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Women in their 40s might suffer from redistribution of fat,

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and it generally tends to be around the midsection.

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Would you say that this is part of the natural aging process,

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or is there something we can actually do about this?

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You can always do something about it.

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Yes.

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What can we do?

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What can we do?

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MUSIC

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Hey, hey, and welcome to the 40s Formula,

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your go-to place for insightful discussions on navigating the 40s

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and thriving in this transformative decade.

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We're your hosts, Jasmin and Amanda,

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two women that are passionate about exploring the challenges

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and adventures that come with turning 40 and what lies ahead.

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MUSIC

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Dr. Mina Karelia-Ohman is a physician scientist

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and board certified lifestyle medicine doctor

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with over 25 years of research in cardiometabolic diseases,

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conducted at leading universities in Finland,

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the United States and Singapore.

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Her extensive publications in top tier journals

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cover critical topics such as obesity, cardiovascular disease and diabetes.

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In recent years, Dr. Mina has dedicated herself to advancing lifestyle medicine,

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becoming board certified lifestyle medicine physician in 2022.

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A year later, she founded Karelia Health,

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where she works locally and internationally

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to promote evidence-based lifestyle interventions

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that prevent, treat and even reverse disease.

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Through Karelia Health, she not only educates health care professionals

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and the public, but also consults private clients, start-ups

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and large healthcare organisations on the science of health-promoting lifestyle

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and how to apply it in real life.

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Dr. Mina is also the founding president

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of the Singapore Society of Lifestyle Medicine, established in 2023,

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where she is driving initiatives that place lifestyle

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at the forefront of healthcare.

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Last but not least, Dr. Karelia is a registered yoga teacher,

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a nature lover and a mother of two

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and lives in Singapore with her husband for over 24 years.

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We are so excited to have Dr. Mina here with us today on the 40s Formula

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and the reason we're so excited is because we are going to be talking about lifestyle medicine.

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Now, lifestyle medicine has been gaining some popularity recently.

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There seems to be this shift towards preventative and holistic approach in healthcare.

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But for some people who haven't heard of the term lifestyle medicine,

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could you please explain to us what that actually means

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and how it differs from the traditional medical approaches?

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Sure. So lifestyle medicine is a medical specialty

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that uses evidence-based therapeutic lifestyle interventions

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as primary modality to treat disease, prevent disease, treat disease,

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manage, even reverse disease.

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And it's really a patient-centred approach compared to conventional medicine,

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where the patient is like a passive receiver of the care.

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In lifestyle medicine, patient really takes an active role in all this holistic care model.

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And the doctor works with the patient and it's also a multidisciplinary team

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that can help the doctor and the patient

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to carve out this perfect lifestyle intervention for that particular patient.

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So for someone who's in their 40s who hasn't had any sort of previous history of illness,

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should they consider this type of approach or should they wait until something happens?

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When is the best time to introduce lifestyle medicine?

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Oh, from early on. The earlier the better, for sure.

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I mean, it really starts from the childhood or even when the baby's in the womb still.

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But yeah, so the earlier the better because a lot of the chronic diseases,

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they actually take decades to develop.

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And that's why your prevention should also start decades before these diseases develop.

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So really in the childhood, if you establish healthy eating habits, physical activity,

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sleeping habits, these really carry a huge gains later on in life

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because it's much easier than to maintain these healthy habits into adulthood.

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And yeah, if you haven't started the healthy habits earlier, then it's never too late.

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You can always, always improve your health and prevent more diseases from happening.

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And I, for one, I'm so glad that you brought up sleep.

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So I have three little kids at home.

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So I have a four year old, a three year old and now an eight month old.

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And we are absolutely crazy about sleep.

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I mean, I will go to such great lengths to protect my kids sleep routine.

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And first of all, to establish that routine, right?

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And the consistency, the bedtimes, the wake times, everything, and then to protect it.

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Right. So we say no to any invitation for any birthday party or whatever

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that happens after 5 p.m. It doesn't happen in my house because my kids are in the bathtub

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by 5 45 because they're in bed by 6 30.

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And so, you know, it's funny that you mentioned like establishing things in childhood

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makes it so much easier and kind of more natural to then have proper sleep hygiene as an adult.

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Right. Yes. Are there other things that you think that parents with with kids of either

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my age or older kids, right, should be doing with their families from young to really help

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establish, set them up for success in their later years?

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Yeah, yeah. So, I mean, eating habits are one one definitely big thing.

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I mean, the lifestyle medicine, I should have mentioned in the first first question,

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like actually there are six pillars in lifestyle medicine that are healthy eating

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and really like plant predominant eating pattern and the physical activity,

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restorative sleep, but also stress management and avoidance of risky substances

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and then positive social connections.

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And we can talk about all these in detail later.

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But so from the early childhood, if you have all these in your life,

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you definitely are in a very good track in your adulthood and preventing all the chronic diseases.

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But these are all applicable for later ages as well.

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Yes. But if if you learn these in the childhood, it's been shown, for example,

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in obesity research in decades ago, because my PhD actually was on obesity.

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Million years ago. But yeah, so it was shown that in families where they had meal times together,

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everyone was eating on the same at the same table.

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These kids were in a reduced risk of developing obesity later.

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So the usually the common meal times in in families, they really are associated

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with the healthy eating patterns and stronger social connections.

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And all these protect from chronic diseases later in life.

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Yeah, that's getting two big pillars.

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Yeah. And yeah, exactly. It fits in perfectly.

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And it's funny, isn't it? You'll go to a restaurant and you'll say,

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oh, can I have the kids menu? And the kids menu is French fries, chicken nuggets,

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maybe a bolognese. Yeah, bolognese is probably the lightest food.

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And and, you know, these are the types of things that are not setting up the child's for better

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eating habits throughout their lifetime, because I do know adults now who still don't eat

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vegetables, who still don't, you know, get enough fiber in their diet.

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And and I guess all these habits start from when they're younger.

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But how much of these habits are, I guess, lifestyle driven versus maybe a change in the gut

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microbiome? Do you think that that that can affect how people eat as well?

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Oh, everything affects everything. OK.

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So how the how the six pillars actually synergize to promote the health and affect each other is

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is really, you know, they can either form a vicious cycle or then you can like,

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you know, go back and restore everything because the gut microbiome, healthy gut microbiome

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that starts with eating fiber every day and fiber you only get from plants.

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So that really can support your metabolism, your brain health, gut health, reduce inflammation.

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And when your gut health is good and supporting you, like reducing chronic low grade inflammation,

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for example, you have a easier time to sleep.

