WEBVTT 00:00:00.000 --> 00:00:03.259 What is the first thing that you would drop for 00:00:03.259 --> 00:00:05.360 women in their 40s to know about heart health? 00:00:05.599 --> 00:00:08.580 Your risk is not really lower than men. Hypertension 00:00:08.580 --> 00:00:10.560 is actually more common in older women than it 00:00:10.560 --> 00:00:12.839 is in older men. Diet, like a bit of a pescatarian 00:00:12.839 --> 00:00:16.039 diet, so to speak. It's very hard for Singaporeans 00:00:16.039 --> 00:00:19.199 and Asians to do. You need about 150 minutes 00:00:19.199 --> 00:00:22.699 a week of moderate intensity exercise to pass 00:00:22.699 --> 00:00:25.539 if your heart's healthy, but you fall down when 00:00:25.539 --> 00:00:27.920 you're going down a flight of stairs. It's still 00:00:27.920 --> 00:00:30.579 not great. Everybody was just no carbs. Every 00:00:30.579 --> 00:00:33.619 girl wanted to be tiny and little. You can be 00:00:33.619 --> 00:00:53.270 strong and being strong is great. and welcome 00:00:53.270 --> 00:00:55.969 to The 40s Formula, your go -to place for insightful 00:00:55.969 --> 00:00:58.570 discussions on navigating the 40s and thriving 00:00:58.570 --> 00:01:01.469 in this transformative decade. We're your hosts, 00:01:01.570 --> 00:01:04.150 Jasmine and Amanda, two women that are passionate 00:01:04.150 --> 00:01:05.989 about exploring the challenges and adventures 00:01:05.989 --> 00:01:08.549 that come with turning 40 and what lies ahead. 00:01:18.250 --> 00:01:21.069 Dr. Jean Ong is a cardiologist at the National 00:01:21.069 --> 00:01:24.030 University Heart Center Singapore and Ung Teng 00:01:24.030 --> 00:01:27.170 Fung General Hospital. She has clinical interests 00:01:27.170 --> 00:01:30.569 in women's heart health, heart failure, cardiac 00:01:30.569 --> 00:01:34.489 imaging, and cardiac rehabilitation. She is passionate 00:01:34.489 --> 00:01:36.629 about spreading awareness on heart disease in 00:01:36.629 --> 00:01:39.810 women. When she's not working, Jean can be found 00:01:39.810 --> 00:01:42.010 throwing around a barbell in the gym or chasing 00:01:42.010 --> 00:01:45.090 after her border collie. All opinions expressed 00:01:45.090 --> 00:01:47.700 in the following episode are her own. and do 00:01:47.700 --> 00:01:50.840 not represent any hospital, institution, or constitute 00:01:50.840 --> 00:01:53.689 any medical advice. All right, well guys, you 00:01:53.689 --> 00:01:55.569 know that I'm about to go full fangirl today 00:01:55.569 --> 00:01:57.590 with the guests that I have been waiting to talk 00:01:57.590 --> 00:01:59.569 to you for the past few weeks, who I've been 00:01:59.569 --> 00:02:02.129 calling the CrossFit cardiologist. She didn't, 00:02:02.129 --> 00:02:03.969 she didn't coin it, but I'll take it. She's both 00:02:03.969 --> 00:02:06.049 a consultant for the National University Heart 00:02:06.049 --> 00:02:08.889 Center here in Singapore and a competitive CrossFit 00:02:08.889 --> 00:02:11.030 athlete. So in other words, she's a total baddie 00:02:11.030 --> 00:02:13.669 in all walks of life. Welcome, Dr. Jean. Thank 00:02:13.669 --> 00:02:15.689 you so much for having me. Yeah, we are super 00:02:15.689 --> 00:02:17.710 happy to have you here, as you know. Oh yeah, 00:02:17.729 --> 00:02:20.629 Amanda has been going on and on and on about 00:02:20.629 --> 00:02:24.069 this episode. I'm so glad. So what is the first 00:02:24.069 --> 00:02:26.629 thing that you would drop for women in their 00:02:26.629 --> 00:02:29.009 40s to know about heart health? That's such a 00:02:29.009 --> 00:02:30.710 difficult question. I want them to know everything. 00:02:30.889 --> 00:02:34.050 Yes, I want them to too. I think the most important 00:02:34.050 --> 00:02:36.250 thing that I would advocate for people to know 00:02:36.250 --> 00:02:39.069 is that your risk is not really lower than men. 00:02:39.169 --> 00:02:41.530 Your lifetime risk is not lower than men. A lot 00:02:41.530 --> 00:02:44.960 of women think heart disease is a... men's disease 00:02:44.960 --> 00:02:47.479 and they don't consider it to be something that 00:02:47.479 --> 00:02:48.919 they will have to worry about in their lifetime. 00:02:49.199 --> 00:02:51.620 But because we kind of live longer than they 00:02:51.620 --> 00:02:54.080 do, we tend to experience heart diseases much. 00:02:54.810 --> 00:02:57.090 you know older age it's more complicated so that's 00:02:57.090 --> 00:02:59.569 kind of like the first thing i do want people 00:02:59.569 --> 00:03:01.569 to know first thing is beware it's going to get 00:03:01.569 --> 00:03:04.729 you in the end yeah but no you're right i operated 00:03:04.729 --> 00:03:06.530 under that misunderstanding before that it's 00:03:06.530 --> 00:03:08.189 like oh you know men die of heart attacks women 00:03:08.189 --> 00:03:10.729 die of xyz right but it's like no we just die 00:03:10.729 --> 00:03:14.030 of older heart attacks in a way yeah very much 00:03:14.030 --> 00:03:16.210 so so to that end right i found a youtube video 00:03:16.210 --> 00:03:18.090 where you're talking about the shocking fact 00:03:18.639 --> 00:03:22.020 that women die of heart failure at higher rates 00:03:22.020 --> 00:03:24.000 than men can you can you explain that so heart 00:03:24.000 --> 00:03:25.800 disease heart failure like what are what are 00:03:25.800 --> 00:03:27.699 the distinctions so usually when people say heart 00:03:27.699 --> 00:03:29.400 disease they're talking about blockages in your 00:03:29.400 --> 00:03:31.939 heart arteries so that's very long word for it 00:03:31.939 --> 00:03:34.560 is atherosclerotic coronary artery disease which 00:03:34.560 --> 00:03:38.180 in in and of itself is a it is more uh a male 00:03:38.180 --> 00:03:40.659 disease but when we talk about heart failure 00:03:40.659 --> 00:03:42.699 that's kind of the end point of all heart disease 00:03:42.699 --> 00:03:45.000 if you don't treat heart disease well your heart 00:03:45.000 --> 00:03:48.250 gets weak or you're unable to pump uh effectively 00:03:48.250 --> 00:03:50.590 and that's heart failure the sad thing about 00:03:50.590 --> 00:03:52.110 heart failure is there's there's a few different 00:03:52.110 --> 00:03:53.909 types this one where your heart is stiff and 00:03:53.909 --> 00:03:56.110 this one that where your heart's weak women get 00:03:56.110 --> 00:03:58.830 the stiff heart one more common so the function 00:03:58.830 --> 00:04:01.949 of the heart by right It's normal. Okay. But 00:04:01.949 --> 00:04:04.430 you're not filling your heart as much with as 00:04:04.430 --> 00:04:06.069 much blood. So you're still not getting enough 00:04:06.069 --> 00:04:09.009 blood to the rest of your body. That's one. So 00:04:09.009 --> 00:04:11.669 we get that. And honestly, the treatment for 00:04:11.669 --> 00:04:14.689 that type of heart failure is very complicated. 00:04:15.069 --> 00:04:17.990 It's very complex. And only in the past, maybe 00:04:17.990 --> 00:04:20.670 five, 10 years, do we actually have. you know 00:04:20.670 --> 00:04:23.689 guideline directed medication for that uh first 00:04:23.689 --> 00:04:26.709 for the weak heart um surprisingly as well that 00:04:26.709 --> 00:04:30.050 is kind of more common in men but we women are 00:04:30.050 --> 00:04:32.899 still less likely to get all the medication required. 00:04:33.279 --> 00:04:37.740 So the chances of women dying after a heart attack 00:04:37.740 --> 00:04:39.439 from heart failure are actually higher than men. 00:04:39.699 --> 00:04:41.939 Oh, so okay. So that's where that kind of number 00:04:41.939 --> 00:04:44.220 comes up. There's a lot of little nuances to 00:04:44.220 --> 00:04:46.819 it, but there are numbers in various aspects 00:04:46.819 --> 00:04:49.300 to show that women overall, after they get diagnosed 00:04:49.300 --> 00:04:52.040 with heart disease, they do way worse than men 00:04:52.040 --> 00:04:55.079 do. What would you say are the biggest driving 00:04:55.079 --> 00:04:58.569 factors that cause... heart disease or heart 00:04:58.569 --> 00:05:00.810 failure in women? You know, is it something that 00:05:00.810 --> 00:05:02.810 we're eating? Is it something we're doing or 00:05:02.810 --> 00:05:05.329 not doing? What would you say? So it's very different 00:05:05.329 --> 00:05:07.589 in different parts of the world as well. I think 00:05:07.589 --> 00:05:09.629 here, but one of the most common things that 00:05:09.629 --> 00:05:13.529 has come up is actually hypertension. So hypertension 00:05:13.529 --> 00:05:15.629 is actually more common in older women than it 00:05:15.629 --> 00:05:18.110 is in older men. It's also less likely to be 00:05:18.110 --> 00:05:20.009 treated well. When you say less likely to be 00:05:20.009 --> 00:05:22.230 treated well, what do you mean? So women get 00:05:22.230 --> 00:05:25.800 less medicine, get less medicated for it. They 00:05:25.800 --> 00:05:27.879 are on lower doses of medications. Is there a 00:05:27.879 --> 00:05:29.819 reason? Yeah, why is that? I mean, there's been 00:05:29.819 --> 00:05:31.579 many people who've looked into this, you know, 00:05:31.600 --> 00:05:34.120 many studies out there, but it's just multifactorial. 00:05:34.120 --> 00:05:37.120 Women don't like medicine. We also don't feel 00:05:37.120 --> 00:05:39.120 that we should be taking it. We all prefer to 00:05:39.120 --> 00:05:41.579 take supplements over medicine. You're talking 00:05:41.579 --> 00:05:44.079 to two nutritionists. Believe me, we know people 00:05:44.079 --> 00:05:46.060 do not want to take medicine. They'll take whatever 00:05:46.060 --> 00:05:48.139 unregulated supplement. They will take some oil 00:05:48.139 --> 00:05:50.259 and powders and whatever, but they're not going 00:05:50.259 --> 00:05:52.870 to take their medication. Also, you know, if 00:05:52.870 --> 00:05:55.930 you see a little old lady or a small little lady 00:05:55.930 --> 00:05:57.949 come in and her blood pressure is a bit high 00:05:57.949 --> 00:05:59.629 and she goes, I'm a bit nervous. You're like, 00:05:59.689 --> 00:06:02.310 it's OK. Yeah, it's white coat. Yeah, it's white 00:06:02.310 --> 00:06:05.230 coat. You're anxious. Go home and relax and you're 00:06:05.230 --> 00:06:08.569 fine. So I think there's a lot of little nuances 00:06:08.569 --> 00:06:10.370 to it, but it's still something we're trying 00:06:10.370 --> 00:06:13.189 to figure out how to get over as well. OK, let 00:06:13.189 --> 00:06:15.170 me tell you this. This is an honest example of 00:06:15.170 --> 00:06:18.389 myself. So I'm just going to cut the shit. I 00:06:18.389 --> 00:06:20.750 am a woman in my 40s, early 40s, always been 00:06:20.750 --> 00:06:22.579 active, always been. athletic never been overweight 00:06:22.579 --> 00:06:25.819 no risk factors except yeah that i do have a 00:06:25.819 --> 00:06:27.639 father with high blood pressure who is medicated 00:06:27.639 --> 00:06:29.860 right so medicated normal blood pressure but 00:06:29.860 --> 00:06:32.860 unmedicated high i've never been medicated my 00:06:32.860 --> 00:06:35.620 blood pressure is always high normal so if 120 00:06:35.620 --> 00:06:37.699 over 80 is like you know normal normal i'm always 00:06:37.699 --> 00:06:41.540 like 130 over 85 for someone like me what would 00:06:41.540 --> 00:06:43.639 you recommend so by and large right now it's 00:06:43.639 --> 00:06:46.180 still a lot of you know, lifestyle modification 00:06:46.180 --> 00:06:49.279 at this point in time. Because we also don't 00:06:49.279 --> 00:06:51.139 want to medicate people for long periods of time 00:06:51.139 --> 00:06:53.759 if they don't need to. So by and large, I think, 00:06:53.759 --> 00:06:55.620 if I'm not wrong, the American guidelines do 00:06:55.620 --> 00:07:00.540 just state to modify your risk factors. But there 00:07:00.540 --> 00:07:02.839 is a whole train of thought of people who are 00:07:02.839 --> 00:07:05.699 aiming for blood pressures of under 120 for everyone. 