your book, she exhibited all eight of these.

[00:15:38.440] – Dr. Levy

Well, you had to make a good example, but it wasn't too far of a stretch.

[00:15:46.190] – Allan

Frances, frances had it rough. And as she went through her evaluation, and we're going to talk about this evaluation process later, but as Frances went through it, she hit on all eight of these things. Like I said, I love lists, but poor Frances, can you talk through the eight MRPs that you could deal with when you're dealing with medications?

[00:16:06.880] – Dr. Levy

Yeah. And so I introduced those MRPs, not to make it more convoluted or complicated, but to help individuals understand that there's a lot to look at when helping a person look at their full medication regimen and is everything appropriate in helping them. And the goal is to minimize the risk of harm, obviously. So the MRPs that I talk about, so this is like a standard way I would do a medication review. I think most pharmacists would take this general approach. The first type is the adverse drug reactions. Right? So very obviously linked to medications have side effects, adverse drug reactions, it's kind of the same name. And so we have to look for is a person experiencing any adverse drug reactions or side effects at the time? Drug interactions is another important medication related problem. And also with this, we have to remember to always looking for not just prescription drug interactions, but also the non prescription medicines a person might take. Don't forget the over the counter medications as well as the dietary supplements. And I also talked go into a little more detail in one of the chapters about interactions. How drugs can interact with disease states a person's health condition.

[00:17:16.560] – Dr. Levy

So we need to be careful of someone who's taking a non steroidal anti-inflammatory if they have heart failure or high blood pressure, it can worsen those conditions. We look at dosages doses that are too low or too high. As we talked about, doses can be too high. So we worry about that for our older adults, especially if there's kidney issues, liver problems, for example. But something that can be overlooked is a dose too low. So another important consideration we should have with the medications we're taking is is it effective? Is it doing what it's supposed to be doing? And if not, is it because there's a dosage issue? So if we're going to treat high blood pressure or treat high cholesterol, let's make sure we're at a correct and effective dose that the drug is going to work for the person. So those are the two kind of partner problems too high and too low. A fifth medication related problem is the selection of improper drug. And this is I spend more time in a couple of chapters in the book on this topic because as we get older, geriatric experts have identified a list of medications that are considered potentially inappropriate for older adults.

[00:18:20.130] – Dr. Levy

And I do emphasize the potentially part because everybody is different. But it just brings to mind that as we get older, again, because of those changes I mentioned earlier, the pharmacinetics and pharmacodynamics medicines may not be the best, certain medicines may not be the best choice as we get older. Another problem is an undertreated or untreated condition. So that's just as serious. If someone has a condition that really does need medical care and they're not getting it, that can lead to further problems. Anything from maybe it's an undiagnosed respiratory infection, someone's treating a cough, and it really becomes becoming something more serious. Or what feels like reflux of stomach issue. Maybe it's a heart issue. I know you talked about that on a recent episode. So we want to make sure that nothing is being missed. Osteoporosis, the weakened bones. Is a person getting enough calcium and vitamin D, for example, not getting a medication? That's another again, a whole chapter is devoted to someone not getting a medication for various reasons. Maybe they're not taking it the way they should be taking it at home. Maybe they can't afford it and they never fill the prescription or they stopped filling it.

[00:19:27.030] – Dr. Levy

Maybe they didn't fully understand when and how to take it, so they're just not taking it properly. And then the last one is the unnecessary medications. And that's a really big concern in healthcare today and working with older adults because we have these growing medication lists and is everything still needed? So that's a real big topic we can talk about too. Those are the eight problems.

[00:19:49.610] – Allan

And I think, again, one of the reasons I wanted to talk about this in particular is that this kind of shows you the complexity of the model. You got the number of medications, what they do, what the risks are, and then all of these little kind of caveats of, are you getting enough? Are you getting the right thing? Are you actually taking it the right way? Are you taking it regularly enough? Are you now kind of making decisions? You talked about a patient who said, okay, this is too much. So instead of going and having the dose brought down, she's like, I'll take it every other day. And her condition didn't improve, so the doctor gave her another medication, and then she decided, well, I don't want to take this the same day I'm taking that one again, not how it was prescribed. And every other day she's taking that one again. The condition doesn't improve. So the doctor is like, well, we got to put you on a third blood pressure medication. And now they're on three blood pressure medications, where perhaps if they had just asked the doctor to lower the dose of the first one to the appropriate dose, it wouldn't happen.

[00:20:47.870] – Allan

But that's hard and add to the complexity. You're listening to this podcast. So if you've made substantial lifestyle changes, some of the medications you may have been on, you may no longer need. A lot of people have high blood sugar, high blood pressure. They start eating better, they start moving better. Their blood pressure comes down naturally, their blood sugar comes down naturally, but they're still on the same dose of those medications. Your blood pressure might go too low, your blood sugar might go too low. And now you're going into the doctor, why is your blood sugar too low? And it's like, I don't know. Now they're putting on a third medication.

[00:21:25.930] – Dr. Levy

You're nailing a really important point, or I've fallen. I don't know. I've had these experiences of falling in the past month. Doctor, what's going on? And you find out the blood pressure has been dropping too low. So that densifying therapy and what you're bringing up the topic of communication, which I sprinkle throughout the book, because it's so important for us as consumers to communicate with our healthcare team, with our physicians. She may or may not have been on the right dose, but she wasn't feeling right, or she didn't like it. She needed to say something to her doctor rather than go on silently and tolerating whatever she thinks she's doing, making her own adjustments.

[00:22:07.590] – Allan

The other thing is, people will go to the doctor, they'll get a prescription, the condition will not improve, and they'll just continue to take what they were told to take, even though the stomach isn't better, this isn't better, they don't feel better

[00:22:22.040] – Dr. Levy

or pain not improving or something like that. Right. So is it the way the person is taking it? Is it the dosage too low, perhaps? Is it maybe just the wrong medicine for the person? But yeah, to continue and that's where we get into these unnecessary medicines and for people to think it's been approved by the FDA. My doctor's prescribing it. There's absolutely no risk, I think is just misleading for us. And we fall into that complacency. We just get comfortable with the medicines. I think we need to be a little bit more vigilant. Not to doubt all the medicines, but just to make sure, do I need it? Because ideally, we want that fine line of taking just what you need that's helping you and avoiding what is not helping you. But you make a great point about people who are making lifestyle changes and improving their blood pressure, blood sugar control, all that wonderful stuff. The medicines might be over too high of a dose at that point, right?

[00:23:19.340] – Allan

At least letting your doctor know that you're making these lifestyle changes and therefore they'll know, okay, well, you may have to lower this drug. Measure your blood sugar, measure your blood pressure. Let's see where it's trailing. If it starts to go low, call in and we'll lower the dosage on your medication.

[00:23:37.350] – Dr. Levy

So that's part of that monitoring. And there's so much we can do at home. And that's, again, being on the healthcare team. Help your doctor monitor, do what you need to at home. Check the blood pressure. If you have the blood sugar monitoring, do what you need to do and make sure you're talking with your doctor about those results.

[00:23:54.090] – Allan

Now, one of the things about that team is that this is I'm not going to call it rocket science, but the biology of medications, particularly when they're combined and as we age, is very confusing, can be really confusing and really maybe above our head. And it's okay. It's okay to admit that this is above my head. I don't have all the answers, but there is kind of a solution out there. I think if we search for it, we can find it. But getting a comprehensive medication review by a professional that does these things, particularly for older adults, can be a valuable thing. Because the other things you brought up in the book that we haven't even touched on are things like over the counter drugs, the supplements we might be taking, our dietary changes in the way we feel or look, if you've lost significant weight, if you're not moving as much as you were. So sometimes lifestyle is going in the opposite direction of what you were doing. I mean, sometimes it's just you're losing bone mass, you're losing muscle mass, and it might be one of the drugs you're taking that's causing some of that to happen.

[00:25:03.670] – Allan

Can you talk a little bit about the comprehensive medical review, what would be involved, and then how we would go about the process of deprescribing? Because I think a lot of people think, well, I'll just quit a medication, and sometimes that creates more problems than the medication did. So you can kind of talk about that, because I don't think this is something where you just make the decision, I'm going to take this every other day because I'm not feeling good on it. Can you talk about that review and how it would go?

[00:25:30.860] – Dr. Levy

Yeah, sure. So I think a most valuable tool is to have a medication review. And like you mentioned, it needs to be by somebody who knows the drug therapy, who knows the medications, and for the older population, which is where my focus is, it's going to be someone with that geriatric specialist, geriatric specialty. And pharmacists have that specialty, geriatricians, or the physicians who are specialized in geriatrics. But nurse practitioners and physicians assistants can also have that Geriatric specialty. So the medication review is a chance to look at everything a person is taking. And as you touched on thank you for mentioning it, the over the counter, the OTC products, things like antacids and even aspirin a lot of people don't think about aspirin being on their regimen because they get it without a prescription. Right. I've come across that all the time to other pain medicines, cough and cold preps anything you might be taking without a prescription is important to be included in that medicine list for the review, as well as the dietary supplements. And dietary supplements is a whole other ballgame because it's just important to mention that they're regulated as food by the Food and Drug Administration, not as medication.

[00:26:35.910] – Dr. Levy

So there's a whole other little ball of concern we have with the supplement. But a medication review is a chance for that medication expert to look at everything you're taking and look for all of those eight medication related problems that I mentioned earlier and identify not only actual problems. What I do a lot is looking for potential problems because if we can prevent something from happening, then we prevent the additional doctor visit, the added prescription, the emergency department visit, or even a hospitalization. Right. So all those statistics that we know go with having an adverse event with a medication, we want to prevent it. Right. So a lot of people might say, I'm doing fine right now. I'm taking what the doctor has told me to take. There still are things to find when you open up the lift, the hood and you look under the hood of the car, you can find some of those eight problems. And things like very hard it's very hard to identify without talking with a person and doing a review is finding out how they're taking their medicines at home and looking for the under treatment issue and are they even getting their drugs and taking them the way they should be taken.

[00:27:40.260] – Dr. Levy

So where you go about finding a review is a challenging part. And I touch on as best I can. I truly believe pharmacists have the therapy. So I always encourage people to find a pharmacist who can do this type of review. And if you're enrolled in Medicare Part D, there is a comprehensive review that is part of that program. I just cannot say universally these are the criteria of who's going to qualify. I encourage people to call their part D plan to find out if they qualify. And then there's senior care pharmacists out across the country who do this on a private basis kind of thing as well. So does that answer anything else you want to touch on with the medication review?

[00:28:20.450] – Allan

Because I think that the situation is the doctor, he gets maybe seven, eight minutes with you, and he's looking at your medicine list, so he knows what you're taking, but he's got to make some decisions, and he's not necessarily going to ask you or tell you how to take this medication. Now, you go to the pharmacy and you get your prescription filled. They may give you information or maybe a booklet or something that you didn't read. It's like, oh, everyone knows how to use an inhaler, or Everyone knows how to use eyedrops.

[00:28:48.330] – Dr. Levy

No sometimes. Right.

[00:28:50.330] – Allan

Right. So it's just those concepts of let's talk about it, let's set up a plan, find the right teammate to come in and help you complete this so that you're in it. And I think you recommended, if you can and it works for you, to try to get this done about once a year, because your medications may change in that time, your lifestyle might change and well, sorry, we're one year older.

[00:29:16.370] – Dr. Levy

Absolutely. It's like the regular tune up. You just want to make sure and with a little luck, maybe some medicines are no longer needed and those can be removed.

[00:29:25.440] – Allan

You save that copay and you can hire a coach.

[00:29:28.710] – Dr. Levy

There you go. I think that lifestyle just yeah, there's so much we can do to be looking at the full picture. Right. So it's not just the medications. That's one piece of this puzzle of how to age healthy and taking care of ourselves is such an important part, and you kind of touch on it. The physician doesn't have a lot of time. Pharmacists are the most accessible healthcare profession. We're there, unfortunately, yes. Pharmacies look very busy these days. But I also will continue to say that pharmacists are trained to communicate and educate about drug therapy. This is what we love to do.

[00:30:03.470] – Allan

They have that little kiosk over that little booth thing. You go over the other window away from everybody. You can have that private conversation

[00:30:09.370] – Dr. Levy

consultations over there. Right. And I'd like to see them use more. We have our healthcare system. We can stand to have some improvements, but pharmacists do have the skill and this interest. So I would always tell people, don't be so intimidated. Ask if the pharmacist has time. For sure when you pick up a prescription and you are asked, do you want to have any questions for the pharmacist? How many people ever say, yes, very

[00:30:30.010] – Allan

We're in a hurry to grab that bag, give them our credit card and walk out. People at this pharmacy there sick people at this pharmacy.

[00:30:36.990] – Dr. Levy

I don't want to stay, but I encourage people say yes. Try saying yes and talk with the pharmacist. You don't know what you don't know is another important theme, I think. But if the pharmacist is busy, then find another time when they can speak with you. He or she can talk to you about your medications to do a more thorough review. Probably they can't do that on the spot. You're going to have to set aside a separate time. And I'm hoping pharmacy will continue to evolve where we do have more time with the patient to do what we call primary care, to go through these medications to help people understand their drug therapy and identify problems. So when I do my work, any potential or actual problems, I find I'm communicating with the patient's physician because that's where the changes can get made. Pharmacists can't prescribe. It's the physicians that do that. And that brings us to maybe the deprescribing considerations. That's okay. So as you said, just stopping something on your own can be very scary. Of course, you hear a lot of people say they did it and everything's okay, and you're like, by the grace of God, if it was fine, things can happen.

[00:31:38.930] – Allan

Yeah, a lot of people jump out of airplanes and don't die.

[00:31:43.070] – Dr. Levy

Right? It depends on what risk you want to take. Right. But your health is additive. So with the deprescribing so this is a fairly new term that has taken hold in the medical world because and I have a love hate relationship with the term initially. I view deprescribing. By definition, deprescribing means reducing or eliminating drug therapy when appropriate. And I've been arguing for 25 years that's what I do. I review the medications, I identify ways to optimize drug therapy. What can we remove? Where is a dose too high? What is still necessary? Is the person taking it correctly? So I try to clean up the medication list for a person with their physician. The deprescribing movement, though, is relevant because we have to name it to be able to talk about it. We do need some research about deprescribing because when it comes down to is it safe to stop a certain medicine and how do we stop it? Can it be stopped cold turkey? Does it need to be tapered in the person with these conditions? Is it okay to stop it? What are the risks of the problem recurring if you stop it?

[00:32:43.990] – Dr. Levy

we don't have all of that science, right? So that's where deprescribing as a science, needs a name and needs that attention. So we do have a lot of research going on in this deprescribing area. When we bring it down to the individual, it means, like I said, as we talked about that medication review, finding what may might look like a medicine that may no longer be needed, then we have to have the conversation looking at all the health information, how stable is the disease or the health condition? What are the patient's preferences? That's a really important piece. What matters most to the individual taking fewer medicines? Or maybe they want to prevent something in the future from happening. And sometimes some of our medicines are prevention. Right. Are you willing to risk possible side effects now to prevent a heart disease or something later on? Or are you more concerned about how you're doing right today? There's some interesting studies that have looked at even, like with sleep, do you need immediate sleep relief that taking care of that symptom right now is most important? Or are you willing to you understand the risks of some of those medicines and you'd rather figure out the harder way to improve your sleep right.

[00:33:51.150] – Dr. Levy

The sleep hygiene and other factors that might help. So there is a lot that goes into deprescribing, and then we come down to, okay, if it is agreed upon that we will stop a medicine. Typically in general, it's safer to slowly lower that dose, but patients need to be educated. So if you're going to slowly reduce the dose, what symptoms might you be looking for in yourself or your mom or dad, whoever's involved? And what do you do should they return? Right. Those symptoms come back. So that part of that educational piece needs to be part of that deprescribing, if you will. I want to make sure I cover it.

[00:34:26.620] – Allan

Yeah, absolutely. No, that's why I think this book is so valuable is this is really a good primer for you if you're dealing with a lot of medications or if you know someone who is, because let's face it, with 10,000 people are turning 65 or older every month, I think you said. And so most of us, we're going to turn 65 and we're going to be in that age group. And so the medications we start taking today don't necessarily have to be the medications we're taking and probably shouldn't necessarily be the dosage and medications we're taking then. So getting ahead of the curve and understanding what we're on now and understanding what it's for and how we feel and is it helping us. I think there's just a lot of opportunities there for us to not nip this in the bud, but be on more solid footing as we age to make sure that we're doing the right things and our team is there supporting us and helping us do the right things too.

[00:35:21.290] – Dr. Levy

Yeah. And I want to say I think this statistic is even 10,000 per day.

[00:35:25.190] – Allan

Are turning per day. Okay. Yeah.

[00:35:26.790] – Dr. Levy

Turning 65. We have millions and millions of these baby boomers. We're all there or almost there are turning 65. So those numbers are upon us, and that puts more strain on the healthcare workforce right. To manage these older adults. And that Geriatric specialty. Unfortunately, there's not enough of us trained in Geriatrics to fully know these nuances about the drug therapy, which makes it even more important that you kind of stay on top of it. And the book, yes, it has a lot of information and it doesn't always have the fix. But the point is to ask the questions, to empower you, to feel confident that I do need to ask questions about the medications and I'm entitled to ask those questions. And these are the questions I can be asking. At least start the conversation right.

[00:36:12.150] – Allan

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

[00:36:22.010] – Dr. Levy

And one thing that's really important that I always focus on is what matters most to the patient. So that happiest and it's a very subjective thing of what of wellness and where you are, where are you on the realm of possibility? So I love the question and the three things I came up with would be one, adherence. So that's another term I bring up in my book. But it's taking the medications as instructed. If you're prescribed a medicine, your doctor has identified a condition that can be treated with this medication, make sure you're taking it correctly. So that means if you have side effects or cost issues or maybe you don't quite believe in the medication, so those health beliefs matter. You need to communicate with your physician about the medication. But if you had medications, take them as instructed. Don't take them here or there when you feel like it. So that's an important piece. The other piece, which is I talk about a lot in that book, is minimum in the book, is minimizing the unnecessary medications, right? So wellness is when you're trying to be your best and feel your best. You don't want the drowsiness or with the risk of a fall or other issues, that's common side effects or stomach issues or whatever it might be.

[00:37:38.360] – Dr. Levy

So minimize unnecessary medicines and take only what's really needed and helpful. The third strategy I think is really important is that self advocacy. Speak up for how you feel day to day concerns you have and when it's going great. I mean, that's something important to share too. This feels right. This medication, I think, is important to me. That's an important piece to share also, but how you feel day to day. I use the analogy of chain. The healthcare is a link chain, if you will, and you are the end of that chain. So you have the physician, the nurses, the pharmacist, but you ultimately are at the end of that chain knowing how you feel every day, how those medicines are affecting you, good or bad. If you notice something different, you need to say something about it. Maybe it's the medications which that title came after many years, a couple years of using another title. I came to that title very last minute. But maybe it's your medications, you need to talk about it

[00:38:34.820] – Allan

thank you. Dr. Levy, if I were to send someone to learn more about you and learn more about the book, Maybe It's Your Medications. Where would you like for me to send them?

[00:38:44.230] – Dr. Levy

My website for the book is maybeitsyourmeds.com, and there you have links to my blog as well as to more information about the book and myself.

[00:38:55.210] – Allan

Cool. You can go to 40plusfitnesspodcast.com/604, and I'll have the links there. Dr. Levy, thank you so much for being a part of 40+ Fitness.

[00:39:06.750] – Dr. Levy

My pleasure. Thank you so much, Allan.

Post Show/Recap

[00:39:09.550] – Allan

Welcome back, Ras.

[00:39:11.190] – Rachel

Allan, oh, my gosh, I loved it. Starting with the title, maybe it's your Medications. I love that title so much. I mean, there are time and a place there is a time and a place where we need something. We need some medications, but sometimes it's like opening Pandora's box. There's a lot that can go sideways whether you intend it to or not.

[00:39:31.740] – Allan

Yeah, it was on Twitter a couple of days ago, and there was a health and fitness influencer. She likes to be called an influencer. I just want to help people. But she's an influencer. And so she went on this little live rant because that's what you do now, is you find something to be just up in arms about, and you rant about it on social media. Well, her rant was that she had been using this birth control pill for years consistently, so she wouldn't have a period because her doctor said that's the way you can do it. So you don't get pregnant. Very low likelihood you get pregnant and you don't have periods. So she's been taking this stuff consistently for years, and then she's ranting because now she's finding out that there is a side effect to this medication that includes cancer.

[00:40:23.750] – Rachel

Oh, my goodness.

[00:40:24.770] – Allan

And so her rant was, well, my doctor never told me. My doctor never told me that there was a side effect of cancer.

[00:40:33.970] – Rachel

Oh, my gosh.

[00:40:34.910] – Allan

And I'm thinking there's a little piece of paper in the box. You fill that prescription if you're going to be taking it consistently and skipping the little sugar pills or whatever they use now for the little pills that are in there that you're supposed to take. I don't know. I haven't had a person that needed birth control in a couple of decades, but it used to be these little foil pack things, and you took one every day, and there was a couple of them that were basically they said sugar pills.

[00:41:00.060] – Allan

Yeah. Okay. I'm thinking now, maybe they'd moved away from the sugar pills, but she was upset with Was because no, she's probably getting three or four of these at one time just to keep her going for a few months. And then she'd go and get it filled again. And there'd be a little piece of paper in that box and that little piece of paper would never get unfolded, it would never get read, and it would never be understood. And so, yeah, every medication you take, even most supplements, have potential side effects. And so if you're taking something, you really need to know the core three things why am I taking this? What's the possible downside and the risks associated, particularly for someone in my condition or my age or whatever? And then three, how do I take it properly?

[00:41:52.510] – Rachel

Oh, my gosh. That's a big one right there. Taking it properly.

[00:41:57.230] – Allan

Well, it seems like a simple thing. but sometimes it's not take with food. So if you're taking four or five or 15 medications and eight of them are with food and three of them are not, and some are in the morning and some are in the evening, you need to math something. You need a box. I don't even Google. Maybe that's something Google would be really good at, is, okay, Google, I want these alarms each day at this time and remind me, I got to take these with food. And maybe AI can do that stuff where you're just sending you a message or text and saying, hey, it's time for you to take your glaucoma medicine, or whatever. But it's just one of those things where you have to understand what you're doing and why you're doing it, because you're the CEO, and if you've taken a medication and you didn't know the side effects, that's a problem. If you're taking a medication and don't know how to take it, and beyond knowing how to take it, the question comes up. Okay, so, yes, you know how to use your inhaler. You have asthma, and you know how to use your inhaler.

[00:43:03.270] – Allan

But can you do it when you're stressed? Can you do it when you're kind of freaking out because you're having an attack, and now you had to go back into the kitchen, you're having difficulties, and you grab it out of the counter and you're trying to take it? And can you do it properly when you're in that stressed situation? And we talked a little bit about this. Yes, you want to work with your doctor. Yes, they're part of your care team, but you've got to do those three core things, right?

[00:43:32.440] – Rachel

Well, it's important. Alan I just started taking thyroid medicine for hypothyroidism, part of my menopause journey, and this is the first time that I've had to take a medicine without having an illness. Like, I've taken antibiotics before, but this is a full time, probably for a very long time medicine that I got to take. And so my doctor gave me some information, but when I got home, I did read that little tiny piece of paper that comes in my pill box, and I actually learned some things that my doctor did not fill me in on. So if anyone's not taking a thyroid medicine, you actually have to take it on an empty stomach FYI you can't just take it willy nilly at any time of the day when you feel like you've just remembered to taking it. And then I've also learned, too, that there are certain foods that will make it less absorbable. So I take it on an empty stomach, you have to wait 30 minutes before you can even eat anything. And then there's some foods that you shouldn't be eating. You shouldn't be taking an iron supplement. At the same time, you should not be having walnuts and some other random food items.

[00:44:36.060] – Rachel

So I did all that research, I did all that little fine print reading to figure out I need this thyroid medicine to work. That's my a goal. So I want to do everything I can to not sabotage that by eating the wrong things at the wrong time. But I can only imagine with blood pressure medicine, heart medicine, diabetes medicine, there's got to be a ton of rules for all these other things.

[00:44:59.740] – Allan

Yeah. And then the other side of it is what happens if there's a change in you. So you're listening to this podcast, and so I'm going to go on the general assumption that you want to improve your lifestyle and live a long, healthy life. So let's say you lose 30 pounds. What does that change? Because some medication doses are based on how big a human you are.

[00:45:25.740] – Rachel

Weight. Yes.

[00:45:26.620] – Allan


[00:45:28.090] – Rachel


[00:45:28.680] – Allan

And so if you lose some weight and now do you need the same medications? And so it's worth going to even if just go to the pharmacist, go to the counter. They've got the little quiet little booth over there. It's kind of private. You can go there and say, hey, I'm just curious. I've done a little bit of reading, but I weigh 30 pounds less than I did when these medications were prescribed. Should I be taking the same amount if I weigh 30 pounds or 60 pounds less? That's a big difference. You tell your doctor, hey, I'm going to go low carb, or basically say, I'm going to cut out sugar. How should I manage my medication when I start reducing the sugar that I'm eating? Because what I don't want to do is have my blood sugar go too low. And now what am I doing? I'm drinking orange juice or soda just to make it all work right. And so it's one of those things you need to know why, you need to know what the risks are, and you need to know how. And that's most of what this book is. But she has a lot of great information in there.

[00:46:36.290] – Allan

How to approach your doctor, how to have these conversations, how to get one of those reviews done,

[00:46:43.740] – Rachel

one point I want to make really quick, Alan, is that we rely on our doctors to tell us all of this information about the medicines we should be taking and how to take them. But I want to remind people that all of the doctors that we go to may not always be on the same page. So, for example, if you're going to a cardiologist and he has you on a blood pressure reducing medicine, and then you go to your general practitioner and she sees that your blood pressure has dropped so low that she puts you on a different blood pressure medicine to get it back up to normal, obviously, it's a contradiction there. So just I want to point out that you need to make sure that all of the doctors that you see are fully aware of all of the medicines that you take so that they're not counteracting what each of them are trying to achieve with helping your health.

[00:47:31.140] – Allan

And that's one thing well, that's one of the things Dr. Levy got into, was she know if your kidney's not functioning very well, and then because your blood pressure, your doctor puts you on a diuretic, I think you can see there might be a problem there. Your doctor knows that you have some kidney issues. At this point, I'm not on any medications at all. I did take aspirin the other day because I had a headache, but the only thing I can remember taking in, I don't know, three or four years was maybe a little bit of aspirin here and there. But if I were on multiple medications, when I went into any doctor, any doctor I walked into, I would have that piece of paper and I would say, okay, here, you can put this in my record. If you need to, but I want them to be able to pull it out when we're having I'm going to get a copy here, maybe, but just here's. List of everything I'm taking. Here's when I'm taking it, here's how much I'm taking. So I want you to have a complete transparency, and then any issues that are going on.

[00:48:33.920] – Allan

I lost 30 pounds. I've gained 30 pounds. My hair is falling out. Other things are going on in my body. And if the doctor tells you, well, that's just getting old, I would probably go find another doctor.

[00:48:46.660] – Rachel

Yes, please.

[00:48:49.530] – Allan

But have conversations. Yes. They'll give you seven to eight minutes, but be ready. If you just sit there and listen to them for eight minutes, you're not going to learn everything that you need to know.

[00:49:01.720] – Rachel

Yeah. Neither are they. You need to tell your doctor what's going on. You need to keep them 100% informed with what's going on so that they can treat you properly.

[00:49:10.740] – Allan


[00:49:11.950] – Rachel

Yeah. Great. I love this book. It could be your medication.

[00:49:16.690] – Allan

Well, it is, and it's definitely the right conversation to know, because your pharmacist and even your pharmacist will take more time, but your doctor just isn't given enough time. I talked about that last week with the urologist, Dr. Boone. They're just not given enough time to really tell you everything they want to tell you or should tell you. And so you have to be an advocate. You have to ask the right questions.

[00:49:39.180] – Rachel


[00:49:39.980] – Allan

This book can be a good start to that.

[00:49:42.060] – Rachel

Super helpful. Yeah.

[00:49:44.110] – Allan

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

[00:49:46.730] – Rachel

Great take, Allan.

[00:49:48.050] – Allan

You too. Bye.

[00:49:49.060] – Rachel

Thank you. Bye bye.

Music by Dave Gerhart


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

– Anne Lynch– Ken McQuade– Leigh Tanner
– Debbie Ralston– John Dachauer– Tim Alexander
– Eliza Lamb

Thank you!

Another episode you may enjoy


August 15, 2023

Unsaid things during your urologist appointment with Dr. Martha Boone

Apple Google Spotify Overcast Youtube

On episode 603 of the 40+ Fitness, we meet Dr. Martha Boone and discuss her book, The Unfettered Urologist: What I Never Had Time to Tell You in a Fifteen Minute Office Visit.


Let's Say Hello

[00:01:25.690] – Allan

Hey, Ras. How are things?

[00:01:27.230] – Rachel

Hey, Allan. Good. How are you today?

[00:01:29.890] – Allan

Doing all right. We had another incident this weekend.

[00:01:35.080] – Rachel

Oh, no.

[00:01:36.270] – Allan

But this is a happy ending.

[00:01:38.580] – Rachel

Okay, good.

[00:01:40.110] – Allan

Well, it's happy because here's the deal.

[00:01:43.190] – Allan

A friend of mine here, another friend. Here had actually listened to our podcast when I talked about losing my friend, Greg to a heart attack. Well, this weekend, he's short of breath, pressure in his chest, not feeling well. The night before, he felt kind of an odd thing in his shoulder. Now he sees these lineup of symptoms.