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You have less pains. I mean, if you're going to talk about menopause.

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Yes, very, very important.

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If you are physically active, you have a better sleep quality also.

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Physical activity also contributes to microbiome.

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And if you are sleep deprived, that's being associated with inflammation levels,

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higher inflammation levels, and inflammation in itself actually feeds to leakiness of the gut.

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And so other things like risky substances, substances like tobacco and alcohol,

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they contribute the microbiome, deteriorating that.

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And whatever else, the positive social connections.

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This is really important to understand that also the positive social connections

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contribute to your stress levels and they can actually, there was a study I want to mention really.

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It's so remarkable, I think, if you have acts of kindness towards other people

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versus towards yourself, the kindness towards other people actually reduces

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the gene expression level of your inflammatory genes.

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Wow.

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Yes.

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That's amazing.

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Yes, yes, it is.

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So take two doses of Being Kind and call me in the morning.

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Yes. So really, all the six pillars are tightly linked and can support each other

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in creating more health and promoting health.

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And just to mention about the chronic low-grade inflammation,

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it's really present in all chronic diseases.

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It really contributes all the diseases in the end that we think like cardiovascular disease,

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diabetes, any kind of lung diseases, autoimmune diseases, other brain neurodegenerative diseases,

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they're all linked to chronic low-grade inflammation.

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Yeah.

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It's scary, isn't it, like how much it can affect, like inflammation,

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how much it can affect your body in so many different ways.

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Yes.

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So going back to menopause and possibly obesity, women in their 40s might suffer from

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redistribution of fat and it generally tends to be around the midsection.

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And we know that this could be because of, say, low muscle tone, low estrogen.

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Would you say that this is part of the natural aging process

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or is there something we can actually do about this?

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You can always do something about it.

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Yes.

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What can we do?

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What can we do?

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And now back to the show.

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So, but yes, for sure it's part of the natural process called aging.

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You've never heard of it.

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Yes.

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You know, we start to lose muscle.

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It starts in our 30s already, right?

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But it becomes more visible actually in our 40s.

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And then when we start to lose muscle mass gradually, muscle is metabolically more active

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than adipose or fat tissue.

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And that then, if we have less muscle mass, our basal metabolic rate will be also lower

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because muscle burns more energy than fat tissue, right?

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So this is one factor.

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Then other is the hormone levels.

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Estrogen, protesterone, you must know all this.

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And when they start to also lower down, this will affect how our fat is distributed in

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the body.

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So it starts to go towards the male, you know, fat accumulation to the midsection, the belly

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fat.

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And also what happens in our 40s, we can be at the life stage that we are really surrounded

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by multiple stress factors.

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So whether we have young kids or teenage kids, you know, it can be a source of stress.

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Kids are just stressful.

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Yeah.

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But also a source of happiness.

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But then we can have elderly parents that we may be, you know, taking care of.

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That can create a lot of stress.

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So if we don't have kids or elderly parents, we can be in our work life.

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We can be in already like climbing the ladder and be at the more positions of high responsibility

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and high stress.

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And so there are all these different factors that contribute to your stress.

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And what happens in stress is your cortisol levels go up.

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And what cortisol does to your fat distribution, it's the same thing than the male.

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Your body starts to accumulate to the midsection.

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Plus if we have because of the hormone fluctuations in perimenopause, menopause, and all the stress

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factors, our sleep can deteriorate.

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And this again increases inflammation, stress levels again contributes to the fat accumulation

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to the midsection.

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So there's really multiple factors.

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It's like these cogs, isn't it?

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Like when one gets jammed, then everything is screwed.

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Yeah, yeah, yeah.

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But you can implement all the six pillars and then they work in synergy to help you

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in this.

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And Dr. Mina, I have to push on something that you brought up, Dr. Tash brought up,

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which she was with us, and that I think our listeners really need to hear again, which

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is the role of muscle, right?

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The role of metabolically active tissue that is muscle.

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I'm just thinking about a patient that we had in today in our clinic and came in with

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the presenting concerns that exactly what Jasmine was talking about, right?

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So widening midsection, is it my hormones and my perimenopausal, right?

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I'm in my late 40s.

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And the first thing she said was, I, my exercise routine is spot on.

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Perfect.

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I run, I do spin class, I do Pilates.

239
00:15:32,720 --> 00:15:36,240
And I said, and where do we do our progressive strength training?

240
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And she was like, oh, no, no, no, I don't want to get too bulky.

241
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Can you talk to women specifically as a woman and as a doctor about what is the difference

242
00:15:44,640 --> 00:15:48,440
between, I guess, lean muscle and the perception of bulk?

243
00:15:48,440 --> 00:15:52,680
I guess that's a very, you know, subjective question.

244
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What is bulky?

245
00:15:53,680 --> 00:15:54,680
Yeah.

246
00:15:54,680 --> 00:16:00,160
But I don't think women in general need to be worried about building too big muscles.

247
00:16:00,160 --> 00:16:06,640
Actually you would need to do a lot of strength training to build bulky muscles and eat tons

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and tons of protein.

249
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And normally women just don't do that.

250
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I mean, women who compete in these areas.

251
00:16:14,440 --> 00:16:15,440
Amanda's been trying hard.

252
00:16:15,440 --> 00:16:16,440
Yes, exactly.

253
00:16:16,440 --> 00:16:19,440
Every day of my life.

254
00:16:19,440 --> 00:16:22,240
Amanda, you know how much I love Little Farms?

255
00:16:22,240 --> 00:16:23,240
Well, guess what?

256
00:16:23,240 --> 00:16:26,600
They've just come on as a sponsor and I am so bloody excited.

257
00:16:26,600 --> 00:16:27,600
Oh, me too.

258
00:16:27,600 --> 00:16:28,600
I love the Little Farms.

259
00:16:28,600 --> 00:16:30,240
Isn't just a grocery store.

260
00:16:30,240 --> 00:16:35,760
It's been a go-to for top quality, all natural groceries and delicious cafe meals since 2016.

261
00:16:35,760 --> 00:16:36,760
Same.

262
00:16:36,760 --> 00:16:39,440
And their commitment to whole food nutrition is amazing.

263
00:16:39,440 --> 00:16:42,760
Did you know they've got a band ingredients list with over 200 items.

264
00:16:42,760 --> 00:16:48,300
That means no artificial preservatives, flavors or colors, only real all natural ingredients.

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00:16:48,300 --> 00:16:50,880
That is one of the reasons that I trust them so much.