00:07:05.920 --> 00:07:08.220 And I think that becomes a very personal choice 00:07:08.220 --> 00:07:11.220 as to whether or not, you know, does your dad 00:07:11.220 --> 00:07:13.339 just have high blood pressure or does he have... 00:07:13.550 --> 00:07:15.790 complications of high blood pressure and if he 00:07:15.790 --> 00:07:18.149 has all these complications do you then want 00:07:18.149 --> 00:07:20.589 to take measures earlier to prevent yourself 00:07:20.589 --> 00:07:22.470 from getting those complications yeah but if 00:07:22.470 --> 00:07:24.410 he just has fairly well controlled high blood 00:07:24.410 --> 00:07:27.529 pressure you know you're fairly healthy doing 00:07:27.529 --> 00:07:29.269 what you you know you're doing everything you 00:07:29.269 --> 00:07:32.050 should be doing then then um what more is there 00:07:32.050 --> 00:07:33.670 to do really at this point i guess that's true 00:07:33.670 --> 00:07:35.870 yeah yeah and hey i'm gonna give my dad a shout 00:07:35.870 --> 00:07:38.129 out here my dad is 76 years old about to be 76 00:07:38.129 --> 00:07:41.170 years old and he runs a 5k every other day wow 00:07:41.170 --> 00:07:43.329 so either three or four times per week depending 00:07:43.329 --> 00:07:46.050 yeah my husband is always like your dad's the 00:07:46.050 --> 00:07:48.430 healthiest old dude ever like he has one little 00:07:48.430 --> 00:07:50.470 blood pressure med is no big deal but but again 00:07:50.470 --> 00:07:53.209 because i have it i'm like ah like why so does 00:07:53.209 --> 00:07:56.029 the hypertension or risk of hypertension change 00:07:56.720 --> 00:08:00.160 or vary depending on like your ethnicity or your 00:08:00.160 --> 00:08:02.600 background so for example would somebody who 00:08:02.600 --> 00:08:07.220 is of american descent have generally a better 00:08:07.220 --> 00:08:09.839 blood pressure than someone who's let's say of 00:08:09.839 --> 00:08:11.740 indian descent or someone who's indian living 00:08:11.740 --> 00:08:17.379 in england another hypothetical so i'm just wondering 00:08:17.379 --> 00:08:21.399 because you know if 120 over 80 is the ideal 00:08:22.320 --> 00:08:25.160 Is it really the ideal or would that change based 00:08:25.160 --> 00:08:27.420 on who you are, where you're from, what you do? 00:08:27.519 --> 00:08:29.959 There's a little bit of variance in who you are, 00:08:30.040 --> 00:08:35.419 where you're from. But I think in all populations, 00:08:35.539 --> 00:08:37.539 there are people who are at higher risk and there 00:08:37.539 --> 00:08:40.059 are people who are at average risk and things 00:08:40.059 --> 00:08:43.139 like that. I mean, obviously I know the Asian 00:08:43.139 --> 00:08:44.840 statistics or the Singapore statistics better 00:08:44.840 --> 00:08:46.799 because most of my practice has been here. But 00:08:46.799 --> 00:08:50.000 I do think that in America, the blacks and Hispanics, 00:08:50.019 --> 00:08:52.909 they do have higher risk. south asians wherever 00:08:52.909 --> 00:08:54.889 you live unfortunately you have high risk i'm 00:08:54.889 --> 00:08:56.990 so sorry to tell you i know i know this like 00:08:56.990 --> 00:08:59.309 the indian gene first we found out it was bad 00:08:59.309 --> 00:09:01.090 to be married remember and now we find out it's 00:09:01.090 --> 00:09:04.590 bad to be south asian sorry but that ethnicity 00:09:04.590 --> 00:09:06.710 doesn't necessarily contribute to your blood 00:09:06.710 --> 00:09:08.429 pressure being higher it just means that if you 00:09:08.429 --> 00:09:10.029 do have high blood pressure maybe you want to 00:09:10.029 --> 00:09:11.809 be more aggressive with treating i've actually 00:09:11.809 --> 00:09:15.029 got hypotension oh interesting do you pass out 00:09:15.029 --> 00:09:17.309 i've never passed out so actually whenever i've 00:09:17.309 --> 00:09:19.230 gone to get checked i've always they're all i'm 00:09:19.230 --> 00:09:22.720 like Like low average, but I've never passed 00:09:22.720 --> 00:09:25.519 out. And when I had my DNA thing done, it says 00:09:25.519 --> 00:09:28.860 I am at risk of hypo. But I think because I work 00:09:28.860 --> 00:09:31.000 out and I do, you know, I eat plenty of salt, 00:09:31.059 --> 00:09:33.679 you know, I'm fine. She's salty. That's okay 00:09:33.679 --> 00:09:36.919 for now, I think. Like how hypo is problematic. 00:09:37.100 --> 00:09:38.899 Yeah. I mean, nowadays we know a lot of women 00:09:38.899 --> 00:09:43.350 who have POTS. um it's postural autostatic tachycardia 00:09:43.350 --> 00:09:46.029 so very long i have i've had the full term yes 00:09:46.029 --> 00:09:48.809 and they've got uh inappropriate sinus tachycardia 00:09:48.809 --> 00:09:50.649 we talked about it a lot uh after and during 00:09:50.649 --> 00:09:53.450 during covid because so many people had it during 00:09:53.450 --> 00:09:55.950 covid i kind of feel that so many people had 00:09:55.950 --> 00:09:57.350 it during covid because everybody had at the 00:09:57.350 --> 00:09:59.409 same time so therefore they when i have this 00:09:59.409 --> 00:10:01.769 oh you have this oh this actually is a thing 00:10:01.769 --> 00:10:03.990 whereas if we all had it at different times you'd 00:10:03.990 --> 00:10:07.080 be like It's fine. But what happens is, you know, 00:10:07.080 --> 00:10:08.740 actually when you sit to stand, your heart rate 00:10:08.740 --> 00:10:11.539 should increase and some people's increases abnormally, 00:10:11.600 --> 00:10:14.580 things like that. So they can pass out. Having 00:10:14.580 --> 00:10:16.480 changes in blood pressure from sitting to standing 00:10:16.480 --> 00:10:19.279 is perfectly normal. And usually if that happens 00:10:19.279 --> 00:10:22.100 and you do faint, our general treatment guidelines 00:10:22.100 --> 00:10:25.700 are usually, again, mostly lifestyle, salt, isotonic 00:10:25.700 --> 00:10:28.269 drinks. If you feel like you're going to pass 00:10:28.269 --> 00:10:30.809 out, lie down on the ground. There are medications 00:10:30.809 --> 00:10:33.350 for it, but we don't like to give it because 00:10:33.350 --> 00:10:35.850 these medications cause hypertension and things 00:10:35.850 --> 00:10:38.990 like that. But I think low blood pressure in 00:10:38.990 --> 00:10:40.970 itself is not really a danger if that's what... 00:10:41.080 --> 00:10:43.639 you've always had. Obviously, if your blood pressure 00:10:43.639 --> 00:10:46.080 suddenly became low from being high, then that 00:10:46.080 --> 00:10:48.100 might be something else. But if you're always 00:10:48.100 --> 00:10:50.080 on the low side, that probably protects you, 00:10:50.139 --> 00:10:54.360 you know, hopefully. For something. Yeah. It's 00:10:54.360 --> 00:10:57.379 like that came full circle. What about food? 00:10:57.480 --> 00:10:59.919 Now, we always, I mean, the sort of the past 00:10:59.919 --> 00:11:02.039 thoughts have always been, you know, cholesterol 00:11:02.039 --> 00:11:03.940 is going to lead to heart disease. High fatty 00:11:03.940 --> 00:11:06.059 food is going to lead to heart disease. What's 00:11:06.059 --> 00:11:08.580 your thoughts on that? Disclaimer, not a dietician. 00:11:09.179 --> 00:11:11.899 Not a nutritionist even. But I think from my 00:11:11.899 --> 00:11:13.279 kind of understanding is that, you know, diet 00:11:13.279 --> 00:11:15.620 trends always change. At the end of the day, 00:11:15.679 --> 00:11:18.659 we do know the basics. Too much of anything really 00:11:18.659 --> 00:11:21.399 is a problem. The heart healthy diet is always 00:11:21.399 --> 00:11:24.360 kind of the Mediterranean diet, which is fish, 00:11:24.539 --> 00:11:27.559 lots of leafy vegetables, some legumes, some 00:11:27.559 --> 00:11:30.379 carbohydrates, but not a lot. So that's kind 00:11:30.379 --> 00:11:32.879 of the tried and tested. diet like a bit of a 00:11:32.879 --> 00:11:35.639 pescatarian diet so to speak it's very hard for 00:11:35.639 --> 00:11:38.539 singaporeans and asians to do because you go 00:11:38.539 --> 00:11:41.320 to the hawker center and everything is cheap 00:11:41.320 --> 00:11:45.580 and good and and fried and fried yes and not 00:11:45.580 --> 00:11:49.559 fishy yeah yeah i'm not so strict with my patients 00:11:49.559 --> 00:11:53.019 i tell them if 75 of the time you're well behaved 00:11:53.639 --> 00:11:55.799 and 25 of the time you're not that's better than 00:11:55.799 --> 00:11:57.559 i feel like you're kind of most people say 80. 00:11:57.860 --> 00:12:00.500 yeah yeah 75 is gentle you can tell you you can 00:12:00.500 --> 00:12:02.399 tell you're working 80 but i kind of go by like 00:12:02.399 --> 00:12:04.600 if you have four four meals a day you know like 00:12:04.600 --> 00:12:06.299 one of them can be yeah one of them can be a 00:12:06.299 --> 00:12:08.419 little cheeky yeah but if the rest of them are 00:12:08.419 --> 00:12:10.659 good then you're still kind of winning because 00:12:10.659 --> 00:12:13.399 if not a lot of people end up restricting too 00:12:13.399 --> 00:12:15.960 much And then they go the complete other direction. 