[00:02:10.170] – Allan

And you get nervous and so blood pressure goes up and a lot of the things going on. Anyway because there's not really an ambulance. There is an ambulance service on the island, but you do better to walk. Even if you're having a heart attack, you'll get there faster. But my wife went by, she has a car, so she picked him up and took him.

[00:02:30.000] – Allan

And I just stayed online with them and just kept him calm and said, okay, here's what you do when you go in to talk to the doctor. Here's what you tell them, and then you don't leave there. Even if they tell you it's nothing. You don't leave there until you get an EKG. They can do anything else they want to you, but you're not leaving there till they do an EKG and tell you it's normal.

[00:02:53.110] – Allan

And he did that, and he actually did have to advocate for himself to get the EKG because the doctor just wants to say, well, this is indigestion, and you've got bronchitis and you're old man, so this is normal and it's not normal.mAnd we're going to talk about that a little bit later. But the whole point being is, it was probably not a heart attack. At this point, we're not sure.

[00:03:14.220] – Allan

The doctor says it's not, but at this point, it's like you have to be an advocate, you have to be demanding. His wife had to go in there because he was sitting in the waiting room and she literally had to go in there and start raising hell to get them to come out there and start taking care of him. So if you find yourself in a waiting room and you were having chest pains, don't sit in that waiting room. You go up there and tell them, I'm a middle aged man or woman. And I'm having chest pains and I'm not going to die in your waiting room while you sit here and do whatever the hell you think is more important.

[00:03:49.610] – Allan

If nothing else, get me an aspirin, get me a nitroglycerin, get me something that you know is going to help someone if they're having a heart attack. But I'm not going to just sit here and not be cared.

[00:04:00.330] – Allan

You know, again, we're not in the United States, but you hear horror stories of emergency rooms in the United States too, so it happens everywhere, I'm sure, but it's just you got to advocate for yourself. And he did.

[00:04:11.040] – Allan

And fortunately, the outcome is not a bad outcome. And he was in the right place he needed to be. If he was having a heart attack because he didn't ignore the symptoms.

[00:04:22.160] – Allan

And it might have been indigestion and it might be bronchitis, it might be a lot of things, but at least at that point they confirmed to him that it was not a heart attack. They did the EKG, they did the blood work. And so he's reasonably confident that he was not having a heart attack, which, again, very good, but it's also convincing him he should probably quit smoking.

[00:04:41.330] – Allan

And I concur. okay.

[00:04:45.320] – Allan

But these are the health conversations we need to be having and we need to be aware and pay attention to ourselves. So again, if you don't know the symptoms for a heart attack, a little different from a woman and a man, but take some time, get yourself familiar with those things because it's not normal to fall apart over time. If we do the right things for our body, our body will be healthy for a long, long time. And so if you notice symptoms, pay attention.

[00:05:11.420] – Rachel

Yeah, for sure.

[00:05:12.420] – Allan

And then the second thing I want to talk about is I've been planning our trip.

[00:05:15.890] – Allan

We're going to take September off from Lula's for sure. We're shutting down Lula's and I'm going to not take any new clients in September. So today is August 15 and so after got two weeks. Now if you want to work with me, this is your time to sign up. I'll be servicing clients. Podcast will keep rolling on through September, but I won't be taking on new clients. So if you decide you want to message me in September, I'll take your details, you can fill out the form.

[00:05:45.600] – Allan

But you're not going to see anything on my calendar to book, so you could email me and send me your details, and I'll say, okay, I'll talk to you October, probably October 2, and that's it.

[00:05:54.790] – Allan

So if you want to work with me, you can go to 40plusfitness.com/discovery. It'll let you there's a calendar right there that actually ties to my calendar.

[00:06:03.980] – Allan

So if you see open dates, that's times that I'll take those calls, but I promise you right now, you will not see one of those dates in September. So, 40plusfitness.com/discovery if you're looking to make a health and fitness change.

[00:06:17.380] – Rachel

Awesome. Sounds great. Glad you get to take this time off, Allan. It'll be really nice for you and Tammy.

[00:06:23.120] – Allan

Yeah. I mean, I'll still service the clients that I have that are remote online because I can. But I'm not taking anymore. It's too much work to onboard a new client, and I don't want to be doing that while I should be on a beach somewhere

[00:06:38.200] – Rachel


[00:06:39.170] – Allan

Yeah. Or doing something fun.

[00:06:41.090] – Rachel


[00:06:42.050] – Allan

Tammy's planning 99% of it, and I'm just going along for the ride.

[00:06:47.400] – Rachel

Nice. That sounds awesome.

[00:06:49.280] – Allan

How are things up there?

[00:06:50.960] – Rachel

Wonderful. I'm having a very relaxing week. I'm in taper mode for a race that's coming up this weekend. So besides talking with you and run club later tonight, I literally have nothing on my calendar, and I'm just taking the time to relax and chill and get ready for the weekend.

[00:07:09.330] – Allan

That's awesome.

[00:07:10.520] – Rachel

It is. Feels good.

[00:07:12.700] – Allan

Well, good luck with your run.

[00:07:14.590] – Rachel

Thank you.

[00:07:15.260] – Allan

I want to hear next or over the next couple of weeks how that went.

[00:07:18.860] – Rachel

Sure, yeah. I'll keep you posted.

[00:07:20.570] – Allan

Let us know. All right.

[00:07:21.980] – Allan

So are you ready to talk to Dr. Boone?

[00:07:24.440] – Rachel



[00:07:58.810] – Allan

Dr. Boone, welcome to 40+ Fitness.

[00:08:01.940] – Dr. Boone

Thank you for having me. I'm excited to be here.

[00:08:04.540] – Allan

Now, your book is called The Unfettered Urologist: What I Never Had Time to Tell You in a Fifteen-Minute Office Visit. And as I went through the book, it's set up really well for you to if you just had an incident or issue and you wanted to flip to that part of the book, you could. But quite frankly, I would encourage anyone that wants this book or wants to learn more about this. Maybe you're having some issues or have had some issues and you just don't have the answers, read the whole book, because there's things in the book that, as I went through it I'm like, okay. And then it was like juxtapose backwards and forwards, and I was like, okay, this is actually kind of interesting because everybody wants simple rules, right?

[00:08:50.320] – Allan

They want, okay, vitamin C is good for you. Well, it can be for a UTI and maybe not so much for a kidney stone.

[00:09:01.170] – Dr. Boone


[00:09:02.410] – Allan

And so it was just kind of that thing of saying, everybody thinks, well I'm just going to have my orange juice every morning, and that could actually be a problem, even though we would personally call it healthy.

[00:09:14.450] – Dr. Boone

Exactly. Everything in moderation.

[00:09:17.660] – Allan

Yeah. And so that was just one of the interesting things as I went through the book, to sit there and say, I didn't know that. And so if I had kidney stones. I wouldn't have thought to avoid citrus. And then I didn't even know there were two different types of kidney stones. And so it's just as I went through the book, I'm like, there's a lot more to this than it sounds like. It seems like simple plumbing till you really start looking at what's down there.

[00:09:38.440] – Dr. Boone

Yeah, we've made a whole field out of good.

[00:09:42.250] – Allan

Actually visited a urologist not long ago because there was a little bit of blood involved. And so I did go see a urologist and my co-host Rachel, who'll be on the know, we talk about this episode in other sections. Her husband had some blood, and he got diagnosed with kidney cancer, and he's had one of his kidneys removed, and he's just 50 years old. And you actually had a girl in the book that was much I mean, she was young young, and she had kidney cancer. So there's a lot in this book to help us stay healthy and know when and how to work with our urologist. So I really appreciate the opportunity to profile this.

[00:10:23.510] – Dr. Boone

Thank you.

[00:10:25.110] – Allan

So let's jump into kidney stones, because I've actually had a little kidney stone before, and I say little because it wasn't nearly what a lot of people go through. And fortunately, technology, I was able to excrete it. So that was the cool part for me. But kidney stones are, I guess, the way you said in the book, they get rated up there as being worse than pregnancy or at least as bad. Can you tell us a bit about kidney stones? What they are, how they form, how we can prevent them? And then if we do find that we have kidney stones, we can't pass what we should consider for treatment.

[00:11:01.820] – Dr. Boone

So when I first was interested in becoming a urologist, we would make foot long incisions on people to get a kidney stone out. The technology has advanced so that we can get most kidney stones out with a quarter inch fiber optic tube. We can use laser energy to break up the stones, and we can take the pieces out with baskets so most people do not have to get cut on their bodies at all. But women who have had both childbirth and had a kidney stone would pick childbirth every day. So it is one of the most painful things that can ever happen to a person. So we want to prevent them as best we can. Now, even though the technology for getting rid of stones and surgically treating them has greatly advanced, the incidence of kidney stones or the number of people who have them in the population has skyrocketed. We're seeing so many more children with kidney stones. We're doing surgeries on children for kidney stones. And most of this is totally preventable because it's based on our bad dietary choices and our lifestyle choices. So the number one thing for preventing kidney stones is to make sure that you're adequately hydrated and adequately hydrated.

[00:12:17.040] – Dr. Boone

For a simple test, all you have to do is look in the toilet. If you're not taking a drug or a supplement that can make your urine dark, then your urine should look like pale lemonade. If it starts to get dark or psychedelic yellow, then you're very far behind with your hydration. So what causes the kidney stone to form? Our body gets rid of toxins in multiple ways. We breathe them out, we defecate, we sweat, and we get rid of liquid toxins through our urine. So anything that our body perceives that it doesn't need will show up in our urine if it's a liquid form. And what we have in that urine are crystals. And if we become dehydrated or we have the right environment, the crystals could stick together, almost like those crystal experiments we saw in middle school, where you would put all these things together and then the crystal farm would grow. That's exactly what happens in the kidney. So we want to make sure that what is presented to the kidney is either dilute enough through good hydration so that the crystals don't stick together, or that the components of the crystals are decreased.

[00:13:19.690] – Dr. Boone

So number one is hydration. Of course, your hydration will vary based on what you're doing. I mean, if you're outside a big athlete like you are, and you're sweating a lot, you're going to need a whole lot more fluid than a 90 pound elderly woman who's sitting at home all day. So you'll have to calculate your fluid intake based on your activity. And for the average person who's not doing anything extraordinary, it's basically your body weight in pounds divided by two. So if you weighed 140 pounds, most people would be hydrated. If you took 140, divided it by two, which gives you the number 70. If you stay somewhere in that range with your total fluid intake on a daily basis, you should be hydrated. The second thing that leads to kidney stones is a high salt diet. And this is ubiquitous in the world right now. If you went and had one fast food diet that would be more sodium than you should have for the entire day. And the problem with sodium is that the kidney level is exchanged for calcium. So anytime that you're eating high sodium, you're leaching calcium out of your bones, which can lead to osteopenia or loss of calcium in the bones, and it is delivered to your kidneys, which can lead to kidney stones.

[00:14:32.370] – Dr. Boone

So managing the sodium in your diet is very important. For the average person, you should have less than 2300 milligrams for 24 hours. Sounds like an awful lot. But if you start reading labels and particularly looking at anything that comes in a box or fast food, you'll quickly see that we are having way too much sodium in our diet.

[00:14:54.590] – Dr. Boone

One of the old wives tales out there is that you should limit calcium in your diet. There are actually types of stones that are more likely to occur if you limit your diet too much in calcium. And we need our calcium for bone health, so please do not be limiting the calcium in your diet. Now, if you were a chronic stone former, somebody who's made more than one stone, that would indicate that you would want to have either your urologist or your nephrologist do a panel of blood tests. It's about 30 blood tests and a 24 hours urine. And what the doctor would do is compare what's in your blood to what's in your urine, and then they could make very specific dietary changes. Sometimes medication is necessary. Sometimes it's something that you're taking. You had mentioned the vitamin C, so vitamin C is healthy for most people, but if you take too much, it's exchanged at the kidney for oxalate, and oxalates form stones. So if you take too much vitamin C, like the typical scenario we would see in the wintertime, people think if they take a whole bunch of vitamin C, it wards off colds or the flu.

[00:16:01.720] – Dr. Boone

And we would see people come in who'd never made a kidney stone before, and they had made one based on taking way too much vitamin C. So if you are making stones regularly, your doctor would check your blood and your urine to figure out exactly what needs to happen. Now, if you've made one or two stones and you just want to try to do what you can best do for yourself, I would encourage you to look at a product called therolif XR. I have no financial relationship with this company. It's a quality company. The company name is Theralogix Theralogix, and this product has some natural compounds in it that are actually stone blockers. And so if someone wanted to start themselves on something that definitely wouldn't harm them and could possibly decrease their stone incidence, then that would be a product to try. The other thing we want to be careful about is going on these really high protein diets. I had never made a kidney stone in my life, and I decided that I was going to lose weight going on a very high protein diet. Well, I had my first experience with kidney stones because high protein can lead to dumping of calcium in the urine, which can lead to kidney stones.

[00:17:12.020] – Dr. Boone

So we want to make sure that we're taking in the right amount of protein for our exercise level and for our age and for our body weight. Those are the prevention things.

[00:17:25.230] – Allan

Good. Because yeah, even though the surgery is a little less invasive now, waiting for that to happen and having them get in there and all that, that's not going to be a joyous moment. So being a kidney maker, I mean, a stone maker is not necessarily a good pastime.

[00:17:45.730] – Dr. Boone

No, not at all. I was very indignant when it happened to me. I was like, how could this happen to me? I'm a urologist. In fact, at first I didn't know what it was. I thought it was ovulating. And then I looked in the toilet and there was all this blood and I was like, oh, that might not be an ovulation.

[00:18:01.290] – Allan

All right, so now, another thing that is fairly common in women, a little less common in men, are urinary tract infections, UTIs. And I know as women get older, the incidence of UTIs tends to go up, right?

[00:18:16.130] – Dr. Boone


[00:18:17.020] – Allan

So let's talk a little bit about that, what that is, and then what we can do to prevent and if we need to treat it.

[00:18:24.290] – Dr. Boone

So as urologists, we all have kind of wacky sense of humors. And I think of urinary tract infections as very good evidence that God must be a man, because the anatomy of the female is a set up for having an infection. You have the rectal area which has the highest content of bacteria in the body, right next to the vagina, which is basically a warm, moist, culture medium which is right next to the urethra, which is connected to the bladder, which is supposed to be sterile. So you have an organ which is sterile in most people, very close to an organ that is the highest content of bacteria. So the real question is why don't all women have urinary tract infections? And we believe that it has to do with local immunity. The person's local immunity is able to fight off the bacteria. Now, again, what could prevent bladder infections? We go back to this being hydrated. It's simple flow dynamics. If the bacteria have tracked from your rectum up into your bladder, if you're drinking an adequate amount of fluid, you can flush them out. So it's kind of mechanical. The second thing is to be sure that your hygiene is good.

[00:19:35.460] – Dr. Boone

So the old thing that your mother teaches girls to wipe from front to back, it's a very valid thing. You don't want to pull the bacteria from the back to the front, so you want to use good hygiene. Another thing that works well is to be sure that you're managing your stress. There's no scientific study that shows this, but we know that stress can make all infectious diseases worse. And the way that it works is that you get stressed, your cortisol levels go up and that kind of suppresses your immune system. So even if you had the native immunity to fight them off during times of stress, you might not be as well able to do that. And we see this all the time and it can be even good stress. We see young ladies who are about to get married or who are about to graduate from college or something fabulous is about to happen to them, but they experience it as a stress will change and they'll get a bladder infection just in time for the wedding or the honeymoon or whatever they have planned to do. So the big problem with urinary tract infections is the overutilization of antibiotics.

[00:20:40.250] – Dr. Boone

When a woman goes to a doctor and has all those hideous symptoms of a bladder infection, the doctor feels motivated to do something right then. So they'll give them a full course of antibiotics. The problem with that is that the bacteria are brilliant and they will do something called become resistant to that bacteria, I mean, to that antibiotic. So they recognize that the antibiotic is present and they can actually change themselves so that that antibiotic no longer works on them. And they tend to become stronger and stronger and stronger each time that they're exposed to an antibiotic. And this is how we produce something that's called a superbug. And a superbug is something that's so strong it cannot be killed by any of the current antibiotics. If we keep going like we're going now, the way we're utilizing antibiotics, we're going to reach a point where we have all these superbugs that we cannot treat and they can cause death. So we'll go from having an aggravation to something that could actually cause mortality. So it behooves all of us, both patients and doctors, to work on this problem from a prevention standpoint. Now, the good news is, when we look at prevention, we have an excellent protocol for preventing them and it involves using a good quality Cranberry supplement.

[00:22:02.330] – Dr. Boone

Now, when we talk about Cranberry, we want to know why would this work? And what Cranberry does is it has something in it called PACs. The scientific word is a pro anthocyanidin. And this is a compound that can keep the bacteria from sticking to the lining of the bladder. So that when we're hydrated and we drink fluid, it will push the bacteria out more likely than it would be for them to grab onto the lining of the bladder and be able to set up a full blown infection. Now, the Cranberry products that have the best budgets for advertising are not necessarily the best product. So over many years of having my patients utilize these things, I learned that the following things work. And again, I don't have any financial relationship with any of these people, and there'll be information on my website. If people want to go and read the actual studies for themselves, they can do that. But pure cranberry juice works beautifully. The problem with that is most ladies would gain about 20 pounds in a year if they drank enough cranberry juice to be able to ward off infections. So the products that I've had the best results with are a product called Theracran, another product called Elura and a third product called Utiva.

[00:23:23.740] – Dr. Boone

And these are all made by small companies that don't have big advertising budgets, but what they have is quality control. So you want to make sure that each pill has the adequate amount of these PACs in it to be able to actually work. And I would have my patients, if they are not having a lot of UTIs, and if they're having three or four year, I just have them take one pill at night so that the product is sitting in their bladder and affecting the bacteria while they are asleep. If they're having more than four infections per year, then I would have them take it morning and night to be sure that they're getting maximum effect from this. And then I would make sure that the patient partners with whomever is managing their UTIs to try to use the lowest amount of antibiotic for each infections that they can possibly use, the fewest number of pills, the shortest course, and try to do everything that they can to not use the stronger antibiotics. Because we know that this is just going to get worse and worse and worse if we don't manage this on the front end.

[00:24:31.990] – Allan

Yeah. When I was reading your book, one of the things that kind of came across my mind when you were talking about the design of a woman, I was actually thinking that maybe there was a purpose to it in that. No, when you have something bad and you have something good so I have good bacteria and I have bad bacteria. And when they're forced to fight the good bacteria, the hormetic effect, they get stronger. And then now the child is born through the vaginal tract, and that becomes a part of their microbiome. So a thought to me was, this might be just a way to make sure that the vagina is properly populated with good bacteria that are strong and resilient so that they could take care of the baby. But that's just a theory.

[00:25:17.570] – Dr. Boone

I think that's a great idea. Found that anywhere in science, but I think it would be something that be worth studying.

[00:25:23.790] – Allan

Well, yeah, maybe, but that was just the whole point of, yeah, we're talking about design. And I would just say, okay, I don't believe there's an accident out there in design. I think there's a specific reason for it. And we might not like the outcome all the time, but there's probably a very good reason for it.

[00:25:43.950] – Dr. Boone

I did want to mention one other thing. So you had mentioned about how the incidence of infections becomes greater as you get older, and I wanted to address that. So when a woman is young and we have a lot of estrogen, the vagina tends to be acidic and the acid environment makes it very healthy for the local microbiome, which you were speaking of. And that makes it less likely that the pathogens can take root in there. As we get older, with less estrogen, naturally we become more alkalotic in our vagina and so the pathogens can have a much bigger party down there. Also, as we get older, our bladders don't empty as well. So clearing everything out with each emptying is not as good as it is when we're younger. So one thing that a lot of women have been able to benefit from is either topical estrogen right to the urethra and the vagina, or being estrogenized through hormone replacement therapy. So we have seen women who are appropriate for that and some women are not. Their doctor will decide, will help them decide whether they're appropriate for it or not. But that has been something that we've really seen to be able to break the cycle also good.

[00:26:48.630] – Allan

Now let's shift gears a little bit, if you will, and let's talk a little bit about erectile dysfunction.

[00:26:56.710] – Allan

It is also something that men tend to notice as they age, but it's not always related to testosterone. Could you tell us a little bit about what it is, how we can prevent it and if we do find ourselves with ED, what we can do to treat it?

[00:27:14.490] – Dr. Boone

As urologist, this is one of my favorite topics because the penis is actually an amazing organ. It has to have good nerve input, it has to have good arterial input and it has to have normal venous outflow to be able to function well. So it's actually a very complicated organ. The thing I'd like for the listeners to really remember is that it is normal for a man to occasionally have problems with erections. And the reason for that is the sympathetic nervous system. The design is such that you don't want to have an erection if you have to go out of the cave and fight the tiger. So the man is hardwired during times of increased sympathetic outflow of the sympathetic nervous system to not be able to have an erection. So the brain doesn't know the difference between it's time to fight the tiger and I had a fight with my boss or I've been on the road traveling for two weeks and I'm exhausted, or my wife and I have been squabbling because I've been on the road traveling for two weeks. So having the occasional difficulty is normal and it's not anything to get too freaked out about.

[00:28:22.450] – Dr. Boone

If you are a young man under 55 and you are having regular problems with erections, this is a wake up sign that you do not want to ignore, because what that implies is that there is something metabolically going on. Sometimes it can be pre-diabetes, sometimes it can be high blood pressure, sometimes it can be elevated cholesterol. But there's a 50% increased incidence of having a heart attack as a young man, if you are having regular erectile dysfunction. So if you are attempting to have intercourse and you can't because your penis won't become fully erect, you need to go to your internal medicine doctor and be worked up for all of these possible causes. And that is so important. I mean, this could actually save your life. So it's not anything to ignore. Now, what are the things that can cause it? Smoking will damage the blood supply to your penis, and interestingly enough, sometimes it never comes back. So if you're a young man out there and you're thinking, I'm going to smoke for a while and then I'll stop later, please don't think that smoking is very toxic to the blood flow. Unhealthy lifestyles, being sedentary, being overweight.

[00:29:38.630] – Dr. Boone

Fat cells are not just sitting there doing nothing. They're very metabolically active. And in the male, they can make estradiol which feminizes the man. And this estradiol can have a feedback mechanism that can decrease your natural testosterone. So decreasing your percentage body fat can be very helpful to improving erections. Alcohol use. Alcohol can very much affect erections, as can drug use. Diabetes, diabetes causes both damage to the nerves and to the blood supply to the penis. High blood pressure, elevated cholesterol damage the blood flow, psychological issues, anxiety issues. During the first ten years that I was urologist, I almost never saw young men with ED. In the last 20 years of practicing, I saw this all the time. People were overworked. They were trying to juggle home life and traveling and just the stresses of modern life. So I saw so many young men with really no metabolic problem who all of a sudden had erectile dysfunction. Then we have all the neurologic diseases, things like Parkinsonism, multiple sclerosis. I encourage men also to look at sleep disorders. If you have sleep apnea, that can cause you to have elevated cortisol, which can also affect your erection.

[00:31:04.510] – Dr. Boone

So if your partner tells you anything like, hey, you're snoring or you seem like you're stopping breathing sometimes at night, you definitely want to see your internal medicine doctor to consider getting a study to make sure you don't have sleep apnea. The relationship between low testosterone and erections is something that the urologic community argues about. The conventional urologic literature will tell us that the hormone testosterone causes desire or libido, but it's not necessarily connected to the actual functional aspects of being able to have intercourse. In my clinical practice, I did not find that to be the case. Over and over and over again, when men had very low testosterone and we would supplement it, they would report that the quality of their erections were much better. So I'm not sure that that case is really closed. But if you look at the literature, they're going to say testosterone does not cause you to have better quality erections. But I don't believe that.

[00:32:05.610] – Allan

I think it's on the social psychomatic side where when you are feeling better and more masculine and everything that testosterone does maybe have more muscle mass, lose some body fat percentage, those things are just going to happen as a side effect, if you will. Maybe not a direct correlation, but definitely I think when your testosterone is higher, you feel more like a man, and I think that's going to help.

[00:32:33.730] – Dr. Boone

Yes, it's very complex. I think it's fascinating. I mean, I loved seeing these patients because it was never just one thing. It was always lack of exercise, too high body fat, stress, not enough sleep, relationship issues. I mean, it's always complicated. And so I loved helping people work through those kinds of issues.

[00:32:53.370] – Allan


[00:32:53.880] – Allan

And I think one of my core takeaways from this conversation in the book was, okay, don't just go in there and ask your urologist for that blue pill and go on. Spend some time actually figuring out why this might be happening, because it could be a sign of a bigger problem for you. And if you just go straight to the blue pill, you might miss something important.

[00:33:15.390] – Dr. Boone

Yes, I think that is an excellent point.

[00:33:21.150] – Allan

Now, I love having doctors on here that are sort of not doctors as much now as they were before. And the concept of your book was, if I could have told you in the 15 minutes everything I needed to tell you, this is it. And you called it a love letter to your patients. If I go to a doctor, I'm the kind of person who wants the best health outcome possible.

[00:33:43.880] – Allan

I'm not worried about what it's going to cost me. I'm not worried about the rest of it. I'm like, okay, I want a good health outcome. And so if I go into a doctor, how do I get the best health outcome? Because it just seems to go against the way the system is designed right now. It's designed almost as a conveyor belt. And the sad part and I'll tell the story, I have a friend that had a heart attack, and so I thought, okay, well, I'm going to go get a calcium score just to see where I stand. And because I don't live in the united States, I don't have a US based GP. And so I go to call a clinic that does the calcium scores. It's $200. It's a simple little X ray thing, takes five minutes. $200. I'm like, okay, I just want one of these.

[00:34:36.070] – Allan

And they're like, well, your doctor has to call it in. I'm like, Why would I have to go to a doctor? I'm 57 years old, and I want to know my calcium score, and it's reasonable. It's not like I'm asking them for a test that doesn't make any sense. And so as I try to manage my health outcomes, working with doctors, it just seems like the system is built to make it very difficult for me to do that.

[00:35:00.770] – Allan

So what's some of the advice that you have for us to approach the medical system the right way?

[00:35:08.690] – Dr. Boone

So, the system is definitely not user friendly. It is not user friendly for the doctors, and it's not user friendly for the patients. So to say that in many ways it's broken, I think is absolutely correct. For your specific scenario that you just mentioned, the two main reasons to not have patients be able to walk in and get whatever test they want. A calcium score is a very high radiation test. So someone who is monitoring your overall health and paying attention to how much total radiation you're getting from various tests should be deciding the benefit versus the risk and presenting that to you and then having you make an informed decision. So I think patients being able to go in and just get any test, I kind of agree that that's not a good idea because you don't know what you don't know. The other thing is, if you go in to get that test, someone needs to be monitoring the follow up that knows what the test means. So if you were to go in there and see a large percentage blockage in your left anterior descending artery, you might need a calf and a stent that day.

[00:36:19.070] – Dr. Boone

You might be on the verge of having a major heart attack. So if a doctor hasn't ordered the test and there's not a doctor assigned to review the results, the radiologist is not really the person who can do that. Radiologists don't manage patients. They look at studies and tell you what's on there and then call the doctor or whatever. So the follow up part for a test needs to be there also. So those are kind of the two main reasons that they would not have the patient be able to get it for themselves. Now, as far as how to work the system, I think managing expectations is really important. What is an MD? An MD is a person with incredible science background. Now, what does science mean? Science means it has been demonstrated in a randomized, double blind placebo control study. What does that mean? It means that we have tried to eliminate bias from the study. So Dr. A, who thinks that his little pet procedure is the best thing in the world, goes around telling everybody, hey, we've got to treat everything this way. In a scientific study, you would have people who did not know

[00:37:32.940] – Dr. Boone

Dr. So and So did not know it was his Pet study, and they were studying it blindly to see if it worked or not. And so we would get information about whether something was really effective or not. And that's pretty much what science is. So when you go to an MD, we are licensed to tell you the things that have been proven by science. And so there may be things going on out there in the alternative community that we don't know anything about, or we may have some sideways information about it, but we don't have the randomized double bond control studies. And so it's not within the purview of our licensing to recommend things that have not been proven scientifically. Now, how would a person figure out how to have their best health? I read your book, The Wellness Roadmap, and I saw so many tools in there that I think would be helpful to a person. So I think recognizing that an MD is there for catastrophic things, the doctor is the one you go to when everything's failed and you've got a big mess and you've got a problem and somebody's got to fix it.

[00:38:39.580] – Dr. Boone

My appendix needs to come out. We're really good at that kind of stuff. We don't in the past have had a lot of training in prevention of diseases. So the average MD, unless they've gone to the trouble to educate themselves, is not going to be the one who's really going to know a lot about nutrition. Many doctors don't know anything about exercise. I mean, some of the Orthopedic guys can tell you a bit about that, but most of us really don't know a whole lot about exercise and how the body responds and exactly what we need. So I think for a person to realize that they could need a lot of people other than the doctor to have their best wellness, they might need a life coach like you, they might need a trainer, they might need a masseuse, they might need an acupuncturist, they might need a chiropractor, they might need a hypnotherapist. I mean, they may need a whole lot of other things. But the main job of the MD is to help guide the patient towards what tests they need to have. Like when is the best time to get a colonoscopy, how often should you have a mammogram, those types of things.