266
00:16:50,880 --> 00:16:54,640
Every product on their shelves has been carefully vetted, making it really easy for us to make

267
00:16:54,640 --> 00:16:56,760
healthier choices for our families.

268
00:16:56,760 --> 00:16:58,440
And they've really expanded.

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00:16:58,440 --> 00:17:03,680
Now with six restaurants including their all-day brand new dining spot in Sentosa.

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00:17:03,680 --> 00:17:07,680
Each one has a consistent menu but also features unique dishes tailored to the neighborhood

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00:17:07,680 --> 00:17:11,520
like rendang, lamb shank and sesame tuna tisaki.

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00:17:11,520 --> 00:17:16,200
Plus they've got amazing weekly deals like one for one small plates on Tuesdays, happy

273
00:17:16,200 --> 00:17:21,320
hour on Thursdays and my personal fave, the kids eat free on Sundays.

274
00:17:21,320 --> 00:17:23,640
And for our listeners, we have an exclusive offer.

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00:17:23,640 --> 00:17:29,400
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00:17:29,400 --> 00:17:31,080
a hundred dollars.

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00:17:31,080 --> 00:17:35,720
It's perfect for stocking up on premium groceries, wellness supplements and ready to eat meals.

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00:17:35,720 --> 00:17:39,760
Whether you're dining in, grabbing groceries or stocking up on wellness products, Little

279
00:17:39,760 --> 00:17:43,360
Farms has everything you need to eat well and live well.

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Now back to the chat.

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00:17:48,440 --> 00:17:53,840
Women also secretes small amounts of testosterone from ovaries and that also starts to go down

282
00:17:53,840 --> 00:17:55,440
with age in women.

283
00:17:55,440 --> 00:18:01,840
So it's like the female hormones and testosterone is needed for bulky muscles too.

284
00:18:01,840 --> 00:18:06,520
So it's just simply impossible to really build those bulky muscles as well as you're using

285
00:18:06,520 --> 00:18:08,520
some anabolic steroids or something.

286
00:18:08,520 --> 00:18:13,480
But you need support in this building.

287
00:18:13,480 --> 00:18:18,200
But women should understand that really the strength training is essential for bone health

288
00:18:18,200 --> 00:18:25,320
as well, really to prevent the osteoporosis, which has to be a big risk factor after menopause.

289
00:18:25,320 --> 00:18:29,280
And that would be to sort of help with, I guess, in case you fall, there's a higher

290
00:18:29,280 --> 00:18:33,920
chance of hip fractures and bone fractures, which could then possibly lead to an earlier

291
00:18:33,920 --> 00:18:37,720
death if you've got weaker bones.

292
00:18:37,720 --> 00:18:41,280
Now I think a lot of people, when they think about making lifestyle choices, they think

293
00:18:41,280 --> 00:18:42,280
they have to do something drastic.

294
00:18:42,280 --> 00:18:45,040
You know, they have to severely cut calories.

295
00:18:45,040 --> 00:18:47,640
They have to exercise every day.

296
00:18:47,640 --> 00:18:53,200
Is this the case with lifestyle medicine or are there sort of small realistic changes

297
00:18:53,200 --> 00:18:59,480
or things that people can implement to make a difference in their life?

298
00:18:59,480 --> 00:19:02,200
So lifestyle medicine works.

299
00:19:02,200 --> 00:19:06,840
It works those responsibly, just like drugs, right?

300
00:19:06,840 --> 00:19:14,280
So if you want to make big changes in whatever you want to change, then yeah, big changes

301
00:19:14,280 --> 00:19:16,080
can make wonders, right?

302
00:19:16,080 --> 00:19:18,040
They can do wonders.

303
00:19:18,040 --> 00:19:22,200
But more important actually is consistency, right?

304
00:19:22,200 --> 00:19:26,840
And in lifestyle medicine in general, the health coaching in general, the patient really

305
00:19:26,840 --> 00:19:32,320
defines how they want to go about it, how big of a goals they want to take and start

306
00:19:32,320 --> 00:19:34,080
building on that.

307
00:19:34,080 --> 00:19:38,840
So that is really dependent on the patient's motivation.

308
00:19:38,840 --> 00:19:44,560
And then the lifestyle medicine doctor works with the patient, you know, how the patient

309
00:19:44,560 --> 00:19:49,080
chooses what they want to do, how much you build these smart goals and yeah, you know

310
00:19:49,080 --> 00:19:50,080
what that is, right?

311
00:19:50,080 --> 00:19:53,080
But sorry, for people who've never had a smart goal before, could you just...

312
00:19:53,080 --> 00:19:57,680
Oh, a smart goal is a specific, measurable, attainable...

313
00:19:57,680 --> 00:19:58,680
We say relevant.

314
00:19:58,680 --> 00:19:59,680
Oh, yeah, yeah.

315
00:19:59,680 --> 00:20:00,680
Relevant, yes, right.

316
00:20:00,680 --> 00:20:01,680
And timely.

317
00:20:01,680 --> 00:20:02,680
Relevant and time-bound, right.

318
00:20:02,680 --> 00:20:03,680
Yeah.

319
00:20:03,680 --> 00:20:07,120
So this can be like, for example, if you want to change your eating patterns towards more

320
00:20:07,120 --> 00:20:16,120
plant-based, you would think like, okay, so I would want to increase my broccoli intake

321
00:20:16,120 --> 00:20:23,560
and so I would start to eat broccoli two times per week with dinner, something like this.

322
00:20:23,560 --> 00:20:29,680
So it's quite measurable, it's time-bound and yeah, for the next four weeks or something,

323
00:20:29,680 --> 00:20:30,680
right?

324
00:20:30,680 --> 00:20:31,680
Something like this.

325
00:20:31,680 --> 00:20:32,680
Yeah.

326
00:20:32,680 --> 00:20:35,480
So it's not just saying, rather than just saying, oh, I'm going to eat healthy.

327
00:20:35,480 --> 00:20:36,480
Oh, yeah, yeah.

328
00:20:36,480 --> 00:20:37,480
Eating healthy kills me.

329
00:20:37,480 --> 00:20:38,480
Yeah.

330
00:20:38,480 --> 00:20:39,480
Even eat more vegetables.

331
00:20:39,480 --> 00:20:40,480
Yes, yes.

332
00:20:40,480 --> 00:20:42,480
Not specific enough, like when, how?

333
00:20:42,480 --> 00:20:44,160
Yes, yes, yes, yes, yes, yes.

334
00:20:44,160 --> 00:20:45,160
What kind of vegetables?