00:12:16.179 --> 00:12:18.659 So, yeah, but I mean, I don't think there's any 00:12:18.659 --> 00:12:21.720 magic diet. There was some data on intermittent 00:12:21.720 --> 00:12:24.659 fasting. There was some data on ketogenic diet. 00:12:24.879 --> 00:12:28.740 There is a very interesting dietitian here who 00:12:28.740 --> 00:12:32.620 does healthy keto. Yes. Which, yeah, which honestly 00:12:32.620 --> 00:12:36.350 basically is kind of. like the Atkins pescatarian 00:12:36.350 --> 00:12:38.830 diet. It's kind of just low carb, but she's actually 00:12:38.830 --> 00:12:41.610 used that very effectively in patients who are 00:12:41.610 --> 00:12:44.230 obese and actually decrease their risk. But if 00:12:44.230 --> 00:12:46.750 you look at what's actually happening, realistically, 00:12:46.970 --> 00:12:49.629 they're just restricting their calories, losing 00:12:49.629 --> 00:12:51.990 weight. And yeah, so. Yeah, my mother -in -law 00:12:51.990 --> 00:12:53.870 was in that study, in the pilot study for the 00:12:53.870 --> 00:12:55.850 healthy keto. So she was one of those individuals, 00:12:55.950 --> 00:12:58.210 the elderly, you know, 65 plus Singaporeans that 00:12:58.210 --> 00:13:00.190 was given the meals and all this stuff. And it 00:13:00.190 --> 00:13:02.549 was wonderful, you know, and I think, you know, 00:13:02.549 --> 00:13:05.809 healthy. keto it needs to be rebranded to something 00:13:05.809 --> 00:13:08.429 that isn't because as soon as people hear keto 00:13:08.429 --> 00:13:10.269 they think oh no no I have a heart problem I 00:13:10.269 --> 00:13:12.029 can't do keto and it's like okay what can we 00:13:12.029 --> 00:13:15.299 call it I feel like pumped up pescetarian but 00:13:15.299 --> 00:13:19.100 it's really great because they got a thumbs up 00:13:19.100 --> 00:13:22.179 or a thumbs down depending on if the food fit 00:13:22.179 --> 00:13:24.299 the framework you know so for for elderly people 00:13:24.299 --> 00:13:26.200 it was fantastic right because it's very clear 00:13:26.200 --> 00:13:28.759 thumbs up thumbs down no need to track macros 00:13:28.759 --> 00:13:30.559 you just see the little thumb yeah and then obviously 00:13:30.559 --> 00:13:32.100 the meal delivery service was the additional 00:13:32.100 --> 00:13:34.639 level it was such a great program so props to 00:13:34.639 --> 00:13:36.799 that doc yeah it was great it's amazing and i 00:13:36.799 --> 00:13:38.679 think that these are like at the end of the day 00:13:38.679 --> 00:13:40.340 that's what you need you need people who are 00:13:40.340 --> 00:13:42.879 really doing things completely differently to 00:13:42.879 --> 00:13:45.240 actually change you know how people see things 00:13:45.240 --> 00:13:47.059 and how they do things because if not every singaporean 00:13:47.059 --> 00:13:51.039 is going to be like where do i get healthy You 00:13:51.039 --> 00:13:53.840 know, for example. Exactly. Yeah. And until until 00:13:53.840 --> 00:13:55.600 unfortunately the Hawker Center has like cognac 00:13:55.600 --> 00:13:57.059 noodles or something, you know, something that's 00:13:57.059 --> 00:13:59.299 like a true alternative. Yeah. It's never going 00:13:59.299 --> 00:14:01.919 to change. But even then it's going to be pricier. 00:14:02.059 --> 00:14:04.320 You know, so then it doesn't have to be, though. 00:14:04.379 --> 00:14:06.299 The government has plenty of money to subsidize 00:14:06.299 --> 00:14:08.639 whatever they want. Oh, yeah. OK, please don't 00:14:08.639 --> 00:14:12.460 take my podcast off the air. Maybe one day. Yeah. 00:14:12.519 --> 00:14:14.779 And I mean, so diet is obviously one huge part 00:14:14.779 --> 00:14:16.799 of lifestyle. Right. But girl, you are standing 00:14:16.799 --> 00:14:19.340 before me with these guns like we have to talk 00:14:19.340 --> 00:14:22.370 about. exercise like exercise is another massive 00:14:22.370 --> 00:14:25.210 piece of the puzzle yes so if we're talking about 00:14:25.210 --> 00:14:27.850 what exercise moves the needle toward better 00:14:27.850 --> 00:14:30.649 heart health talk to us about it it is unfortunately 00:14:30.649 --> 00:14:38.389 um cardio exercises are good for cardiology i 00:14:38.389 --> 00:14:44.509 guess it's actually quite a fair bit of exercise 00:14:44.509 --> 00:14:47.450 you need about 150 minutes a week of moderate 00:14:47.450 --> 00:14:51.159 intensity exercise Yes. Two. to say that you 00:14:51.159 --> 00:14:54.960 are gaining a benefit. What's moderate? Oh, so 00:14:54.960 --> 00:14:57.519 there's so many ways to look at it. But the way 00:14:57.519 --> 00:14:59.580 that I feel is the most accessible to most patients, 00:14:59.720 --> 00:15:02.320 it's just you can talk, but you can't sing, which 00:15:02.320 --> 00:15:04.240 is what I use for my elderly patients. We want 00:15:04.240 --> 00:15:05.799 you to be able to talk, be a bit out of breath. 00:15:05.980 --> 00:15:07.799 But if I ask you to sing, you wouldn't be able 00:15:07.799 --> 00:15:09.799 to. You know, if you've got heart rate zones, 00:15:09.919 --> 00:15:11.779 go ahead and use that. So if you're using your 00:15:11.779 --> 00:15:14.480 watch, kind of a zone two to zone three would 00:15:14.480 --> 00:15:17.539 be where you would go, bearing in mind that the 00:15:17.539 --> 00:15:19.379 watch is not super accurate for you. heart rate 00:15:19.379 --> 00:15:23.039 um but yeah it's usually half an hour five times 00:15:23.039 --> 00:15:27.039 a week or you can be like me and choose hit or 00:15:27.039 --> 00:15:28.700 high intensity interval training because then 00:15:28.700 --> 00:15:31.740 you get to do half the amount which is 15 minutes 00:15:31.740 --> 00:15:36.720 it just feels much worse 10 times harder i feel 00:15:36.720 --> 00:15:39.960 like i i mean i do do hit as well i actually 00:15:39.960 --> 00:15:42.379 prefer it i prefer to just get it over and done 00:15:42.379 --> 00:15:46.019 with Amanda, I feel the older we get, the more 00:15:46.019 --> 00:15:48.379 important protein is. But the thing is, not many 00:15:48.379 --> 00:15:50.700 women are eating enough. Absolutely. And you 00:15:50.700 --> 00:15:52.700 know, protein isn't just for muscles. It helps 00:15:52.700 --> 00:15:55.539 with hormones, metabolism, staying full longer. 00:15:55.639 --> 00:15:58.940 And don't just guess. Make quality protein a 00:15:58.940 --> 00:16:01.080 priority. And that's why we trust The Meat Club. 00:16:01.159 --> 00:16:03.440 They deliver ethically sourced meats directly 00:16:03.440 --> 00:16:06.980 to you. You can get grass -fed beef, organic 00:16:06.980 --> 00:16:10.360 chicken, wild -caught seafood. That is... nutrient 00:16:10.360 --> 00:16:12.840 dense and packed full of the good stuff. And 00:16:12.840 --> 00:16:14.740 here's the fun part. We want to see what you're 00:16:14.740 --> 00:16:18.059 cooking. Show us your creations and tag at the 00:16:18.059 --> 00:16:21.700 40s formula and at the meat club SG so that you 00:16:21.700 --> 00:16:24.740 have a chance to win $250 in the meat club goodies. 00:16:25.220 --> 00:16:27.299 Entries will close on the 5th of June and the 00:16:27.299 --> 00:16:29.539 winner will be announced on the first episode 00:16:29.539 --> 00:16:32.299 of season six. So come on guys, get cooking. 00:16:32.990 --> 00:16:34.690 And if you haven't already used The Meat Club, 00:16:34.809 --> 00:16:37.509 you can. And you can save yourself $12 off by 00:16:37.509 --> 00:16:41.830 using code TFF12. Head over to TheMeatClub .com 00:16:41.830 --> 00:16:44.990 .sg, get cooking, and who knows? You could even 00:16:44.990 --> 00:16:48.049 get $250 off your next shop. I have to say, I've 00:16:48.049 --> 00:16:49.309 been running and doing a little bit more Zone 00:16:49.309 --> 00:16:51.169 2 now, and it is still very enjoyable. Dr. Jean, 00:16:51.289 --> 00:16:55.889 so off -brand. I tried High Rocks. I did High 00:16:55.889 --> 00:16:58.230 Rocks. Did you really? I did. Here in Singapore? 00:16:58.289 --> 00:17:00.529 Yeah, we actually managed to qualify for Chicago. 00:17:01.009 --> 00:17:03.809 Wow! It's just because no one else did the pro, 00:17:03.990 --> 00:17:07.589 you know, and we were CrossFit girlies. So we 00:17:07.589 --> 00:17:09.289 were like, we have to do the heavier weights. 00:17:09.309 --> 00:17:12.529 So we did them and nobody else did it in our 00:17:12.529 --> 00:17:14.589 age group really. And we were like second and 00:17:14.589 --> 00:17:17.200 we were like, oh. Oops. So now I've got to go 00:17:17.200 --> 00:17:19.019 there and be not embarrassing. So we've been 00:17:19.019 --> 00:17:21.980 running. But you will have to run. That's true 00:17:21.980 --> 00:17:23.720 fact. That's what puts me off my rocks is the 00:17:23.720 --> 00:17:25.200 running. I'm going to be honest with you. It's 00:17:25.200 --> 00:17:26.579 a running event with some other things. Yeah, 00:17:26.599 --> 00:17:28.900 but it's only 1K at a time. So it makes it a 00:17:28.900 --> 00:17:29.839 little bit more. I do like the other things. 00:17:29.859 --> 00:17:32.279 I love the idea of the other things. Just the 00:17:32.279 --> 00:17:35.119 running. I'm like, ah, it's still 8K. Can I do 00:17:35.119 --> 00:17:37.140 it? Just think about 1K at a time. That usually 00:17:37.140 --> 00:17:38.740 helps. Because that is what you literally have 00:17:38.740 --> 00:17:40.500 to think about. Even those laps, right? It's 00:17:40.500 --> 00:17:41.920 like one lap at a time. And then it's like, okay, 00:17:41.960 --> 00:17:45.240 I can get three in the night. So because of that, 00:17:45.299 --> 00:17:47.400 I've been doing a little bit more running. So 00:17:47.400 --> 00:17:49.640 that's nice. It's nice to get a variety once 00:17:49.640 --> 00:17:51.920 in a while. But the hit's great, especially if 00:17:51.920 --> 00:17:56.609 you're busy. Women are always busy, I feel. You're 00:17:56.609 --> 00:17:58.750 stuck with all sorts of responsibilities sometimes 00:17:58.750 --> 00:18:01.670 you did or did not ask for. Can I ask you about 00:18:01.670 --> 00:18:03.410 the HIIT though? So I think this is something 00:18:03.410 --> 00:18:05.710 that I think women in their 40s get a ton of 00:18:05.710 --> 00:18:08.789 conflicting evidence about, right? So let's talk 00:18:08.789 --> 00:18:12.089 about what is HIIT. Okay, so what type of exercise 00:18:12.089 --> 00:18:15.410 qualifies in that category? And then what the 00:18:15.410 --> 00:18:18.170 dosage of that exercise would be optimally? And 00:18:18.170 --> 00:18:19.450 then, you know, I'll bring up my counterpoint. 00:18:19.450 --> 00:18:22.309 So again, very, very debatable, even amongst 00:18:22.309 --> 00:18:25.220 the cardiac. rehabilitation community. People 00:18:25.220 --> 00:18:27.460 don't quite know, even in the cardiac rehabilitation 00:18:27.460 --> 00:18:30.380 community, how to administer HIT in a consistent 00:18:30.380 --> 00:18:33.140 way. Because, you know, continuous 30 minutes, 00:18:33.220 --> 00:18:35.319 everyone knows how to do that. Plunk a patient 00:18:35.319 --> 00:18:38.480 on the treadmill, set it, look at your heart 00:18:38.480 --> 00:18:40.400 rate and go, yeah, you've done 30 minutes. But 00:18:40.400 --> 00:18:42.359 there, you know, anything that kind of increases 00:18:42.359 --> 00:18:45.500 your RPEs to, I mean, we're going out of 10 here. 00:18:45.619 --> 00:18:47.960 So seven, seven and above, six to seven and above, 00:18:48.019 --> 00:18:50.460 or your heart rate zones are four to five and 00:18:50.460 --> 00:18:53.000 you come back down, that is HIT. So you're doing 00:18:53.000 --> 00:18:55.220 high intensity at various intervals. People have 00:18:55.220 --> 00:18:58.839 gone anything from eight minutes on, one minute 00:18:58.839 --> 00:19:01.119 off, which is literally like, what, two cycles? 00:19:01.279 --> 00:19:05.000 To going four minutes on, one minute off, anything. 00:19:05.140 --> 00:19:07.660 People have found that regardless of which one 00:19:07.660 --> 00:19:10.920 you do, they do provide some benefit. There are 00:19:10.920 --> 00:19:12.660 studies that have suggested that they increase 00:19:12.660 --> 00:19:17.059 your VO2 max a little bit quicker, faster, and 00:19:17.059 --> 00:19:20.220 there's more time saving. But these, if I remember 00:19:20.220 --> 00:19:23.279 correctly, they're still a little bit because 00:19:23.279 --> 00:19:26.380 we're not really testing a person's true VO2 00:19:26.380 --> 00:19:28.819 max most of the time. We're taking a watch parameter 00:19:28.819 --> 00:19:31.500 or something along those lines. VO2 max seems 00:19:31.500 --> 00:19:32.960 to be the buzzword right now. Lots of people 00:19:32.960 --> 00:19:34.819 are talking about it. So for people who don't 00:19:34.819 --> 00:19:36.180 know, could you just explain what that means? 