[00:39:43.020] – Dr. Boone

The MDS have the best scientific information about what your blood test actually means. So if you go somewhere and have 50 blood tests done, you're an intelligent person, you've done a lot of reading, so you'll be able to figure out on the surface what it all means. But an MD should be able to look at the details and help give you some ideas about what's coming down the road that you need to watch out for. So I think having the best expectations of what you can get at the doctor and what you can't get at the doctor I think would be very helpful. Then there are people who are opening up concierge practices where they're trying to offer more time to the patient more discussion, someone intelligent like yourself who's done so much reading and interviewed so many people, you would go to the doctor with a different level of information, and you would want to talk on a different level. And so a concierge doctor may be the kind of person who would work better for you because you could have an hour long visit and you could go through all the different things that you've read, and they could give you the pros and cons of why you might want to try this as opposed to that.

[00:40:49.150] – Dr. Boone

But when you're going just to a standard doctor for your routine visit, it's hard to get that in the current environment.

[00:40:55.610] – Allan

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

[00:41:08.630] – Dr. Boone

So my personal prejudice is that it all starts in your mind. I think what you choose to think creates your personal environment. And I saw that over and over and over again. Two people can get diagnosed with the same cancer. One person sees it as a wake up call. They get rid of a toxic relationship. They change their job, they start to exercise, they change their diet, they start to take supplements. They start to look at all kinds of alternative therapies while they're having surgery and chemo and radiation. Another person will see this as a call to having a gigantic pity party, oh, my God, why did this happen to me? I'm such a good person. And they will become angry and miserable and regretful, and they'll die a terrible death and have a lot of misery until that death comes. And the difference between these two people is what they're choosing to think about the situation that they're in. And I think that speaks to all parts of our health and our wellness. I mean, you and I were talking before we started the podcast about trying to motivate people and trying to help people stay motivated and why one person will get on a program and stay on it and another person won't.

[00:42:31.480] – Dr. Boone

I think a lot of it has to do with what we tell ourselves. I mean, you talk in your book about having a vision. Well, you're a big accomplished athlete. Me, I'm a bit of an egghead. So my vision was to not be a little old lady with a bag full of pills going around to every doctor in town. So my motivation for going out there and exercising when I don't want to do it is to take the fewest number of pills, have the fewest number of doctors visits and test and surgeries and all that as I can possibly have. And to be able to enjoy my life, to get up and down off the floor without having to hold on to something. I have those visions. I mean, I want to be able to go sailing and jump off the boat and swim around and look at the fish. So I think having a vision and using your mind to be able to create a plan for wellness is, to me, the most important thing. Number two is also kind of something that you alluded to in your book, which is trusting your body.

[00:43:32.310] – Dr. Boone

I mean, we're all at different levels. You told a story about getting some CDs or DVDs and exercising, and the next day you couldn't get out of bed. And I think having patience, a person who is not healthy didn't get there overnight, and you're not going to get out of that overnight. I mean, I had a two year plan for my wellness, and I based it on watching so many people come in my office and getting gung ho with both the nutrition and the exercise and everything at one time. And then they just couldn't keep it up. It was just too much. So what I recommended to my patients and what I did for myself was the first thing I did was I tried to cut down on sugar, I tried to cut down portions, and I tried to just simply move more. I mean, in the beginning, I would park my car at the end of the doctor's parking lot, I would take the stairs up to the operating room. So I incrementally changed all these little things. And my endpoint was not weight reduction. It was to feel better, to not be short of breath, and then ultimately to get off some of my pills.

[00:44:38.260] – Dr. Boone

And that has happened, and I'm very grateful. The third thing is meditation. Oh, my Lord, this is so underutilized in our world. I mean, I think we should be teaching kids to do this when they're young. Our mind is like a gerbil in there jumping around. And through meditation, we can learn to calm down and to not trust all those thoughts. And that those thoughts are creating emotions, and those emotions are leading many of us to the refrigerator. And so if we can change those thoughts through calming them down, then we can stop it before we get to the negative emotions of anxiety and agitation that lead us to want to go to the food. And then the last thing I think is just to try to be patient with your body. The body is brilliant. It can heal most things if we just give it sleep and proper nutrition and move around and manage our stress. The body is just brilliant at taking care of itself.

[00:45:43.550] – Allan

Yes. Thank you for that. So, Dr. Boone, if someone wanted to learn more about you and learn more about the book, The Unfettered Urologist, where would you like for me to send them?

[00:45:53.810] – Dr. Boone

So my website is www.marthaboone.com. It has on there both my novels because I'm a fiction writer, too, and it will have the links on there for a lot of the things that we've talked about if people want to educate themselves further.

[00:46:16.730] – Allan

Awesome. Thank you so much and thank you for being a part of 40+ Fitness.

[00:46:21.250] – Dr. Boone

Thank you for having me. I appreciate it.

Post Show/Recap

[00:46:27.630] – Allan

Welcome back, Ras.

[00:46:29.390] – Rachel

Hey, Allan. That was a really great conversation with Dr. Boone. There's a lot to really talk about, but kidney stones, UTIs, erectile dysfunction, these are all really important things or situations that need to get reviewed and managed before things get out of control. And they can happen quite frequently, especially as we age.

[00:46:50.050] – Allan

Yeah, I mean, OOH, what's that?

[00:46:55.890] – Allan

We're talking about parts of the body that people don't really want to spend a lot of time talking about. But the whole point being is if things aren't normal yes, things aren't normal.

[00:47:05.690] – Rachel


[00:47:06.260] – Allan

So don't take a little thing and say, oh, it's just a little blood, or, oh, there's a little itch and it doesn't go away, or, oh, this keeps happening. It's not normal.

[00:47:19.110] – Rachel


[00:47:19.660] – Allan

They're not normal. Healthy responses. Yes. So it might seem like a little thing. You're not a hypochondriac. If there's blood in your urine and you go see a urologist, they're not going to call you a hypochondriac unless you're seeing them five times a month, you know, I recently went to urologist because there was blood where there wasn't supposed to be. What's going on? And I've had kidney stone before, so I kind of knew. But you can't help but Dr. Google search.

[00:47:57.190] – Rachel

Usually not good.

[00:47:58.090] – Allan

There's blood. What are the possible things? And again, some people will poo poo it and say, oh, well, maybe this happened or maybe that happened, and I can excuse it. I can say, oh, well, this is why this is this way. It might not be, and so it might not be what you think it is, so it's at least worth going and nothing else. They'll give you a couple of blood tests or they'll do a little bit of urinalysis or something to at least give you the appropriate treatment.

[00:48:26.710] – Allan

But recognizing that these things are happening, there are lifestyle changes for almost every one of them.

[00:48:35.480] – Rachel

Oh, for sure, yeah. There's a lot of preventative measures we can take to maybe stave off kidney stones and UTIs and anything else. Supplements we could take. Exercise, eating well, staying hydrated. Super important.

[00:48:53.290] – Allan

That sounds so much like the five pillars of health.

[00:48:56.220] – Rachel

As usual. Yeah, as usual.

[00:48:59.110] – Rachel

And even lowering stress. Like Dr. Boone had said, stress can begin the snowball effect for some of these illnesses.

[00:49:09.710] – Allan

You're not going to be able to go into a urologist office and have a 15 minutes conversation with them today. She said 15 minutes, but I don't know. I mean, I was because it's Panama, so it's a little different. But most of the time when you're in there, you're going to see their nurses and keepers, people that are hustling you around, moving you from place to place, and you're going to see the doctor for a few minutes, probably no more than seven or eight. And that's the way the medical system is set up right now.

[00:49:42.890] – Allan

So having your questions in order and having the right conversation when you're having it, and don't think Dr. Google's better than what the doctor has to say. But if there's a misalignment, if there's a misalignment over what you're reading and you know it's coming from a credible source. So credible source, cleveland Clinic sometimes WebMD anything that's coming from probably the government, the CDC or something like that, that's information that that doctor should know. And so their response should be generally in align with what you're you know, you can go to the Heart Association website and ask for the symptoms of heart attack.

[00:50:25.400] – Allan

It's right there on the page. You can print it out, tell the doctors, like, look, I got six of these.

[00:50:30.300] – Rachel

Yeah, check.

[00:50:32.570] – Allan

So something else is going on. Let's talk about it. But what they say should make sense to you because you're the lead advocate. You're the CEO, you're the team captain. And they're the players and the coaches. And so you've got to make this all work with them. So it's about working with them. And don't ignore the little things because little things become big things.

[00:50:53.970] – Rachel

Well, I always like to say, too, Allan, I know it's a terrible statement. A lot of people hate this, but you don't know what you don't know. And I'm not a doctor, so I can do Dr. Google and maybe get some things together. But like I've mentioned to you and our listeners in the past, when my husband had blood in his urine, we were in marathon training at the time, and blood and urine is not unusual. It's a condition called grabdo. And I know there's a longer word for that. I don't know what it is, but it's when your muscles kind of break down some proteins and nutrients and it pees it out, that's fine. That's not a dangerous condition. But there are other things it can't be. It can escalate, like, everything. Yes.

[00:51:39.230] – Rachel

And that would have made sense for us at the time. But what if it was a kidney stone that came out of the blue? And in Mike's case, as I've mentioned, the past ended up being kidney cancer, which is something that we would not have known at the time had we not gone to the doctor, had the pee test done, had some scans done where they could actually see it in his kidney. So something as innocuous as maybe blood and urine, it's not always you just don't know what it could be. And that's why you need to go to the doctor to have it more further evaluated.

[00:52:14.790] – Allan

Yeah. And, yes, there's a cost involved. There's always a cost involved. But the cost of prevention is a lot lower than the cost of what happens when this becomes a chronic problem.

[00:52:31.490] – Rachel


[00:52:32.150] – Allan

And so catching it early will cost less and give you a higher probability of living longer, better.

[00:52:43.060] – Allan

So just recognize that the earlier you have that conversation, the earlier you go get checked out. It's better all the way around, it costs less, and the health outcome is going to be a lot better.

[00:52:57.610] – Rachel

And we talked about earlier, too, not necessarily reaching for a pill. Right? I mean, of course, if you have a UTI, you might need an antibiotic or something to help with the infection, but what was it that caused the infection in the first place? Is it poor hygiene? Were you swimming in a pond or a lake somewhere? Do you have an allergic reaction to maybe the detergents you're using for your undergarments? I mean, there could be just a dozen different reasons, but same thing with erectile dysfunction. That could be a symptom of a larger issue.

[00:53:32.290] – Allan

I would dare say I'm almost going to go out of limb and say most of the time it is, yeah.

[00:53:37.300] – Allan

You'Re ignoring something else in your lifestyle, and as a result, this is the outcome. And if you dealt with the lifestyle problem, because healthy thing, healthy heart, that's all I'm going to tell you right now, is that if that's struggling, your heart is struggling, period. And that's about blood. It's about blood.

[00:54:01.390] – Allan

So if you are pre diabetic or diabetic and you're having this problem, it means your feet are not getting enough blood. Okay? And so you're probably at some point, you're, like, going to lose a foot.

[00:54:11.710] – Allan

So dealing with the lifestyle stuff, if you're diabetic and those types of things, if you're having difficulty with blood flow to your pelvis, you're having difficulty blood flow everywhere else in your body.

[00:54:23.140] – Allan

So just think about that for a minute. It's a symptom. It can be treated with a blue pill or there are other pills now.

[00:54:31.750] – Allan

And they give you the warnings. There's a downside to everything you put in your mouth, food or medicine or supplement. There's always some form of downside, some reaction you could have to it, and not knowing that could be a problem. So if you're having symptoms, it's not normal?

[00:54:49.850] – Rachel


[00:54:51.450] – Allan

No. I can tell you right now that's not what getting old does to you. It's about your healthy or unhealthy lifestyle.

[00:54:59.080] – Rachel

Yeah. There could be a lot more going on than what we can figure out by Dr. Google.

[00:55:04.290] – Allan


[00:55:05.270] – Rachel

It's worth going to the doctor.

[00:55:09.650] – Allan

Little tests, blood tests or something like that. It's worth going just to know.

[00:55:13.330] – Rachel

Oh, absolutely. If you can fix this in the short term, then you won't have long term consequences later. I just feel like some things can be reversed or fixed through lifestyle changes. Save that pill for later. But, yeah, better to go now than wait till later.

[00:55:32.600] – Allan

I agree.

[00:55:33.720] – Rachel


[00:55:34.220] – Allan

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

[00:55:36.250] – Rachel

Sounds great, Allan. Take care.

[00:55:38.050] – Allan

You too. Bye.

[00:55:39.060] – Rachel

Thank you. Bye bye.

Music by Dave Gerhart


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

– Anne Lynch– Ken McQuade– Leigh Tanner
– Debbie Ralston– John Dachauer– Tim Alexander
– Eliza Lamb

Thank you!

Another episode you may enjoy


August 8, 2023

Personalize your approach to menopause with Dr. Heather Hirsch

Apple Google Spotify Overcast Youtube

On episode 602 of the 40+ Fitness Podcast, Dr. Heather Hirsch and I discuss her book, Unlock Your Menopause Type: Personalized Treatments, the Last Word on Hormones, and Remedies That Work.


Let's Say Hello

[00:02:51.430] – Allan

Hey, Ras. How are you?

[00:02:53.400] – Rachel

Good, Allan. How are you today?

[00:02:55.320] – Allan

I'm good. I'm back in Bocas where I like to be. It was great to visit family. Don't get me wrong, that was a great catch up and I'm glad I did it, but I'm just happy to be home.

[00:03:08.170] – Rachel

Yeah, I hear you. It's hard to be away from your own home, your own habits, your own kitchen, your own bed for so long.

[00:03:14.940] – Allan

And my dogs. Those little things.

[00:03:20.750] – Rachel

That's right.

[00:03:22.110] – Allan

How are thing up there?

[00:03:23.570] – Rachel

Good about the same. I'm doing the same thing you are. I'm squeezing every moment I can with family. When I get it, we're trying to get some vacations planned and just being as busy as we can. Summertime just feels like it goes by so fast because we aim to spend a lot of time together. Because I'll tell you right now, in the winter time, I shut down. I do not want to drive in the snow. I don't want to be outside except to run where I can at least generate some steam, some literal steam. Yeah, but, no, I'd like to spend as much time with my family as can.

[00:03:59.600] – Allan

So, yeah, Tammy and I are planning our September holidays because we're going to close Lula's down for the month and just go explore. So we're going to take some time off and just travel around this country. And Mexico. We're going to go up to Mexico for a little while, but that's kind of the plan for September. So we're putting that all together right now. But this trip will be the two of us together. To be better.

[00:04:25.330] – Rachel

Yes. Oh, that's wonderful. I'm glad you get the time to do that. That's great.

[00:04:30.330] – Allan

All right. And I mean, guys, guys, because I don't normally say this kind of thing, but look, the topic we're going to talk about today is menopause. And if you've listened this far, you need to keep listening. The health of the women around us is important to the quality of our lives, too. And so just recognizing that, no, she's not crazy, she is going through something, maybe seeing these buckets and that we're going to talk about in this interview and just saying, hey, that's her, that's her. And maybe this book will give her some options that will help her, I think that'd be a very valuable thing for both of you. So don't tune out just because this is a menopause issue. There's a lot of education in here that can help you, help the people around you and your relationships. So please do listen on.


[00:06:06.310] – Allan

Dr. Hirsch, welcome to 40+ Fitness.

[00:06:09.590] – Dr. Hirsch

Well, thank you so much for having me. This is so exciting.

[00:06:13.510] – Allan

So your book is called Unlock Your Menopause Type: Personalized Treatments, the Last Word on Hormones, and Remedies That Work. Now, my wife has just recently gone through menopause and so I've experienced this side of that relationship thing. I haven't experienced it, obviously. I've had a lot of conversations with experts in the field and in talking to them, particularly women that have experienced it, there's this concept that every woman experiences perimenopause and menopause differently. But your book took them and kind of said, look, we can group these into buckets, if you will, and within that, basically now you can be a lot more specific about how you address your health and wellness and mental everything by knowing kind of what your type is. I really like that idea because I think so many times people think, well, what's the answer? The answer? And it's a lot more complex than that.

[00:07:16.170] – Dr. Hirsch

Right, exactly. Wouldn't that be so easy? I'm glad you liked the types because certainly it was meant in many ways to really help women really help better target their symptoms by thinking through what are the predominant symptoms or what is the predominant health history I have leading up to menopause. So did I have surgery or cancer or did I never have a hot flash at all? Because if you never had a hot flash or an outward symptom, it may not even be on your radar. And therefore, actually your health could be really deterred by not knowing what that means. And so I also love The Buckets because I think truly there's not one size fits all. But I couldn't write a book that was like the million types of menopause that could add into limited at some point.

[00:08:14.770] – Allan

Yeah, your editor probably would have had a problem with a million types

[00:08:19.020] – Dr. Hirsch

she would have. Yeah. Actually, my agent actually, before I got to my editor, I said, I really want to write a book on why nobody cares about menopause. And she said, Well, I think that might make a better blog post. And actually we spent a lot of time thinking about the menopause books that were already on the market and what would make mine different, because there are good books, but I really also felt that there weren't inclusive enough. So I talk a lot about depression and anxiety. Younger women, women with cancer, seemingly kind of get left out of the equation because they just don't fall into the cookie cutter, 51 year old with hot flashes.

[00:09:01.150] – Allan

Yeah. Now, while we're on it, let's just briefly go over the six types and what kind of makes each of them unique.

[00:09:11.020] – Dr. Hirsch

Yes. So the first type is the premature type. And actually this is one that is a medical diagnosis. There is something called premature menopause, and that is when you have menopause before age 40 and early menopause is menopause between ages 40 and 45. Meaning really simply whether it's surgery and your ovaries were taken out or your period stopped and you had lab levels that showed menopause about one to 5% of the population has early menopause. And I had a patient last Friday she was sitting with me in my New York City office, and she said, how rare is this? And I said, Well, I think I did the math. And I said like 1%. I'm going to get this wrong, but 1% of 5 million is 50 million is 1% of 50 million. I don't know what the number it was either. How much is it?

[00:10:12.360] – Allan

I think it's 50,000.

[00:10:13.640] – Dr. Hirsch

50,000, right? Yeah, 50,000 women a year, and that's just 1%. But we could go up to 5%, right? So I said 50,000 women each year is not nothing either. And I also think that that number is dependent on getting lost in the weeds here. But I'm really passionate about this. I think that number is also getting lost in the weeds because she said also I haven't seen a doctor in a really long time, and I don't even know if my doctor really even considers the fact that I haven't had periods anymore. So that number 1 – 5% is probably an underestimate. Okay.

[00:10:45.070] – Dr. Hirsch

The second type is the sudden menopause type, often due to either something suddenly happening. I think of chemotherapy for cancer treatments. I think of surgery for maybe endometriosis or cysts or cancer, again, thinking of lupron or certain medications, even high dose steroids. I had a lady who went into menopause after a traumatic car accident. She had a traumatic car accident. Boom. Never got her periods again. And so for most women, the sudden menopause type is potentially where hormone therapy is not indicated because there are patients here who are suddenly waking up and taking chemotherapy for cancer.

[00:11:29.040] – Dr. Hirsch

And so this type really talks a lot about, in my book, non hormonal therapies, but also different ways of exercising, different ways of treating your body with a sudden type of menopause.

[00:11:40.930] – Dr. Hirsch

A full throttle menopause is exactly what it sounds like. Symptoms from head to toe, hair loss and night sweats and waking and fatigue and lack of motivation. And every single symptom you could think of is really your full throttle menopause.

[00:11:57.750] – Dr. Hirsch

The mind altering menopause, which is type four, is really near and dear to me as well because I think there are many women for whom their symptoms are really more mental health hearing, whatever that means. So there still could be a big shift in hormones, and they may get either misdiagnosed with depression, anxiety, bipolar, and there certainly could be multiple factors, but the shift in hormone there is huge. And this is actually one where I say movement really is medicine. There's the lingering menopause type, which is symptoms that just sort of never seem to go away, never as terrible as full throttle or as obvious as sudden menopause. But too many women let menopause symptoms go on for many, many years without feeling as though they are worth treatment or they're worthy of treatment, or they're just taking care of too many other people.

[00:12:55.530] – Dr. Hirsch

And then silent menopause type is really what I touched upon is that even if you never had a symptom, your body still changes. So what are the exercises you need to do? What are the health tests you still need to do? Because women with silent menopause type may seem lucky on the outside, but if that doesn't remind them that their body is still changing, they may be left at a disadvantage.

[00:13:18.030] – Allan

And I think it's important for them to kind of go through that process of deciding, okay, what's the best approach for me? Because there is no one size fits all. So here's an opportunity for you to do a lot of different things. And one of the things that's going to come up unfortunately or unfortunately, I guess it's unfortunate, is there's kind of this confusion about hormone therapy, because there was the nurse's study, and so we have information from a nurse's study. And that's what most, I think probably most general practitioners and maybe even a lot of gynecologists were taught was okay, this was the science. But we've learned a lot since that study. So pros and cons, should a woman consider hormone therapy or not?

[00:14:04.510] – Dr. Hirsch

So absolutely a woman should consider hormone replacement therapy. And I always like to preface all of my either talks or podcasts with again, I still don't think one size fits all. So it's not h or T or bust. But there are so many indications and there is so much now we know about the safety and efficacy. So I kind of think about it like this. If a person was diagnosed with hypothyroidism and they were feeling sluggish and slow and their hair was falling out, we wouldn't say to them, oh, well, just set your alarm earlier and meditate like you'll be okay. We would give them thyroid hormone. We would replace their medication because they're missing a hormone that is crucial to their entire body. And truly, estrogen is very similar. Now, biologically, women were meant to go through menopause. I don't know how long women lived postmenopausally, probably not as long as we do now. Maybe five years, ten years, I don't really know. And I actually think there is an evolutionary basis to being in menopause. You could help your children and then they could help their grandchildren. So I actually think there is an interesting evolutionary basis for menopause.

[00:15:26.880] – Dr. Hirsch

But now we live very, very long and our symptoms can be really quite severe. And now midlife is the peak of a woman's functionality in terms of intellectual capability, financial capability. And so not that all women need hormones or hormone replacement therapy, but for so many women it's just like that hypothyroidism, they lose their estrogen, progesterone, testosterone, and yes, things like meditation and gratitude and journaling, they can certainly help. But just like that example I gave you, oftentimes when I give them estrogen back, boo, it's like night and day, they're back to functioning and feeling so well. And we should not demonize an endocrine dysfunction or disorder. Now people get all up in arms. You ask the simple question about is it safe? But truly it is. And the thing about the safety of HRT back to your original question, is, it is so peppered with cultural and societal norms about menopause and whether we should take hormones or not. But anyways, it's not necessarily that menopause is a disease, and yes, it is a natural part of life. But when you are a doctor, when you see what I've seen, that the majority of women really feel so much better almost instantaneously, not all of them.

[00:16:46.850] – Dr. Hirsch

It really does. You really just see at the basics of this, you lose a hormone, I replace it, you function well again. So we know from the Women's Health Study, as well as some of those longer studies, right, the Nurses Health Study, lots of studies about HRT, that there is an immense amount of safety data, particularly for women who start within ten years of menopause. That's the one thing that the Whi scared people about. And the idea that hormone therapy increases the risk of breast cancer has also been demystified. And that if we use certain formulations, estradiol and prometrium, which are FDA approved, which you should absolutely get FDA approved, we don't see statistical increases in breast cancer. And we do know that women who do take FDA approved hormone replacement therapy live longer, die less from all causes, have less diabetes, gain less weight, have improvements in quality of life, better bone health. Oh, stops your symptoms, I forgot to say work longer, retire later. So many benefits from hormone replacement therapy. So before I get off my soapbox, my last thing is you're not doomed if you don't take hormone therapy. It's just that the last statistics showed that probably about seven to 10% of the US population is taking hormone replacement therapy. And if we can even get that numbers to 20%, at the peak before the WHI, it was 45% to 55% of women. I just want women to be able to have better conversations with their clinicians, with themselves, and to think about HRT as a valid option.

[00:18:27.730] – Allan

Yeah. And I think that's what's really important here is that you educate yourself. You're your own coach. I mean, you're your own CEO, and you have to make the best health and life decisions for yourself. And if you just go at it like a knee jerk, oh, no, that's bad, without really looking at your particular situation and what it would mean, and talking, of course, to your medical advisor, your practitioner, your gynecologist, and having those conversations, then at that point you can make an educated judgment of what's best for you.

[00:19:03.630] – Dr. Hirsch


[00:19:05.950] – Allan

Now, this is not all about getting a shot or pellets or whatever else, creams and everything else. There are things you can do every day to help symptoms help yourself feel better, to get through this easier and come out stronger. And we call those diet, exercise and self care. Can you talk a little bit about how those play into this?

[00:19:30.150] – Dr. Hirsch

Yeah, I think they're really crucial. And even to come off the backbone of talking about medication, sort of right off the bat, I do think that diet, lifestyle, mental health and sleep really lay the foundation for adding a medication on top of this. Because whether you take that medication off or on or you change the dose, these are the things that set up good habits for the rest of our lives. And once we're postmenopausal, we're always post menopausal. So to keep it brief, I will say one more plug for my book is which is incredible that I was even able to do this, but for each of those different types, I talk about the best types of diet, lifestyle, mindsets and foods for each one, which is really crucial. So let me give you a little window. The sudden menopause type, we talk a lot about anti inflammatory foods because I'm thinking if something suddenly brought you into menopause, perhaps you have cancer or you're taking chemotherapy. And when we talk about exercise, I'm talking more about like graded exercise, stretching, mobility, flexibility. When we talk about the mind altering menopause type, I feel as though because of that loss of dopamine, there are certain foods that can include those feel good that could increase not include increase those feel good hormones in the mind type of menopause.

[00:21:02.730] – Dr. Hirsch

I think that exercise is really medicine here. And getting your body moving, getting your cardiovascular system moving is so, so crucial to also help you release dopamine, serotonin and those happy neurotransmitters. And for the silent menopause type, I talk a lot about weight bearing exercise. And actually, of course, I should say across the board, weight bearing exercise for women as we get into our 40s is absolutely crucial.

[00:21:33.070] – Allan

Thank you for thank you for saying that.

[00:21:37.330] – Dr. Hirsch

Yes, it does not have to be going to CrossFit, does not have to be. But really, if you're new to it, starting with weight bearing exercises, squats and then picking up your milk and doing deadlifts with that, and upper body, your shoulders, your back. In my book, I talk about a lady who had silent menopause. She had a BMI of 20, played tennis two, three times a week, and as she was getting the turkey out of her Thanksgiving, out of the oven for Thanksgiving, she stood up, fractured her spine, and she hadn't been weight bearing, hadn't been told about osteoporosis at all. And so the weight bearing is so crucial, not just for the silent, but for all women post menopausally.

[00:22:21.780] – Dr. Hirsch

It really has to be incorporated in some way, shape or form. When we think know, I am not a bona fide nutritionist. I actually had Elizabeth Ward as a dietitian who wrote a wonderful book, a great companion book called The Menopause Diet Plan. And there are really certain foods that are so important that we should be getting for vitamins like zinc and iron and magnesium. Now, iron is not as important postmenopausally because you're not bleeding anymore. But perimenopause in your 40s, it's really crucial because it can lead to a lot of fatigue. And me, I always recommend a diet with at least 80 to 100 grams of protein a day. I have tracked macros once in my life. I personally hated it just because it just made me feel so crazy about it. But increasing protein in midlife is so important. So weight bearing, exercise, increasing your protein intake. And then we can talk a little bit more about some of the other lifestyle tips like sleep. But these are really such foundational backbones to thriving and feeling well because how you treat your body between ages 40 to 60 really sets up how you're going to spend the rest of your time on this planet.

[00:23:46.630] – Allan

Now, one of the topics that's come up, it's like why is a guy interviewing and reading all these books on menopause? Because I try to do at least one per year.

[00:23:57.290] – Dr. Hirsch

We love this. We love this.

[00:24:00.760] – Allan

Well, to me it's important to understand what's going on in my wife's life. And I know there's a lot of women out there that need this information. Me being a guy, that's not a valid reason for me to say I don't need to know this. But I've read some statistics. I couldn't quote them right now. But there's a lot of divorces that happen during perimenopause and during menopause and a lot of it can probably be traced back to just changes in behavior, changes in what's going on in your life. And as a result, there's a disconnect in your relationship. And there's a lot of other things that probably play into that like kids moving out of the house and other things. But I think it's just really important and I wanted to bring this up is that you have a conversation with your significant other, with your kids. I'm not screaming at you because I hate you. Maybe I'm just going through something here and helping them understand it. Could you talk a little bit about how someone can start that conversation? Particularly once they know they're tight?

[00:25:03.570] – Dr. Hirsch

Oh my gosh, 1000%. And really I got so excited and clapped. Is because it's so fundamental that men really understand this. And I think that it's easy to look at this now. We're in 2023, right? In terms of your partner being pregnant, certainly there are some nowadays I'm going to make some assumptions and a heteronormative relationship. So an assumption there, and that's not always the case. But in this assumption, or this scenario, men now are expected to go to some doctor's business, not all because that would be bizarre and touch the belly and help build the crib and take maternity pictures and help if their wife is and learn about and learn about breastfeeding and all of those things, right? There is no difference here. There is no difference here. There's not a big belly and there's no crib that needs to get built. But the process is so uniquely similar. We're going through a complete hormonal shift that we do so that we can reproduce for the species, right? And for men to be inquisitive, to want to learn, for their partners, to want to educate too, and educate other men or women, who knows?

[00:26:25.210] – Dr. Hirsch

And I actually think that men find this very interesting because as much as women have been shut out, they certainly feel shut out and also feel like same thing in the hospital when the baby's being born. Like, what can I do? What can I do?

[00:26:41.730] – Dr. Hirsch

I think you asked me what are tips for women to start the conversation. But gosh, I think that if men also were there for the conversation or almost even said actually men should say nothing. Women should take the lead maybe, right?