335
00:20:45,160 --> 00:20:46,160
Yeah.

336
00:20:46,160 --> 00:20:47,160
Is it like...

337
00:20:47,160 --> 00:20:48,160
Potato?

338
00:20:48,160 --> 00:20:49,160
Yeah, deep fried.

339
00:20:49,160 --> 00:20:50,160
Yes.

340
00:20:50,160 --> 00:20:51,160
More fried vegetables.

341
00:20:51,160 --> 00:20:53,520
Yeah, not potato chips or fries.

342
00:20:53,520 --> 00:20:54,520
Yeah, yeah, yeah.

343
00:20:54,520 --> 00:20:57,800
So really whole foods and yeah.

344
00:20:57,800 --> 00:20:59,800
So you've mentioned obviously plant-based a few times.

345
00:20:59,800 --> 00:21:05,720
Would you say that there is a particular diet or a particular way of eating that can benefit

346
00:21:05,720 --> 00:21:08,080
most people?

347
00:21:08,080 --> 00:21:13,640
Everyone will benefit from eating whole plant-based foods.

348
00:21:13,640 --> 00:21:14,640
Yes.

349
00:21:14,640 --> 00:21:19,560
So really increasing the vegetable intake because they contain so many good things for

350
00:21:19,560 --> 00:21:26,740
you, vitamins, all the phytonutrients, polyphenols.

351
00:21:26,740 --> 00:21:31,680
And then really thinking about how much you're eating sugar.

352
00:21:31,680 --> 00:21:36,880
So these are the refined carbohydrates that the fiber has been taken out.

353
00:21:36,880 --> 00:21:41,600
And you know, when the industry processes the foods, so the ultra-processed foods, they

354
00:21:41,600 --> 00:21:47,240
usually do not contain any fiber anymore because industry wants these products to stay, have

355
00:21:47,240 --> 00:21:50,120
a long shelf life.

356
00:21:50,120 --> 00:21:57,200
And also saturated fat is one thing that has been consistently shown in preclinical and

357
00:21:57,200 --> 00:22:02,680
clinical studies to be associated with increased cardiovascular disease risk.

358
00:22:02,680 --> 00:22:08,280
And so intake of salt is something that you really should pay attention to that contributes

359
00:22:08,280 --> 00:22:14,400
to hypertension or high blood pressure, a very severe risk factor for cardiovascular

360
00:22:14,400 --> 00:22:19,760
disease, stroke and heart attacks.

361
00:22:19,760 --> 00:22:22,560
And kidney disease also.

362
00:22:22,560 --> 00:22:23,560
So what was there?

363
00:22:23,560 --> 00:22:28,320
Sugar, salt and saturated fat, yes.

364
00:22:28,320 --> 00:22:32,760
And then really the fiber intake, which comes from plants.

365
00:22:32,760 --> 00:22:36,720
So fiber is only present in plants.

366
00:22:36,720 --> 00:22:41,240
So when someone buys something from a supermarket that says plant-based and it comes in a nice

367
00:22:41,240 --> 00:22:47,320
wrapper that's green, would you say that that is then, oh yeah, that's fine to eat?

368
00:22:47,320 --> 00:22:52,360
Or would you say, because you mentioned ultra-processed there, or would you say that when you are

369
00:22:52,360 --> 00:22:57,560
going plant-based, you should actually be focusing on whole foods?

370
00:22:57,560 --> 00:22:58,560
Yes.

371
00:22:58,560 --> 00:22:59,560
Yes.

372
00:22:59,560 --> 00:23:00,560
Not processed.

373
00:23:00,560 --> 00:23:06,880
So just think about like rather eating a whole fruit, which contains the fiber, intact fiber,

374
00:23:06,880 --> 00:23:12,400
than drinking fruit juice, for example, or eating like an apple pie and McDonald's.

375
00:23:12,400 --> 00:23:13,400
Yes.

376
00:23:13,400 --> 00:23:19,840
Oh, damn it, I thought that was part of my one-a-day, one-fiver-day.

377
00:23:19,840 --> 00:23:26,380
And then the vegetable, you've heard this, eat the rainbow.

378
00:23:26,380 --> 00:23:32,440
So really the different colors, because they contain different kind of polyphenols and

379
00:23:32,440 --> 00:23:34,240
beta carotenes.

380
00:23:34,240 --> 00:23:39,840
So that's essential for everything, for brain health, for endothelial health, if you want.

381
00:23:39,840 --> 00:23:46,680
So cardiovascular health, gut health, reducing inflammation.

382
00:23:46,680 --> 00:23:52,720
And then also think about the protein sources, that even the protein source can contain fiber

383
00:23:52,720 --> 00:24:01,320
if you eat nuts and seeds and legumes, especially legumes, so beans and lentils and that stuff.

384
00:24:01,320 --> 00:24:05,400
And for women especially, if we go back to menopause a little bit.

385
00:24:05,400 --> 00:24:13,440
So a natural way to get the estrogens is eating soy, soybeans.

386
00:24:13,440 --> 00:24:18,720
So for example, tofu, tempeh, natto, miso, drinking soy milk.

387
00:24:18,720 --> 00:24:25,600
There was a study done a couple of years ago showing that menopausal women that had hot

388
00:24:25,600 --> 00:24:33,980
flashes, if they ate half a cup of soybeans for, I think 12 weeks was the study duration,

389
00:24:33,980 --> 00:24:37,560
they could cut their hot flashes by 80%.

390
00:24:37,560 --> 00:24:38,560
Wow.

391
00:24:38,560 --> 00:24:41,540
Yes, that's what I was missing out on.

392
00:24:41,540 --> 00:24:49,800
So the soy contains a phytoestrogen or isoflavone, which binds to, so there's two different kind

393
00:24:49,800 --> 00:24:54,520
of estrogen receptors in the body, estrogen receptor alpha and then beta.

394
00:24:54,520 --> 00:25:02,320
So our own estrogen hormones and hormone replacement therapy hormones, they bind to alpha receptor,

395
00:25:02,320 --> 00:25:09,840
whereas the phytoestrogens from soy or other beans actually also, they bind to beta receptor.

396
00:25:09,840 --> 00:25:12,760
And these receptors are in different tissues actually.

397
00:25:12,760 --> 00:25:17,480
So when you eat the soy products, you can actually improve your bone health and vascular

398
00:25:17,480 --> 00:25:20,440
health and brain health.

399
00:25:20,440 --> 00:25:28,400
And you don't increase the risk of if there is a risk after menopause with the hormones.