00:19:36.200 --> 00:19:38.619 So this is perfect time because I just went. 00:19:39.079 --> 00:19:43.099 for a VO2 max, like a CPAT study. So the cardiopulmonary 00:19:43.099 --> 00:19:45.779 exercise test study thing yesterday or the day 00:19:45.779 --> 00:19:48.440 before. So basically we're testing when your 00:19:48.440 --> 00:19:50.579 body changes from using aerobic to anaerobic 00:19:50.579 --> 00:19:53.180 exercise. And that is kind of the maximum kind 00:19:53.180 --> 00:19:56.259 of oxygen your body can process beyond that it's 00:19:56.259 --> 00:19:58.599 processing carbon dioxide in my very layman terms 00:19:58.599 --> 00:20:01.039 of describing it. So it's like you're a lactate. 00:20:01.230 --> 00:20:03.970 threshold. People use it to determine fitness, 00:20:04.250 --> 00:20:06.769 health and things like that. There are some people 00:20:06.769 --> 00:20:09.309 who believe that your maximum VO2 max you could 00:20:09.309 --> 00:20:11.349 ever achieve is genetic and it's not something 00:20:11.349 --> 00:20:13.289 you can change. I don't want to believe that. 00:20:13.329 --> 00:20:16.390 If not, why am I running so much? What is training? 00:20:17.450 --> 00:20:20.990 Why? Are you willing to share your result? No, 00:20:20.990 --> 00:20:24.549 I didn't do it. I've got mine on my watch, but 00:20:24.549 --> 00:20:26.789 I don't believe that one. If you ever want to 00:20:26.789 --> 00:20:29.890 test, my husband and I run an exercise lab. We 00:20:29.890 --> 00:20:32.089 administer VO2 to test every single day. It is 00:20:32.089 --> 00:20:34.730 one of the joys of my life. As you know, nothing 00:20:34.730 --> 00:20:36.869 I hate more than testing myself, but nothing 00:20:36.869 --> 00:20:39.309 I love more than testing others. Because it's 00:20:39.309 --> 00:20:41.930 so, first of all, it's a beautiful study in physiology. 00:20:42.289 --> 00:20:45.049 Second of all, it's a beautiful -er study in 00:20:45.049 --> 00:20:47.730 psychology. Because when you, this is what I 00:20:47.730 --> 00:20:49.789 wanted to bring up with women pushing to zones 00:20:49.789 --> 00:20:51.690 four and five, or pushing toward your functional 00:20:51.690 --> 00:20:55.519 maximum. It is uncomfortable. okay it's uncomfortable 00:20:55.519 --> 00:20:59.839 is uh putting it lightly you you get to the point 00:20:59.839 --> 00:21:01.599 well let's put it this way it teaches you a lot 00:21:01.599 --> 00:21:04.279 about yourself in terms of what you can handle 00:21:04.279 --> 00:21:06.460 and and what you're willing to trade off yeah 00:21:06.460 --> 00:21:08.480 you know so you mentioned which i agree with 00:21:08.480 --> 00:21:12.160 hit is excellent for time poor women right you 00:21:12.160 --> 00:21:14.180 don't have a lot of time do you have 15 to 20 00:21:14.180 --> 00:21:16.720 minutes yeah let's hit it that sounds very appealing 00:21:16.720 --> 00:21:19.519 when you're actually in the zone five workout 00:21:19.930 --> 00:21:22.269 And you are operating at a heart rate of, you 00:21:22.269 --> 00:21:25.269 know, like for me, like 176. It's unbelievably 00:21:25.269 --> 00:21:27.529 uncomfortable. It's so awful. It almost pushes 00:21:27.529 --> 00:21:28.990 you to the point of panic because you're like, 00:21:29.049 --> 00:21:31.630 can I finish? Can I keep on going? Right. So 00:21:31.630 --> 00:21:35.650 the cortisol and the stress after that, you know, 00:21:35.650 --> 00:21:39.309 of that intensity of effort can be really difficult. 00:21:39.410 --> 00:21:41.750 I think for particular for some women, particularly 00:21:41.750 --> 00:21:43.920 those who have a lot of. chronic stressors in 00:21:43.920 --> 00:21:45.579 their life yeah so this was kind of my point 00:21:45.579 --> 00:21:49.619 is like is HIT for everyone um are there patients 00:21:49.619 --> 00:21:52.819 that you would advise choosing different modalities 00:21:52.819 --> 00:21:56.640 it's very personal what you decide to to me I 00:21:56.640 --> 00:21:59.099 you know I it's very crudely I say I don't care 00:21:59.099 --> 00:22:01.079 what you're doing as long as you're doing something 00:22:01.079 --> 00:22:02.700 and you enjoy it I think that's what we also 00:22:02.700 --> 00:22:04.539 say and it's something you can maintain yeah 00:22:04.539 --> 00:22:07.480 and for me that might be hit because it's faster 00:22:07.480 --> 00:22:10.059 it's quicker I enjoy it chronic stress wise I 00:22:10.059 --> 00:22:12.960 feel that it's a great place to to expend all 00:22:12.960 --> 00:22:15.660 of the stress. Especially in CrossFit when you've 00:22:15.660 --> 00:22:18.519 got some weights to smash around. It's great 00:22:18.519 --> 00:22:20.779 just being able to drop something and it not 00:22:20.779 --> 00:22:22.740 break, you know? And it's funny you say that 00:22:22.740 --> 00:22:24.400 about like expressing stress, right? Because 00:22:24.400 --> 00:22:26.039 yeah, so you can probably tell from the way I 00:22:26.039 --> 00:22:28.039 describe it. Zone five makes you want to die. 00:22:28.559 --> 00:22:30.640 The CrossFit Open is literally my worst nightmare. 00:22:30.759 --> 00:22:32.119 It's my worst nightmare. It's like having to 00:22:32.119 --> 00:22:34.559 perform at my best over and over and over. Usually 00:22:34.559 --> 00:22:37.359 I give my best like once a year. I have to give 00:22:37.359 --> 00:22:39.960 my best three times. Anyway, you know, I hear 00:22:39.960 --> 00:22:42.259 a lot of women say like, oh, you know, I love 00:22:42.259 --> 00:22:44.660 exercising because it like, you know, I think 00:22:44.660 --> 00:22:46.539 about my kids and the example I want to set for 00:22:46.539 --> 00:22:48.519 them or whatever. I actually, when I'm exercising 00:22:48.519 --> 00:22:51.680 at that level, it's when I do not think about 00:22:51.680 --> 00:22:53.920 my kids. I don't think about anything. I think 00:22:53.920 --> 00:22:57.660 about raw survival, getting through without disease. 00:22:57.920 --> 00:22:59.720 And like, you know, it's one of those things 00:22:59.720 --> 00:23:02.640 where I think that can be appealing. Like if 00:23:02.640 --> 00:23:04.640 for women who've never tried it, and I'm not 00:23:04.640 --> 00:23:06.200 saying CrossFit, I'm just saying that intensity 00:23:06.200 --> 00:23:09.440 of exercise. Yeah. Being able to have an outlet 00:23:09.440 --> 00:23:12.619 like that can be really powerful. And so dissuading 00:23:12.619 --> 00:23:15.200 women away from it, I think is a bit of a disservice, 00:23:15.220 --> 00:23:17.359 right? Because it's like, hey, it could actually 00:23:17.359 --> 00:23:19.960 be a solution for you, you know, for women who 00:23:19.960 --> 00:23:22.069 struggle with. lots of stress i really resonate 00:23:22.069 --> 00:23:24.349 with that i feel like the only time my brain 00:23:24.349 --> 00:23:28.089 is not thinking of something else is when it's 00:23:28.089 --> 00:23:31.190 thinking about trying not to die yeah breathing 00:23:31.190 --> 00:23:33.470 yes yeah which is really because you're just 00:23:33.470 --> 00:23:36.250 like i'm taking a breath i'm okay yeah okay i'm 00:23:36.250 --> 00:23:38.690 not gonna die it's so true i feel like when you're 00:23:38.690 --> 00:23:40.869 in the gym you have like two types of people 00:23:40.869 --> 00:23:42.990 especially when the countdown's on for that exercise 00:23:42.990 --> 00:23:45.490 you've got the last i don't know 10 seconds left 00:23:45.490 --> 00:23:46.509 and you've got the people who are like right 00:23:46.509 --> 00:23:48.390 i'm going to smash it and i'm going to go hard 00:23:48.390 --> 00:23:49.930 then you've got that oh there's 10 seconds left 00:23:49.930 --> 00:23:52.069 i can stop now they put it down yep they put 00:23:52.069 --> 00:23:53.410 the kettlebell down they're like that was enough 00:23:53.410 --> 00:23:56.450 they're still trying though yeah i mean yeah 00:23:56.450 --> 00:23:58.089 everybody's in the same room and i appreciate 00:23:58.089 --> 00:23:59.829 that and that that's what i love about crossroads 00:23:59.829 --> 00:24:02.519 like everyone's there together yeah Regardless, 00:24:02.700 --> 00:24:05.660 I mean, everyone is dying in their own way. So 00:24:05.660 --> 00:24:08.359 I think, you know, whether you look like you're 00:24:08.359 --> 00:24:11.079 dying less than someone next to you doesn't mean 00:24:11.079 --> 00:24:13.960 that you are. I do think that, you know, exercise 00:24:13.960 --> 00:24:17.319 is a very personal choice because I've, and I 00:24:17.319 --> 00:24:20.200 think. if you've been exercising like all your 00:24:20.200 --> 00:24:21.940 life if you played sports growing up if you've 00:24:21.940 --> 00:24:24.039 been running if you were like in a situation 00:24:24.039 --> 00:24:26.799 where you were dying as a 13 year old yes doing 00:24:26.799 --> 00:24:28.599 a sport and your coach was like you're not dying 00:24:28.599 --> 00:24:32.019 get up and go you know you know that you can 00:24:32.019 --> 00:24:34.200 push yourself but i've met women who have never 00:24:34.200 --> 00:24:36.960 exercised all their life come to me and gone 00:24:36.960 --> 00:24:39.480 like i went for a run with my partner and i was 00:24:39.480 --> 00:24:41.920 breathing a bit hard and something is wrong with 00:24:41.920 --> 00:24:45.980 me and Usually I'm like, you know, that's exercise. 00:24:46.400 --> 00:24:48.960 That's exercise. And yeah, that's exercise. And 00:24:48.960 --> 00:24:50.779 also like wink, like you might be out of shape. 00:24:51.079 --> 00:24:52.960 It may be an indicator. But you have to tell 00:24:52.960 --> 00:24:56.420 them really nicely. But so there's been situations 00:24:56.420 --> 00:24:58.220 where I've had to talk to people to explain to 00:24:58.220 --> 00:25:00.539 them like that is what happens when you breathe. 