[00:26:59.370] – Allan

Well, that's what I'm thinking. You know, one of the things is at this point of this show, my guess is that our listenership is all women. Most of the guys tuned out the first minute when I said we're going to talk about menopause unless their wife was going through it or they thought they were going through it, most men are going to tune out. If you didn't message me, let me know. I'd be very interested to hear otherwise. But I think it's incumbent on the woman to recognize that as she changes, as hard as it is having conversations, because I've heard of women unable to complete their jobs. They have to quit their jobs because of the symptoms they're experiencing. And that's so unfortunate because it's a medical condition. And so they need to have a conversation with their employer and say, okay, I'm going through a medical situation. I'm treating it. I'm working with a doctor, and then you have certain protections that you wouldn't have otherwise. But I think it's just that point of saying, okay, I need to start these conversations because this is not just a thing I'm going to just breeze through and accept this could change me.

[00:28:03.340] – Allan

It is going to change me at some level, but it could change me drastically. And I need my partner to know that. I need my children to know that. I need my work to know that so that I can live a whole full life and not let these symptoms take me down.

[00:28:17.870] – Dr. Hirsch

I couldn't agree more. And I think that there may even be shows like this, for example, that they could sit down with their significant other to say, I think I could be entering perimenopause. There's probably some cute, humorous things that can light heartedly bring up the conversation. I have a small section on this, on my book, too, and telling not even just your partner, but also if there's children still at home, which sounds kind of silly, but it can help your children better understand that there's just…

[00:28:53.610] – Allan

Mommy's not crazy.

[00:28:54.190] – Dr. Hirsch

That there's a transition here that's not them. But women can have shorter fuses, feel more irritable because they're having trouble sleeping, because they don't feel good, and they're so used to more often taking care of the whole family. So there's also guilt and there's worry and anxiety there. But even just sitting down at the dinner table one day and talking a little bit about it and the physiology books are always great, unlock Your Menopause type is a great one. Podcasts like this show can be great for partners to listen to because it's so nice sometimes to hear a guy's voice. I did another interview on a Boston radio show with two male hosts, and it was just great because I love having men as hosts. These can serve as bridges, and it's so crucial.

[00:29:46.090] – Allan

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

[00:29:56.030] – Dr. Hirsch

Oh, what a good question. Okay, I'm just going to go with what I've been doing. So, you know, not that I'm perfect, but I am certainly just a mere mortal myself. I try to be pretty introspective when I can. So I actually just started going back to therapy. I've been in therapy on and off for many years, and certainly I have no problem saying that out loud. And it really helps me to take off the mental load of I listen to a lot of patients talk about their lives and their histories. And for me to be the best doctor, for me to be the best mom or parent, I need a place where I can digest all of that information so that I could be a better continue to be a better doctor, continue to be a better wife and mother and friend. So for me, that's kind of what I call my mental health. That's my mental health, right? So for me, that's cognitive behavioral therapy, and I'm lucky that I have resources. But another way of doing that is other things that you can do, like journaling or journaling especially. It's basically free cognitive behavioral therapy.

[00:31:06.140] – Dr. Hirsch

For me, it's 20 minutes of exercise most days that keeps me also really feeling my best. I used to be a long distance runner. I used to run marathons. And in this time in my life, actually, I think that would be more stressful on my body if I didn't absolutely love it and have all the resources to refuel my body. And so I like to do 20 minutes of exercise a day, if I can, in the mornings, and it really sets me up for just a wonderful day. And oftentimes I'm either doing my Peloton or some cardio sorry, or some weights because the weight bearing activity is so important. The third thing that I do to be my best self. I would say gosh, I could say so many things, probably I could say sleep. But let's not lie. I love scrolling it. But I like being present, so I like to be in the present moment. So whether my kids are snuggling with me on the couch or I'm reading a book to them, my husband's telling me about his day. I'm looking out, beautiful scenery outside. I'm taking my first breath of air.

[00:32:07.180] – Dr. Hirsch

I'm just trying to live in the present moment that actually keeps me very sane and happy.

[00:32:12.970] – Allan

Awesome. If someone wanted to learn more about you and learn more about your book, Unlock Your Menopause Type, where would you like for me to send them?

[00:32:21.090] – Dr. Hirsch

I would love for you to send them to my website, heatherhirschmd.com. It's got all the resources you could ever need or my social media. I'm @heatherhirschmd across all the platforms.

[00:32:33.930] – Allan

Great. Well, thank you so much. And thank you for being a part of 40+ Fitness.

[00:32:38.450] – Dr. Hirsch

Thank you. It was a complete joy and pleasure to chat with you today. Thank you so much for talking about this topic.

[00:32:46.160] – Allan

Thank you.

Post Show/Recap

[00:32:47.160] – Allan

Welcome back, Ras.

[00:32:48.650] – Rachel

Hey, Allan. Menopause is the topic of the day for me right now. As I mentioned to you and our viewers, way back in the spring, I hit menopause. So I'm postmenopausal now and I'm trying to deal with all these weird symptoms. But I also appreciate what you just mentioned in our intro that for the guys to listen in. And I happen to be married to my husband Mike, and I've been cluing him in on my strange behavior and my questions that I have and all the things that I've got going on. We do have an open discussion and for any of the ladies out there whomever your partner or spouse is, be open and start talking about it because it can be very helpful to get that conversation started.

[00:33:32.320] – Allan

Yeah. Me doing what I do, I talk to a lot of people in the field that are doctors. I try to have at least one menopause issue per year because I think it is an important age related topic for us to get into. But guys, we're going to live with this for potentially a decade or more. They're living with it and we're not experiencing what they're experiencing, but sometimes they're not going to articulate why they are all emotional and going off on you because you didn't mow the yard right or didn't pick out the trash right. Or like, okay, it went out and it's not in here. Sorry, I forgot to put the bag in there, that kind of thing. It's not worth trying to choke me to death, you know, just realize that that could be a symptom. And so it's worth having that discussion. And one of the things that I liked about Dr. Hirsch's book was the concept of the buckets.

[00:34:27.870] – Rachel


[00:34:28.620] – Allan

Because it shows you just how different the different symptoms for different women can be. And here's something we didn't really get into in the conversation, but the woman can be a combination of a couple of these. Actually, when you start reading through the descriptions and getting into a little bit more detail, you can be, well, I'm sort of a little bit that one, and sort of a little bit that one. And you may not be having all of the symptoms. You might only really have one or two, or you might have every single one of them that anyone's ever listed in any kind of thing. It's like, do you have yes, I got every one of them. Check them all off. But again, the book gives you some practical guidance and talks about different solutions and things that you can consider and if it's adversely affecting your life, again, you have to have the conversations and you have to find the relief that you can so that you can live as normal a life. Now, it's not a new normal. And I think that's one of the big takeaways from most of the interviews that I've done is that a lot of doctors in the past have just told women this is just how it is.

[00:35:41.710] – Rachel


[00:35:43.710] – Allan

Okay. And it's not. You do have some treatment options and you should really pay attention to those.

[00:35:50.590] – Rachel

Yeah. I think that's one of the biggest mysteries of menopause is that we all think this is natural. We went through puberty, now we did our childbearing years, now we're going through menopause. It's all very natural. But when things do interrupt your life, when things aren't quite right, there is a solution. And the second part to that, the second tricky part is that we're used to when you get a cold, you take antibiotics. When you break a bone, you get a cast. When you get menopause, there's a big blank after that and that's the hardest thing. So when you're young and in your thirty s and forty s, it's really important to start paying attention to what your body is doing, what's normal for your body. And then as you're shifting into perimenopause, which is when your hormones are all crazy and fluctuating, then you really got to dial it down. Because I think that's where I went wrong is that I'm a very athletic person. So when I'm getting achy and emotional and tired, it's probably because I ran too many miles and didn't eat enough. But that's not necessarily the case. So trying to piecemeal these different symptoms, it can be really difficult.

[00:37:01.830] – Rachel

And before you know it, like in my case, I'm in menopause and now I am really dealing with the carnage of my hormones being all out of whack. So I think that it is important to find a doctor who knows you to pay attention to your symptoms, start tracking some things and then doing some blood work when necessary to see if there's anything that can alleviate the symptoms, but that's part of it is chasing the symptoms. And that can be hard sometimes.

[00:37:28.620] – Allan

Yeah, well, I mean, when most of us went through puberty, a lot of folks really suffer with acne as an example. So what do you do? You look for treatment for acne because, again, it's somewhat debilitating as a 15 year old, 16 year old who's just completely breaking out with acne and feeling self conscious, and that's affecting everything in your life. This is actually maybe even a little bit more severe than that. And so just knowing, okay, I'm going through this. I do not want this to affect my career. I do not want this to affect my relationship. I do not want this to affect my kids. And so, depending on where you are in life, you're juggling a lot of different things, and now, boom, here's

[00:38:13.470] – Rachel

another thing to deal with. Yes.

[00:38:16.080] – Rachel

That highlights everything. It overshadows everything. And like you had mentioned, too, because emotions are often tied with menopause. Like, we are emotional people. I'm an emotional person just to begin with. But anxiety and depression is another side effect of these changing hormones. And if your husband or your partner notices those things and can talk to you about that, that could be another signal to go to your doctor. And we have talked about, or you guys talked about hormone therapy. A lot of people call it hormone replacement therapy, but that is another way to treat some of these symptoms, especially if you're getting super emotional with anxiety, depression, and even anger. Like you had mentioned, sometimes we are quick to get angry. And I noticed that in my own personality, I'm usually a very happy, very patient, very calm person. But since I've hit menopause, my emotions are pretty quick to change, and I've noticed that. So if your spouse or partner notices that, that could be a helpful symptom to chase with a doctor.

[00:39:26.540] – Allan

Yeah, because you're half aware of what you're doing most of the time.

[00:39:32.230] – Rachel

Yes. Half aware,

[00:39:34.480] – Allan

or you feel it afterwards, it's like, why did I go off on him? Why did I run into the bedroom and start crying? Those kind of things. And granted, I can't say I've experienced that we go through andropause so there is a lowering of our hormones, and we recognize that as we get older, we get a little softer, usually. But it's not that you have to or must do, but it's that you can. And so it's the thinking through, how do I properly treat myself so that I can live the best life possible? Because I say wellness is healthiest, fittest and happiest. And if this is adversely affecting your happiness and your lifestyle, it's a health problem. It's something that you should spend some time addressing. Now, it's not always hormone therapy or hormone replacement therapy, right? HRT, however you want to define it, but that's an option that's out there, and it's worth you having a conversation with your doctor. Now, if you're well out of menopause, you've been in menopause for several years, you're probably not a candidate for hormone replacement therapy, particularly estrogen and progesterone, if you still have a uterus.

[00:40:54.060] – Allan

But just recognize that it's available to most women that are perimenopause or just going through menopause. So while you're going through the heat or hot or everything else of the symptoms, the worst of the symptoms, that's the point where you have an opportunity to lessen the blow and live probably maybe even a better normal life, maybe even a better life than you had before. Because you know yourself and your body so much better when you give yourself the energy and stuff that you had when you were in your 30s. By this hormone replacement therapy, you're capable of moving more, you're capable of thinking clearer, you're capable of better, making better decisions and all that put together, it's kind of like a trifecta of health because you're moving more, you're eating better, and you're feeling better and you're happier. So just look at these solutions and decide what works best for you and your lifestyle. But don't just think you're a victim of your body. You do have a team and some people you can talk to that can help you work through this.

[00:41:59.050] – Rachel

So true. I think this book would be a really great place to start. I really like how she did put the six types, or the buckets of symptoms of menopause. I think that would be a fantastic place to start. And then also, I'm personally working with the women's health department of my hospital network, so I actually have a menopause specialist helping me get through all this. So start with your symptom management. Start taking notes, start journaling with how you're feeling. Get a book like this to maybe kind of put some of those thoughts into a framework and then maybe speak with your doctor and see how it's going. But please don't wait. If you're even thinking something's off, you're in perimenopause. Your periods are kind of wacky. Start now and go see a doctor and figure this out before it's too late. Or not that it's too late in a bad way. But the better you can get started now, the better you'll be later.

[00:42:55.110] – Allan

Yeah, well, the cool thing about the buckets is that then she gives you some ideas of protocols, like how you should be moving, how you should be eating. Hint, it's whole food. Yeah, for just about every bucket. Well, for every bucket. But it's just that concept of you're going to have some tools, some things you can try that she's worked with thousands of patients and helped them through menopause. So she's in a really good position to teach you how you can treat your body to make the symptoms less where you feel better, more like yourself. And yeah, after reading what she has to say about it, if you believe hormone therapy or hormone replacement therapy or HRT, however you want to say it is the right thing for you, then you can have that conversation with your doctor from a point of self education that now you can understand the answers to the question. Your doctor is just poo pooing it and saying no. You'll know, that that's not entirely the case. And you can just ask them if they've read anything since medical school, but just talk to them and you have a team and just make it work for you.

[00:44:04.350] – Rachel

On that note, Alan, I have a general practitioner. Like everybody, you have your main doctor and they know a lot. But when you have something important going on, you find an expert, whether that's a menopause specialist, a cardiologist, anybody out there you see a PT for muscular or other imbalances know, start with your general practitioner. But then when you need to see an, just go right to the expert.

[00:44:30.390] – Allan

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

[00:44:33.910] – Rachel

Great. Take care, Allan.

[00:44:35.440] – Allan


[00:44:36.030] – Rachel

bye. Bye.

Music by Dave Gerhart


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

– Anne Lynch– Ken McQuade– Leigh Tanner
– Debbie Ralston– John Dachauer– Tim Alexander
– Eliza Lamb

Thank you!

Another episode you may enjoy


August 1, 2023

You’re going to die – Martinus Evans shares his journey and expertise for anyone interested in running

Apple Google Spotify Overcast Youtube

On episode 601 of the 40+ Fitness Podcast, we meet Martinus Evans and discuss his book, Slow AF Run Club: The Ultimate Guide for Anyone Who Wants to Run.


Let's Say Hello

[00:02:48.550] – Allan

Hey, Ras. How are you?

[00:02:50.540] – Rachel

Good, Allan. How are you today?

[00:02:52.540] – Allan

I'm doing all right. I'm traveling to see family. We're doing a family reunion on my father's side. First time I'm probably going to be around all of my brothers and sisters on that side of the family in it's got to be 15 years. No. They all came to my wedding. So there was the wedding, which I guess was a little over eight years ago. So eight years ago we were all together. But this is extended families, so my father's brothers are going to be there with their families and my stepmother's sister is going to be there. There's going to be all the nephews and nieces and all that. So what turned into what was going to be just probably about a dozen of us is now going to be something like 30 or 35.

[00:03:41.990] – Rachel


[00:03:43.110] – Allan


[00:03:43.580] – Rachel

That's awesome.

[00:03:44.390] – Allan

It's kind of crazy. Yeah. And you may have recognized that last week I didn't really talk a lot about my life, about what was going on, and I apologize. I did that on purpose. I was going through a pretty rough week. I lost a really good friend, and it was very frustrating because he was staying with us at Lula's, and he was supposed to stay through July 5th, and then he left two days early, and he died of heart attack on the morning of July 5th. Now, the thing was, when he got to Lula's, he wasn't feeling well. He told us he wasn't feeling well, stomach issues and that kind of thing. And so we were like, okay, you got a parasite, go get some medication, that kind of thing, because it happens down here. It just does. But he started complaining about heartburn, and then he justified that in that he had had spicy soup the night before. There's a Japanese chain here. It's the only chain restaurant we have on the whole island. And I don't actually like their sushi all that much, but he had one of the spicy soups, and as spicy as they'd make it, that's one thing he and I had in common, was we like spicy food.

[00:05:11.570] – Allan

But he was complaining about heartburn, and then he was complaining about just difficulty breathing, and that's what I heard. And I was like, okay, well, just try slowing yourself down, slowing your body down, and try breathing through your nose. If you can get yourself to where you're breathing through your nose, you're going to regulate your sympathetic nervous system, and that should help calm you down. That's why people will, if they're hyperventilating, will breathe into a bag. It's all about slowing down your sympathetic nervous system anyway and getting a balance of CO2 and oxygen. But I wasn't in the conversation where he talked about the arm pain, so I didn't know about that symptom. But my wife had tried to talk him into going down and seeing the doctors and having a conversation, getting an EKG or something. Again, had I known this, I think I have an EKG at the house somewhere. I still find it, but I have one. And we could have sat down with him and done that, or we could have just made him go to the hospital, which we didn't. We didn't do either of those. And so it's kind of one of those things where you're like, I should have paid attention to the symptoms.

[00:06:25.870] – Allan

I know the symptoms. He had poo pooed them as being the soup, and I should have paid a lot more attention. So I was just saying, the only reason I'm bringing this up today instead of I didn't bring up last week because it was still really raw, was just pay attention to the people around you. If they're not feeling well, tell them to go get checked out, particularly if they're over 50, over 60. Just tell them, don't play around with it. Don't play around with it. Just go get checked out. In our little hospital, it would have cost him I shouldn't even probably say this on the air $18, $18 to get an EKG. He'd gone down to the emergency room. They'd have brought him in. They'd have hooked him up to an IV, because that's what they do. They would have hooked him up to an EKG a little bit later. They would have probably seen some problems, enough problems to tell him, we've got to ambulance you to Changanola or David, where he would have gotten proper care in time. And as a result, now he hasn't, and he passed. So I'm only saying that to bring you down or anything, but I just recognize your body tries to tell you when it's hurting.

[00:07:44.380] – Allan

It tries to tell you when things are wrong. And if you feel things are wrong, things are wrong. So listen to your body. Listen to what's going on, and then just go get checked out. It's not that big a deal. And yeah, there's a little bit of expense, even more expense maybe for you up there in the US. But just realize that if you don't get checked out, what's the alternative?

[00:08:11.790] – Rachel

I'm sorry, Allan. I'm really sorry for the loss of your friend. My heart goes out to you. And I think just to emphasize your point again, I feel like we're in our 50s. Most of us, and a lot of our listeners are certainly over 40, but we're not as invincible as we used to be. And it's easy to dismiss common aches and pains because we're weekend warriors or we're doing these really big projects around the house and we hurt our joints and we're fatigued and stuff. But I think that once you hit 40 or maybe even over 50, those little aches and pains can also signal something else. And you're absolutely right. I'm not a doctor, and I need a doctor to help diagnose what's going on, and it's just a quick trip to the hospital. I'm a better safe than sorry kind of person myself. Good to listen.

[00:09:07.150] – Allan

Go get your regular tests, the things you're supposed to do. If there's blood in your urine, go talk to a doctor. Urologist, if your chest is a little tight, if your arm is hurting, if you're having trouble breathing, if you have what you think is heartburn and it lasts more than a tums, go to the doctor. It's worth it. And you don't even have to make it a 911 thing. It's just a simple, hey, let's head on down to the emergency room, let them know I'm having this symptom. And I can tell you from experience when you go up to an emergency room and you're over 40 years old and you walk in there and tell them your chest hurts, you go in first.

[00:10:01.020] – Rachel

You get attention.

[00:10:02.330] – Allan

They just walk you back there. There's no questions about, oh, go sit in the no. They just come on with me. You're literally sitting down and you're hooked up to an IV and an EKG. Boom.

[00:10:15.070] – Allan

Like that. They're handing you a nitroglycerin and saying, here, take this. And you ask them what it is. It's a nitroglycerin is it just a precaution. Doesn't hurt you if it's not a heart attack, but could really help you if it is. For me, that one was dehydration and water poisoning. I collapsed and I threw up, and I defecated at the same time, which is not a nice thing to do. I don't recommend it. Probably was really close to going into a coma and didn't know it. Went home and I told my coworkers, don't call 911 because it's kind of the thing. I got dirty underwear now, I didn't when I came to work, but I do now. I'm going home and getting cleaned up. And I went home, got cleaned up, I rested, and I didn't feel any better. I went to the emergency room, but I didn't call 911. I just got in my car, calmly drove down to the hospital, walked in and told him I have chest pains. So we'll kind of get off that topic because we are going to talk about running and new runners and health and things of that.

[00:11:24.860] – Allan

So, yes, let's have this conversation with Martinus.

[00:11:29.310] – Rachel



[00:11:55.350] – Allan

Martinus, welcome to 40+ Fitness.

[00:11:58.190] – Martinus

Hey, man, thank you for having me.

[00:12:00.250] – Allan

So your book is called Slow AF Running Club: The Ultimate Guide to Anyone Who Wants to Run. This is a family-friendly kind of show, so I'm not going to spell out what AF is. But even if you're not one of the hip kids, I think you kind of know what that is.

[00:12:16.250] – Martinus

And fabulous. Slow and fabulous.

[00:12:18.910] – Allan

Slow and fabulous. I'm really glad that you took the time to write this book because so many of the books that are out there and I think you even mentioned it, they're written by previous Olympians. They're written for someone who wants to shave 30 seconds off their time so they can come in with a PR on their half marathon or whatever, and where they're going to get that one, two or three place in their run. But you're this person that's in the back of the pack that doesn't fit the mold, if you will. When I was doing my longer runs, I weighed about 195 pounds, and that was called a Clydesdale. In those days, we'd call those Clydesdales because there weren't a lot of us that big running marathons and ultramarathons. And you kind of saw it because I was probably a good 60, 70 pounds heavier than just about everybody else out there. But I was also somewhat of a back of the packer then because I just couldn't run as fast as most of them could. But I still ran. And I think that's what was so awesome about your story is you were basically told you need to do something or you're going to die.

[00:13:31.420] – Allan

And then you told him what you were going to do, and then he says, you're going to die. You mind telling that story?

[00:13:38.230] – Martinus

Yeah. So approximately ten years ago, I was working at Men's warehouse at the time. Let's give it a little context. Working at Men's Warehouse was on my feet eight to 10 hours a day in hard bottom dress shoes selling suits. And I developed some hip pain because of this, right? Like, who wouldn't in your hard bottom dress shoes walking on concrete. So I go see a doctor. First time he ever meeting this doctor. He has no previous experience with me, and he goes, I know why you in pain. Okay, what's that? He's like, you're fat. And then he goes on to say, fat, you need to lose weight or die. And I remember being frustrated, just being a person of size, and just going through all of this again. Like, you telling me to lose weight or die, but you don't know me, right? Like, you're here to figure out what's going on with my hip. So then he's going like, you need to start walking. You need to go buy walking shoes and all this other stuff. And I was like, screw that. I'm going to run a marathon. And then he laughs at me and tells me that's the most stupidest thing he has heard in all his years of practicing medicine.

[00:14:44.340] – Martinus

So now you didn't call me fat, now you didn't tell me I was going to die. And then he goes on to say, well, if you run this marathon, you're guaranteed going to die on the course. So I'm just sitting here with all these options where it just ends up just me being dead, for lack of a better words. So, like, lose weight or die. All right, I'm going to run a marathon. No, you can't run a marathon because you're going to die then. So I just left that doctor's office very frustrated and very irritated, and on my way home, I just happened to drive by a running shoe store, and I went in there and told them, I need running shoes. I need them now.

[00:15:20.410] – Allan

And that's awesome. It's funny. That what will actually trigger us to basically say, we've got to do something different. We're going to do something different. And I love stories like that, because yours was one of being a rebel of just saying, screw it. I know what I can do. Don't tell me who I am. I'm going to prove you wrong. Now, when you decided, okay, then you had those new running shoes, and you put them on, your first running story didn't quite go as planned. How does someone get started doing this? Because I see a lot of people thinking about it the same way you did as well. Just jump on this treadmill and go, can you talk a little bit about that, your story? And then how does someone get started?

[00:16:06.470] – Martinus

Yeah. So I get home, I got these shoes on. I was like, I'm going to run a marathon today, and I'm inconveniently sandwiched in between two gazelles on a treadmill. These guys are going nine and ten on the treadmill. They made it look effortlessly. And here I am, 300 pound guy who haven't been on the treadmill in years, and trying and sizing these guys up to figure out, all right, how fast do I need to go? So I thought to myself, where these guys is going nine and ten, I can at least go seven. And next thing you know, 15 seconds later, I fell off the treadmill. Mortified, embarrassed, because the gazelles all on their pedestal. They just looked down at me as they're still running. I just feel like they just look down on me like, hey, bro, are you all right? So I went home, tears in my eyes, embarrassed. And it's something about that, right? I have this tattoo on my right wrist, and I talk about this in the book of like, I have a tattoo that says no struggle, no progress, which is a famous quote from Frederick Douglass. And the portions of the speech that stands out to me is where he goes, if there's no struggle, there's no progress.

[00:17:22.330] – Martinus

Men who favor freedom, yet deprecate agitation is men who want crops without plowing the land. They want rain without thunder and lightning. They want ocean without its roar. He goes on to say that the struggle may be a physical one, a moral one, or even a mental one, but there needs to be some type of struggle in order to get progress. And I think for myself, going through that and hearing that speech rang true in my head in this situation and being like, okay, I really know what this quote really means. This really means that, all right, I have to go through this struggle in order to figure out what's on the other side. And I think that's one of the things I want to mention to the people who are out here, right, where you're starting to get started. Hopefully, you don't fall off the treadmill like I did.

[00:18:10.220] – Martinus

Hopefully. I pray that you don't, but I think that when it comes to most individuals, when they do start out, they do what I call the terrible twos. They start out too fast, too soon, or do too much. So if they do too much too soon and too fast, you're still going to have that fall off the treadmill instance because they are going out the gate and not necessarily going at a speed or at a rate that can be healthy and something that their body can get used to.

[00:18:42.710] – Allan

Now, the run plans that you do have in the book, I like how they kind of start someone out where they are. So not everybody's going to jump right into maybe your twelve week program for the 5K. They might need to do a little bit of base building first. And you kind of have almost like a four week plan in there that they can repeat and do until they feel like, okay, now I can do this and now I'm ready to do this. And so it's kind of stairstep built. So I really like how you put that together because I think it makes it, I'm not going to say brainless, but at least makes it to where someone knows, okay, I have to conquer this thing first and then I'm ready for this thing. And I just like how you did that.

[00:19:24.240] – Martinus

Thank you. And I think that really just goes from the amount of experience I have coaching individuals as well as the experience I had when I was going through this journey when I first got started running, is that most training plans start you off with, let's start running with a slow ten minute mile. And it's like, wait a minute, this is what you're assuming is slow and this is what you're assuming a beginner should do? And I think that's where a lot of people get tripped up at.

[00:19:58.940] – Allan

Yeah, I think that's important because for some people who have never run and you say ten minute mile, that doesn't actually mean anything to them until they get out there and actually get on their watch and they do a mile, and they're like, okay, well, that mile took me 20 minutes, so I'm not ready for a ten minute mile yet.

[00:20:18.550] – Martinus


[00:20:19.750] – Allan

I'm ready for a 20 minutes mile. But here's the key of it. You put in the 20 minutes of work and you got that mile behind you. And every mile that you do after that is just another one that's building on the one you're going to do next. And I think that's when you talked a lot about how you got started and then you were going and there are times even when you were well trained, that you struggled and you fought. And so I appreciate again you saying that this is about the struggle and running for anyone that's done it for any amount of time knows that that's what most of this is, is a struggle and it's an internal struggle because no one else is going to pick up your foot. You got to do it, and you got to take that step in the next step. And the next step. And I liked how in the warm up, because everybody will say this, okay, well, do your warm up. And so you're going to put a warm up in there. But your warm up is not just physical. You have a mental component to your warm up.

[00:21:22.810] – Allan

Can you talk a little bit about your warm up process?

[00:21:26.330] – Martinus

Absolutely. So running is just as mental as it is physical. And I personally think that running is 90% mental and 10% physical because anybody, if you do it consistent enough, you can lift this bottle of hand sanitizer and get something out of it. Right. So the actual movement part, I think it's the easy part. I think it's the mindset part that a lot of people struggle with. Right. Like, anybody can be a runner, but not everybody do it. And it's because of the mindset aspect of it. So when it comes to my mindset, warm up, it's one of the things of really just getting yourself mentally prepared for this bout of movement. You're understanding, how do I feel in this moment? Did I get an argument with my significant other? Did my dog bite me? Whatever may happen, right. To really figure out, all right, where am I at mentally right now? So then you can figure out, all right, do I need to have a mental adjustment to really get into this? Because for a lot of people, when it comes to running, it's like, oh, I don't want to do this. The weather is not good.

[00:22:39.430] – Martinus

The wind is blowing in the wrong way, like all these other things, right. So first is where are you mentally and do you need a mental adjustment? And then the second thing is really understanding, all right, let's go through your body. Let's go through from head to toe. How are your legs feeling? How are your arms feeling? So that way, once you start to go into the physical aspect of it, you'll already know where you need to add more focus. 

[00:23:08.620] – Allan

And the reason I think all that's really important is this is not a straight line. You're going to have great training runs, and you're going to have some that just suck. And it's your energy level. It's something. But you got out there, and it wasn't your day, and you've got to kind of accept that because that one day doesn't define you unless you let it. And so I really liked that idea of checking in with yourself beforehand, because that kind of gives you some precursors to know, my energy level is not 100% today. Maybe I didn't sleep as well as I needed to. Maybe I haven't been recovering as well as I need to. Maybe my nutrition is off. And you talk about a lot of all this in the book. So that's why I liked the book overall, because it was not just a just do it kind of thing. It was, here's everything that you need to consider as you go into this, because for you, a lot of what's out there isn't designed the way it should be for a runner that's going to finish back of the pack or maybe not even finish before time.

[00:24:17.730] – Allan

And I think that was another important thing that I kind of took out of this, was for a lot of people going out to run their first five or 10K, they don't really take into consideration, well, what happens if it takes me over the 50 minutes for this 5K and I'm not finished? What are they going to do then? And there's a lot of other considerations that you brought up that I thought were really important. Can you talk about some considerations if someone's looking at their first five or 10K, maybe even first half marathon, that they should consider looking into before they get started?