400
00:25:28,400 --> 00:25:32,280
And what would you say to our listeners who, Jasmine kind of mentioned this with the example

401
00:25:32,280 --> 00:25:35,920
of the plant-based packaging, but it's like, okay, they hear this podcast and they say,

402
00:25:35,920 --> 00:25:36,920
soy, great for me.

403
00:25:36,920 --> 00:25:40,200
Now I'm going to get my soy milk at Starbucks every day.

404
00:25:40,200 --> 00:25:45,400
And not realizing that a lot of the commercially available soy milk products are heavily sweetened

405
00:25:45,400 --> 00:25:46,960
process, et cetera.

406
00:25:46,960 --> 00:25:53,000
So how do you help your patients look for the right kinds of soy products?

407
00:25:53,000 --> 00:25:56,520
Definitely you go to the most original nature packaging, right?

408
00:25:56,520 --> 00:26:01,840
From nature, like Edamame beans, like you kind of get more closer than that.

409
00:26:01,840 --> 00:26:02,840
Right?

410
00:26:02,840 --> 00:26:04,800
So the less unprocessed, the better.

411
00:26:04,800 --> 00:26:07,320
Always, always applies to everything.

412
00:26:07,320 --> 00:26:08,320
Yeah.

413
00:26:08,320 --> 00:26:13,720
So soy milk, yes, you have to carefully look at the sugar content and what is added there.

414
00:26:13,720 --> 00:26:18,960
If there's like these are emulsifiers that are not good for your gut health.

415
00:26:18,960 --> 00:26:22,760
But yeah, so like I said, you know, soybeans would be the best.

416
00:26:22,760 --> 00:26:27,460
And then the fermented soy is even better because from fermented foods, you get the,

417
00:26:27,460 --> 00:26:32,360
you know, enrichment of the microbiome, tempeh and natto and liso.

418
00:26:32,360 --> 00:26:38,460
Going back to sort of gut health, obviously eating plenty of fiber, introducing probiotics

419
00:26:38,460 --> 00:26:40,160
and prebiotics.

420
00:26:40,160 --> 00:26:47,520
I also heard that giving your gut a rest is a good idea to help with your sort of microbiome.

421
00:26:47,520 --> 00:26:49,240
So what are your thoughts on intermittent fasting?

422
00:26:49,240 --> 00:26:52,360
I feel like that seems to be quite a buzzword.

423
00:26:52,360 --> 00:26:54,880
Everyone's either tried it or are trying it.

424
00:26:54,880 --> 00:27:01,560
What are your thoughts about intermittent fasting or time restricted eating?

425
00:27:01,560 --> 00:27:06,520
There are studies that show benefits from it, for sure.

426
00:27:06,520 --> 00:27:14,280
I don't think it's absolutely necessary for you to be, you know, super healthy.

427
00:27:14,280 --> 00:27:24,320
But it can help people if they try to find different ways to, for example, reduce whatever

428
00:27:24,320 --> 00:27:31,040
they are eating, that if they need to lose weight, it can be one of the methods.

429
00:27:31,040 --> 00:27:36,600
How you, you know, you find your own solutions what works best for you.

430
00:27:36,600 --> 00:27:43,320
Definitely the 12 hour fast window, overnight 12 hour fast is recommendable because yes,

431
00:27:43,320 --> 00:27:44,320
you're very right.

432
00:27:44,320 --> 00:27:50,880
The gut should have, should give, should be given time to rest process from the processing

433
00:27:50,880 --> 00:27:53,160
of all the food digestion.

434
00:27:53,160 --> 00:28:00,400
And I have a longer than 12 hour overnight fast myself, but I wouldn't say that it's

435
00:28:00,400 --> 00:28:03,400
needed, but you can experiment with it.

436
00:28:03,400 --> 00:28:04,400
Yeah.

437
00:28:04,400 --> 00:28:07,600
So 12 hours should just be not even considered a fast.

438
00:28:07,600 --> 00:28:08,600
That's just your overnight.

439
00:28:08,600 --> 00:28:09,600
That's right.

440
00:28:09,600 --> 00:28:10,600
Sleeping.

441
00:28:10,600 --> 00:28:11,600
That should be the basic.

442
00:28:11,600 --> 00:28:12,600
Absolutely basic.

443
00:28:12,600 --> 00:28:18,280
And then anything more than that, then that's obviously a tool that you could use if you

444
00:28:18,280 --> 00:28:25,400
are either looking to, I guess, optimize weight management or so it's not like it's needed,

445
00:28:25,400 --> 00:28:28,080
but it could be used as a tool if it works for you.

446
00:28:28,080 --> 00:28:29,080
Yes.

447
00:28:29,080 --> 00:28:30,080
Yes.

448
00:28:30,080 --> 00:28:34,760
I mean, there are different approaches also in there are publications, for example, from

449
00:28:34,760 --> 00:28:44,280
Valter Longo, one of the longevity researchers looking at fasting in itself to for diabetes

450
00:28:44,280 --> 00:28:51,480
patients to restore the glucose metabolism, how it should actually work to get rid of

451
00:28:51,480 --> 00:28:53,280
insulin resistance.

452
00:28:53,280 --> 00:29:00,640
So in his methods, they tried fasting for, I think between three to five days or three

453
00:29:00,640 --> 00:29:06,160
to four days each month, like like the cyclical fasting.

454
00:29:06,160 --> 00:29:10,680
And then, so eating very low calorie diet for these very specific, it's only plant based

455
00:29:10,680 --> 00:29:18,840
diet in these few days in a month and then doing this for a few months in a row.

456
00:29:18,840 --> 00:29:26,600
And this can actually lead to very good results in reduction in in those glucose markers like

457
00:29:26,600 --> 00:29:33,720
HbA1c, glycated hemoglobin, which is one of the markers in diabetes, fasting glucose

458
00:29:33,720 --> 00:29:34,720
of all this.

459
00:29:34,720 --> 00:29:42,760
So yes, body is a very wise in itself and it knows if you give it a chance, it actually

460
00:29:42,760 --> 00:29:48,240
can start repairing itself if you stop damaging it.

461
00:29:48,240 --> 00:29:49,440
Yeah, that's the key.

462
00:29:49,440 --> 00:29:50,440
That's the key, isn't it?

463
00:29:50,440 --> 00:29:53,760
Stop damaging it.

464
00:29:53,760 --> 00:29:54,760
Stop beating yourself up.

465
00:29:54,760 --> 00:30:01,520
So Dr. Mina, what do you wish every woman in her 40s would know about her health, her

466
00:30:01,520 --> 00:30:02,520
body?