00:25:00.640 --> 00:25:02.099 And they're like, no, there has to be something 00:25:02.099 --> 00:25:04.099 wrong with me because everybody else doesn't 00:25:04.099 --> 00:25:06.500 look as out of breath as I do. I'm like, oh, 00:25:06.519 --> 00:25:09.759 sweetie. Yeah, just try again. Like it's honestly 00:25:09.759 --> 00:25:12.059 true. Well, so this actually is a good segue 00:25:12.059 --> 00:25:14.319 into what I wanted to ask you. getting deeper 00:25:14.319 --> 00:25:17.180 into women and exercise right i have found in 00:25:17.180 --> 00:25:19.720 my profession that i've seen two major drop -offs 00:25:19.720 --> 00:25:22.019 right in terms of when women lose their fitness 00:25:22.019 --> 00:25:25.789 level yeah one is pregnancy yep One is perimenopause 00:25:25.789 --> 00:25:28.130 and menopause, the transition. Those two transitional 00:25:28.130 --> 00:25:31.069 periods I feel are like when women really start 00:25:31.069 --> 00:25:32.910 to kind of lose the script on their consistency, 00:25:33.230 --> 00:25:36.430 on their self -doubt starts to creep in because 00:25:36.430 --> 00:25:38.390 their bodies are changing. Do you see that as 00:25:38.390 --> 00:25:41.069 a cardiologist? And then if so, how do you encourage 00:25:41.069 --> 00:25:43.250 women to keep going through these times? Even 00:25:43.250 --> 00:25:45.750 at this point, you know, my friends, everything 00:25:45.750 --> 00:25:48.170 like that. But I think my job is to tell them 00:25:48.170 --> 00:25:50.910 it's okay. It's okay if for a phase in their 00:25:50.910 --> 00:25:54.269 life they can't. really exercise we've got you 00:25:54.269 --> 00:25:55.990 know a lot of great health coaches who work with 00:25:55.990 --> 00:25:59.230 us nowadays who try and find little pockets of 00:25:59.230 --> 00:26:02.509 time that patients can go and exercise so they 00:26:02.509 --> 00:26:04.470 would be they would say you could take the stairs 00:26:04.470 --> 00:26:07.369 instead of take the elevator and our general 00:26:07.369 --> 00:26:09.730 mantra is that something's better than nothing 00:26:10.430 --> 00:26:12.369 Five minutes is better than zero minutes. So 00:26:12.369 --> 00:26:15.529 even if that's all you can find, try and do it. 00:26:15.529 --> 00:26:17.230 Try and do something with your kids if that's 00:26:17.230 --> 00:26:19.630 possible. But if it's really not, if it's really 00:26:19.630 --> 00:26:21.990 not possible at this point in your life, then 00:26:21.990 --> 00:26:24.769 maybe that's OK. Put a pin in it. Come back to 00:26:24.769 --> 00:26:28.029 it later. You know, I mean, I don't want to add 00:26:28.029 --> 00:26:30.890 additional stress onto a woman who is probably 00:26:30.890 --> 00:26:33.210 struggling, you know, being a first time mom 00:26:33.210 --> 00:26:36.049 or with. suddenly two kids from one you know 00:26:36.049 --> 00:26:39.089 so they're chasing everyone around all the time 00:26:39.089 --> 00:26:42.670 so i usually tell them that phases in life happen 00:26:42.670 --> 00:26:45.549 and it happens for everyone and it's okay if 00:26:45.549 --> 00:26:47.410 for a period of time you can't you can't do it 00:26:47.410 --> 00:26:49.769 yeah but when you're ready get back to it get 00:26:49.769 --> 00:26:51.490 back to it it's funny that you say that right 00:26:51.490 --> 00:26:53.529 because like so i'm obviously a huge advocate 00:26:53.529 --> 00:26:57.250 of exercise in pregnancy but having to choose 00:26:57.250 --> 00:26:59.789 something different you know i mean like you 00:26:59.789 --> 00:27:01.750 may be able to do crossfit and then and then 00:27:01.750 --> 00:27:03.869 that's great you know but you may not So then 00:27:03.869 --> 00:27:06.529 being able to choose something better than nothing 00:27:06.529 --> 00:27:09.349 is still an option. You know, it's like, I totally 00:27:09.349 --> 00:27:10.750 agree with you there. It's like, fine, you know, 00:27:10.750 --> 00:27:13.130 either, yeah, know that it's all temporary, you 00:27:13.130 --> 00:27:14.789 know, whatever adjustment that you have to make. 00:27:15.130 --> 00:27:17.069 Okay, so now we've talked a lot about cardio, 00:27:17.170 --> 00:27:20.250 right? Let's talk about strength. Is there any 00:27:20.250 --> 00:27:22.829 correlation between strength training, muscle 00:27:22.829 --> 00:27:26.210 development, accumulation of lean mass, and the 00:27:26.210 --> 00:27:27.750 prevention of heart disease? Are those two things 00:27:27.750 --> 00:27:29.890 linked? I think for heart disease prevention, 00:27:30.289 --> 00:27:32.430 you can always say that if you've got more lean 00:27:32.430 --> 00:27:35.789 muscle, you're able to keep fat off, especially 00:27:35.789 --> 00:27:38.490 visceral fat. That's going to improve your cardiovascular 00:27:38.490 --> 00:27:40.650 outcomes. But I think if you're talking about 00:27:40.650 --> 00:27:42.990 directly kind of making your heart stronger, 00:27:43.210 --> 00:27:46.130 better, less the lower likelihood of heart disease, 00:27:46.470 --> 00:27:51.109 that's probably not something that has come up. 00:27:51.250 --> 00:27:54.029 That being said, when we run a cardiac rehab 00:27:54.029 --> 00:27:56.130 program, we still involve strength and resistance 00:27:56.130 --> 00:27:59.339 training. say weight training, because not everybody 00:27:59.339 --> 00:28:01.960 likes weights, but we want to maintain bone density, 00:28:02.200 --> 00:28:06.000 especially muscle mass, balance and stability. 00:28:06.299 --> 00:28:07.839 I mean, these are going to all help us as we 00:28:07.839 --> 00:28:10.700 age. If your heart's healthy, but you fall down 00:28:10.700 --> 00:28:13.160 when you're going down a flight of stairs, it's 00:28:13.160 --> 00:28:15.059 still not great. No, still not great. Still not 00:28:15.059 --> 00:28:16.240 great. Still don't land you in the hospital. 00:28:16.640 --> 00:28:20.019 Have you ever seen someone who is relatively 00:28:20.019 --> 00:28:24.480 fit, you know, lots, plenty of muscle mass, great 00:28:24.480 --> 00:28:27.740 bone density, but has heart disease heart disease 00:28:27.740 --> 00:28:30.359 yeah oh wow because there's a lot of things that 00:28:30.359 --> 00:28:32.359 are just genetic that we can't control yeah so 00:28:32.359 --> 00:28:36.019 like apb yeah and even then you know like just 00:28:36.019 --> 00:28:38.180 just even if you've got high cholesterol in your 00:28:38.180 --> 00:28:40.559 family which a lot of asians and singaporeans 00:28:40.559 --> 00:28:44.119 do we look really healthy but all of us have 00:28:44.119 --> 00:28:47.500 terrible cholesterols um and a lot some of my 00:28:47.500 --> 00:28:48.900 patients come up to me and be like i exercise 00:28:48.900 --> 00:28:51.059 all my life why do i have heart disease and they 00:28:51.059 --> 00:28:53.960 feel really upset they cheated right like i did 00:28:53.960 --> 00:28:56.500 this yes they get invested and and this happens 00:28:56.500 --> 00:28:57.940 and i tell them well if you didn't do all of 00:28:57.940 --> 00:29:00.160 this you would have gotten heart disease 10 10 00:29:00.160 --> 00:29:02.380 years earlier five years earlier it's not it's 00:29:02.380 --> 00:29:04.240 not like you could have prevented it completely 00:29:04.240 --> 00:29:06.900 but you've delayed it significantly there is 00:29:06.900 --> 00:29:09.599 also a very unfortunate side of all these things 00:29:09.599 --> 00:29:12.180 where over training and marathon training and 00:29:12.519 --> 00:29:15.279 and um and uh kind of long distance endurance 00:29:15.279 --> 00:29:18.259 athletes do get calcium in their heart arteries 00:29:18.259 --> 00:29:20.839 um over time and that's because of just what 00:29:20.839 --> 00:29:23.000 they think is the higher shear pressures in your 00:29:23.000 --> 00:29:25.880 in your arteries but um you know that's a whole 00:29:25.880 --> 00:29:28.400 nother aspect of things yeah that's interesting 00:29:28.400 --> 00:29:31.019 i you know everyone obviously thinks cardio more 00:29:31.019 --> 00:29:33.599 if cardio is good more cardio is better but not 00:29:33.599 --> 00:29:35.740 necessarily not necessarily there's there i can't 00:29:35.740 --> 00:29:37.200 remember off the top of my head but there is 00:29:37.200 --> 00:29:39.920 like a a peak amount that beyond that that people 00:29:39.920 --> 00:29:42.799 do think that it's not good for you but it's 00:29:42.799 --> 00:29:44.740 very hard to define because again your genetics 00:29:44.740 --> 00:29:47.079 you know how your body is really contributes 00:29:47.079 --> 00:29:49.119 into whether you develop those things you mentioned 00:29:49.119 --> 00:29:52.000 visceral fat so can you talk about if you don't 00:29:52.000 --> 00:29:54.720 mind what is visceral fat like why is why is 00:29:54.720 --> 00:29:57.160 this word such a dirty word right and how does 00:29:57.160 --> 00:29:59.200 it correlate with heart disease so visceral fat 00:29:59.200 --> 00:30:02.430 is just the fat around your organs In terms of 00:30:02.430 --> 00:30:04.369 heart disease correlation, I believe that it's 00:30:04.369 --> 00:30:06.369 kind of correlated to your general, you know, 00:30:06.390 --> 00:30:08.069 your cholesterol levels and everything as well 00:30:08.069 --> 00:30:10.369 and your general health. So I think that kind 00:30:10.369 --> 00:30:13.049 of correlates to heart disease. Do you guys assess 00:30:13.049 --> 00:30:15.549 that with patients? Are you able to? Not often. 00:30:15.569 --> 00:30:18.369 We still use very crude metrics here. BMI, things 00:30:18.369 --> 00:30:21.069 like that. Yeah. So there's weight circumference 00:30:21.069 --> 00:30:22.970 as well. There's a certain, I can't remember 00:30:22.970 --> 00:30:25.390 now, if your weight circumference is above a 00:30:25.390 --> 00:30:28.380 certain number. at high risk of a whole bunch 00:30:28.380 --> 00:30:30.099 of things. Yeah, I do have that number just because 00:30:30.099 --> 00:30:32.240 I just gave a talk on it. So it's for Asians 00:30:32.240 --> 00:30:36.660 80, 8 -0, Asian females, 88. for caucasian which 00:30:36.660 --> 00:30:39.180 is actually quite a big difference yes i know 00:30:39.180 --> 00:30:41.440 it's a massive difference yeah but it's also 00:30:41.440 --> 00:30:44.420 not a lot really you know i mean i mean i guess 00:30:44.420 --> 00:30:47.019 if you look at our relative sizes if you look 00:30:47.019 --> 00:30:49.500 at me versus jasmine i think you see the difference 00:30:49.500 --> 00:30:51.839 no but i mean you see lots of people with who 00:30:51.839 --> 00:30:54.700 have to be above 80 or 80 oh yeah right yeah 00:30:54.700 --> 00:30:57.279 you think oh actually maybe i should be a little 00:30:57.279 --> 00:30:58.859 bit oh you're saying like those numbers aren't 00:30:58.859 --> 00:31:07.640 that big yeah yeah no they're not But no, but 00:31:07.640 --> 00:31:09.700 yeah, it's actually not that big. Like I would 00:31:09.700 --> 00:31:12.380 say in our practice, and obviously we see self 00:31:12.380 --> 00:31:14.099 -selected people for weight management. So of 00:31:14.099 --> 00:31:15.779 course, you know, but like, yeah, it's actually 00:31:15.779 --> 00:31:19.019 very rare that we see an ADCM or below coming 00:31:19.019 --> 00:31:21.200 in with a weight problem, right? Like usually 00:31:21.200 --> 00:31:23.000 if there is an existing weight problem, if BMI 00:31:23.000 --> 00:31:26.079 is out of normative category, then it's, yeah, 00:31:26.160 --> 00:31:28.299 it's. Except when I say rare, I think I can't 00:31:28.299 --> 00:31:30.839 think of a single patient that was under 80 but 00:31:30.839 --> 00:31:32.660 had like physical fat problems and all this stuff. 