[00:24:51.500] – Martinus

Absolutely. I would say the first thing is really understanding what is the pace limits? Like, what is the pace cut offs for this particular race? And then that way you can understand, all right, where are you at physically to understand if you're either going to have a good time with this pace cut off, or you're going to have what I like to call a bad time with this pace cut off? So I think that's the first thing that you think about. And then you ask yourself, all right, can you do it within this pace time? The answer is yes. Great. If the answer is maybe. All right, now let's see what happens to the runners who fall behind the pace limit. Do they let you continue to run? Do they put you on a sidewalk? Do you put you on a bus? You really need to understand what is the ramifications if you don't make it to the finish line in the allotted time. And then you have to ask yourself, are you okay with those ramifications? Are you okay with having to run on the sidewalk because they're open the streets up? Are you okay with getting on a bus because they're like, hey, the race is over.

[00:25:57.410] – Martinus

You got to get on this bus because this thing is done. Are you okay with that? I know for some people, they'll be devastated if they participate in their first race. And the bus is like, hey, you're too slow. We got to open this course up. You got to get on this bus. We're sorry, but your race is over with. And some people will be devastated. They might not even run ever again. So making sure that they understand, what are the ramifications if you don't make it to the finish line in that certain time period? And then I think there are other ancillary things that you can also think about the time of day the race start. Like is it a morning race, is it a night race? I think about for longer distances. Say you're training for a half marathon or a marathon. Are you training for a spring marathon, which means you have to train throughout the winter, or are you training for a fall marathon which means you have to train throughout the summer. And those have their own ramifications as well. Whether you're training throughout the summer months and I don't know if you're down south or whatever, but that's something you also need to think about as well.

[00:27:04.390] – Martinus

And I also think about the last thing is for individuals who enjoy traveling to know how easy is it to get to that particular place. So for example, I went to a race in Montana, I live in New York City. You would think out of all the places, there would be a straight shot or a non stop plane to Montana, to New York City because it's one of the busiest cities in the world. That wasn't the case and I ended up getting delayed on a stop and all types of things that goes along with that. So it's also understanding where are you going and what does the airfare looks like or the travel look like to get there as well.

[00:27:50.580] – Allan

Yeah, I was running the Big Sur Marathon. They had the expo the day before and I went to the Expo and they had this speech and the director did not say anything about the four hour limit for the finish line. So what they were doing was they said okay, because they had some mudslides. So they were having to close this particular road, this particular bridge for the race, and they didn't want to shut it down any longer than they had to. So they were looking at the first finishers finishing in 2 hours and a little over 2 hours. And then at 4 hours they said, okay, well, we're going to have to open up the bridge. And so I'm running and all of a sudden they divert us and now we're running through this artichoke planting. This is down a gravel road into the middle of nowhere. There's no fans down there, there was no nothing. You finished the race and it's like, here you are, here's your medal. And it's like, okay, there's two guys standing down here besides the people that were just running in with me. So we're walking back up to where the finish line is, which was now about another mile and a half away.

[00:28:55.800] – Allan

And then all the people that had come to watch people finish, they didn't see us finish. So there's these things that happen because 4 hours, that was a slower marathon for me at the time, but it was that whole thing of had I known, I could have run just a little bit faster pace, particularly for the last few miles, and I probably would have made. Their cut off. But you brought up a couple of other important things in the book as far as they may run out of medals, they may not have your Tshirt size. There may be all these other little things that are going to somewhat be little digs into you and being a slower runner or your size or those different things. And that can really mess with you as a runner because you did finish the race, and now you don't have the medal to hang up in your closet or wherever you hang up your medals. And so there's a lot of considerations that you had in the book that I agree you want to make sure you're paying attention to because we all do it. We're all going to make mistakes as we prepare for our race.

[00:29:58.180] – Allan

Like you said, not having a nonstop flight. I had my luggage lost when I was flying to the DC marathon, the Marine Corps. Fortunately, I was wearing my running shoes. But I had to go into the Expo and break your primary rule, which is nothing new on race day. My shorts, my shirt, everything else I was wearing besides even my socks, all I had on was I had my running shoes on on the plane. And that's all I had going into the next morning for the race. So I had to stop at the Expo and buy everything I needed. And that was not the funnest race because I broke your rule. And I agree it's an important rule, nothing new on race day. Now, another area that you got into, a lot of runners kind of skip because they think, okay, well, I'm running, so that's my exercise for the day. I'm done. And they're going to run even if it's just I'm going to run three or four times per week. That's all I need to be in good shape and be able to run. But you're a big proponent of cross training. Can you talk a little bit about why you're a proponent of cross training and what someone should consider doing for cross training if they're running?

[00:31:12.680] – Martinus

Absolutely. So what I like to tell people is the things that you don't do as a runner that actually makes you a better runner. And I have this phrase that I tell all the people that I train, and that is you make time to cross train or you're going to make time for doctor's appointments and physical therapy appointments because you're going to get injured. And it's not if you get injured, it's when you get injured. So that's something I always tell people, is that make time for cross train. Are you going to be making time for doctor's appointments? Because that is the true fact about running. And this sport that we do is a very repetitive sport. I think that a lot of people forget about all the other ancillary muscles or accessory muscles that needs to help keep you upright while you run and get injured a lot. So I'm a big proponent of cross training, more particularly, most people, since we all have jobs that makes us sit on our butt. There's this phrase called gluteal amnesia, dead butt syndrome. And this is thing, this is real. And it's the fact that you sit on your butt for so long that your glutes don't fire properly or don't fire at all when you're running.

[00:32:35.860] – Martinus

So then while you run it, you rely on some of the smaller muscles versus some of the larger muscles in your body. So you rely on calf or mainly your calf and your soleus muscles to help push off versus using your glute muscles, which is like one of the larger muscles to help move your body. So that's one of the things that I like to tell people and let people know that you need to strengthen your glutes. And then the last thing is like engaging your core. I think that comes with another thing. We're just sitting down for so long is that a lot of people forget how to necessarily engage their core and really think about that. When people say core or like AB workout, they think about like sit ups. Right? But your core moves in multiple directions. It just don't go in that crunchy format. It goes to the side, it goes left to the right, to the front and the back. We need to make sure that our core is stable in order to make sure that everything else is grounded while we run as well.

[00:33:42.380] – Allan

Yeah, I like to explain the core to people I train and say think of it as like a soda can. And when that soda can is full, it's solid, you can put something on top of it, you can move it around, it's not going to crush. But you take that fluid out, which is how most of us are walking around, or worse, put a kink in it and it's going to collapse. And so any kind of training volume you put on yourself, if you don't have a strong core, it is going to break, it is going to break you at some point. So I totally agree with that. Strength training, core training, and then even doing some of your endurance training off of your feet or off of the road so that it's not so much extra repetitive effort on your body just to have a certain level of cardiovascular strength.

[00:34:29.150] – Martinus

Yes, and I think that's a great thing to mention right inside the book. I break up cross training in like two ways, right? You have strength cross training and you have cardio cross training. And I think a lot of people tend to forget that cardiovascular fitness can be brought on through various methods of exercise. It don't necessarily have to be running, it can be swimming, it can be cycling, it can be a plethora of things. But all of that still helps you with running as well.

[00:35:04.060] – Allan

Yeah, well, when I trained for my first one, I was in Washington, DC. And I was training during the winter because it was a spring, it was a February marathon. So I'm like, okay, I'm in Washington, DC. It's cold January in December in Washington, DC. And I was from Mississippi, so I was flying up there, but that's when I had to train. So I'm like, well, I'm going to go over here to this YMCA and go in there and just do some training. There some cross training inside and they had a 20 minutes limit on the machines. So I would get on one machine like an elliptical, and I'd do that for the 20 minutes, and then I'd have to move over to a different machine like a bike or a Stepper or a treadmill or whatever. And then that's how I did a lot of my training was just to cross train there. And I think one of the core advantages of it was that I got my cardiovascular endurance way up without putting so much stress on my knees, particularly running around Washington, DC. Where the pavements like granite. Oh my, yeah, it's not a fun place to run, even when I was in a safe part of the town.

[00:36:11.450] – Allan

But it was cold and it was hard, and I was like, no, I'm not going to do that too much. I did get out some and run, but for the most part, I did a lot of cross training and that was enough. That was enough to give me the endurance to be able to complete the run and my goal time. So I agree with all that. And I think one of the cores and things that you have in here is you're repeatedly thinking about the needs of the runner from the perspective of protecting their investment, protecting their body. So you talk about cross training, you talk about recovery and sleep and nutrition and all those different things. So I think it's a really good book for someone who does. You call it The Ultimate Guide for anyone who wants to run. Boom. That's exactly what this book is. Now, I define wellness as being the healthiest, fittest, and happiest you can be. What are three strategies or tactics to get and stay well?

[00:37:06.190] – Martinus

Oh, man. So let's start with the happiest. Right. I think when it comes to physical activity, a lot of people get into a comparison trap. They look at you, they look at me or whoever, and it's like, oh, I'm not where I need to be or I'm not where you at, and so on and so forth. And I think that one of the things that I've learned throughout all these years of running is that comparison is the thief of joy. It's the thief of joy and happiness. And one of the things I always like to tell the people that I train is that if your life doesn't depend on winning 1st, 2nd, or third place in the race, you're here and you're running a race to get a participation medal that you've already paid for. So there's no need to take yourself so seriously and get yourself so riled up for a race that A, you're going to get participation medal at the end of it, you're not winning. So you already know that. So you got to have something else that's going to drive you to run. So that's the first thing comparison is a thing for the journey. Fittest, being the fittest that you can possibly be.

[00:38:19.380] – Martinus

I think the best way to do that is through consistency. I think a lot of people underestimate the power of just being consistent, and this can be okay, I'm going to be active most days out of the week, which is, I say four days out of the week. Right. I think there's so many benefits that come with being regularly physically active that you'll get in your body even if you don't lose weight, that I think that there's still so many benefits to continue to be active. And I think that's another thing that a lot of people fail to realize as well is that we've been so taught to understand that exercise equals weight loss, right? So when people do exercise, they don't lose weight. They get all upset and sad and depressed and then stop exercising, not knowing that there's so many other benefits. Better A1C's, better cholesterol, better blood pressure, all these other things. The mental health benefit that comes with it that it's so beneficial that even if you don't lose weight, it's still a benefit, you still continue to do that. And I think that also rolls into the last part of the healthiest right by being regularly physically active.

[00:39:40.090] – Martinus

All of those markers that we look into or look at when we are going to a doctor, those markers get affected in a positive way when you are consistently being active.

[00:39:54.280] – Allan

Cool. Thank you. Martinus, if someone wanted to learn more about you, more about your Run Club and more about your book, Slow AF Run Club, where would you like for me to send them?

[00:40:05.730] – Martinus

You can go to slowafrunclub.com. That'd probably be the best hub to go there to get more information so we have information about the book there. The book is available wherever books are sold. And then we also have an app on iOS and Android. So if you download the Slow AF Run Club app on your favorite phone Apple device, you'll be able to find the app there as well.

[00:40:29.080] – Allan

Cool. Well, you can go to 40plusfitnesspodcast.com/601, and I'll be sure to have the links there. Martinus, thank you so much for being a part of 40+ Fitness.

[00:40:41.060] – Martinus

Thank you for having me, Allan

Post Show/Recap

[00:40:42.050] – Allan

Welcome back, Ras.

[00:40:44.570] – Rachel

Hey, Allan. You know me. I love everything to do about running and listening to Martinus share his story was super motivating. His story and his run club, I looked up his Run Club and his website, Slow AF. It sounds like a really fun group of people. It's a really great community.

[00:41:03.570] – Allan

Yeah. And that's kind of one of the cool things. Again, it wasn't one story. I think that was what I really liked about the book, was that he really talked raw about the tough things that he went through, the chafe monsters, and being told he should get on the bus because he's not going to make it. And he knew he was going to make it, particularly because the guy on the bus told him to get on the bus and kept coming back and asking him to get on the bus. And so there's a lot of lessons in there about what running means, particularly for a slower runner. A lot of the things that slower runners have to put up with. He talks about shoes, he talks about everything else. But I think one of the big stories out of all of it was that running, it's a solo thing because you have to do the work, but it's also a very social thing when you let it be.

[00:42:04.460] – Rachel


[00:42:05.450] – Allan

And so the Run Club thing, he formed that online run club predominantly because he couldn't find his tribe in real life. He was trying and he went out with a group and in a place where you would kind of expect a lot more tolerance and acceptance. And he went out to join the slow group and was informed, okay, they're running this trail that he didn't know, and they were going to run ten minute miles, which was about twice as fast as he would normally have wanted to run. That because his running is going to be more in the 15 to 18 range as a normal run, just for a marathon or any kind of longer distance. He wasn't looking to run ten minute miles. Now, he tried because that was the slow group. And then they left him.

[00:43:02.200] – Rachel


[00:43:03.080] – Martinus

And as a result of being left, he turned to go back to the parking lot and got a little lost and then found two other runners that were trying to get back to the parking lot. So they all went back together. I only say that story not that you would avoid a run club because there's a lot of advantages. And I know, Rachel, you can talk a lot more about being in run clubs, forming run clubs and all that, but to me, the cool advantages of a run club is the social aspects of it, of having friends, having those peer groups. When we talk about motivation, there's a peer group waiting for you on Tuesday night to do the 07:00 run. You guys show up and do the 07:00 run, have your beer together, and then it's a social thing, but it's also a safety thing, especially if you're doing trails or doing areas. Running with other people is a huge safety thing. But it's not either of those things if the group is going to leave you. Because, again, now there's no social. You're alone on the trail and there's no safety because you just got left alone on the trail.

[00:44:12.930] – Allan

But there are run clubs out there. And if there aren't, you could form your own.

[00:44:16.770] – Rachel

That's right.

[00:44:17.600] – Rachel

And the great thing about Martinus putting his book together is that he is one of those back of the packers. He was a new runner. He made all the classic new runner mistakes and finally found his people. He found a group of people that he could form a club with and do their thing together, which is so important. And I want to point out a couple of things, is that a lot of people are afraid to start running because there are those fast people out there. There are people that run Boston, which those are only fast runners run the Boston Marathon.

[00:44:54.680] – Allan

But not only no, because again, if you read his book, you'll know that there are lotteries.

[00:45:00.860] – Rachel

Oh, yeah, there's charity, charity groups and.

[00:45:04.710] – Allan

There are lotteries where you can be picked for a lottery. Because he went through that process, too, of lotteries, because he's run some of the big ones, too.

[00:45:15.030] – Rachel

There's some races where you have to qualify, though, have a fast time. And Boston is one of those ones. And Allan, I've been running for 25 years. I am not a fast runner. I will never run the Boston Marathon. I'd have to shave 2 hours off my marathon time, which is not meant for me. But that's the intimidating part of running. And that's why having a run club with people who are not always the fast runners is helpful because then you get to be with people that are more your speed and more your ability and have the goals that you have, which are a little different than running marathons and setting PRs. So the problem with run clubs, though, is that there are so many run clubs. The Roadrunners Club of America has a website where you can look up running or run clubs in your community or nearby your community. And most of them have a website and they'll tell you what they run and they'll give you an indication of what type of club they are.

[00:46:19.280] – Rachel

Right here by me, there's probably, I would have to guess, five, six, seven different run clubs in my area. And I know because of experience, some of them are the fast ones. There's one run club in the city that I cannot even keep up with and it twists and turns through the city. So if I don't have my eye and look which direction the guy's turning, I'll be lost for the rest of the day, just like Martinus was on.

[00:46:45.430] – Allan

That just means you get to do more miles.

[00:46:48.610] – Rachel

As long as I can find my way back to start, I guess we're okay. But with my run clubs that I participate with or that I manage on my own, is we have a local trail. It's an out and back course. And when somebody new joins us, I ask them all the questions. How fast do you run? How far do you want to run if this is your first time out? We'll run a mile together. If you're an experienced runner, I'll tag you with the faster runners that are more experienced. So I kind of watch for people in my run clubs, but not all run clubs are that way. So it's important that you kind of pick and choose. Don't just blindly show up and then not be aware, just like what Martinus had experienced with his run club.

[00:47:31.230] – Allan

And so, you know, again, it's a really good book if you're a beginner, because he does tell the stories of the mistakes and the struggles, and that's actually a big part of why he runs. He runs because of the struggle.

[00:47:49.350] – Allan

Okay? And he runs because he's not supposed to run. He's over 300 pounds. You're not supposed to run when you're over 300 pounds. His doctor even said that. So just realize that you should run if you want to run. You should do what you want to do to live the life that you want to live. And again, as long as you don't have some underlying condition that you don't know about, which he didn't. He didn't have the underlying condition other than being a big boy, a very big boy, then it was, okay, now if I want to run, I just got to do it right. He went and got shoes, and he started, but still, lesson after lesson, the chafe monster got him on one bit. And then there was this getting lost when the run club left him, and that so there were a lot of lessons that hopefully you go through and you start your journey and you've read his book, you kind of have the idea, okay, Cotton is not my friend. Once I start doing more than about 30 minutes of running, just little things like that that don't seem like a big deal, can be a very big deal.

[00:48:58.800] – Allan

But that's what's so cool about running, is at first, you just need a pair of comfortable, sturdy shoes that are going to last a little bit, get out there and start going. Then you can start investing in better shoes. Then you can start investing in better clothes, and then you can start investing in all kinds of gear and stuff and goose and all kinds of stuff. But in a general sense, it's the easiest sport to start and then grow into.

[00:49:26.040] – Rachel

It is it's a great sport. You get out of it what you put into it. It's really all on you, and it's how you're feeling, how far you want to go, what you feel like accomplishing, but it gives you so much more back. It can give you your health. It can bring you to friendships in the run clubs. And that's why I love it so much. And I could drone on for hours about how great it is, especially how great run clubs are, but also back to run clubs. That is a good place to learn, because every single one of us runners has made all of these mistakes at one time or another. And this is how we can help you become a better runner by maybe getting you through some of these mistakes so you don't have to make them all. But it is a great place to be. And his book sounds really fun.

[00:50:14.080] – Rachel

Sounds like a great read.

[00:50:15.540] – Allan

If you're thinking about running or you're a beginner runner, it is a really good book. All right, well, Ras, I'll talk to you next week.

[00:50:23.370] – Rachel

Take care, Allan.

[00:50:24.490] – Allan

You too.

Music by Dave Gerhart


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– Anne Lynch– Ken McQuade– Leigh Tanner
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Thank you!

Another episode you may enjoy


July 25, 2023

Episode 600 – Behind the Scenes at 40+ Fitness

Apple Google Spotify Overcast Youtube

On episode 600 of the 40+ Fitness Podcast, we take you behind the scenes.



[00:02:53.760] – Allan

Hey, Raz. How are you?

[00:02:55.660] – Rachel

Good, Allan. Things are getting exciting up here. We've got a lot going on this month. Got a couple of trips to see family, all of our big birthdays. We have a lot of July birthdays in our families. We've got a lot of parties lined up. July is our busiest month, I think, of the summer. But things are going good.

[00:03:15.340] – Allan


[00:03:15.800] – Rachel


[00:03:16.600] – Allan

So happy birthday, I guess. It's not really a birthday, but this is kind of a landmark episode.

[00:03:26.730] – Allan

This is episode 600 podcast. Now a couple of different things. Obviously, I'm going to talk a little bit about the podcast today. So this won't really necessarily be a. Health and fitness thing, but I just wanted to kind of give folks an idea of how things work behind the scenes and how they can be a part of it and help us keep this thing going.

[00:03:49.050] – Allan

But I've actually even had there were some bonus episodes out there that didn't count towards episode numbers, but they weren't really episodes, they were just me making an announcement and putting it out there early on. So there actually have been more than 600 items released as part of this actuallypodcast, but actual 600 episodes.

[00:04:11.940] – Allan

So kind of wanted to talk a little bit about the story because a lot of people don't necessarily know they found this podcast at some point over the last several years. They started listening. They're still listening, and that's great, but new people are finding us every day. And so you may not know the story of where this podcast came from.

[00:04:33.180] – Allan

And why it's here, or a few other interesting tidbits, but I started this podcast predominantly because I had made some significant changes in my health and fitness and I had people asking me about it.

[00:04:50.160] – Allan

And one of the challenges I had when I was trying to figure my path out was that there wasn't anything out there.

[00:04:57.860] – Allan

There were no online personal trainers focused on people over 40. There were no podcasts in the health and fitness space for people my age. Everything that was out there was pretty much CrossFit, a lot of nutrition stuff. So the vegans had their ones, some runners had some podcasts, but again, none of these were specific to who you are when you're over 40. And I just thought that was bizarre that I couldn't find answers to this thing. And even when I did searches, or even when I went and said, okay.

[00:05:30.000] – Allan

Well, what about 40 Plus Fitness? And I actually keyed that in 40plusfitness.com and keyed that in nothing, someone owned it. Someone owned the domain, but when they weren't doing anything with it, and I'm like, this is just kind of crazy. So I did start the podcast and.

[00:05:48.590] – Allan

I did a lot of work before I launched it. What a lot of folks don't know is this wasn't actually my first podcast. I had one before that was about internal audit. The problem with that was I would work twelve to 14 hours a day in internal audit, and then I was trying to produce a podcast about internal audit, and that was a little much.

[00:06:13.660] – Allan

Yeah, and I didn't know anything at the time when I launched that podcast. I think I got like 600 downloads on one of my first episodes and I just thought that was terrible. I'm like, there's 70,000 internal auditors out there and only 600 of them listen to my podcast. I didn't realize 600 was actually a pretty good number, particularly when you're first starting out.

[00:06:37.280] – Rachel


[00:06:37.810] – Allan

So that said, I did sign up with a coach to help me launch the podcast the second time. And so I went through the process that he had laid out. It was a big group thing.

[00:06:50.400] – Allan

I had friends that we became an accountability group within this thing and putting this all together. So I literally started planning the podcast like June of 2015, and started putting together ideas for how the show was going to work and then lining it all up.

[00:07:10.560] – Allan

I built a Facebook group and a Facebook page and started getting people to like that page. And I was putting some stuff out there. Not a lot, but just enough to try to get people involved before I launched the podcast. Because at that point, pages were really kind of valuable. People were seeing the posts from pages.

[00:07:28.020] – Allan

So if I had thousands of people that like my page, thousands of people would see my posts. And I thought, okay, this is a good way to kind of launch this podcast. So I launched the podcast December 6 of 2015.

[00:07:39.670] – Rachel


[00:07:40.310] – Allan

And part of the timing of that was I wanted to have a certain number of episodes out before January 1. And I wanted to make what at the time was actually a pretty big deal called New and Noteworthy on Apple. And I wanted to be New and Noteworthy on Apple on January 1, and. I actually was number one in New and Noteworthy.

[00:08:06.330] – Rachel

That's awesome.

[00:08:07.770] – Allan

So it's pretty cool. And that kind of helps spur people finding it, because people would get their Christmas phone and then they'd get on there, they'd put that podcast app on, and then the first that it pop up is New and Noteworthy. So if you said, okay, Health and Fitness, New and Noteworthy, there's my podcast.

[00:08:24.470] – Allan

And so I was new. I wasn't necessarily noteworthy yet, but I was new.

[00:08:32.790] – Allan

And then when I first launched this my format was very different than it is today. It was predominantly a solo show. I wanted to do five episodes a week, make each of them about 15 minutes, and it was just go for a walk, be walking, be moving while you're listening to this podcast, because it was one of the things of people our age weren't moving around enough. So if I could just encourage them to move for 15 minutes a day, that's so much better than what they would have been doing otherwise.

[00:09:06.990] – Allan

I felt like that was a win. Now when I started doing interviews for. Parts of the show, because I realized. Okay, I can't talk five times per week, every week and be interesting. I had clients I was training. So there was a science session, there was a client session. There's a lot of other stuff in there. So it wasn't just me talking the whole time, but there were themes to each of the days and that went on for I'm guessing somewhere around eleven or twelve weeks and I was really burning out because that's a lot of episodes.

[00:09:45.830] – Allan

And then I did an interview of a guy, he had three different books. I said, well I'll interview you once for 45 minutes and break it into three episodes. So I literally staged and had the conversation three different books I had read and put them together and I was like, I really like this interview. I didn't like having to try to keep it to less than 15 minutes because if someone starts talking, I don't want to tell them to shut up.

[00:10:12.930] – Rachel


[00:10:14.850] – Allan

At any rate, so I decided I would drop it back to three and I'd be a little bit more liberal about how long the episodes were. But even then I wanted to do more interviews and reading the book and trying to do three interviews in a week was just a lot, so I dropped it down to one.

[00:10:33.680] – Allan

Now here's one of the interesting things that came about from all of that though was the years that I had hundreds of episodes come out, I didn't have more downloads per episode. I may have had more total downloads that year, but not per episode. Whereas when I dropped it to once a week, I actually peaked out on the volume of people that listened to each episode.

[00:10:57.420] – Allan

And so what I found is if someone comes on and say they missed three or four days, what they're going to do is they're going to pick and choose one. They're not necessarily going to say, I'm going to listen to all three of these, some people will, but they'll pick one and then they'll listen to that one and they may not listen to the other two. So it actually was a diminishing return to just having more episodes done and now I'm able to focus a lot more on the quality.

[00:11:22.090] – Allan

So I do dive in a lot deeper in the conversations and I'm able to do that because I can dedicate more time to planning each of these podcasts.

[00:11:30.920] – Allan

Now I've changed the music a few times. One time the original music I had was out there and then I decided I want to change it and I changed it. And then the guy who sold me the license or ran the license through the company called Pixaby sued me, didn't really sue me, but claimed copyright on YouTube, meaning that he claimed rights to my show. And that meant if at any point in time I was monetizing the show through YouTube, he would get that money, not me.

[00:12:04.310] – Rachel


[00:12:06.010] – Allan

I messaged the dude directly because I had the evidence that I had actually paid him because that was a voluntary thing anyway, was to pay someone for that music. I did voluntarily and I kept sending the declines. I declined that. This is copyright but the way YouTube was set up, I had the burden of proof. So if they said it was theirs YouTube just accepted it. And then they were the arbitrator, they were the judge, they were the jury.

[00:12:39.310] – Allan

And so I just decided, OK, I want to change it. And so I can't remember the exact episodes, but it's been a little while now. But Dave Gerhart. You can find him at www.steeldrummer.com. He's doing our current music. It's kind of a Caribbean vibe, which I like because it's the steel drums. So we're running with that right now. And that's our current music. I don't have any intention of changing it anytime soon, but that's there.

[00:13:08.110] – Allan

And then of course, I changed the format another time when I brought Rachel on. So, Rachel, you came on in September of 2020.

[00:13:17.680] – Rachel

My goodness. Well, it's been a while.

[00:13:21.890] – Allan

It has, but the whole point being is you decided you were going to work on your personal training cert, and co-hostso we were talking back and forth and somewhat mentoring you through that process. And then when you passed it, it was like, do you want to come on and be a co host?

[00:13:40.950] – Allan

And part of the reason I wanted that was you and I are different. We do different things from our training perspectives. You're female, I'm male. I just felt like it give the show a little bit of balance when we talk about the different interviews. And so I think it has. And we've get a lot of great feedback from people that are glad you're on the show and insight you bring. So I think that's been a huge addition to the podcast.

[00:14:11.550] – Allan

Now I'm going to shift and just talk a little bit about how we do this whole big crazy thing of a podcast. And there might be some bits of this that you didn't even know, Rachel.

[00:14:22.840] – Rachel


[00:14:23.560] – Allan

Because I'm the producer in the background doing a lot of this stuff. So basically the way the podcast works is it's a bunch of bits and pieces. Okay? So each little section and you may not be able to pick them out as sections exactly, but they're each their own music file. Own file. So it's an MP3 file of some sort.

[00:14:43.790] – Allan

And so what I do is I start out I have a Trello board. So Trello is this application that basically lets you kind of keep lists and keep organized. So you have a list and then you can put an item on that list, like a note card.

[00:15:02.160] – Allan

And then what I'm able to do is each of those columns, those lists are where we are in the process. And so as I start the idea for a podcast, like, maybe I see there's a book that's going to be published, I have the author's name and they're under the contact. And then we'll go through that whole process and I'll kind of talk about how that works in a minute. And then I'm just able to move the cards across as we go. So as I get into production and then closed, each card has a place.

[00:15:30.220] – Allan

And then within the cards, I can put the order so I know which episode, which date, and I can just put information in there about the book and everything else. So it's all in one place, but it helps keep me organized so I know, okay, where am I with current episodes? So I can tell you, I just recorded episode 603 a couple of days ago.

[00:15:52.180] – Allan

I'm going to record episode 601 tomorrow and then the next day 602. And so I can kind of tell. I've got a lot of reading to do.

[00:16:03.750] – Rachel

Oh, gosh, yeah.

[00:16:05.590] – Allan

And tomorrow I'll be reading a lot, but that's cool. And then sending over show plans and doing that to get them on the interview.

[00:16:14.550] – Allan

Obviously, guests are an important aspect. I want to have good quality, a good variety of guests. So we're talking about a lot of different issues that affect our health and fitness. A lot of people ask, well, where do you find your guests? I get over 100 emails every single day.

[00:16:35.280] – Rachel


[00:16:35.950] – Allan

Of someone that wants to be on this podcast. And some of them will even go out and find my phone number and text me. They will WhatsApp me. They will email me, they will fill out a contact form, all the different ways that you could get in touch with me these folks find ways to do that.