467
00:30:02,520 --> 00:30:08,600
Because it's something you'd love to sort of shout from the rooftops, Nazi shawls.

468
00:30:08,600 --> 00:30:16,280
I would want women to understand that their bodies are actually constantly changing throughout

469
00:30:16,280 --> 00:30:19,080
their lifetime compared to men, right?

470
00:30:19,080 --> 00:30:27,280
We really go through various, you know, different phases in our life and even every month, right?

471
00:30:27,280 --> 00:30:30,040
Because of the hormones.

472
00:30:30,040 --> 00:30:36,160
So don't beat yourself up and also understand that women, if we're now comparing to men,

473
00:30:36,160 --> 00:30:44,120
since you said women, I guess, women tend to take a lot of responsibility for other

474
00:30:44,120 --> 00:30:49,360
people, but not not really taking care of good, really good care of themselves.

475
00:30:49,360 --> 00:30:52,920
Oftentimes they abandon themselves.

476
00:30:52,920 --> 00:30:56,960
And this is something that I really want to remind.

477
00:30:56,960 --> 00:31:02,680
It's really important to give value to yourself, to really take care of yourself.

478
00:31:02,680 --> 00:31:11,320
And especially in the 40s, if we go to this period of time, there's is really a decade

479
00:31:11,320 --> 00:31:14,960
of huge transformations that can happen.

480
00:31:14,960 --> 00:31:21,320
You can start in your peak performance, early 40s, and then you can go to the rock bottom

481
00:31:21,320 --> 00:31:25,000
in your late 40s because of the transition.

482
00:31:25,000 --> 00:31:30,520
Also because the body is aging very rapidly in your late 40s.

483
00:31:30,520 --> 00:31:37,560
There's a couple different time points in the human lifespan where the aging happens

484
00:31:37,560 --> 00:31:38,680
really rapidly.

485
00:31:38,680 --> 00:31:42,200
One is late 40s, one is around 65.

486
00:31:42,200 --> 00:31:50,360
I think I saw an email, part of Peter Attia mailing list, and he specifically gave the

487
00:31:50,360 --> 00:31:51,360
age 44.

488
00:31:51,360 --> 00:31:52,360
I was like, God, I've got two years left.

489
00:31:52,360 --> 00:31:53,360
Two years left.

490
00:31:53,360 --> 00:31:57,880
And you're talking about rapid aging?

491
00:31:57,880 --> 00:32:00,600
When you say rapid aging, do you literally mean cellular aging?

492
00:32:00,600 --> 00:32:04,520
Do you mean metabolic demise?

493
00:32:04,520 --> 00:32:07,680
What are the markers of aging that unfortunately we have to be looking out for in the late

494
00:32:07,680 --> 00:32:08,680
40s?

495
00:32:08,680 --> 00:32:09,680
Ah, the hallmarks of aging.

496
00:32:09,680 --> 00:32:15,440
Okay, so in this specific study that they defined this, actually I don't remember what

497
00:32:15,440 --> 00:32:20,680
markers they were looking at, but there's different kinds of hallmarks of aging, which

498
00:32:20,680 --> 00:32:31,320
is oxidative stress, protein dysfunction, mitochondrial dysfunction, low-grade inflammation,

499
00:32:31,320 --> 00:32:41,160
telomere shortening, a couple of you once that I didn't review for this podcast.

500
00:32:41,160 --> 00:32:46,880
So epigenetic changes where you measure the clocks, it's actually it differs between different

501
00:32:46,880 --> 00:32:48,720
tissues.

502
00:32:48,720 --> 00:32:56,280
But one thing is a lot of these clocks that measure the epigenetic changes of DNA methylation,

503
00:32:56,280 --> 00:33:01,760
a significant amount of these markers actually related to cortisol or your stress hormone

504
00:33:01,760 --> 00:33:02,760
signaling.

505
00:33:02,760 --> 00:33:03,760
Wow.

506
00:33:03,760 --> 00:33:08,880
So really understanding that, you know, that stress is crucial to manage.

507
00:33:08,880 --> 00:33:09,880
Yeah.

508
00:33:09,880 --> 00:33:15,480
So we hear oftentimes people say that when they do an intermittent fast or when they

509
00:33:15,480 --> 00:33:21,800
do exercise or when they either go to a sauna or a cold plunge, these are all stresses to

510
00:33:21,800 --> 00:33:23,080
the body.

511
00:33:23,080 --> 00:33:27,800
How does that type of stressor affect the body in comparison to say, you know, that

512
00:33:27,800 --> 00:33:32,920
work deadline that you've got or your kids or your financial stress?

513
00:33:32,920 --> 00:33:35,560
Like how is that different or is it the same?

514
00:33:35,560 --> 00:33:36,560
Can your body tell?

515
00:33:36,560 --> 00:33:41,600
So yeah, I mean, yes, for sure, like, you know, exercise or, you know, these short-term

516
00:33:41,600 --> 00:33:48,560
shocks that have a clear defined start and end is very different than a chronic stress

517
00:33:48,560 --> 00:33:53,920
that you really don't know the mental stress, like, you know, your toxic boss or something

518
00:33:53,920 --> 00:33:59,160
that, you know, you lose your sleep with.

519
00:33:59,160 --> 00:34:08,400
So the short duration of the stress is a different kind and you can recover from that.

520
00:34:08,400 --> 00:34:14,080
However, if you accumulate even these short stresses, if you accumulate them too much,

521
00:34:14,080 --> 00:34:19,960
you go over your ability to then compensate for all the stress because all the stress

522
00:34:19,960 --> 00:34:28,320
creates oxidative stress creates these radicals, oxygen radicals in your body.

523
00:34:28,320 --> 00:34:36,040
And if your system is not optimized to work with these oxygen radicals or reactive oxygen

524
00:34:36,040 --> 00:34:43,600
species with, for example, nutritious diet, healthy diet that contains antioxidants, then

525
00:34:43,600 --> 00:34:50,300
you accumulate too much of this uncompensated stress in your system.

526
00:34:50,300 --> 00:34:55,880
And this can lead to, for example, mutations in the DNA because these radicals are really

527
00:34:55,880 --> 00:34:56,880
powerful.

528
00:34:56,880 --> 00:34:57,880
Yeah.

529
00:34:57,880 --> 00:35:05,240
So the sources of stress, you know, if you are not sleeping well, but you are doing all

530
00:35:05,240 --> 00:35:12,360
of these, you know, exercise and whatever you were just listing there, but then you

531
00:35:12,360 --> 00:35:16,000
have a huge mental stress and you're not sleeping well.