00:31:32.759 --> 00:31:34.839 But I think we use quite crude. We still use 00:31:34.839 --> 00:31:37.720 BMI. I mean, we don't necessarily want to subject 00:31:37.720 --> 00:31:39.559 all our patients to all those, you know, fat 00:31:39.559 --> 00:31:41.019 testing, things like that. Not in a hospital 00:31:41.019 --> 00:31:43.359 setting, I think. And also because you've got 00:31:43.359 --> 00:31:44.839 too many different machines. They're not sure 00:31:44.839 --> 00:31:46.680 if they're validated, all of those things, you 00:31:46.680 --> 00:31:48.900 know. They're useful for if you work out, if 00:31:48.900 --> 00:31:50.460 you're at the gym, you want to see your fat percentage 00:31:50.460 --> 00:31:52.740 change. But I think in a setting where the patient's, 00:31:52.839 --> 00:31:55.400 someone's clearly unhealthy or clearly needs 00:31:55.400 --> 00:31:57.660 to modify risk. factors and so i guess you would 00:31:57.660 --> 00:31:59.480 know like if someone came in and they had a bmi 00:31:59.480 --> 00:32:02.180 of 25 but they look like it's muscle probably 00:32:02.180 --> 00:32:04.900 not too much of an issue but if it's obviously 00:32:04.900 --> 00:32:09.079 not and they yeah you can tell yeah you can tell 00:32:09.079 --> 00:32:12.720 generally so talk us through a day as a cardiologist 00:32:12.720 --> 00:32:15.519 so like what what type of patients are you seeing 00:32:15.519 --> 00:32:17.890 are you seeing patients like you know like like 00:32:17.890 --> 00:32:20.049 what urgency do you know i mean like are you 00:32:20.049 --> 00:32:21.789 like you know on the ground saving people's lives 00:32:21.789 --> 00:32:25.410 that sounds i mean that's that's what the tv 00:32:25.410 --> 00:32:27.329 would suggest yeah that is what i'm basing it 00:32:27.329 --> 00:32:30.589 on that yes i think i i think um at least where 00:32:30.589 --> 00:32:34.250 i work um i'm quite lucky that we don't rotate 00:32:34.250 --> 00:32:37.089 on the wards that much but when we do it's it's 00:32:37.089 --> 00:32:40.349 awful um so meaning that we're really busy so 00:32:40.349 --> 00:32:42.970 i actually work out in the west of singapore 00:32:42.970 --> 00:32:47.509 um in the hospital there so uh when We are on 00:32:47.509 --> 00:32:50.390 the wards. We go in for the morning. We see up 00:32:50.390 --> 00:32:52.650 to 40 patients in the morning. In the morning, 00:32:52.670 --> 00:32:53.670 just in the morning? In the morning, like in 00:32:53.670 --> 00:32:57.190 the rounds in the hospital. And then we run a 00:32:57.190 --> 00:32:59.650 chest plane clinic in the afternoon and our teams 00:32:59.650 --> 00:33:02.349 do an exit round in the afternoon, which if they've 00:33:02.349 --> 00:33:04.329 got any issues, they highlight to us. And then 00:33:04.329 --> 00:33:07.049 we're on call the whole week as well. So if there's 00:33:07.049 --> 00:33:10.079 any issues with patients overnight. um someone 00:33:10.079 --> 00:33:12.759 can't read an ecg they give us a call so that's 00:33:12.759 --> 00:33:16.200 kind of the more exciting part of it exciting 00:33:16.200 --> 00:33:19.839 is a word if people have heart attacks they come 00:33:19.839 --> 00:33:22.880 in and we have to whisk them off to the lab the 00:33:22.880 --> 00:33:26.559 cath lab and get their arteries stented that's 00:33:26.559 --> 00:33:28.559 generally done by my junior doctors now or the 00:33:28.559 --> 00:33:32.980 residents so that was me some time ago But then, 00:33:32.980 --> 00:33:35.400 you know, I just have to make the decisions about 00:33:35.400 --> 00:33:37.180 what's happening with people. We get called for 00:33:37.180 --> 00:33:40.259 people who, you know, have heart attacks outside 00:33:40.259 --> 00:33:42.640 of hospital and collapse, whether we need to 00:33:42.640 --> 00:33:45.099 make some decisions about whether we're going 00:33:45.099 --> 00:33:48.079 to do an angiogram tonight, you know, things 00:33:48.079 --> 00:33:50.200 like that. That'll be my busy weeks. Yeah, that 00:33:50.200 --> 00:33:53.519 sounds busy. But the other times I run clinics. 00:33:53.539 --> 00:33:56.019 So we run clinics three to four times a week. 00:33:56.319 --> 00:34:00.819 I do run a women's heart clinic. So we see women 00:34:00.819 --> 00:34:02.720 -specific heart diseases and things like that. 00:34:02.960 --> 00:34:05.259 The rest of the time, we just see everyone. So 00:34:05.259 --> 00:34:07.259 people with any kind of heart disease or people 00:34:07.259 --> 00:34:12.219 with just chest pain. And then... I either do 00:34:12.219 --> 00:34:14.840 some imaging in the afternoon. So I look at heart 00:34:14.840 --> 00:34:16.219 scans and things like that. And then I try and 00:34:16.219 --> 00:34:17.840 go to the gym. Yeah, well, that's what I was 00:34:17.840 --> 00:34:20.539 going to say. So if you guys are hearing what 00:34:20.539 --> 00:34:23.260 a day in Dr. Jean's life is like, talk to me 00:34:23.260 --> 00:34:25.579 about how you do fit exercise in. Like, where 00:34:25.579 --> 00:34:27.500 does that even slide for you? So I'm going to 00:34:27.500 --> 00:34:29.440 be very honest and admit some days I do get lucky 00:34:29.440 --> 00:34:32.760 because I do this imaging thing. And my boss 00:34:32.760 --> 00:34:35.280 has been very supportive that if we don't need 00:34:35.280 --> 00:34:38.380 to be physically. in the hospital we can work 00:34:38.380 --> 00:34:40.320 from home so he's made it so that we can all 00:34:40.320 --> 00:34:42.679 report scans from home which has been great for 00:34:42.679 --> 00:34:45.099 the moms and in the team and things like that 00:34:45.099 --> 00:34:47.159 um so while they're looking after their kids 00:34:47.159 --> 00:34:50.059 i'm at the gym yeah um so flexible work arrangements 00:34:50.059 --> 00:34:52.159 guys works for everybody it's the best you still 00:34:52.159 --> 00:34:53.760 get your work done you know you can choose to 00:34:53.760 --> 00:34:56.090 get it Done whenever. And then that's when I 00:34:56.090 --> 00:34:58.409 try to hit the gym. On the days when I'm on the 00:34:58.409 --> 00:35:01.909 wards, it's kind of like a 6 p .m. thing. You're 00:35:01.909 --> 00:35:04.150 always getting called on the phone. So it's not 00:35:04.150 --> 00:35:07.630 the best. But, you know, I try and remember that 00:35:07.630 --> 00:35:09.510 as long as I'm doing something, it's better than 00:35:09.510 --> 00:35:11.210 nothing. I would say this really wise doctor 00:35:11.210 --> 00:35:13.050 we had on the show said something is better than 00:35:13.050 --> 00:35:16.010 nothing. Yeah. But that's again, if you can fit 00:35:16.010 --> 00:35:18.889 it in with what you just described, I mean, everyone 00:35:18.889 --> 00:35:22.050 can do it. Right. What would you say came first, 00:35:22.190 --> 00:35:24.969 the cardiologist or the CrossFitter? Definitely 00:35:24.969 --> 00:35:28.809 the cardiologist, I would say. I mean, I picked 00:35:28.809 --> 00:35:31.889 up CrossFit when I was in residency at some point. 00:35:31.909 --> 00:35:35.130 And it was because I could go for an hour class, 00:35:35.530 --> 00:35:40.170 get all of these random fun things, learn random 00:35:40.170 --> 00:35:42.309 new fun things. And I could do it at like 7 p 00:35:42.309 --> 00:35:43.929 .m. because sometimes the classes would run late. 00:35:44.090 --> 00:35:45.690 And I could go to work the whole day and then 00:35:45.690 --> 00:35:47.550 show up there. Someone would tell me what to 00:35:47.550 --> 00:35:50.519 do. um i just got to learn something new i get 00:35:50.519 --> 00:35:52.639 to like switch off my brain for a while and obviously 00:35:52.639 --> 00:35:55.639 like at that point in time you know i wasn't 00:35:55.639 --> 00:35:57.960 really thinking about where it was going in terms 00:35:57.960 --> 00:36:00.880 of whether i was ever gonna do things more competitive 00:36:00.880 --> 00:36:04.239 to be honest sometimes even now i don't really 00:36:04.239 --> 00:36:07.059 see myself as it's a bit of imposter syndrome 00:36:07.059 --> 00:36:09.800 when it comes to competing for sure for sure 00:36:09.800 --> 00:36:11.500 you're allowed to have it but you don't need 00:36:11.500 --> 00:36:14.739 to you're the real deal you know i feel like 00:36:14.739 --> 00:36:16.889 you know you know most of the time when you see 00:36:16.889 --> 00:36:19.210 me at the gym and it looks like you know everyone's 00:36:19.210 --> 00:36:20.789 like oh you're lifting so much you're lifting 00:36:20.789 --> 00:36:23.690 so heavy i'm just like it's just it felt awful 00:36:23.690 --> 00:36:27.010 yeah yeah i was just snatching 80s it's fine 00:36:27.010 --> 00:36:29.489 it's fine like it just feels awful so you just 00:36:29.489 --> 00:36:31.670 feel like you're doing your best you know and 00:36:31.670 --> 00:36:33.809 and i've been lucky that that's been good enough 00:36:33.809 --> 00:36:36.510 to to get me to experience things like competing 00:36:36.510 --> 00:36:38.949 and things like that it's amazing that you picked 00:36:38.949 --> 00:36:41.849 up crossfit you know and it wasn't like oh drinking 00:36:41.849 --> 00:36:46.269 or going to a bar and so do you feel like obviously 00:36:47.230 --> 00:36:50.030 going through medical school and doing your residency 00:36:50.030 --> 00:36:52.550 kind of influenced that journey as well a bit 00:36:52.550 --> 00:36:54.349 or was it purely just a way for you to switch 00:36:54.349 --> 00:36:56.969 off it's a little bit of both i think you know 00:36:56.969 --> 00:36:58.590 there was definitely a period of time when i 00:36:58.590 --> 00:37:00.849 was in when i was in med school and we were out 00:37:00.849 --> 00:37:03.349 drinking all the time yeah definitely you needed 00:37:03.349 --> 00:37:05.750 one of those things to be a balanced human being 00:37:05.750 --> 00:37:08.409 um but i think sometime after that i was one 00:37:08.409 --> 00:37:12.340 day i was like i'm not very fit and i was doing 00:37:12.340 --> 00:37:15.619 pole dancing for a while wow um and i realized 00:37:15.619 --> 00:37:18.320 that i couldn't go more than four minutes without 00:37:18.320 --> 00:37:20.099 feeling really out of breath and i went this 00:37:20.099 --> 00:37:22.500 is not okay like you know this i know this is 00:37:22.500 --> 00:37:24.260 not okay so that's when i started to look around 00:37:24.260 --> 00:37:26.860 for other things to do i didn't feel like um 00:37:26.860 --> 00:37:29.079 i could run because you'd spend so long on your 00:37:29.079 --> 00:37:31.659 feet in the hospital that running just felt like 00:37:31.659 --> 00:37:34.059 another extension of that yeah like my feet already 00:37:34.059 --> 00:37:36.519 hurt i'm just not gonna make them hurt more. 00:37:36.579 --> 00:37:39.599 So I think that was the choice I also made because 00:37:39.599 --> 00:37:41.139 I felt that if I'm going to have to sit there 00:37:41.139 --> 00:37:44.099 and tell my patients to go and exercise, I should. 