[00:16:55.990] – Allan

And say, hey, I want to be on your show. And I'm like, great, what are you going to talk about? It's like just health and fitness. Nope, no, you're not. So there's hundreds now. Sometimes these guests are excellent. Tony Horton, his agent reached out to me. There's been others that I'll be like. Yes, I absolutely want to talk to this person.

[00:17:21.550] – Allan

But 99.9% of them are a definite no. And when you think I'm getting 100 or more emails every day, okay, I only have one show per week, so. It becomes pretty clear that I can't get that many interviews out.

[00:17:39.940] – Allan

And again, I'm really looking for the quality. So over the years, I have developed some good relationships with some publicists. So there's a few of them that as soon as I see their email in my box, I know this is golden, and I'm going to want to talk to their guest, to whoever they're supporting. So there are a few of those that I do have a good long term relationship with, and it's the same when I send them a request, they definitely jump on it pretty quick because they know I'm going to give a good interview for their clients.

[00:18:09.540] – Allan

But most of my guests come from Amazon. Yeah. What I do is I go out on Amazon and I search for a topic or sometimes just generic health or health and fitness, and all these books come up. And then if you look on the left hand side if you're doing on a computer, you'll see these filters and you can go filter. And one of the filters that's out there is books that haven't been published yet, upcoming books, so you can see 90 days, 30 days, and then upcoming books. So I click on that upcoming books and then I get a kind of a list of books.

[00:18:44.890] – Allan

Now sometimes people do this kind of silly thing where they basically write the same book and they publish it on. Amazon like a hundred times. It's an ebook, like a workbook or something like that. They'll do, but they'll name it a hundred different things and throw them all out there. So they're all showing that they're going to come published soon and they clog up that whole search.

[00:19:06.590] – Allan

So then if I need to, sometimes I'll go over to that same set of filters and you can filter on hardbound. What I've found is the big publishing houses are always going to have a hardbound version, so they tend to be the higher end guests.

[00:19:21.030] – Allan

And so then I'll kind of have a list and I'll go through and add them to my trello of potential upcoming guests and I'll line them up based on their published date and everything else. I'll say, okay, I'll start reaching out now.

[00:19:32.710] – Allan

What I do is I go in and find out who the publisher is and then I Google the publicity for that publisher and I get their email address and then I send my pitch to their publicity department.

[00:19:46.170] – Allan

And for most of them, because again, this is an upcoming book that they would love to promote and have podcast interviews come out while the book is when the book goes live, I'm in a position to do that. So they'll then kind of work on my behalf to get the guests booked.

[00:20:04.140] – Allan

They send me an electronic copy of the book. Now, I used to get the hard copies, but they send me an electronic copy and once I have that, I send them a link to book on my zoom. And I use a little app called Tidy Cal, which is like Calendly, if you've used Calendly, but it's done by a company called AppSumo and it's a one time payment and then it works just like Calendly. And you don't have to pay for it every year because I do have different booking types and so I would have to pay for the calendar type book, calendar every year. I think it was $144 a year. Versus I paid once for Tidy Cal and it works just as well.

[00:20:47.630] – Allan

And so, yeah, they'll book their interview. And then what I do is, once. I see when the interview is like I said, I've got one that's coming. Up tomorrow, another one that's coming up Thursday. I'll go ahead and do reading the book. I'll send over a show plan. My show plan is just basically a set of bullet points to give them. An idea of what I'm going to talk about, what we want to talk about.

[00:21:08.870] – Allan

So if at any point in time you've ever heard a guest say, I have no idea what that is, or I don't remember,

[00:21:14.200] – Rachel

oh, no.

[00:21:16.950] – Allan

I told them what we were going to talk about. And even before we go online and when we start the recording, I kind of ask them if they have any questions about the plan. So they knew the questions. They knew I was going to talk about it, but they just didn't pay attention.

[00:21:32.230] – Allan

But that's neither here nor there. I do try to make sure the guest is prepared for the conversation. And then, yeah, I do record the interview on Zoom.

[00:21:40.770] – Allan

Now, when I get through with that interview, I now get an audio file from Zoom where I've recorded, and I get a video file, and then I get two audio files, one with their channel and one with my channel. So there's actually four different files that I work from.

[00:21:56.980] – Allan

So the first one is the full recording, and I put that in a folder for Rachel to listen to, so that's the interview she's listening to is just a full audio of both of us that I put in her folder. I take the video file and I put it in my admins folder for her to make clips for YouTube or Facebook and things like that. And I'm just terrible about not posting those regularly enough. But I have them. They're out there. She's working on them, and so they're out there, so I have them.

[00:22:29.070] – Allan

And then I take the two audio files that are different channels, and I put that into a folder that's my production folder for that particular episode. Okay, then what I'm going to do is I will record the intro and the outro. So that thing you hear me say on episode of the 40 Plus Fitness podcast, we're going to meet such and such and discuss their book, such and such. You can find the full show notes for the say I've memorized it because I've done it a lot.

[00:22:59.140] – Rachel

A few times.

[00:23:00.300] – Allan

A few times.

[00:23:01.770] – Allan

But the point is, then I make those files. So as you kind of see, now there's two files for the interview. There's now two files, intro and outro. I'm bringing in the music that we play at the very beginning, which I call the show music at the front, and then at the end, the outro for the full version of the song, the steel drum thing that Dave did. And so basically, I have those files.

[00:23:31.370] – Allan

And then each now, Tuesday morning, Rachel and I get on Zoom and we record our part. So there's usually a hello section, and then there's a discussion section. And if you get on the Facebook Group, I'm going to actually put the videos of those together. So, like, Rachel and I will come on and kind of have a quick little conversation about where we want to go. And then we'll have our hello section, and then we'll have our discussion section. And basically I've recorded those for the last interview we had. And I'll go ahead and share that on the Facebook page. I mean Facebook groups, if you go to 40plusfitnesspodcast.com/group, that'll take you to the Facebook group and you'll see a video of Rachel and I going through that little bit of the production.

[00:24:19.150] – Allan

But from our production recording, I have now two more files to add. And then of course, if I have a guest on, I have to record the bio. So I'll go out on Amazon and find out how their bio is organized out there. Some of them will send me a bio because they're publicists put together all this collateral and material. So sometimes I'll use that. But that usually almost always agrees with what's in Amazon. They don't rewrite all that stuff. So I'll read that, but that takes a little while because I screw that up about a dozen times.

[00:24:56.270] – Rachel

Oh gosh.

[00:24:57.170] – Allan

Well again, I don't want it to sound like I'm reading, but it probably does. And there's going to be words, particularly when I'm dealing with doctors and scientists, that I'm going to mispronounce a few times. So I try to get it all right, or at least as close to right, where I'm just like, okay, that's cool. So now that goes into the audio file.

[00:25:17.840] – Allan

So now I end up with on average usually about nine files that then are there. Now what I do is I have to download that as a zip file and then I share that with my audio production group. And so each week they go in and they put it all together. Now there are some weeks I get a little behind because they need 48 hours. So I get a little bit behind sometimes I'll do it myself and just get it done. It takes me probably about 2 hours to do that myself versus they can get it done probably a lot faster. And I'm not involved.

[00:25:56.090] – Allan

When they get done, they email me and say your file is ready. I download that and then what I do is I upload it into an application called Happy Scribe. And what Happy Scribe is, it's an AI that does a transcript. So this AI does the full transcript of the show and it's fairly good. I mean, it's not perfect. So what I do then is once it's uploaded and done that way, I send that over to my assistant and I tell her, okay, this one's ready to review. She goes in and she puts the because the timestamps are already there, but the AI doesn't know who's speaking. It just knows it's probably a different voice.

[00:26:36.070] – Allan

And it's again, pretty good about that, particularly you and I. Rachel knows you're you and I'm me.

[00:26:43.305] – Rachel


[00:26:43.710] – Allan

So it keeps this part. I've had some guests that sound too much like me and as a result it can't really pick up who's who. But if that's the case, again, she goes in and puts the names and makes sure the timestamps are all set up. And once that's done, then I kind. Of have what I need for posting.

[00:27:01.020] – Allan

So what I have to do then is I have this audio file and I have the transcript. I take the audio file and I have to add some tags to it. So the picture that goes along with it, so you see it on your. Pod catcher, whatever you're listening to podcast, you see the logo for that episode, the notes of what you see on your app, that all has to be written up and ready. And then of course, other information like my name, your name, those things that are in that audio file. So it picks up what it needs when it goes out there.

[00:27:38.390] – Allan

I use a company called Liberated Syndication or Libsyn for short, and they're basically where I host all the audio files. So the audio files go out there. And then what they do is they release it. And so Apple goes out there and picks up off of them, as does Google, Stitcher, iHeartRadio, Amazon, Audible, all of them go out there. So this thing kind of basically syndicates my files, all those files out as a podcast.

[00:28:10.750] – Allan

And then I have to create a post on my website. So the website 40 Plusfitnesspodcast.com is basically a blog. It's a WordPress type site that is hosted. I use Deluxe Hosting as my host. They're really good for just small companies, small business kind of stuff, and you. Get a good amount of hosting space and throughput it works really well. But it's important to make sure that your podcast host and your music or the actual music file are hosted on different platforms.

[00:28:44.250] – Allan

So basically I'm not slowing anything down. It can pick up regardless of where we are. But if you try to put it all on one, like if I try to put it all in Deluxe Hosting, it's all my eggs in one basket. And they're not set up for podcasting, whereas Libsyn is. And there are a lot of new players out there in the game and some are good and some are not. But I've been with Libsyn since the beginning and so it worked very well for me.

[00:29:17.490] – Allan

And so then basically as I go through, I'm posting the transcript out there links to the book, all the different things that you see. If you go out there and look at the show notes, I get all that post out there and then I'm pretty much done just all that scheduled. And then if I do some promotion, I will put all that out there. And say, okay, here we are, here's the episode, things like that. And that's it pretty much soup to nuts.

[00:29:44.080] – Allan

Now the interesting thing is, if you think about. It, this is 600 episodes. I put about 10 hours of just my time. So I've got people helping me, but. I put about 10 hours per week of my time into just about every episode. All the things yeah, so if you. Take that 10 hours times 600 episodes, that's over 6000 hours that I've dedicated just to this podcast in seven and a half years.

[00:30:16.630] – Rachel

That's a lot. It's a lot of time, Allan.

[00:30:20.810] – Allan

It is a lot of time. It is a lot of time. But to me it's valuable time because I'm able to bring some great information forward, have some conversations that people need to have, teach some concepts that no one else really is talking about. And I think that's where I really struggle with a lot of this, is that if there was someone else doing this the way I'm doing it, then I would probably stop doing it.

[00:30:49.630] – Allan

But most people don't stick. The average podcast that's out there goes live and maybe gets seven, maybe 15 episodes, and then caput, it's gone. Some people do get bigger, and some people do keep going, which is great. But they're usually in their own little niche, their own little thing, and it doesn't really have anything to do with you. And so that's why I do what I do.

[00:31:16.780] – Allan

And right now, reading a book about menopause why are you reading about menopause? Well, I'm reading about menopause because it's really important for most of the women that are listening to this podcast, because you're either almost about to be perimenopause, you are perimenopause or you are menopause. You're one of those three right now if you're a woman over 40.

[00:31:40.350] – Allan

And so I want to make sure you have the best, most current information. And, yeah, I've been talking about it for seven and a half years. Is there anything new under the sun? I learn something new every time I read a book.

[00:31:52.950] – Rachel

Every time.

[00:31:53.570] – Allan

Every time I read a book, there's something in that book. And so this is just another one. I want to make sure that that context and information is out there. So, yeah, we've done 600 episodes. That's over 385 guests.

[00:32:07.920] – Rachel


[00:32:08.570] – Allan

And almost every one of them wrote a book that I read. It's a lot of books. The episodes are longer than 30 minutes, particularly today. But if you just said, okay, the average episode was 30 minutes, then that's 300 hours of listening, time of information and stuff that you can find. So you can do a search on my podcast. If you're on Apple or something, like some of these apps, they only show you like, the last 100 episodes or last 300 episodes. All 600 of them are available for you to listen to. So you can go to our website, 40Plusfitnesspodcast.com/podcast, and you'll see that there's sort of the different pages for all the posts.

[00:32:56.340] – Allan

You can click on the biggest number over there. I don't know how many that is, and that'll take you to the first episode. And it's horrible.

[00:33:05.930] – Rachel

Oh, jeez.

[00:33:07.380] – Allan

it is horrible. But it was me getting started, and as I say, progress over perfection. I got started. I got a little bit better. I invested a little bit more money here and there to make sure that this is growing and giving information.

[00:33:25.360] – Allan

And we've had about 3.6 million downloads of this podcast since I launched it. Some are a lot bigger than others, but most are getting 5000 – 6000 downloads per episode, and they're getting those within the first two months. And then after that, they have kind of what I call long tail, because we get about 10,000 downloads per week. And so you can kind of see how this thing goes if you're getting 45,000 to 50,000 downloads a month and there's only four or five episodes, it's not just those episodes. People are listening to the back episodes too, which is great. It means that I'm relieving some value out there for people to find, and I really like that.

[00:34:09.920] – Allan

So I don't have any real intentions of stopping this. I want to keep doing it as long as I possibly can but I do want to ask for just a little bit of help.

[00:34:22.850] – Allan

First off, you could leave a rating and review for the podcast. I haven't asked anybody to do that in years. But if you do like the podcast and you want people to find out about it, go leave a rating and review it's right there. There's three little dots or something right there on your phone. You can click on that and leave a rating and review. And that does tell the people that give you that app, be it Apple or Google or whatever, that you like the show. And that means they're much more likely to show it to someone else when they start looking for shows, you can tell someone about the show.

[00:35:01.550] – Allan

There have been times when I've been sitting there talking about the show and someone says, well, what's a podcast and how do you listen to them and where are they? And I'm like, okay, let me see your phone. And I literally pull up the app and I search for my podcast and I hit subscribe and I say, There you go. There's the last four or five episodes. And you can listen to whenever you like. It's right there on your phone. So you could do that, just tell people about it, or you can go.

[00:35:28.540] – Allan

To 40plusfitnesspodcast.com and if there's any books that you're interested in. So let's say I'm having a conversation with Dr. Hirsch about Menopause, and you're interested in her book, The Menopause Types. You decide that's an interesting book rather than going directly to Amazon yourself. If you go through my website and click on that link, there is a small affiliate commission, 2 – 3%, but it's still a little something. Let's say you decided you want to buy a car on Amazon, you could click on that link first, buy the book and the car, and I'd get a nice little commission check out of that.

[00:36:10.150] – Rachel


[00:36:11.910] – Allan

But yeah, as you're doing your shopping and you think, I want to go on Amazon if you have that cookie. I mean, they're not using cookies anymore, but whatever it is, if you click on my link and go over there and then do your shopping, it will help the podcast. It'll give us a little bit of money.

[00:36:27.260] – Allan

You can go over to Amazon and get the book. So you can go to 40plusfitnesspodcast.com/book and that'll take you to the. Wellness Roadmap on Amazon and you can buy my book. It's still valid. It's still evergreen. I even talking to someone who read it just this week and she's like, I can't believe you wrote that five years ago. You could have written it today. And it's just as valid as it was then. And I'm glad someone actually recognized that because that's what I was trying to do then. And so it is still a good book.

[00:36:59.590] – Allan

And then, yes, there's always working directly with me on my site, 40plusfitness.com. There are challenges, there are programs. So if you want to just do something, there's a sugar challenge, there's a functional fitness challenge. If you're interested in working more directly, you can get in contact with me there.

[00:37:19.450] – Allan

And then, of course, Rachel, you have some places you'd like to send people?

[00:37:24.580] – Rachel

Sure. I think the easiest place to find me would be on my website, which is Strong-Soles.com. That's souls, as in the souls of your shoe. S-O-L-E-S. Strong souls.com. And from there, I've got a contact form if you want to ask me any questions or give me some feedback on the 40 plus fitness podcast. But also there's links to my two socials on Facebook and on Instagram. Those are the only two platforms I'm on. It's plenty for me, so you can reach me in any of those places quick.

[00:37:55.910] – Allan

I do this podcast for you. And so if there's a topic that you just want more information on, something you're dealing with specifically, or someone your family is dealing with specifically that you'd like to know more about, reach out to me. Like I said, I do searches for guests, and I'm looking for specific topics at times. So if you come and tell me here's an issue that I'm dealing with, and I'm looking at your podcast and there was not really any one thing out there for it, would you be interested in finding somebody to talk more about this thing? I'll be glad to do that.

[00:38:39.350] – Allan

I need a new guest every week. And while I do get hundreds and hundreds of solicitations, most of those are just trying to sell some corporation that they're a part of. They're not actually trying to inform you about anything. So if there is a topic or something you're interested in, just let me know and I will do what I can to try to find somebody to talk about that particular topic so you'll have some more information, better information, and have a good starting point for your education going forward.

[00:39:10.220] – Allan

So with that, I'd just say thank you so much for being a part of 40 Plus Fitness. We've been doing this since December of 2015. We're going to keep doing this. Because I'm only doing one a week. We're not going to hit 1000 for another 7.8 years. So we won't be celebrating 1000 anytime soon. But we will keep going. We will keep recording, we will keep looking for awesome guests and I will keep reading the books and making sure I'm asking the right questions for you.

[00:39:44.990] – Allan

But I appreciate you very much. Thank you for being a part of all of this. And if you have any questions, just let us know.

[00:39:52.530] – Rachel

Awesome. Congratulations, Allan. Congratulations on 600 episodes and a lot of great information that people can actually use.

[00:40:00.480] – Allan

Yeah, thank you. I appreciate that.

[00:40:02.360] – Rachel

You bet.

Music by Dave Gerhart


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

– Anne Lynch– Ken McQuade– Leigh Tanner
– Debbie Ralston– John Dachauer– Tim Alexander
– Eliza Lamb

Thank you!

Another episode you may enjoy


Transform your relationship with food | Kim Shapira

Apple Google Spotify Overcast Youtube

On episode 599 of the 40+ Fitness Podcast, we meet Kim Shapira and discuss her book, This is What You're Really Hungry For.


Let's Say Hello

[00:02:52.390] – Allan

Hey, Ras.

[00:02:53.710] – Rachel

Hey, Allan. How are you today?

[00:02:56.090] – Allan

I'm okay. Just okay.

[00:02:58.360] – Allan

I went for a long walk this weekend and it was really hot and humid and I think I tripped myself back into hypothermia again. Yeah, so I think my sodium dropped too low. And I have had a really tough couple of days.

[00:03:15.950] – Allan

Sleeping, a lot of it, but just trying to get more salt into my diet, more potassium into my diet and just try to get myself back on an even keel. But it's been a tough couple of days.

[00:03:27.160] – Rachel

Oh, that's miserable. It just feels bad. When those types of events happen, that's really a game changer.

[00:03:34.870] – Allan

Yeah, I just went out on my normal walk. I'm like, okay, do this. And I originally said, I'll just do 12 miles, you know, what the heck?

[00:03:42.060] – Allan

And I got to the six mile mark and I'm like, you know what, I'm feeling pretty good. I'll go ahead and go and make it more of a 13 point something walk.

[00:03:51.980] – Allan

I walked all the way to the sign that's at the end of the road, and then I turn our fence gate and I just turned around and.

[00:03:58.830] – Allan

I'm walking back and got to mile 10, and I'm like, okay, something's not cool. I gutted it out for the final 3.25 miles, but yeah, got in and I was like, I don't feel good. So I got a little bit of hydration in me, cooled myself down, took a shower, took a nap, thought, okay, that should do it. Went out to a celebration party, some friends were anniversary, and then we got back, it was like 05:00, and I'm like, Done. So I'm like, okay, going to go to sleep.

[00:04:28.610] – Allan

I slept for 13 hours.

[00:04:30.310] – Rachel


[00:04:32.630] – Allan

And then got up and said, okay, I'm up. And I started trying to do a few things and then just crashed again.

[00:04:39.370] – Allan

So I took another nap. And then last night went to bed at 8:30 and didn't want to get up this morning at six, but I did. It is what it is.

[00:04:49.470] – Allan

I still got a lot of work to do. I fell behind on, but it's just my body hit a line and I know I have low sodium. That's one of the advantages of testing myself over time, is just knowing I run on that lower line and I just have something I have to be aware of. But I just pushed a little harder than I should have at that particular time and went over the line.

[00:05:11.410] – Rachel

That's the crazy thing about the hyponitremia is that that line is not always right in front of you, like a bright neon sign. The right temperature, the right amount of sweating, not enough sodium in your diet over the last few days. I mean, just all of that stuff, it's hard to see sometimes. And then it lines up and then there you are, and it just sucks the life out of your body. It's hard to recover from that. It really is.

[00:05:38.110] – Allan

Well, but I caught it. I think I caught it early enough that just adding sodium to my diet for the next couple of days should do it. The last time, the first time I got it, they had to put me on IVs for a couple of days to get me past it. But I think I can get by with just some higher sodium and potassium in my food.

[00:05:58.440] – Rachel

Yeah. Well, I'm glad you're hopefully on the mend.

[00:06:01.510] – Allan

How are things up there?

[00:06:03.000] – Rachel

Oh, good.

[00:06:04.040] – Rachel

Last week I was talking with you. I was in Boston. Now I'm back home. It's nice to be home again. We had a great trip. Like you, we're having incredible heat right now here in Michigan. I was just out for a run this morning, and, man, I think I sweat as much as I drink. But as a runner, I always have my electrolytes with me. I don't usually run with just plain water. It's usually electrolytes. So I was fine, but it's hot.

[00:06:31.960] – Allan

Yeah. So got to watch that. Can be a big deal. So pay attention to the signals your body's giving you, because it is. You just have to listen.

[00:06:41.910] – Rachel

That's right.

[00:06:43.110] – Allan

All right, well, you ready to have a conversation with Kim Shapira?

[00:06:46.710] – Rachel



[00:07:12.810] – Allan

Kim, welcome to 40+ Fitness.

[00:07:15.380] – Kim

Thanks for having me. I'm so excited.

[00:07:17.570] – Allan

Well, I really enjoyed reading your book. It's called, This is What You're Really Hungry For: Six Simple Rules to Transform Your Relationship With Food and Become Your Healthiest Self. And I think one of the reasons I really got into the book early on, one, I look at the table of contents, I'm like, well, we might not agree there, we might agree here. I went in kind of I'm not going to say open minded, but I kind of said, okay, we're going to dive into this. But you said something really early in the book that I think we overlook it so much that.

[00:07:48.790] – Allan

We'll see a friend go on a diet or we'll read something in a magazine while we're standing in line at the grocery store, and it's like, wow, this person lost 30 pounds in three months. Now, the little fine print at the bottom says, these are not typical results but we think we should be able to do the same thing and get the same result, and it just doesn't work like that. And then you use the word. I think that's really important is then we feel shame for not being like someone else.

[00:08:20.060] – Kim

Yeah, it's interesting. I was touring the bookstore the other day and kind of reading as many different books as I could just for the fun of it, and I came across a book called Contagion, and it was saying that the most viral posts and emails that had ever occurred are the ones that gave people the feeling of awe. And it's really interesting is when you read an article or you walk past something or you hear your friend saying, I was successful doing this. It's that light bulb that goes off that kind of ignites some excitement in you that thinks, like, maybe there's hope and maybe I can do that too. But the reason why diets fail is because people don't deal with what triggers them. That takes them off the path. And so, as a registered dietitian, I believe the way that we eat makes our bodies well. The problem is people don't want to eat certain ways because they don't understand the call to eat things that aren't making them well. And so in the beginning of my career, I put everybody on diets thinking, you're going to want to eat kale because you know it's good for you and it has a bunch of different vitamins and minerals.

[00:09:28.990] – Kim

And the problem is, they were eating ice cream and cake after because they were eating the kale because someone told them it was healthy. They weren't eating it because they felt good about it. And what they really wanted was the ice cream and the cake, or so they thought.

[00:09:41.130] – Kim

But it was because they were restricted from it in their minds because they had been on a diet that is really what called them to even eat it to begin with. I know I probably just went off on a whole another tangent.

[00:09:51.690] – Allan

No, that's exactly what I meant. My story, okay, I went paleo because I hired a dietitian, and that was the hot thing at the moment. So she's like, oh, you've got it. Do you know what paleo is? I'm like, no. So she gave me this whole little notebook thing that she had made up all this information, all these studies, all this stuff. I'm like, okay, cool, I'll give it a shot.

[00:10:12.200] – Allan

And it worked until it didn't.

[00:10:15.350] – Kim

There it is. Did you get that line from my book?

[00:10:19.000] – Allan

No. Well, no, it's it's actually actually, I was thinking before we came on, I was thinking about Dr. Fung because in his book, The Obesity Code, he said all diets work and all diets fail.

[00:10:29.660] – Allan

And so it's like what I ended up doing was I was just tweaking what I was eating and I ended up transitioning into keto, and then the rest of the weight dropped off. And so for me, the paleo keto approach worked very, very well. And as I got to talking with hundreds of people in this field, because this is episode 599, I realized that there are 1000 million different ways to eat because there's a billion people plus on this planet, there's a way that you should eat that's very different from the way I should eat. And while what I did worked very well, for me, it may just be completely unsustainable for you. And so it's great to explore. It's wonderful to explore different foods, to explore different ways of eating and realizing, as you said in the book, this is about providing nutrition for your body.

[00:11:22.010] – Allan

this is not about saying, okay, food is this savior out there that's going to make my life more exciting and more fun and we'll be here bored because I got to sit here and answer this phone and it's not ringing. So I think I'll just go to the vending machine and buy a candy bar because that's going to be a lot more fun with a candy bar than just sitting here with no phones ringing. So it is that thing of it's really hard.

[00:11:49.220] – Allan

But if you can tailor the way you currently do things and make small adjustments with these six rules, this could be a very sustainable way for just about everybody to tweak who they are. What they're doing just a little, and make some substantial changes that are sustainable.

[00:12:08.370] – Kim

So what I really heard you say was, if you can be curious, which people don't know to be curious, and that is one reason why they fail. So they already assume they know what they need to do and they're also totally neglecting what they need to do. And I think it actually starts with being curious, which you are very curious. I mean, look what you uprooted your life, you take care of things, you pay attention. And the thing about I'm sure we're going to get into is rule number two, eat what you love, but make sure the food loves you back.

[00:12:38.840] – Kim

What I have found is that people have a hard time sustaining weight loss because they're not really eating the foods they love, they're eating foods other people love. They're not paying attention to the way their physical body feels. They already know this is going to be good for me, so I'm just going to eat it. Not paying attention to joint pain, digestive issues, things like that. They're not curious about specifically what's important to them. So they're focused on weight loss and they're not focused on weight maintenance. And I would say changing your relationship with food, the side effect is weight loss.

[00:13:11.620] – Kim

Changing your relationship with food, the side effect is weight loss. So instead of focusing on losing weight, changing the focus to changing my habits, getting curious about why I'm eating and what I'm eating. And the only way that a person, I believe, like you can begin this process is to go back to kindergarten. And that's learning the rules. So I know it sounds scary when.

[00:13:35.850] – Kim

I say eat whatever you love, but. Now it's the first time somebody actually has permission to be guilt free, shame free to eat what they love.

[00:13:44.660] – Kim

And then that opens the door for them to say, I didn't even realize that those were making me sick. That's why I don't feel good. I thought I loved ice cream. It turns out it's beating the crap out of me.

[00:13:56.140] – Allan

Right. And that was one of the initial disconnects I had, was like, no, please don't tell. Eat whole food.

[00:14:02.240] – Allan

Please just eat whole food. Stay away from the processed stuff. I know it's delicious, but they want you to eat more of it. And so I was thinking as I went into this and we're talking about relationships, and I'm like, okay, we all probably know someone in our lives that had a really toxic relationship.

[00:14:15.960] – Allan

I was one of those people, but I stayed in that toxic relationship. And so in your book, you talked about the four reasons we eat.

[00:14:25.270] – Kim


[00:14:25.910] – Allan

Okay. And some of these reasons, if you listen to it from a relationship perspective, you're like, that's the abusive girlfriend, that's the abusive boyfriend. That's the relationship you want to get out of if you're eating for that reason. Can you talk about the four reasons?

[00:14:39.840] – Kim

Yeah. And I just have to say, I was scrolling on Instagram this morning, and I ran past a quote that it said something about, before you go to sleep at night, call back all your energy. And I loved this because we put out so much energy in different places, and we take other people's energy. And the idea that we can call back and fill ourselves back up with our own energy is really important to me. So I always think in terms of, here I am in my physical body.

[00:15:06.500] – Kim

And I have an emotional self, and I have a physical self. Right. And most people are paying attention to their emotional self. They're thinking their mind is telling them what they need to do, not even aware that their mind is wired to help you survive in the most pleasurable way. And people are not paying attention to their physical body and all the signs and signals it's giving us all day long of telling us exactly what we need.

[00:15:29.240] – Kim

And so if we can kind of learn to separate, understanding that our emotions come and go every 15 minutes and moods last longer, but our physical body is always telling us when we have.

[00:15:39.630] – Kim

To pee, when we have to eat. I mean, nobody wakes up in the morning and thinks, oh my God, I have to pee six times today. Where are all those toilets?

[00:15:46.760] – Kim

Right? We trust that we will find a bathroom. It might get a little uncomfortable, but we trust it. And so we need to start trusting our physical body and paying less attention to what our emotional selves are telling us. And so the four reasons why a person eats is because, number one, emotional reasons. Number two is because the food is in front of us. Number three, because we're having cravings. And number four, because we're physically hungry. And the reason why I want you to read this book is because I want you to only be eating for physical hunger and to have a normal relationship with food. Which means sometimes I eat birthday cake on a Monday, but I'm not doing it on Tuesday, Wednesday, and Thursday.