532
00:35:16,000 --> 00:35:21,520
So you accumulate a lot of stress that can actually be harmful in the end.

533
00:35:21,520 --> 00:35:25,880
So you so you kind of have to know where's your balance, how well you can recover.

534
00:35:25,880 --> 00:35:26,880
Yeah.

535
00:35:26,880 --> 00:35:27,880
Yeah.

536
00:35:27,880 --> 00:35:28,880
Recovery seems to be key.

537
00:35:28,880 --> 00:35:29,880
Yeah.

538
00:35:29,880 --> 00:35:30,880
Recovery is a big theme for us on this season.

539
00:35:30,880 --> 00:35:32,800
I feel like a lot of our experts are talking about recovery.

540
00:35:32,800 --> 00:35:36,200
I was mentioning that my husband started using the Morpheus.

541
00:35:36,200 --> 00:35:40,240
So to track HRV in the morning to test, you know, what kind of protocol he should be using

542
00:35:40,240 --> 00:35:43,480
for his cardiovascular training based on how well recovered he is.

543
00:35:43,480 --> 00:35:45,120
And there's other protocols that are doing this, right?

544
00:35:45,120 --> 00:35:46,120
Or rings and garments.

545
00:35:46,120 --> 00:35:50,560
I've got, I've got my one gives me my body battery score started at a hundred this morning.

546
00:35:50,560 --> 00:35:51,560
Yeah.

547
00:35:51,560 --> 00:35:54,800
Again, I think my sleep has been on point.

548
00:35:54,800 --> 00:36:02,000
So I'm, I'm quite excited that, you know, I get to see that is recording decent sleep

549
00:36:02,000 --> 00:36:03,960
for me and I wake up feeling refreshed.

550
00:36:03,960 --> 00:36:09,320
So the only problem I had this morning was I was running a little bit late.

551
00:36:09,320 --> 00:36:10,800
So I didn't have my morning coffee.

552
00:36:10,800 --> 00:36:13,800
So when I went to the gym, I was like, why am I really tired?

553
00:36:13,800 --> 00:36:16,600
And I was, oh, I didn't get my usual coffee.

554
00:36:16,600 --> 00:36:18,000
Recovery score 99.

555
00:36:18,000 --> 00:36:19,000
I know.

556
00:36:19,000 --> 00:36:22,680
I think, I think it will be, I don't think it's going to be quite there, but Dr. Meena,

557
00:36:22,680 --> 00:36:25,600
it has been absolutely wonderful having you on the show.

558
00:36:25,600 --> 00:36:27,760
I feel like we've got so much more to ask you.

559
00:36:27,760 --> 00:36:31,680
So we might have to get you back in and maybe talk about some, some other stuff.

560
00:36:31,680 --> 00:36:35,680
But before we go, we do have one question that we like to ask all of our guests.

561
00:36:35,680 --> 00:36:38,220
And that is what is your forties formula?

562
00:36:38,220 --> 00:36:46,800
If you had to summarize what people in their forties can do to help, help how they can,

563
00:36:46,800 --> 00:36:48,920
I don't even know what I'm saying.

564
00:36:48,920 --> 00:36:55,280
If people have to, how they can thrive in their forties, what would you say that would

565
00:36:55,280 --> 00:36:56,280
be?

566
00:36:56,280 --> 00:37:04,000
Try to enjoy life to the maximum because forties, the decade, now I'm over 50, so I can look

567
00:37:04,000 --> 00:37:09,040
back and say, it can be a decade of really deep transformation.

568
00:37:09,040 --> 00:37:11,400
So be prepared for that.

569
00:37:11,400 --> 00:37:18,120
Like I said, take care of yourself and also take care of other people because that is

570
00:37:18,120 --> 00:37:19,600
important for social connection.

571
00:37:19,600 --> 00:37:20,600
And kindness.

572
00:37:20,600 --> 00:37:22,540
Yes, yes, yes.

573
00:37:22,540 --> 00:37:30,840
So I love this Tibetan saying, I'm not sure if it's Tibetan, but it says that the recipe

574
00:37:30,840 --> 00:37:43,120
for healthy, happy life is a long life is eat half, walk double, laugh triple, and love

575
00:37:43,120 --> 00:37:44,120
without measure.

576
00:37:44,120 --> 00:37:45,120
Wow.

577
00:37:45,120 --> 00:37:46,120
I love that.

578
00:37:46,120 --> 00:37:47,120
I have not heard that.

579
00:37:47,120 --> 00:37:48,960
That's just the perfect formula, isn't it?

580
00:37:48,960 --> 00:37:51,200
It's like, yeah, that's a literal 40 formula.

581
00:37:51,200 --> 00:37:54,840
So you're welcome listeners.

582
00:37:54,840 --> 00:37:56,280
Thank you so much again, Dr. Mina.

583
00:37:56,280 --> 00:37:59,160
It has been amazing.

584
00:37:59,160 --> 00:38:02,480
And you know, we again, we would love to have you back on the show at some point.

585
00:38:02,480 --> 00:38:03,480
Thank you so much.

586
00:38:03,480 --> 00:38:04,480
Thank you.

587
00:38:04,480 --> 00:38:05,480
Thank you.

588
00:38:05,480 --> 00:38:07,200
Want more from the 40s formula?

589
00:38:07,200 --> 00:38:11,120
Every Friday, we'll be sending our four play Friday newsletter direct to your inbox with

590
00:38:11,120 --> 00:38:15,800
four hot topics, tips and trends personally curated by Jasmine and Amanda.

591
00:38:15,800 --> 00:38:20,640
All you need to do is visit the forties formula.com and sign up with your email address.

592
00:38:20,640 --> 00:38:26,920
That's the F O R T I E S formula.com.

593
00:38:26,920 --> 00:38:28,840
This is Paul, our editor.

594
00:38:28,840 --> 00:38:33,840
He's a 25 year old unmarried Singaporean guy listening to the ramblings of 12 older women

595
00:38:33,840 --> 00:38:37,640
on everything from menopause to weightlifting to sex.

596
00:38:37,640 --> 00:38:41,400
So Paul, what's your thoughts on today's conversation?

597
00:38:41,400 --> 00:38:42,400
Lifestyle medicine.

598
00:38:42,400 --> 00:38:43,400
Yay.