00:37:44.360 --> 00:37:46.340 look it and now they can't argue because it's 00:37:46.340 --> 00:37:47.860 like you know some of them come in and go like 00:37:47.860 --> 00:37:50.360 do you work out and sometimes i'm like no i don't 00:37:50.360 --> 00:37:54.079 do they do they see you like like nowadays they 00:37:54.079 --> 00:37:55.960 would never ask that sometimes they do and i 00:37:55.960 --> 00:37:59.679 go like no no i mean like you're lying you're 00:37:59.679 --> 00:38:02.679 lying look at the guns obviously what do you 00:38:02.679 --> 00:38:04.659 love about crossfit like so you picked it up 00:38:04.659 --> 00:38:06.719 through your residency so you came to it as an 00:38:06.719 --> 00:38:09.360 adult let's say right it was somewhat of the 00:38:09.360 --> 00:38:11.639 gymnastics bits of it you know like just flinging 00:38:11.639 --> 00:38:13.079 yourself around i mean i was doing pole dancing 00:38:13.079 --> 00:38:15.820 so yeah similar yeah that's transferable yeah 00:38:15.820 --> 00:38:17.599 flinging yourself around something i thought 00:38:17.599 --> 00:38:20.679 that it had a good kind of balance of of cardio 00:38:20.679 --> 00:38:22.719 and like all these other random skills that you 00:38:22.719 --> 00:38:25.579 were doing um and then weightlifting just felt 00:38:25.579 --> 00:38:29.780 like something to master something that seemed 00:38:29.780 --> 00:38:33.400 difficult seemed hard but i kind of like challenging 00:38:33.400 --> 00:38:35.179 myself with something and just seeing whether 00:38:35.179 --> 00:38:37.380 you can do it or not yeah yeah so i think that 00:38:37.380 --> 00:38:39.199 was kind of the thing for me but you know it's 00:38:39.199 --> 00:38:41.599 i know it's not for everyone yeah um but there's 00:38:41.599 --> 00:38:44.210 so many people nowadays i see doing hit because 00:38:44.210 --> 00:38:46.809 you've got places so many functional uh fitness 00:38:46.809 --> 00:38:50.429 places like revel bft f45 which are way more 00:38:50.429 --> 00:38:52.510 friendly for women i think to go through yeah 00:38:52.510 --> 00:38:53.869 well that was gonna be my question right like 00:38:53.869 --> 00:38:56.590 how do you you know again we're not crossfit 00:38:56.590 --> 00:38:58.929 is not sponsoring this podcast right but let's 00:38:58.929 --> 00:39:01.449 just say the sport of functional training right 00:39:01.449 --> 00:39:04.380 so something that's different from maybe what 00:39:04.380 --> 00:39:06.440 women have been fed in the past right like you 00:39:06.440 --> 00:39:08.800 know your body pump or your yeah your zumbas 00:39:08.800 --> 00:39:11.000 and stuff like that right like how would you 00:39:11.000 --> 00:39:12.860 give advice to a woman that was looking to try 00:39:12.860 --> 00:39:15.880 something like crossfit or olympic weightlifting 00:39:15.880 --> 00:39:18.280 or using a barbell for the first time but it 00:39:18.280 --> 00:39:20.460 just seemed too intimidating like how did you 00:39:20.460 --> 00:39:22.440 walk in the door that first time i actually think 00:39:22.440 --> 00:39:25.599 i did a um a trial class somewhere and then thought 00:39:25.599 --> 00:39:27.900 i didn't like it I think this was way before 00:39:27.900 --> 00:39:30.559 and then didn't come back to it for a few years 00:39:30.559 --> 00:39:32.900 and then decided, oh. For a few years, wow. Took 00:39:32.900 --> 00:39:34.400 a few years off and then thought, you know what, 00:39:34.420 --> 00:39:35.880 that was a good time. I was like, maybe I'll 00:39:35.880 --> 00:39:39.179 try again at some place different. I think sometimes 00:39:39.179 --> 00:39:41.460 it's the place and not necessarily the exercise 00:39:41.460 --> 00:39:43.280 that you're doing. It's wherever you go nowadays, 00:39:43.380 --> 00:39:45.639 fitness is about community, right? I'm not going 00:39:45.639 --> 00:39:47.260 to say it's just CrossFit community, obviously 00:39:47.260 --> 00:39:49.400 not, because people at all of these gyms, they 00:39:49.400 --> 00:39:52.000 meet. you know like -minded people people who 00:39:52.000 --> 00:39:53.679 encourage them even if people are just going 00:39:53.679 --> 00:39:56.500 for a run club like they're meeting people that 00:39:56.500 --> 00:39:58.300 that that they like and i think that's that's 00:39:58.300 --> 00:40:00.579 part of it go with a friend then you won't be 00:40:00.579 --> 00:40:03.579 so scared and even if you're you know even if 00:40:03.579 --> 00:40:05.980 they decide not to pursue it later on at least 00:40:05.980 --> 00:40:09.320 you've changed a habit but yeah i love the the 00:40:09.320 --> 00:40:11.440 aspect of crossfit that also kind of encourages 00:40:11.440 --> 00:40:15.269 women to be strong and not just you know, the 00:40:15.269 --> 00:40:18.869 runner's body or this and that, which is fine, 00:40:18.989 --> 00:40:21.489 no judgment to anyone's body, but you know, everyone's 00:40:21.489 --> 00:40:23.710 body is different really. So you always hear 00:40:23.710 --> 00:40:28.230 sort of CrossFit and paleo together. Did you 00:40:28.230 --> 00:40:30.969 ever follow the paleo diet? Do you follow the 00:40:30.969 --> 00:40:32.570 paleo diet? What are your thoughts on it? No, 00:40:32.610 --> 00:40:36.469 I like my carbs a little bit too much. uh nah 00:40:36.469 --> 00:40:39.590 not for you not for me i think i think you know 00:40:39.590 --> 00:40:41.449 you've got all these other things that you shouldn't 00:40:41.449 --> 00:40:43.469 be doing with red meat you know people have all 00:40:43.469 --> 00:40:45.710 of those things down down that line as well but 00:40:45.710 --> 00:40:49.090 i think um if you were really subscribed to the 00:40:49.090 --> 00:40:52.329 full crossfit thing back then it probably that's 00:40:52.329 --> 00:40:53.929 what i think they're they teach in their level 00:40:53.929 --> 00:40:56.130 one course they tell you to go on paleo and stuff 00:40:56.130 --> 00:40:59.409 like that but um that for me felt a little bit 00:40:59.409 --> 00:41:03.719 too much of a one track Thing one -track solution 00:41:03.719 --> 00:41:06.400 when there's many many ways to lose weight this 00:41:06.400 --> 00:41:08.360 many ways to have a healthy diet I was strict 00:41:08.360 --> 00:41:10.579 paleo when I got when I joined CrossFit in 2009 00:41:10.579 --> 00:41:13.739 I was also strict CrossFit when I was like in 00:41:13.739 --> 00:41:16.179 2009 when I was young and free I did four days 00:41:16.179 --> 00:41:18.519 a week every single week four to five depending 00:41:18.519 --> 00:41:21.340 right and then I was in run clubs at night so 00:41:21.340 --> 00:41:23.539 I get my cardio up and I was strict strict paleo 00:41:23.539 --> 00:41:24.920 and I think I've told you this story I had a 00:41:24.920 --> 00:41:27.239 memory my birthday that year. So it would have 00:41:27.239 --> 00:41:30.360 been my 26th birthday. I remember I would not 00:41:30.360 --> 00:41:34.440 let up paleo So. For my birthday, I had my little 00:41:34.440 --> 00:41:36.679 ground beef that I've been eating. But you probably 00:41:36.679 --> 00:41:38.639 could have had like a paleo cake, you know? I 00:41:38.639 --> 00:41:40.000 mean, nowadays there's more stuff. Oh, yeah, 00:41:40.079 --> 00:41:42.579 yeah. Back then, you're right. Yeah, you didn't 00:41:42.579 --> 00:41:45.800 have Pinterest. I was so gutted there was no 00:41:45.800 --> 00:41:48.519 Pinterest back then. That was like my prime Pinterest 00:41:48.519 --> 00:41:50.460 date. Now I'm a busy mom. Ain't nobody got time. 00:41:50.599 --> 00:41:53.179 I wouldn't do that if I was paid. But, you know, 00:41:53.219 --> 00:41:55.679 it's like I was so strict paleo because CrossFit 00:41:55.679 --> 00:41:57.820 told me to. And I was really trying to be into 00:41:57.820 --> 00:42:00.440 it and be my best. Looking back now, obviously, 00:42:00.480 --> 00:42:02.610 in the profession that I do. the maturity in 00:42:02.610 --> 00:42:04.230 the sport it's one of those things where it's 00:42:04.230 --> 00:42:07.090 like i don't necessarily think that that matches 00:42:07.090 --> 00:42:10.230 the sport as well as as well as it no was purported 00:42:10.230 --> 00:42:12.449 to so i've been so since i've you know been a 00:42:12.449 --> 00:42:14.929 bit more competitive in crossfit we have i do 00:42:14.929 --> 00:42:17.599 have a nutritionist She doesn't like me very 00:42:17.599 --> 00:42:19.440 much because half the time I don't log my food. 00:42:20.139 --> 00:42:22.659 But I'm like, I've got so many things to do. 00:42:22.820 --> 00:42:24.820 The last thing I'm thinking about doing is logging 00:42:24.820 --> 00:42:27.460 my food. You know, it's been such a evolution 00:42:27.460 --> 00:42:30.179 for everyone in CrossFit from going to something 00:42:30.179 --> 00:42:32.360 very paleo and low carb to going like, you need 00:42:32.360 --> 00:42:34.679 the carbs to perform at the level that you want 00:42:34.679 --> 00:42:37.179 to. And then her going, okay, you need to eat 00:42:37.179 --> 00:42:38.940 this and that. And you actually feeling the difference 00:42:38.940 --> 00:42:42.019 when you train. And it's been, it's been crazy 00:42:42.019 --> 00:42:44.820 because, you know, growing up, like when I grew 00:42:44.820 --> 00:42:47.989 up here in Singapore, everybody was just no carbs 00:42:47.989 --> 00:42:51.309 every girl wanted to be tiny and little i'm surprised 00:42:51.309 --> 00:42:52.889 actually that that's a big thing in singapore 00:42:52.889 --> 00:42:54.929 like i just assumed well i think being tiny and 00:42:54.929 --> 00:42:57.409 little oh yes of course whatever is the popular 00:42:57.409 --> 00:42:59.670 path to tiny and little yes yeah it makes sense 00:42:59.670 --> 00:43:02.110 it used to be like you know i would not have 00:43:02.110 --> 00:43:05.210 lunch and go play tennis the whole afternoon 00:43:05.210 --> 00:43:07.750 come home have dinner with no rice and people 00:43:07.750 --> 00:43:09.250 were just doing all of these things and that 00:43:09.250 --> 00:43:11.889 was the norm because you know people just want 00:43:11.889 --> 00:43:14.710 it to be little yeah yeah and you can imagine 00:43:14.710 --> 00:43:17.369 if we had some to actually sit us down when we 00:43:17.369 --> 00:43:19.889 were kind of school athletes or whatever we were 00:43:19.889 --> 00:43:21.849 trying to do at that point in time and just been 00:43:21.849 --> 00:43:24.030 like maybe you should eat some rice you know 00:43:24.030 --> 00:43:27.150 yeah yeah yeah oh it's so true no I mean Jasmine 00:43:27.150 --> 00:43:29.469 knows this I've been on this like well right 00:43:29.469 --> 00:43:31.489 now four month gains journey so I'm trying to 00:43:31.489 --> 00:43:33.610 put on 10 pounds of mass so I can be more competitive 00:43:33.610 --> 00:43:35.570 at CrossFit right because I always joke like 00:43:35.570 --> 00:43:37.389 the girls that are my weight in CrossFit are 00:43:37.849 --> 00:43:39.710 10 centimeters shorter than me, right? It's like, 00:43:39.730 --> 00:43:42.250 I need to get bigger. And one of the big revelations 00:43:42.250 --> 00:43:44.849 is how many carbs it takes. I don't know how 00:43:44.849 --> 00:43:47.489 you do it though. You saw me do it last night. 00:43:47.610 --> 00:43:49.570 We went out for pasta last night and I was like, 00:43:49.590 --> 00:43:52.449 I have to eat this. You went out for pasta. Sorry, 00:43:52.590 --> 00:43:54.309 we were at a pasta restaurant and I was like, 00:43:54.369 --> 00:43:55.949 I have to finish this bowl or I'll die. I had 00:43:55.949 --> 00:43:58.230 a pasta this pasta. But yeah, I mean, I think, 00:43:58.230 --> 00:44:01.510 yeah, the changing waves of nutrition when it 00:44:01.510 --> 00:44:04.489 comes to performance, I think it has made a huge, 00:44:04.730 --> 00:44:07.190 it's so much different than it was in 2009. Yeah. 00:44:07.309 --> 00:44:11.010 And I, you know, I see all these little, I'll 00:44:11.010 --> 00:44:14.090 say little kids. I see all of the younger CrossFitters 00:44:14.090 --> 00:44:16.409 coming up now. And I'm like, it's great for you 00:44:16.409 --> 00:44:18.789 that you're in a space that this can happen. 