[00:16:22.850] – Kim

Right. Food is fuel, and it only takes up one important place in our life.

[00:16:27.280] – Allan

Yeah. And that's why, again, with the whole food thing is like this is a building block. And so, as you talked about relationship, it's like interning yourself inside. One of the things that I've really gotten become a lot more aware of in the last few years is that there is this inner part of us that needs love, needs attention, and we're the ones not giving it to ourselves. We're not listening to our body, and we're not telling our body and showing our body that love.

[00:16:54.370] – Allan

And so as the result, we go out and we eat things that we know are bad for us, and we're not feeding ourselves. And so when you start changing the relationship with food, you start saying, well, okay, yes, I could have ice cream for dinner. I'm a grown adult.

[00:17:11.290] – Kim

Calories and calories.

[00:17:12.470] – Allan


[00:17:12.920] – Kim


[00:17:13.940] – Allan

What I know is that even if it'S the good stuff, the Blue Bell ice cream or Haagendazs or Ben and Jerry's or whatever your poison is, that's fine. It's good quality stuff, but it's not going to nourish your body the way getting a good balance of vegetables and proteins and all of that is going to go.

[00:17:34.700] – Kim

It would be so cool if you stopped thinking about ice cream for dinner. And I think that's where we have to start is when we know we can have it and we put it on hold and we don't worry about it.

[00:17:46.690] – Kim


[00:17:47.010] – Kim

And the reason why diets fail. And this is a building block. This is the first building block, because now you're in kindergarten, right? You're learning how to play on the playground, because if you're trying to build a house on a faulty foundation, it's going to crumble. And that's what diets are. And so we are building that foundation.

[00:18:03.760] – Kim

Why are you eating? Is it because you're having an emotional need for it? Or because your physical body is needing fuel? And food is not anything other than fuel at any given time. It is always fuel. Your body is, like, so amazing and efficient. It takes up everything you're eating, and it's just checking in to make sure that it's the right kind of fuel for your body. But if we start telling people, don't have ice cream, or if we start saying it's unhealthy or we even call it bad, or we say shouldn't, what happens is then we're automatically assuming that we're bad. And that's what we're putting into our subconscious. Right. So if we stopped labeling food and we called everything a banana, what would happen? Allan, right now, if I handed you a banana, what would you do?

[00:18:44.310] – Kim

If I handed you a banana?

[00:18:45.810] – Allan

I would actually probably just set it down.

[00:18:47.860] – Kim

Yes. You would pause and you would say, why is Kim handing me a banana? Everybody pauses when they get a banana because they only eat bananas when they're hungry. And if we started thinking all food was a banana, we would put that space between the thought to eat and the action to eat. Right.

[00:19:03.460] – Kim

We need a pause. We need to say, Why am I thinking about a banana? Why do I have a banana in my hand? What's my body needing right now? Also, if you put that banana down, you would totally trust that you can come back for it.

[00:19:14.610] – Allan

Yeah, because I just had breakfast not 20 minutes ago, so it was okay. Well, great. I don't need this banana now. If I get a little hungry later because I've got a lot of work to do this afternoon, then, yeah, I might grab it and have it.

[00:19:27.830] – Kim

Right. But I have to just say one more thing. So sorry.

[00:19:30.900] – Allan


[00:19:31.700] – Kim

If you never ever were given a banana and then somebody hands you a banana, now it's a treat. Now it's like, I'm going to have it because I don't know when I'm going to get it again. And if I said, you only have 30 seconds to eat a banana, you're not enjoying it, you're sneaking it, you're shoving it in. There are so many things. So if we slow down the whole process and everything becomes a banana and we become more mindful and we accept that we can have ice cream any time of the day, any day of the week, we no longer need it right now. And maybe days go by and weeks go by.

[00:20:05.600] – Allan

Well, an OD aside is the area of Panama we live in is where they grow bananas for chiquita. So there's a lot of bananas. They're going to run out of bananas or plantains. But you have a very important aspect to that foundation. You talked about the solid foundation.

[00:20:20.970] – Allan

And I think if you take a few minutes and you really look at this and you even said to it, I call it kind of a wellness audit, you called it a wellness wheel. Can you talk about the wellness wheel and the seven spokes and how we can use that as a tool to kind of check in with ourselves?

[00:20:37.390] – Kim

Yeah. So everybody is in the center of their own wellness wheel. Right. And what we're doing is we are attached to all the things that are important to us. And so they could be adventure, they could be our spiritual well being, our physical well being, our financial, our relationships, our career, and then there's a few more and what like environment. But what happens is, if we are disconnected from any one of these things, we are not moving forward in our journey.

[00:21:05.660] – Kim

We're stuck. And so it's paying attention, checking in, how am I doing? Am I connected to the things that are important to me? Have I stayed in my routine with sleep? Have I planned ahead to make sure that I know where my water is coming from and what food is available to me today? Have I booked my next adventure? Have I checked in with my friends?

[00:21:26.140] – Kim

If we're not connected to these things, then what happens is we become unwell because we overthink about where we are and how lost we are and how sad we are and disconnected. And so the first thing to do is kind of check in, where am I on this journey? What can I do to improve that? And then that's how you start moving forward. And we're all in different places, so there's no judgment. And we're all working by ourselves, making this all happen. So you might be further along in your fitness than I am, but I am not looking for perfection. Not that I'm assuming you are either, but I am working for progress. So now I'm open to learning from you and also checking in to see, what have I not done today? Where can I pick that up?

[00:22:09.350] – Kim

Right? This is how we become balanced. If you're tired, how many times do you think about how tired you are during the day? If you had an argument with your friend, how many times do you think about that argument? Right? These make us unwell. We have to get connected and stay connected.

[00:22:23.670] – Kim

And like I said, the reason why people fail is they neglect to do the things they need to do.

[00:22:29.250] – Allan

And I think one of the key things about what you just said is when you start to feel that shame or that loneliness or that boredom or any of it, most of us have been taught, well, food will make me feel better.

[00:22:43.640] – Kim

Yeah, well, that's a trained behavior, right?

[00:22:46.920] – Kim

So for me, it was about shopping. It wasn't about food. I totally trained my mind to think every emotion shopping was a great idea. I definitely needed something, even when I couldn't afford it. And so that's kind of where I started recognizing, oh, my gosh, my clients are literally eating the same way that I shop. And so being able to check in and recognize I want to well, let me go back a little bit so you can understand. Our mind produces about 60,000 thoughts a day. It's doing it all by itself. It's not like you asked your heart to beat or your lungs to breathe, right? Your mind is already doing this for you. We can write a book or we can have a conversation, and we're actually asking our mind to think. But all the other things it's doing is to make sure that we're safe. If we heard a loud sound, we would both stop exactly what we're doing, check in, make sure we were safe.

[00:23:34.910] – Kim

Before we would carry on. Our mind would also give us a few different ways to resolve the issue quickly and safely. And so if we've had any sort of emotional trauma, which every single person on this Earth has between three to 18 different emotions, that can be triggered, that cause them to become irrational. And so our mind remembers, the last time I felt that way, we ate and we felt better.

[00:23:57.930] – Kim

And we have to recognize that our mind is only doing its job and it's not always right. And that we can just say, mind, I'm safe, because all our mind wants to know is that we are safe. And so if we can say to our mind, I see you, I see you directing me towards the pantry, and I see you telling me that ice cream is good in my mouth, but I'm going to laugh right now, and I'm going to remind my body that I'm safe. I'm going to check in, scan my surroundings, confirm I'm safe, and then I'm going to carry on. What happens with most people is they think their mind got their best interest and their mind says, ice cream is a good idea. So they just assume that's their idea. And they end up eating ice cream.

[00:24:37.840] – Allan

And then like you said, when you put that space in there, you get that half step back and you can say, maybe ice cream isn't what I need right now. Maybe I just need some water and to go for a walk. Or in your case, it was, no, I really don't need that sweater. If I need that sweater, I can go buy it later. But yeah, 50% sale, it's beautiful. You don't really need it, but you got to have that space because the emotional part of you is like, I'm never going to get this deal again.

[00:25:02.930] – Kim


[00:25:03.590] – Allan

And you know, there's sales every single day I get an email, 50% off, 60% off.

[00:25:11.970] – Kim

Yeah, it's so true. But you're right and I forgot that part. So once your mind tells you food is a good idea, that's when you have to recognize your alarm is going off, just like any alarm.

[00:25:21.760] – Kim

And so notice that the alarm is going off. Turn it off. Take a deep breath, look at your mind, laugh at it. Okay, mind, we don't need that sweater right now. Let me scan my body and see even why that alarm was triggered.

[00:25:33.990] – Kim

And once you can recognize where the alarm came from and you recognize, okay, my chest is tight or my shoulders are tense or I'm recognizing that I just had this really uncomfortable phone call. Or maybe it is actually hunger, any of these reasons could set your alarm going off, right? Hunger is the most primal signal we have to keep us alive.

[00:25:53.380] – Kim

Hunger is the best signal we can get from our body. We would all run to the doctor if we stopped having to pee. We need to be hungry. We need to be hungry often, but we don't want to stay hungry. But we do need to recognize when our mind is giving us an idea. That is not a real idea that. We need to be doing right now. We need to take a deep breath. Scan our body, and if we're really stressed, then that's when we breathe again, emotions pass.

[00:26:17.110] – Allan

I have two questions in one. So first I got to start out with maybe it's the libertarian in me. But right now, I'm just not a big fan of the word rule.

[00:26:26.250] – Kim


[00:26:27.370] – Allan

And I think there's a lot of people like, I'm a rebel. I set rules for myself, and then I break those rules because that's what rules are made for. But I don't have a better word than rule. So we're just going to call them this, the six weight loss rules.

[00:26:42.860] – Allan

Can you just give us a quick rundown of those and why each one is important?

[00:26:48.130] – Kim

Yeah. So I'm all about staying uncomfortable. Buddhist said life is suffering, and I would say suffering in quotes, right. Like, we're going to either suffer by eating food that we know is going to make us sick, or we're going to suffer by not eating that food. Now, again, it's suffering. It's a little discomfort.

[00:27:08.080] – Kim

Our body does not like discomfort. It will never let us stay uncomfortable. It will always kind of come up with a more pleasurable solution. People are so triggered by the word diet, fats, calories. I mean, diet literal definition of diet is the lifestyle. The way that you eat. It doesn't say in the dictionary restriction. Right? So if we can reframe it and understand we have rules in kindergarten, right? We sit crisscross applesauce.

[00:27:33.860] – Kim

We talk when after we're called on. We don't over talk or speak over somebody else. We have rules, and they really do help the community be better. And so that's what we're doing here. Would you ever think of leaving the house in the morning without brushing your teeth?

[00:27:50.540] – Allan

Probably not, no. It's a habit.

[00:27:54.310] – Kim

It was probably part of something you were taught growing up, that you were trained, and that became a behavior.

[00:28:00.950] – Allan

My parents are going to go and they're going to say, go upstairs and brush your teeth. And then when they come in there. They're going to touch my toothbrush to see if it's wet. There was some police action in my house.

[00:28:12.670] – Kim

Yeah, that's funny. There's probably a lot of police action in a lot of houses. The thing is that the reason I use the word rules is to make you uncomfortable, because I want you to stop and I want you to think. And I want these to become so ingrained that now they're a set of values. You don't brush your teeth because your parents made you do it. Now you actually value it. And so once you start valuing these rules, they become something totally different. They become who you are and your lifestyle. And I could say to so many different people, define your relationship with food. What kind of eater are you? And they wouldn't have any idea. And what I want them to say is, normal. I'm a normal eater.

[00:28:52.740] – Kim

I'm a normal eater. In Italy, in Panama, in California. I'm a normal eater in this restaurant. I'm a normal eater next Thursday at dinner when I don't even know what I'm going to have. I'm normal because I follow these rules. And now they're inside of me.

[00:29:06.830] – Allan

So let's go through the rules.

[00:29:08.310] – Kim

Okay? Do you want to do it? Just kidding.

[00:29:11.710] – Kim

Okay, so rule number one is to eat when you're hungry.

[00:29:15.570] – Kim

These are non negotiable. Eat when you're hungry. So really find your mind and know what your physical body is needing. Take your normal portion and cut it in half. Now people are having visceral reactions, probably listening to this, oh my God, I don't know what hunger is. I don't know what my normal portion is. So your normal portion is whatever you ate the last time you ate.

[00:29:35.790] – Kim

It doesn't have to be what the chef is preparing. It doesn't have to be what is on the box. It is what you would normally eat. Cut it in half. And now you're going to wait 15 minutes to see if you need more food. So we know that it takes 15 minutes to get from our mouth to our stomach to get the signal that we've had enough food. And that's why we're cutting it in half and we're waiting 15 minutes. And the thing is, most people eat their food in two, three, four minutes, giving them eleven minutes of discomfort. And our minds hate discomfort and we'll just say, go ahead and eat it. And we need to remember, no, we're safe, we just had fuel. There's more right here. I'm going to come back to it and see if I need it. So really the trick is to slow down the pace at which you're eating, be more mindful, chew your food, really taste your food, and then let it last a little bit longer. So hard for people. Yeah. So that's real one. Do you have any questions about that?

[00:30:25.990] – Allan

Well, yeah, let's jump ahead in our plan here a little bit because I think this is really important. You put guidelines for hunger and you went from basically over full, Thanksgiving full, all the way down to starving.

[00:30:38.950] – Allan

Number one, there's not a lot of people in Western world actually starving.

[00:30:44.020] – Allan

You're not actually starving. You may be very hungry, but that's a whole nother conversation. It's a range. And we all probably can relate to being so stuffed that we are uncomfortable, really uncomfortable, beyond uncomfortable, all the way down to a point where we got blood sugars falling and our bodies screaming at us, eat anything. Why do we have so much trouble playing in that range of being just a little hungry and thinking we're about to die?

[00:31:12.540] – Kim

It's a good question, especially when your mind is telling you for every emotion you're hungry. I mean, I have 250 pound clients, 300 pound clients, 180 pound clients, everybody who wants to lose ten pounds, 50 pounds, who are telling me they're starving. They're hungry all day long.

[00:31:29.640] – Kim

There is so much confusion on what hunger actually feels like. Hunger is isolated to our stomach. It's actually not painful, it's not scary. It's just a hormone, telling you you're getting a little low on fuel. We need to eat something here. I think people are, again, totally primal. That people don't like to be hungry because it's basic survival. And I think people have to learn and get curious to see what does hunger actually feel like? And so what would happen if I just ate an apple, nothing else? Why is there so much fear in not eating anything else when the food is right in front of you? And so I think it's basic fear. People do not trust that they're going to eat again.

[00:32:12.750] – Kim

And we know historically, you had 21 meals last week and you can't remember what you ate last.

[00:32:18.220] – Allan

And that pantry is stuffed to the gills. Your freezer is stuffed to the gills. Your refrigerator, which also probably needs to be cleaned out.

[00:32:25.900] – Kim


[00:32:26.840] – Allan

Yeah, there's so much food around us, you're not going to miss your next meal.

[00:32:32.350] – Kim

It's fear. Fear and lack of curiosity. Neglecting what they need to do, get curious

[00:32:38.860] – Allan

and listen. Listen to their body.

[00:32:41.010] – Kim

Yeah, totally.

[00:32:42.550] – Allan

Okay, let's move on to rule number two.

[00:32:44.720] – Kim

Okay, so rule number two, which is where I think you have a visceral reaction.

[00:32:50.790] – Kim

Eat what you love, but make sure the food loves you back. So I would say most people are walking around with headaches, clearing their throat, heartburn, bloating, digestive distress, gas joint pain, psoriasis, eczema, nausea, sleepless nights, itchy skin, yeast infections. I mean, tons of food related digestive distress. And then they're eating foods that are directly linked to this. I just remember I'm going to give you an example that you probably read about because I think it's a profound one. I had a ten year old client that was overweight, and they had a friday night dinner every single Friday night at this diner. And this kid always wanted a shake. And the parents said, when you finish your hamburger and French fries, you can have your shake. Now you and I are both hitting our heads going, hamburger and French fries? Okay, yeah, you finish those hamburger and French fries, which is exactly what he would do, and then he would have the shake.

[00:33:47.920] – Kim

And so we know that that's why. This kid was overweight, right? But because he had to finish his food to get the shake, that was the only way, and that's what he was going to do. And this is why diets don't work. And so when I finally convinced the parents, let the kid have the shake, they finally, after a month, let the kid have the shake.

[00:34:08.730] – Kim

And after two weeks of having the shake, the kid no longer wanted it. Because they found that it was not really satisfying and making them feel good, and they never had the shake again. And this is why it's eat what you love.

[00:34:21.540] – Allan

And so, yeah, it's like, well, the donut holes was another one. It's like, okay, yeah. What I found, though, is for some people. For some people, it's that trigger thing. It's like it's the macaroon that then has you craving, puts you back into another state of a reason to eat, is you're now craving this food. And so there are trigger foods that you don't think it doesn't love you. You just think, okay, I want it, I want it. I'm hungry. And so there are foods that I would say some people probably just need to try to avoid, even if there's no physical reason that they should avoid that particular food. Like, most of us are not allergic to donut holes, but the sugar is going to make us want the third one and the fourth one and the. Whole box,

[00:35:06.050] – Kim

and there's trans fats. When we're talking about health, we're talking about a lot of ingredients in the donut hole. But does that mean I can never have a donut hole? No, because everything in moderation. It's just what else did you have today? What did you eat yesterday? What are you doing? And so the truth is, that's why I say have the donut hole on a Monday, but not Tuesday, Wednesday, Thursday.

[00:35:26.110] – Kim

And I remember when I tried cutting sugar out of my own diet just to experiment and see how it was making me feel. I went through a real tug of war with my mind because I loved chocolate, I loved butterfingers and Chips Ahoy. And there was like, now I'm contemplating a life without these things that I loved.

[00:35:45.320] – Kim

Made no sense to me. But when I came up with the idea that I was going to just get curious and experiment, how am I without it? What does my body feel like without it? I opened a door, and so I noticed on day five of not doing it, I only allowed myself five days for this experiment. On the fifth day, the idea of wanting a butterfinger or Chips Ahoy completely vanished. It left my body. I was no longer having physical withdrawals from the sugar. So sugar is heroin, and there's no way around it. It is literally causes us to have an addiction, and then we are spiraling, looking under every single rock for it. But if you tell somebody who loves sugar that they can't have sugar now, they feel suffocated, and that's not going to help them move forward. But if you can get them to understand how the food makes their body feel, don't tell them. Let them experiment and experience how the food makes them feel. Now, it's easy to say, oh, okay. I do love myself, and I don't actually think that that's what I want to have in the middle of the day or right before I'm going to sleep.

[00:36:53.430] – Kim

Right. Teach them to be in their own bodies. And, I mean, I do have sugar. Now, this was that experiment was 14 years ago, but I don't have it two days in a row because I'm aware of when my mind is sending me down this spiral, and I can say, oh, I had it yesterday. And this is only because I'm craving. Because I'm addicted to heroin again and I can walk away from it. But you have to get mindful. You can't believe every thought you have.

[00:37:18.490] – Allan

And that's another area I got to eating mindfully is probably one of the hardest things to do because we're so busy, we've got so much to do. It's like, look, I can do my accounting and eat. I can't record a podcast because I have to use my mouth, but I can eat during just about every other thing I do with my work. And so it's really hard to say. No, put the work down, fix yourself a plate, go sit at the dinner table, take a bite, savor the bite. Feel the bite, take a breath, take a sip of water, wipe your mouth with your napkin, and then have another one. That is hard

[00:38:01.290] – Kim

and boring. It's boring. And you know what? Our mind doesn't want us to be an uncomfortable. It's telling us, no, pick up your phone. No, definitely do something else. Our mind won't let us be suffering. I have a client who came home from work the other day, and his family had bought crumbled cookies, which are just like these giant cookies that are super thick. And in my family, we cut them into like, I don't know, eight to ten slices. And I said, how much of the cookie did you have? And he said, I ate half of it. And I said, what were you doing when you were eating the cookie? He said, I was watching the Bake off and it was 10:30 at night.

[00:38:37.190] – Kim

And I said, what time did you go to sleep? And he said eleven. And I'm like, hitting my head, and that's not going to help him if I'm hitting my head. So what did I say to him is, Where's the cookie now? Where's the other half? And he goes, It's in the kitchen. So I said, Go grab that cookie. And he was so excited, he grabs the cookie, it's a whole half a cookie. He sits down. I can see his salivary glands already getting ready for the first bite. And I said, okay, now cut that into quarters. So he did, and then I said. Now cut that into another quarter, each bite making another half. So now we had eight. And I said, now do it again. So we had 14 pieces of cookie on the same plate. It was like a small cookie. And all of a sudden it was like a whole plate of cookies.

[00:39:16.200] – Kim

And then I said, now take the first bite and just smell it. Don't put it in your mouth.

[00:39:20.590] – Kim

And you can see he was all excited and ready. I said, okay, now we've gotten our body ready. Now put it in your mouth, but chew it longer than you think necessary. Savor it because you think you love food. Let me see you actually love the food.

[00:39:33.720] – Kim

So he ate it, and it took him about 40 seconds to really savor it. And I said, now show me how you would normally eat. And he just pops in his mouth and 2 seconds later it's gone. I said to him, So you say you love food, but you're not even allowing yourself to really love food. Then I had him turn his chair around because we were on Zoom, and I said, show me every single thing in your room. Tell me all about the things on your walls and whatever you have. He spent five minutes giving me the entire higher explanation of all the things he loved in his room. He completely forgot about the cookie. He turns around, he's like, oh my God, I forgot about the cookie. Now I have like twelve more times. I get to eat it, right?

[00:40:10.130] – Kim

And I'm like, but are you hungry? He said, no, I'm going to put it away. Right. So he had the same experience with two bites as he had the night before. With probably five bites. We have to get mindful. Yeah. And that's the fail safe while he'll lose weight, right? Because he won't be eating the whole half. He doesn't need it.

[00:40:28.240] – Allan

Yeah. So let's run through the other four rules real quick.

[00:40:32.010] – Kim

Okay. Rule number three, eat without distractions.

[00:40:34.390] – Kim

So we talked about that. Motions are distractions. Having food in front of you is a distraction. Cravings and hunger. So make sure that you're hungry every single time you eat.

[00:40:43.170] – Kim

Rule number four is to get 10,000 steps every single day. The average American gets about 2500 to 3000. We really need 7000 to prevent sudden death and a bunch of different diseases. I found 10,000 really helps you sustain your weight loss. So if you're somebody who's getting two to 3000, just shoot for 500 more every day. Make sure you're getting seven, but really shoot for ten. We need this built in so that way by the time you're done losing weight, you're already helping your body maintain your weight. And you can do it through lifting weights, walking. I mean, I'm calling it steps, but it's really movement. And we need a variety of different types of movements for our body.

[00:41:24.250] – Allan

And this is something you can do with friends. And as you said, go with a walk for a friend. It doesn't have to be the full we're going to work out to probably close to four and a half to 5 miles. But get out with a friend for a little while. Spend the time enjoying nature with them. You have a little stepper in your room. I remember at one point I was in a hotel room and I was at like 9200 steps and I was like, crap, I got to get 800 more steps in. I'm literally walking around my bed, just doing laps around a hotel room bed to get those extra 800 in there, because I wanted that streak. Because for me, keeping the streak was something that was going to keep me motivated to keep doing it. I didn't want to fall short.

[00:42:03.430] – Kim

I mean, you can move your arms, you can do Arm things during commercials. You can do whatever, just keep moving. Yeah, it's really important. Our metabolism goes from 100% when we're moving to 30% when we're sitting. So we want to stay active. We want to keep those burners on.

[00:42:16.030] – Kim

Rule number five is to get eight cups of water. And it really does change, depending on your climate, what else you're eating, what else you're drinking, and how much weight. But a minimum of eight cups every single day will really help your body lose weight and detoxify every one of your organs.

[00:42:29.970] – Kim

And the last rule is 7 hours of sleep. The average American gets about six and a half. And if we're not getting at least seven, and we need between seven and nine, but if we're not getting at least seven, we're just wreaking havoc on our body and it's going to affect our adrenal glands, our hormones, our digestion and our stress. So we can't lose weight without sleep? We can't be well without sleep.

[00:42:51.340] – Allan

Yeah. So, yes, rules make me uncomfortable, but these are important. These are really good. And if you do these, you are going to lose weight and you are going to keep it off, because they'll just work.

[00:43:01.680] – Allan

They'll teach you a lot about yourself and they'll teach you a lot about food.

[00:43:04.920] – Allan

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

[00:43:13.790] – Kim

Routine, consistency and confidence. That's what I would think.

[00:43:18.880] – Kim

You have to have a routine. It has to be non negotiable. So no matter what you're doing, make sure you're getting up early enough to move your body and plan ahead to get the things you need to take care of your body. I think you need to be consistent. So if you aren't perfect, you have the next day. So we're looking for progress, not perfection. I'm looking for consistency. As much consistency as you can have over time is going to help your body basically thrive and confidence in the fact that you can do this.

[00:43:48.980] – Allan

Thank you. Kim, if someone wanted to learn more about you or your book, This is What You're Really Hungry For, where would you like for me to send them?

[00:43:56.970] – Kim

Everywhere, please. Instagram is Kim Shapira Method. My website. Kim Sharpira Method. TikTok Kim Shapira Method wherever I'm always Kim Shapira Method everywhere.

[00:44:07.080] – Allan

Perfect. And I'll make sure to have the links there on our website at 40plusfitnesspodcast.com/599.

[00:44:14.740] – Allan

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

[00:44:17.750] – Kim

Thanks for having me. It was fun.

Post Show/Recap

[00:44:19.410] – Allan

Welcome back, Ras.

[00:44:20.840] – Rachel

Hey, Allan, I really enjoyed your discussion with Kim, and it sounds like she has a book that was really fascinating to read. I love listening to it. But let's just start off with her six rules. I like rules. I know you don't, but I do like rules.

[00:44:38.330] – Allan

There are some absolutes. There are definitely some absolutes. And so I think there are areas where you can have rules, but where you have rules, you have rule breakers. I would only put rules down on where, you know, this is it. You have to do this.

[00:44:59.680] – Allan

You have to move. You can't be sedentary and healthy. It doesn't work that way. You can't eat crap and be healthy. Even if you're eating less crap, you're not eating some food. If you're not getting the nutrients in your body, then you're not doing the right thing. So there are areas where I think you can write rules and say, stop eating crap smooth, then that'd be a lot. But just start with something. I think that could be a rule.

[00:45:28.180] – Allan

But when I say, hey, Ras, sleep more.

[00:45:34.410] – Allan

Then, sure, just struggling with my sleep right now. That's not always inside your control. So rules can be about the things that you control. Rules can't be about things that happen to you or outcomes.

[00:45:50.420] – Rachel


[00:45:50.820] – Allan

And so that's where when you start saying rules, I'm like, okay, here we go. I think there's just a whole subset of people out there that as soon as they see the term rule, they're like, oh, this is going to be hard, and I'm not going to want to do it. And so then now that there's a.

[00:46:08.740] – Allan

Rule, they're fixated on that rule versus actually trying to change their behaviors and lifestyle.

[00:46:16.060] – Rachel

Right. Well, I think that I do love rules, but I also prefer them as, like, rules of thumb. Like, for example, she said to drink eight cups of water.

[00:46:25.260] – Rachel

Well, I don't drink eight cups of water. I drink a lot of electrolytes, like I mentioned, and I I drink a lot of coffee and occasionally plain water, but not a lot. But, you know, it's just same thing with the 7 hours of sleep. I need eight or 9 hours of sleep. Rules of thumb, like be cognizant that you need more water. Be cognizant that you need more sleep. And then figure out what that means to you. How many hours of sleep do you really need? My husband can certainly live on five or 6 hours of sleep, and he does quite well. I need about eight or nine. So the seven hour sleep rule is not quite where I'm at, but I think that it needs to be customized or you need to be flexible with what works for you as an individual.

[00:47:09.240] – Allan

Yeah, because obviously, Sunday night I needed 13.

[00:47:16.570] – Rachel


[00:47:17.930] – Allan

And so seven would not have done it. And then even with 13, I took a nap that day and took a nap the day before.

[00:47:25.520] – Allan

So there was a lot of sleep in a 24 hours period of time to basically recover for my body to have some healing time, because that's what's happening when you sleep. So I agree with her that the things that are in her six weight loss rules are important considerations. If you're looking at losing weight, these are things that you really want to consider how you can apply them in your life. I'm just a word Smith. And when I see a word, I think about the emotional attachment that I and other people have to those words. And that's why I don't particularly like the word rule. But that said, the six areas that she covers are important, and if you follow them to some extent, you're going to be successful in your weight loss.

[00:48:11.130] – Rachel

The other part of your discussion that even you just mentioned is the emotional aspect. We do have an emotional attachment to what we eat. When we eat it, we live on the fact that we need breakfast, lunch, and dinner, but do we really need breakfast, lunch, and dinner? Do we really need that afternoon snack? Do we really need a giant bowl of cake and ice cream at every single birthday party? There is a lot of emotion, but even that is a good rule in that you begin to think and strategize, like, Why are you eating this? Do you really need this? And ask those types of questions. And if you did need to lose weight, if that is a goal of yours, then that's a perfect time to really reconsider. Like, why are you eating this? Do you really need this right now? Is this the best thing for you?

[00:49:01.580] – Allan

And I think that's what she got into is like, okay, we don't we don't actually ever let ourselves get hungry. Yeah, so she's in her book, she talked about a hunger scale from completely stuffed all the way down to starving.