599
00:38:43,400 --> 00:38:48,040
I think it's pretty cool, you know, to have a preventive set of steps to take to actually

600
00:38:48,040 --> 00:38:54,200
treat these diseases before they occur in the most natural way possible.

601
00:38:54,200 --> 00:38:58,760
And I love the mention of the six pillars of lifestyle medicine being health eating,

602
00:38:58,760 --> 00:39:04,360
physical activity, restorative sleeping, stress management, avoidance of risky substances

603
00:39:04,360 --> 00:39:07,000
and positive social connections.

604
00:39:07,000 --> 00:39:08,400
So guys, there you have it.

605
00:39:08,400 --> 00:39:10,840
Six easy pillars to healthy living.

606
00:39:10,840 --> 00:39:11,840
Yay.

607
00:39:11,840 --> 00:39:15,560
Guys, you know how much we love coffee.

608
00:39:15,560 --> 00:39:18,080
If you want to show some love, you know, you can get us one.

609
00:39:18,080 --> 00:39:22,920
Just visit buy me a coffee.com slash the forties formula.

610
00:39:22,920 --> 00:39:25,400
Cheers.

611
00:39:25,400 --> 00:39:30,120
Before we go, please remember to hit subscribe and take a moment to support the forties formula

612
00:39:30,120 --> 00:39:33,520
by leaving a review on your favorite podcast platform.

613
00:39:33,520 --> 00:39:37,320
Your reviews will help us to reach more people and allow us to continue to bring valuable

614
00:39:37,320 --> 00:39:38,320
content.

615
00:39:38,320 --> 00:39:41,440
It should only take a moment and it's a free way for you to support the show.

616
00:39:41,440 --> 00:39:46,000
You can also stay updated with the forties formula by following us on Instagram at the

617
00:39:46,000 --> 00:39:47,200
forties formula.

618
00:39:47,200 --> 00:39:48,440
All one word.

619
00:39:48,440 --> 00:39:52,000
We share behind the scenes insights, episode updates and much more.

620
00:39:52,000 --> 00:39:54,680
So please be sure to hit that follow button.

621
00:39:54,680 --> 00:39:56,320
We appreciate your time and support.

622
00:39:56,320 --> 00:39:59,500
Thank you for being part of this community and we'll be back next week for more empowering

623
00:39:59,500 --> 00:40:01,800
conversations with inspiring guests.

624
00:40:01,800 --> 00:40:02,800
Bye.

625
00:40:02,800 --> 00:40:24,500
Heyyy!

626
00:40:32,800 --> 00:40:46,240
So you both have three kids?

627
00:40:46,240 --> 00:40:47,240
We do.

628
00:40:47,240 --> 00:40:48,240
I have two.

629
00:40:48,240 --> 00:40:49,240
Wow.

630
00:40:49,240 --> 00:40:50,240
What are the ages of your kids?

631
00:40:50,240 --> 00:40:51,240
Oh, they're all 21 and 19.

632
00:40:51,240 --> 00:40:52,240
Wow.

633
00:40:52,240 --> 00:40:53,240
They're 21 and they're studying in university.

634
00:40:53,240 --> 00:40:54,240
They're doing their own thing.

635
00:40:54,240 --> 00:40:55,240
What are they doing at university?

636
00:40:55,240 --> 00:40:56,240
They study.

637
00:40:56,240 --> 00:41:03,240
So the older one, so she will graduate in June.

638
00:41:03,240 --> 00:41:04,240
Oh my God.

639
00:41:04,240 --> 00:41:09,240
So they're in Toronto, University of Toronto.

640
00:41:09,240 --> 00:41:15,800
So she studies biology and environmental biology, double major.

641
00:41:15,800 --> 00:41:18,240
And then the younger one studies psychology.

642
00:41:18,240 --> 00:41:19,240
Wow.

643
00:41:19,240 --> 00:41:21,240
And they're both at University of Toronto.

644
00:41:21,240 --> 00:41:22,240
Yes.

645
00:41:22,240 --> 00:41:23,240
That's an amazing school.

646
00:41:23,240 --> 00:41:24,240
That's lovely.

647
00:41:24,240 --> 00:41:25,240
Yes.

648
00:41:25,240 --> 00:41:27,040
It is the top school in Canada.

649
00:41:27,040 --> 00:41:29,660
Do they love Toronto?

650
00:41:29,660 --> 00:41:33,440
Is that like a lifestyle that fits them and a weather pattern that fits them?

651
00:41:33,440 --> 00:41:34,440
Very different.

652
00:41:34,440 --> 00:41:37,440
Coming from Sweden though.

653
00:41:37,440 --> 00:41:41,460
So I actually lived outside of Finland for 20 plus years.

654
00:41:41,460 --> 00:41:44,040
So we were in Ann Arbor, Michigan for 10 years.

655
00:41:44,040 --> 00:41:45,580
The kids were born there.

656
00:41:45,580 --> 00:41:46,840
Were you at University of Michigan?

657
00:41:46,840 --> 00:41:49,240
Yes, we both were at University of Michigan.

658
00:41:49,240 --> 00:41:52,280
And then we came here 12 years ago.

659
00:41:52,280 --> 00:41:56,640
So the kids mainly remember, so the kids were that time, what?

660
00:41:56,640 --> 00:42:01,880
Let me think, eight and five and a half, something like this.

661
00:42:01,880 --> 00:42:06,560
So they mainly remember Singapore as their place where they grew up.

662
00:42:06,560 --> 00:42:08,440
And that's a big city, right?

663
00:42:08,440 --> 00:42:12,680
So I was like, because I'm such a nature level, right?

664
00:42:12,680 --> 00:42:17,040
Like, okay, would you like to go somewhere like UBC where there's a lot of nature?

665
00:42:17,040 --> 00:42:18,040
It's gorgeous.

666
00:42:18,040 --> 00:42:19,040
We need the city.

667
00:42:19,040 --> 00:42:22,480
That's what they used to do, it makes sense.

668
00:42:22,480 --> 00:42:24,200
Very different lifestyle.

669
00:42:24,200 --> 00:42:29,440
So then, and now the older one, she was like, oh, I want to work in New York City.

670
00:42:29,440 --> 00:42:32,440
And I was like, well, really?

671
00:42:32,440 --> 00:42:33,440
Just keep getting bigger, right?

672
00:42:33,440 --> 00:42:35,600
City to city to city, right?

673
00:42:35,600 --> 00:42:39,480
But then I was like, okay, I'm hopeful because they can still change their mind.

674
00:42:39,480 --> 00:42:54,600
Like I still move to somewhere with a lot of nature around.