00:44:18.809 --> 00:44:21.329 And then in the US you have the rugby player, 00:44:21.489 --> 00:44:25.789 Ilona Mara, just being amazing. And people have, 00:44:25.949 --> 00:44:28.570 you know, people to look up to who don't look 00:44:28.570 --> 00:44:31.349 a specific certain way and who are healthy and 00:44:31.349 --> 00:44:33.659 strong and are confident. you know, that just 00:44:33.659 --> 00:44:35.599 builds everybody up into, into the fact that 00:44:35.599 --> 00:44:38.559 you can be strong and being strong is, is great. 00:44:38.760 --> 00:44:40.760 Yeah. That's the thing. I think everyone needs 00:44:40.760 --> 00:44:43.719 to hear this. Like. aim for strong not skinny 00:44:43.719 --> 00:44:47.539 yeah exactly aim for strong and you know my husband's 00:44:47.539 --> 00:44:49.420 always quick to say you know like like strength 00:44:49.420 --> 00:44:52.639 and size are correlated but not it doesn't have 00:44:52.639 --> 00:44:54.059 to it doesn't always mean that you need to be 00:44:54.059 --> 00:44:56.420 huger to be stronger right you can work on muscular 00:44:56.420 --> 00:44:59.519 strength aside from hypertrophy yeah or you can 00:44:59.519 --> 00:45:01.420 have both and then also you have performance 00:45:01.420 --> 00:45:03.599 no because i think hypertrophy i mean at least 00:45:03.599 --> 00:45:05.420 from what i understand is also very genetic like 00:45:05.420 --> 00:45:06.960 how much yeah how much muscle yeah what your 00:45:06.960 --> 00:45:12.210 potential yeah yeah so that's what i blame so 00:45:12.210 --> 00:45:14.869 obviously you're not skinny skinny you're not 00:45:14.869 --> 00:45:18.150 petite in that sense do you find people judge 00:45:18.150 --> 00:45:20.389 you or say things to you or are they like a bit 00:45:20.389 --> 00:45:23.210 intimidated like a bit scared all the time all 00:45:23.210 --> 00:45:28.510 the time but i think it's you know it's not always 00:45:28.510 --> 00:45:33.530 out of it's not always ill -intentioned i used 00:45:33.530 --> 00:45:35.849 to always get really sensitive about it yeah 00:45:35.849 --> 00:45:38.170 but i think that's normal i mean even now sometimes 00:45:38.170 --> 00:45:40.909 if like clothes i have don't fit i'm still like 00:45:41.969 --> 00:45:44.510 Maybe I should maybe I should cut a little bit 00:45:44.510 --> 00:45:46.530 because I want to put my clothes on, you know, 00:45:46.530 --> 00:45:49.659 but I think. I think that generally now I feel 00:45:49.659 --> 00:45:52.519 that, you know, people have come in and said 00:45:52.519 --> 00:45:54.480 like, oh, your biceps are so big, like guys can 00:45:54.480 --> 00:45:56.619 be intimidated. And people would just be like, 00:45:56.699 --> 00:45:58.820 well, you can get them if you tried. Amazing, 00:45:59.000 --> 00:46:01.000 I love that. Yeah, if you worked as hard as I 00:46:01.000 --> 00:46:03.139 did, right? I met someone at the gym. She was 00:46:03.139 --> 00:46:05.619 an ex -fighter and she looked amazing. Like you 00:46:05.619 --> 00:46:08.159 could see her muscle definition. She just looked 00:46:08.159 --> 00:46:10.460 amazing. So I asked her, you know, like a few 00:46:10.460 --> 00:46:13.719 questions and her response was, I need to lose 00:46:13.719 --> 00:46:16.079 weight. I was like, are you kidding me? like 00:46:16.079 --> 00:46:18.460 if you i don't know if she lost weight it would 00:46:18.460 --> 00:46:21.500 be muscle like she's so lean already yeah it's 00:46:21.500 --> 00:46:24.039 about you know continuing to share that and say 00:46:24.039 --> 00:46:26.320 that even if you don't fully feel it all the 00:46:26.320 --> 00:46:28.400 time just so that it's out there and everyone 00:46:28.400 --> 00:46:31.239 knows so but i think you know now generally it's 00:46:31.239 --> 00:46:34.059 it's positive things because i think being strong 00:46:34.059 --> 00:46:36.800 and exercising and having a good kind of exercise 00:46:36.800 --> 00:46:40.179 regime is what people kind of look look to or 00:46:40.179 --> 00:46:42.820 look at nowadays so generally They're good things. 00:46:43.059 --> 00:46:45.920 And I try not to see the bad things too much, 00:46:45.920 --> 00:46:48.260 as much as I can. Unless they're really mean, 00:46:48.320 --> 00:46:50.579 then I'll just be like, cool. Then you just take 00:46:50.579 --> 00:46:52.519 them in a headlock and bring them into submission. 00:46:53.500 --> 00:46:55.699 Well, so Dr. Jean, we have loved having you here 00:46:55.699 --> 00:46:57.400 today. And you've given us, first of all, a lot 00:46:57.400 --> 00:46:58.820 of laughs. And second of all, a lot of great 00:46:58.820 --> 00:47:01.679 information. But the last thing that we ask every 00:47:01.679 --> 00:47:03.179 single guest sitting in this chair, and I'm going 00:47:03.179 --> 00:47:06.179 to disclaimer, I know you're not 40 yet. So I 00:47:06.179 --> 00:47:08.199 know that this is advice coming from a youth. 00:47:08.570 --> 00:47:11.769 OK, perspective. But what's your 40s formula? 00:47:11.789 --> 00:47:14.170 What advice would you give women who are in our 00:47:14.170 --> 00:47:16.809 40s for kind of how to thrive in this decade? 00:47:16.969 --> 00:47:19.190 I always try and put on my doctor hat here because 00:47:19.190 --> 00:47:21.969 I'm looking at like a patient. And what do I 00:47:21.969 --> 00:47:24.349 say? If you're looking at some old ladies, what 00:47:24.349 --> 00:47:27.329 do you say to us? Firstly, I would say like, 00:47:27.329 --> 00:47:30.110 you're not old. That's the first thing. You were 00:47:30.110 --> 00:47:33.550 young and really healthy and you've got so much 00:47:33.550 --> 00:47:36.269 life to live. Be who you want to be at 50 and 00:47:36.269 --> 00:47:38.250 60 and 70 and continue to do the things that 00:47:38.250 --> 00:47:40.710 you love. Then you really need to kind of embrace 00:47:40.710 --> 00:47:44.610 all of these healthy lifestyle changes as much 00:47:44.610 --> 00:47:46.690 as you can. But at the same time, you're also 00:47:46.690 --> 00:47:48.349 40. You've got all sorts of other responsibilities. 00:47:48.550 --> 00:47:50.710 And if you know you have to do them, you have 00:47:50.710 --> 00:47:54.599 to do them. of try and understand especially 00:47:54.599 --> 00:47:56.400 for my patients in that age group that you're 00:47:56.400 --> 00:47:58.719 really dealing with everything at the same time 00:47:58.719 --> 00:48:01.460 and um but the first thing is that you're you 00:48:01.460 --> 00:48:03.539 know life is just kind of beginning for you as 00:48:03.539 --> 00:48:06.099 well in a way. Yeah. I love that. Yeah. We're 00:48:06.099 --> 00:48:08.099 not young. Yeah, we're not young. We're not old. 00:48:09.800 --> 00:48:12.280 We're not young, let's be fair. We are young. 00:48:12.300 --> 00:48:14.360 We're not old. But we still have a lot to do. 00:48:14.420 --> 00:48:16.380 Yeah. Yeah. There's still lots of time. There's 00:48:16.380 --> 00:48:18.420 still lots of time to do lots of things. Plenty. 00:48:18.440 --> 00:48:20.159 Well, thank you so much, Dr. Jean. Yeah, thank 00:48:20.159 --> 00:48:21.440 you so much for having me. Yeah, I see you again 00:48:21.440 --> 00:48:22.559 and thank you very much for being on the show. 00:48:22.780 --> 00:48:24.880 It was great. Thank you. Thank you. Let's be 00:48:24.880 --> 00:48:27.719 real. Perimenopause is a game changer. One day 00:48:27.719 --> 00:48:29.840 you're cruising along and the next your body 00:48:29.840 --> 00:48:32.130 puts a spanner in the works. Sometimes symptoms 00:48:32.130 --> 00:48:35.230 feel manageable. Others, well, let's just say 00:48:35.230 --> 00:48:37.269 we have to breathe through those. And I'm not 00:48:37.269 --> 00:48:39.510 there quite yet, but the research shows that 00:48:39.510 --> 00:48:42.289 staying strong physically and mentally makes 00:48:42.289 --> 00:48:44.789 a world of difference. 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And if you want to show us some 00:49:18.139 --> 00:49:19.940 love, you know you can always get us one. Just 00:49:19.940 --> 00:49:23.800 visit buymeacoffee .com slash the 40s Formula. 00:49:24.219 --> 00:49:28.000 Cheers. Before we go, please remember to hit 00:49:28.000 --> 00:49:30.519 subscribe and take a moment to support The 40s 00:49:30.519 --> 00:49:32.579 Formula by leaving a review on your favorite 00:49:32.579 --> 00:49:35.400 podcast platform. Your reviews will help us to 00:49:35.400 --> 00:49:37.400 reach more people and allow us to continue to 00:49:37.400 --> 00:49:39.619 bring valuable content. It should only take a 00:49:39.619 --> 00:49:41.280 moment and it's a free way for you to support 00:49:41.280 --> 00:49:43.599 the show. You can also stay updated with The 00:49:43.599 --> 00:49:47.599 40s Formula by following us on Instagram at The40sFormula, 00:49:47.719 --> 00:49:50.530 all one word. We share behind the scenes insights, 00:49:50.809 --> 00:49:53.809 episode updates and much more. So please be sure 00:49:53.809 --> 00:49:56.110 to hit that follow button. We appreciate your 00:49:56.110 --> 00:49:57.949 time and support. Thank you for being part of 00:49:57.949 --> 00:49:59.849 this community. And we'll be back next week for 00:49:59.849 --> 00:50:01.670 more empowering conversations with inspiring 00:50:01.670 --> 00:50:46.710 guests. Bye. What's a sticky grip? Basically, 00:50:47.329 --> 00:50:50.010 it sticks your hand to the bar. The problem with 00:50:50.010 --> 00:50:51.710 this though, have you ever had grip lock? Did 00:50:51.710 --> 00:50:55.630 you ever use sticky grips? I don't. I death grip. 00:50:55.769 --> 00:50:58.369 I don't put my thumbs around so I don't get stuck. 00:50:59.190 --> 00:51:01.989 They have like these grips that are now developed 00:51:01.989 --> 00:51:03.730 so that you barely even need to grip the bar. 00:51:03.809 --> 00:51:05.869 You just basically hang on by your wrist. But 00:51:05.869 --> 00:51:08.730 it actually makes people perform a lot better 00:51:08.730 --> 00:51:10.010 because you don't worry about grip strength and 00:51:10.010 --> 00:51:12.630 stuff. I do kind of get bruises from the frog 00:51:12.630 --> 00:51:15.119 grips. I do too. Because I keep. Like it's so 00:51:15.119 --> 00:51:17.619 tight. But at the same time, it's better than 00:51:17.619 --> 00:51:20.219 people flying off. Yes. So we finally had things 00:51:20.219 --> 00:51:22.500 that said semifinals on it. And it was like a 00:51:22.500 --> 00:51:24.980 good gathering of like the Asian CrossFit community. 00:51:25.219 --> 00:51:26.800 And then now they've gone like, oh, we're not 00:51:26.800 --> 00:51:28.440 going to have that anymore in this capacity. 00:51:28.559 --> 00:51:31.219 So you're actually taking away a lot of people's 00:51:31.219 --> 00:51:33.639 like first level goals. So I think that's problematic. 00:51:33.760 --> 00:51:35.199 It makes people not want to join. Like either 00:51:35.199 --> 00:51:36.679 your elite level and you go straight to the games 00:51:36.679 --> 00:51:41.329 or yeah, there's no like in between. Strong amateur 00:51:41.329 --> 00:51:41.789 me