[00:49:14.300] – Allan

Again, another word that I don't like. Because you're not actually starving, you're just very hungry. Again, words. Okay, but all that said, I think. Letting yourself get hungry and sitting in that for a little while is healthy.

[00:49:34.150] – Allan

Not that I encourage people to go into fasting, but if you know you're not hungry, don't put anything in your mouth because your body doesn't need it.

[00:49:44.330] – Allan

And then when you are hungry, when you start getting hungry, feel that hunger. And kind of sit in it for a little while and say, okay, this is just I'm hungry. Then go make a good decision on the foods that you're going to eat.

[00:49:58.080] – Allan

And satiate that hunger. That's why her half a plate rule, you literally take what you would normally eat, and you just eat half of it. I don't know if we really got into that rule a little bit.

[00:50:07.090] – Rachel


[00:50:08.770] – Allan

Okay, so let's say you would have a whole chicken breast, and you'd have all this mashed potatoes and rice and all this you just literally say okay I can have all that stuff, but I'm going to cut it all in half, and I'm only going to eat half of it. Now, I know the other half is sitting in the kitchen right now, and I'm sitting at the dining room table. And I'm going to sit down and mindfully eat this, and then I can't go for the other half for 15 minutes. Again, you're giving your body that opportunity to talk back to you. You've given it food, you've potentially given it nourishment if you're eating the right things, and then it will communicate back. Yeah, that was actually enough. Wrap the rest of it up. And that can be a meal for tomorrow or tonight.

[00:50:51.090] – Rachel


[00:50:51.970] – Allan

And so just as you kind of go through this process, like I said, all of these are valuable. If you go through the process of what she's talking about, it is going to help you build a healthier relationship with food. And that's really the crux of weight loss. It's all about your relationship with food. And your relationship with yourself.

[00:51:12.470] – Rachel


[00:51:13.190] – Allan

And the point where you start loving yourself enough to not punish yourself or reward yourself, whichever way you're thinking about it, with food, then the better off you'Re going to be. When you see food as nourishment and energy, only eat enough of it to give you what your body needs, then you're on the track eating healthy and having a great relationship with food.

[00:51:38.960] – Rachel

Yeah. Oh, gosh, yeah, that sounds great. It was just really good discussion. Really interesting questions that we could ask ourselves.

[00:51:47.210] – Allan

Yeah. All right. Anything else you want to talk about today?

[00:51:50.390] – Rachel

No, that was great.

[00:51:51.670] – Allan

Great. Well, then I'll see you next week.

[00:51:53.650] – Rachel

Great. Take care, Allan.

[00:51:55.050] – Allan

You too.

[00:51:55.890] – Rachel


Music by Dave Gerhart


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– Anne Lynch– Ken McQuade– Leigh Tanner
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Thank you!

Another episode you may enjoy


July 11, 2023

Everything you need to know about calories

Apple Google Spotify Overcast Youtube

In the battle to lose weight, many people turn to calories in calories out (CICO) as a way of eating less and moving more. The math can get more complicated than that, but understanding calories can be a good first step in your weight loss journey. On episode 598 of the 40+ Fitness Podcast, we discuss everything about calories.


Let's Say Hello

[00:02:13.320] – Coach Allan

Hey, Ras, how are you?

[00:02:15.120] – Coach Rachel

Good, Allan. How are you today?

[00:02:16.950] – Coach Allan

Good. It looks like you're somewhere fun. I am. Well, you're in a hotel room, which is not fun. Well, it can be fun. I guess it can be fun. I don't want to hear anymore.

[00:02:25.990] – Coach Rachel

Yeah. Mike had to make a trip up to the outskirts of Boston. Actually, we're in Westborough right now where he's got a couple of plants that he needs to take a look at. And so we made a vacation out of it. So we just spent the weekend in downtown Boston, walking all over the city and enjoying the sights of Boston. Now we're here in Westborough for a couple of days, and I'm just going to take it easy talking with you today. I've got books to read and places to go walk, so I'll be a happy camper while he's at work.

[00:02:58.420] – Coach Allan

I lived up that way nearly 20 years ago. You start looking back and say, Well, when was I there? Well, I was at that job for 10 years, at that job for two years. And I'm like, Oh, wow. That was a while ago because I've been here now for a while. So I was like, Okay, yeah. From age 39 to 41, I lived up in Groton, which is a small little village town just outside the loop. And so, yeah, occasionally I'd go into Boston and just have some fun. But yeah, Boston is a really fun town, but it was a really weird town back then. But then things were changing. There's progression as they will. I was like, so they had, I think one of the rules they had just started doing was they had started no smoking in bars and restaurants. And so all the bar owners in downtown area of Boston, that big area, they were really concerned that they would lose all their customers. And I was talking to the bartender. He's like, Yeah, we're thinking we're going to lose all our business. And I'm like, Well, where do you think they're going to go to eat?

[00:04:06.770] – Coach Allan

Where do you think they're going to go to drink? They're still going to come out. They're not going to just stay home because you say they can't smoke there. They'll go outside and smoke. They're resilient. They'll deal with the cold and do it. And some might quit. But it was just interesting that that was happening. And I was sitting in that bar because, again, we were taking a weekend there. And I was like, Okay, I'd like a can of beer. The guy's like, I can't serve you a beer right now. I'm like, What do you mean? He says, Well, it's 1155 and I can't serve you a beer until noon. I'm like, Where in the hell am I?

[00:04:41.730] – Coach Rachel

Oh, my goodness. That's funny.

[00:04:44.900] – Coach Allan

Well, you're as up there, I guess, as you were in Michigan. It's probably straight line across.

[00:04:49.980] – Coach Rachel

Pretty much, yeah. It's hot right now. Hot and humid, but I'll take it. I'll take it. It's just nice to be outside.

[00:04:59.460] – Coach Allan

Get you some chowder and plenty of lobster. You're going to make a drive out to the horn, the Cape?

[00:05:08.580] – Coach Rachel

I'm not sure how much time we'll have for that. Mike's got a couple of long days of work ahead of him, and then we'll just explore the areas close by. But yeah, we.

[00:05:17.570] – Coach Allan

Have no plans. It's like a four hour drive over, but it's beautiful over there. But if you had the time, it's worth the trip. But yeah, you got to spend some time if you're going to make it matter.

[00:05:29.240] – Coach Rachel

Right. Yeah, we'll just explore the areas around where we are.

[00:05:32.810] – Coach Allan

Well, cool. All right. You ready to talk about calories?

[00:05:36.300] – Coach Rachel



Today I want to talk about calories. If you've listened to me for any period of time, you know that I'm just not a huge fan of the calories in calories out model for a number of reasons we'll talk about today. But for a lot of people first starting out, counting calories can be a very beneficial activity because teaches you a little bit about how food works. And so today I want to give you the basics of how calories work in our body, how to do calories in, calories out, and then what to do when it stops working. Because for most people, it does stop working at some point, and that's because there are some limitations. But that said, it's a great way to jump start your journey to learn a lot about what you're eating and how much you're eating and what food is all about. So let's dive into it. Now, before we go too deep in this, calories in, calories out is a pretty simple basic thing. It's what I call just basically the pluses and minuses, the addition and subtract formulas for the way that you can lose weight and have enough energy.

That said, there are more complicated levels underneath this that, if they're not addressed, can cause you some problems. So the next level below that or above that, however you want to look at it, which is more complicated, you can think about the difference between addition and subtraction and when you started learning algebra is when we start talking about macronutrients and micronutrients. If we're not feeding our body what it needs, it's basically going to be a problem. So we can actually be overfed and undernourished. And so that happens a lot with the American diet, particularly with the processed foods and things that are going on today. But all that said, there is a more complex math underneath the calories in calories out model. But from a basic perspective, the calories in, calories out model is not wrong. They're both right. They just overlap. And then there's another level that's a little bit more deeper, a little bit more complicated. You can think of it as the calculus or differential equations. It's the complicated stuff that a lot of us won't be able to do a whole lot about, and that's hormones. Your hormones are going to affect how your body operates.

And so for certain individuals, no matter what they do, their hormones are going to be a progress slower, if you will. It's not going to stop you from necessarily losing weight. But you'll may notice that you don't lose weight as quickly as someone else does. So women have estrogen, men have testosterone. That additional testosterone makes it a little easier for men to lose weight. So if you notice that you and your significant other are basically eating the same foods, but they're losing weight and you're not, or you are losing weight and they're not, it's that hormones. It's not necessarily what you're eating or how much you're eating. It's just you're in a better balance from a hormone perspective to lose weight. So just realize that calories in, calories out is an easy to start model. Over time, it'll probably stop working for you. And that's when you want to start thinking about these other things and either set your expectations or make some adjustments to the quality of the food you're eating to make this continue to work for you. So let's get into the basics of calories in, calories out. A calorie is a measure of energy.

Now, when we use the term calorie, we're actually talking about kilo calories. But just to shorten it, we still call it a calorie. But a kilo calorie is basically the amount of energy necessary to warm one liter of water, one degree Celsius. And so we call it a calorie, but basically it is a measure of energy. And so the principles of what we're trying to do is we're trying to figure out exactly how many calories we're consuming and how many calories we are burning. And then the balance of those two or imbalance of those two is going to basically determine whether we're gaining weight or losing weight. So it's a thermodynamics of looking at energy into a system and energy out. Okay? So when we want to know what our energy burn is, most of the energy burn that we're doing when we're talking about it is a calculation. It's an estimate. So you get on one of those treadmills and it tells you for an hour's time running, you burn 400 calories. It's just an estimate. How they calculate that estimate inside that particular machine is particular to that machine. If you've ever gotten on one elliptical and then got on another elliptical and said, Well, I like the other elliptical more because within an hour I burn 700 calories, where this one says I'm burning 500, you're probably not burning 700 calories.

You may not be burning 500, but it's an estimate. And the only way you'd really know how much you were burning would be if you did some scientific tests where you were in a closed environment and they're measuring your carbon dioxide and they're measuring how much energy you're outputting. That's how they would know. But everything else is an estimate. Okay, now, when you start talking about the foods that we're consuming, for the most part, those are estimates too. What they've done for a lot of these different foods is they've burned them in a container and they've determined how much additional energy is put off when these things are set on fire. And that's assumed that our body would do the same thing, use the same amount of energy. So it's an estimate. And one of the other big issues is because these are both estimates, I prefer to look at these as guidelines and not absolute. But so many people get stuck in the math of, Oh, I'm eating 500 calorie deficit every day and I'm not losing weight. Or you go on to some of these applications and they tell you, You had a great day.

You're 1,000 calories under your requirement. If you eat like this for the next six weeks, you'll lose 30 pounds. And the reality is, one, you're not going to do that. Two, you may not have recorded your food right. And three, the estimates that are in there for your burn and for your consumption may be off. Okay, so what we want to try to do when we're looking at the food that we're eating and the energy that we're expending is just get an idea of balance. And so it gives us some basic information to make some decisions about how much we're eating and how much we're moving and what that means in relationship to each other. So let's dive a little bit deeper into each side of this calculation. So on the expenditure side, how many calories are you burning? Okay, one of the key terms that you'll hear is BMR. Okay, and BMR stands for basic metabolic rate. And what that means is how much do you need to just stay alive, meaning you're laying on your back in bed, completely at rest. How many calories do you need to stay alive? And that's keeping your brain alive, your organs alive, basic metabolic function.

And it's different based on age, gender, and your body composition. So you may have heard, if you have more muscle, burns more calories. And so that's where this all comes in. If you have more lean muscle mass, you're younger. And as I mentioned before, you're male, you're going to have a higher BMR than a woman. And it also has to do with your total size. So if you're 6 foot tall, you're going to burn more energy than someone who's 5 foot tall. So all of these things play into all of this burn. And so what you'll do with most of these things is you'll log in and they'll ask how tall you are, how much you weigh, and then they'll calculate a number. For most of us, the number is going to come somewhere between 1250 and 2,000. Again, that's a pretty wide range. But again, there's a wide range of people, so that range can be pretty wide. So if you're eating less than 1200 calories, it's very likely that you're under eating. You're not even giving your body enough to stay alive. And if you're out there doing exercise on top of that, that's even worse.

So that's where we come up with the term TD EE, or total daily energy expenditure. So if we're moving around, which most of us are, depending on our activity level, you add that to your BMR, and that will give you your total burn for the day. So I put into a calculator and I link to this as the Harris Benedict calculator, 40plusfitness. Com calorie will take you to that calculator. I didn't make that calculator. It's a website that just basically has that calculator, this link will just send you to that. But what it does, if you key in, okay, you're a 5 foot woman and you're basically sedentary, your basic metabolic rate is going to be just over 1200. If you're mildly active or you're sedentary, you're still going to burn more calories because you actually stand up every once in a while. You walk around, you got to go to the bathroom, you got to go to work. So you're moving around a little bit, just a little bit, and that's going to burn about 300 more calories. So for a basic woman to basically survive and deal with her daily expenditure, she's probably going to need, even a 5′ foot woman is going to probably need at least 1,500 calories just to stay in balance.

Now, if you're trying to lose a little bit of weight, you can go a little bit under that, but I would never go below your BMR. That's when you're starting to push yourself beyond. So what we want to do is basically say, okay, if I can up my activity, which we'll talk about and we can talk about, once you start actively increasing your activity, if you can just keep your food the same at roughly your TD EE, you're going to lose weight initially. So a good thing for this calculator is to say, what's the minimum amount I should eat? And that should at least be your BMR. I I would recommend you eat to your TD EE and then move more, just a little more. It doesn't have to be anything crazy, but if you can just add half an hour of activity each day, you're probably going to lose some weight there. Okay? So now let's talk about the consumption side. Okay? And again, this is just what we're trying to do is estimate how much energy is put off by the food that you're eating. And the only way you're really going to know that is to sit down and log it.

And the easiest thing I found to log it is an application called My Fitness Pal. They've got all these other foods out there so basically you can just plug this stuff in. There are other tools that other people have told me they like much more, but find your tool and this will help you in the initial. So what you want to do is you're going to look up what you're eating. So here I am eating a chicken breast and I'm going to have to look at how much that is. So what is that going to require? I need to weigh it. If I'm just estimating that this is a serving of chicken breast, it might be a larger breast or smaller breast. So I can't say both are the same number of calories. They're different. They're different sizes. So if you're going to do this and really get a good basis, you're probably going to need a food scale. You're probably going to need to go in and really pay attention to what goes into the foods that you're eating. Restaurants are notoriously off with their calorie counts. One study showed that they can be off by as much as 20 to 25 % understating your calories of a particular meal.

And so it's really easy to over consume and underestimate how much you've eaten. And so it's worth taking some time to sit down and log your food. But you've got to get the weight right. You've got to get how much you're getting, and you got to look at exactly what you're eating because just different additives, different things they put into it can really change the dynamics of how many calories are in a particular dish. It's a little easier, unfortunately, when you eat processed foods because they're putting it on the label. A serving of pasta has this many calories. A serving of hamburger helper mix has this many calories. So it's a little easier to look that stuff up. But that's not the nutrition your body needs. And so eventually, that's going to create a problem at those other math levels we talked about, the nutrition and the hormones. But that said, they make it a little bit easier for you to know. But if anytime you're eating something and you're not sure, like chicken breast, you can just Google, nutrition facts, chicken breast. If you're eating an apple, nutrition facts, and then the apple and the apple and just the size.

Is it small? Is it medium? Is it large? And that'll give you a basic idea. So now, as I mentioned, these are estimates. So your BMR and your TD EE are estimates of how much your body is burning. You're not actually ever going to really truly know that number, but you're getting an estimate. Unless you're going to take the time to weigh and measure all of your food, you're estimating how much of that you're eating. You're estimating serving sizes based on what's there. Even the numbers that are on the labels are estimates. So estimates of estimates, and you can see how this can run a little haphazard. Also, we sometimes miss things like grazing. So you didn't count on the fact that, or didn't think about, you're standing at your colleague's desk and they happen to have small chocolate there, and you popped two or three of those chocolate and you didn't log it. Well, that could have been 100 or more calories and you didn't log it. So you can see if you're not paying attention, it's easy to eat some things that you don't remember eating or you didn't get logged. So it looks on paper like you're at a deficit and maybe you aren't.

With labels, again, we're talking about processed foods here, and these things are engineered to make you want to eat more. So if you're sticking to processed foods as a way of doing this to make it a little easier, just realize they're engineering those foods to keep you hungry, to make you come back and eat more. They want you to eat more. That's how they make more money. So they're engineering their foods, and if they can fudge it on the label, they're going to fudge it on the label. So just be cognizant that processed foods are not really your friends, even if they make things a little easier and more convenient. The other thing that happens is in our bodies, as we exercise, as we do things physically, we become more efficient. I had Dr. Herman Pontzer on Episode 478. You can go to 40plusfitnesspodcast.com/478. And he went out and studied the Hadza tribe, which is in Tansania. It's one of the only remaining hunter gatherer tribes out there. And they had a way of counting the total number of calories expended, utilizing carbon and a process with the urine and water.

And it's complex. But at the same time, they were looking at how many calories these had stuff who were at least nine miles a day traveling to get the foods that they needed. And so you would think, Okay, here's some really lean athletic guys that are moving around a lot. They're not sitting around much at all. And the ladies are digging for tubulars, and their men are climbing trees to get honey, and they're traveling around hunting and gathering. And what they found was that these individuals had gotten so efficient with movement and their bodies that they weren't really burning many more calories than a sedentary office worker sitting at their desk. So it was about 2,500 calories, which is the basic man of the same height and weight, same age, would basically be burning the same number of calories each day just sitting at their desk doing their job. So realize that over time, your body might get more efficient at using the calories as you get more fit. And that's just the way it works. And so as you're thinking about food, there's a whole lot that's not calculated into any of this. And it can just make it really hard that you feel hungry all the time because you're trying to hit a calorie number.

And sometimes the reason is that we're not counting the thermic effect of food. So protein, for example, requires a lot more processing in our body to process, to make it into something we can digest. That digestion is what we call the thermic effect of food. So if you ate 100 calories of chicken, you're not going to get 100 calories of energy out of that chicken. You're going to basically burn some of that to digest that. Whereas it f you had sugar water, it's going to go right into your system and there's not much processing of that at all. So if you're drinking a Coke or a pop, whatever you want to call it, if you're drinking that, that's going right on. There's no thermic effect. It's just calories straight in. Whereas, again, if you're eating something that takes a little bit longer to digest, there's a cost and that cost means you're getting fewer calories from that. So we may undercount calories for some things. The other thing is there are certain foods that are going to make you feel more satiated. They're going to keep you from being hungry or sooner. Fiber and protein are two examples of that where you're just going to feel fuller sooner and longer, and that's going to help you actually eat less.

And then, of course, with a lot of folks that are trying to do the calories in calories out model, they just start eating too little. And what this leads to later is binge eating or private eating and not logging. I don't know how many times I've been looking at a log for someone, and they've got 700 calories logged. And I'm like, You can't go day after day on 700 calories. They're complaining they're not losing weight, but they're obviously not logging everything, or they're eating too little for a few days, and everything's just shutting down. And while you can't really destroy your metabolism, it is what it is. Your body will start to shut down organs and things. It will start shutting things down if it feels like you're in a stressed, starving mode, and it will start shooting cortisol into your system to help hold on to fat while you're losing muscle. So realize you might see some weight loss at that level, but you may very well be losing the wrong weight. You might be losing muscle and not fat. So you're going to want to eat really close to that BMR number, if not to the TD EE, which is what I would personally recommend when you start.

But just make sure you're eating good quality food and that you're doing the right things for your body because this is not just about calories in, calories out. It can work and it does work. So basically just be careful that you don't get yourself into a mindset of that calories in, calories out is the answer because there's a little bit more to it. So I want to summarize a little bit here and just say, okay, as you go through this process, just start with the basics. Get to know what your numbers are as far as your BMR and your TD EE. Get those in your head. Start learning what the calories are in the various foods that you eat each day, making sure, again, you're getting adequate nutrition, log it for a while and log it correctly. Weigh the food, do the right things, get everything in there so that you have a really good idea of the volume of food that you're eating, the amount of energy you're putting in, and then be thinking honestly about how much energy you're putting out each day, and then watch for trends. If things are not moving the way that you want to, we can make some adjustments, but you just got to start with the trend.

I'm eating this way and I'm losing weight. I'm going to keep eating this way. The other thing is pay attention to your satiety levels and the kinds of foods that you're eating. You need nutrition. Food is not just calories, food is not just calories. Food is everything. Our body is made from food. So if we're not getting enough fat, if we're not getting enough minerals and vitamins, and we're getting the macros our body needs, the protein, if we're not getting those things, our body will not function well, and that can be a problem. So make sure, again, you're paying attention to the food you're eating and how you feel eating that food. And then you can just make adjustments. And I would say make micro adjustments, small adjustments. So never this drastic drop another 500 calories off of this thing. Because again, if I'm saying your TDE is 1,500, 500 calories a deficit means you're at one third of what your body needs to function the way it's functioning. So eventually you're going to find yourself fatigued. You're going to have some issues, and that's where that's coming from. You just went too drastic. But if you're eating to your TDEE and then you're moving on top of that, then that's when you're going to start to see the action.

That's when you're going to start to see things move the way you want to. So again, I'm not a huge fan of calories in, calories out as a model for weight loss. I think you just need to eat high quality whole food and your body is probably going to do what it's supposed to do. But if you're interested and you want to give it a go from the start, it's not a bad exercise for a period of time to at least understand what you're eating, how the food is affecting your body weight, and how you feel when you start eating the amount of food that your body really needs.

Post Show/Recap

[00:25:46.960] – Coach Allan

Welcome back, Ras.

[00:25:48.760] – Coach Rachel

Hey, Allan. I think it's really important to talk about the calories in calories out model on occasion. It's like the best reminder to pay close attention to what we're eating, especially when we have a weight loss goal in mind. There's just so many ways that we can do it wrong. So it's nice to have this refresher.

[00:26:07.360] – Coach Allan

Well, I don't think there's any ways to do it wrong. In fact, seriously, if we go off culture, it's because we're just not paying attention. 99 % of it you realize, okay, well, why am I not losing weight? And then you realize, well, damn it, Sally's got a chocolate on her desk and I'm eating five or six of those every day when I go by there and say good morning. And so you're like, okay, I got to stop doing that. But I don't. I keep doing it. So it's usually just when we stop paying attention. Now, a lot of people will get into Keto and then they're like, okay, well, I'm losing all this weight on Keto. And then they stop losing weight and they get to this point, they're like, I don't understand. I know all the foods that are Keto foods. I'm not eating any carbs, but I'm not losing any weight. Well, you're eating too many calories. I'm like, Well, no, calories don't matter if you're… Yes, they actually don't matter. Yeah, it all matters. And so it's not a bad idea to at least know. And then the other side of it is, I think the other concern I always have is people under eating, really under eating, and that causes other issues.

[00:27:14.530] – Coach Allan

So they'll sit there and say, well, okay, if I can be 500 calories down, I could lose a pound a week. If I can be 1,000 calories a day down, then I could lose two pounds a week. If I'm 1,500 calories down, then I could lose three pounds per week. And I've got 30 pounds to lose. I'd love to lose that in 10 weeks. So let's just do the math.

[00:27:34.960] – Coach Rachel

More is better, right?

[00:27:37.810] – Coach Allan

I got to get on that treadmill for an hour every day and only eat 800 calories. And they're starving all the time. And then they stop really counting all the calories because they're like, Well, I'm just going to have a bowl of cereal. And they eat three bowls of cereal or four. There have been times I probably ate a whole box of cereal in a sitting, just not not knowing and thinking about how many calories were in it. And it wasn't that the cereal was the problem. I just had too many servings of it, and I wasn't paying attention to how much it was. I wasn't paying attention to whether I was full or not. I just was really hungry. I poured a whole bowl of cereal in a big bowl, a whole bunch of milk, and just sat down with a spoon watching morning TV on a Sunday. And that's all the calories I probably should have had for the whole day.

[00:28:27.820] – Coach Rachel

Well, that's where I've gone wrong in the past. I have a cereal bowl at home that maybe it looks like I have a half a cup, the serving size of most cereals, but I know full well that I pour way more in my cereal bowl than half a cup. And I just, I eyeball it, but my eyeballs aren't super accurate. My measuring cups are probably a little bit.

[00:28:49.810] – Coach Allan

More accurate. They would be just a little more accurate. You got to pack it in there. I'm going to get the most out of that half cup.

[00:28:58.300] – Coach Rachel

But then, like you mentioned, too, cereals are usually super satisfying, barely great on the palate. And one bowl becomes two bowls, which becomes three bowls. And you're watching the morning news or something. And did I have one bowl of cereal or four bowls of cereal?

[00:29:15.040] – Coach Allan

You'll lose track pretty easily. I just jumped the chase and got a big bowl and just went at it.

[00:29:20.360] – Coach Rachel


[00:29:21.610] – Coach Allan

I was a growing boy and not growing the right way. But I think if you're struggling and you get to a point where you're stuck, this is a tool to just go back and assess, how much am I really eating? It's not that you have to log all the time and track and weigh everything forever, but it's just getting your head reset about what a portion size looks like and how many calories in it. And then making some basic decisions and realizing, oh, I could have that whole salad over there with chicken breast on it and the dressing that I like, and that's 500 calories, or I can have this little bag of chips.

[00:30:03.390] – Coach Rachel


[00:30:04.370] – Coach Allan

I have the bag of chips and I'm hungry again in 20 minutes. Well, that's important. That salad is going to take me 20 minutes to eat. And so it's just this thing of just saying, okay, food is a building block and it's to provide calories for energy. And if you start thinking of it, yes, you should enjoy your food, have food that you enjoy, but know what's in it, know how much it is and start getting your head around what portion sizes are. E at a little slower. That'll make it easier to eat fewer calories because it's easy to eat a lot of calories if you eat really fast. You'll notice the people that are doing the eating contests on TV, they're not going slow. They're eating faster than their body can even pay attention to just so they can get all that stuff down. And so if you slow down, you'll feel satiated sooner. You'll get an idea when you start looking at it's okay, what's a serving of chicken breast look like? What does a serving of bread? Serving of bread is one slice of bread. Most loaves I've looked at, a serving of bread, who's eating one slice of bread?

[00:31:07.270] – Coach Rachel


[00:31:07.710] – Coach Allan

Already having two servings instead of having a sandwich. And you had two sandwiches, so four servings of bread. You get the idea. It's like, I think I'm eating 100 calories of bread. No, you're eating 250 calories of bread. And does that 150 calories mean a whole lot? Well, if it's 150 more than you needed, yeah, over time, that's going to add up. And so that's going to be extra pounds that you're not losing or you're trying to work off doing these exercises. And it's pretty easy. If I set up a thing of M&Ms in the little cup holder of your treadmill and I said, Okay, here's what I want you to do. Look at how many M&Ms are serving and look at how many M&Ms are now in the pack to get an idea. And say, okay, so if every M&M was like two calories, so walk long enough to burn two calories and then eat an M&M.

[00:31:58.950] – Coach Rachel


[00:31:59.340] – Coach Allan

Think you'll see that bag of M&M is going to wear you out. You'll be on that treadmill for an hour to eat a little bag of it because there's so many calories you got to burn the 300 calories for that little bag of M&Ms. And people don't think that. They think they're burning a lot more calories. So it's a guideline. If you find yourself stuck, it's just an opportunity to sit back. But in addition to looking at the calories, think about the types of foods you've been choosing and which ones are really the better foods for you. I'm not going to say there's good foods and bad foods, but there are better choices.

[00:32:29.900] – Coach Rachel

Well, like you had mentioned, our bodies need nutrients, not food. That's an important thing to look at. Way back when I was using my fitness pal, I was actually pretty shocked to learn that my favorite McDonald's meal was about 1,200 calories in just that one sandwich, aburger and fries meal. And that was my whole day's worth of calories, according to my fitness pal. And there's no nutrients in that meal.

[00:32:58.440] – Coach Allan

But there is some protein. There is some protein, they do put some niacin in the bun to fortify it because they've stripped all the nutrition out of it. If you had pickle, if you had a little bit of ketchup, some lettuce, maybe tomato, there's a little bit. There's not what your body needs, but there's some nutrition there. And so it's just this concept of eat better quality food. It'll be more nutritionally dense than calorie dense. The calorie dense foods, occasionally as a treat, you can work those in. If it fits your load and you're okay with a detour, by all means, you don't have to deprive yourself of things, but you shouldn't think you can have cake every day. No. A cake should be something special. Donut should be something special. They should not be a staple. And unfortunately, too many people get wrapped up into the, every evening I'm going to have ice cream. And then they're having… And it's not a serving of ice cream. It's like, how many servings of ice cream did you put in the bowl? Be honest with yourself. Get a good scoop size. Look at it, understand it, and know how many calories are in that thing, and then make the decision.

[00:34:15.560] – Coach Allan

And if you want to have an extra couple of hundred calories of ice cream in the evening, by all means. But the whole court owns a lot of calories. So just realize that calories do count. You don't have to count them to lose weight, but it is a tool to find yourself stuck.

[00:34:31.860] – Coach Rachel

Yeah. And I think logging a meal periodically or your favorite snack or something, just paying attention to the size of the serving you're taking and what macros are in it as well as the calories. It's just an eye-opening exercise to do. So even if you just logged a dinner meal or your favorite after-work snack or something like that, it's just an eye-opening thing to do periodically.

[00:34:57.610] – Coach Allan

I agree. Yeah. All right. Well, Ras, I'll talk to you. Enjoy Boston and I will talk to you next week.

[00:35:04.190] – Coach Rachel

Great. Take care, Allan.

[00:35:05.540] – Coach Allan

You too.

Music by Dave Gerhart


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