WEBVTT

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Coming up on The 40s Formula. Our hormones go

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beyond reproduction. They protect our heart,

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they protect our bones, our cognition, our brain

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health and our metabolic health. And so when

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they decline, we see other consequences and often

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they're silent. Women are twice as likely as

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men to get Alzheimer's dementia and their lifetime

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risk of dementia is much greater than men. There's

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a risk of 20 % mortality within a year of having

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an osteoporosis. fracture you think of menopause

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and you think right oh i'm getting old i'm gonna

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stop my period i'm gonna get fat and then that's

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it end of yes but there's so much more stuff

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that is actually a hell of a lot more serious

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more important what is the one tip for women

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for how to approach movement in their 40s if

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there's just one thing i would say it's BMI as

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a reliable indicator of my health. Hot or hype?

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It is a hype. Big time. It does not reflect your

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lean body masses, what your fat mass is. We should

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be doing body composition. Dr. Sundas Hussain

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Morgan is a physician and lifestyle medicine

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advocate who believes prevention is the most

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powerful medicine we have. She uses the six pillars

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of lifestyle medicine from food and movement

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to sleep, stress and connection. to help women

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reduce risk and build resilience for decades

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to come. The 40s Formula. The 40s Formula. The

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40s Formula. Hosted by Jasmine Dillon, integrated

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health strategist specializing in gut health,

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hormones, and midlife well -being. And Amanda

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Lim, director of Lift Clinic and a leading expert

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in female strength and metabolism. Named one

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of CNA's top podcasts. and winner of the 2025

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Asia Podcast Awards in the Best Health and Wellness

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Podcast category. The 40s Formula is your no

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-fluff, science meets real -life guide to thriving

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in your 40s. Menopause isn't just about hot flashes

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and mood swings. It's the moment when your risk

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for heart disease, osteoporosis, diabetes, even

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dementia begins to rise. But here's the good

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news. What you do now in your 40s can radically

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change the trajectory of your health. In this

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episode, we're breaking down exactly what you

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can do now to protect your future health. Let's

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get into it. But before we do, don't forget to

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like and subscribe and share this with a loved

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one, especially someone who needs to hear this

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today. Dr. Sendis, thank you so much for being

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with us today. We're so excited for this conversation.

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Thank you for having me, Amanda and Jasmine.

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Really, thank you. I am so encouraged that there's

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so much awareness about menopause and that women

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are getting the help they need to manage the

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symptoms and their quality of life. But one thing

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we're not telling women enough about is the long

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-term health risks of menopause. Menopause comes

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with certain risks. Our hormones go beyond reproduction.

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They protect our heart. They protect our bones,

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our cognition, our brain health and our metabolic

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health. And so when they decline, we see other

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consequences. And often they're silent. Women

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aren't aware of them until it's... unfortunately

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too late or it's picked up on a blood test. And

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what I'm here to say is to look at your health

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risks, get tested for it and become aware of

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them. So what are they? Cardiovascularly, our

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heart health. We know that cardiovascular disease

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is the number one cause of death in women after

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menopause. Our blood pressure rises, cholesterol

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goes up, there's more inflammation and that puts

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women at risk. Bone health, we lose 10 -20 %

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of our bone mass during the menopause transition

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and that puts us at risk of osteopenia or a more

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serious condition called called osteoporosis.

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The risks of fractures in your wrist, in your

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spine, in your hips increases, and that has dire

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consequences. Then we've got the metabolic health.

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We see a change in body composition together

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with muscle mass loss as we age and increased

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visceral fat, so that fat around the midsection.

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There's insulin resistance, which if left unchecked

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can become diabetes. And then brain health, you

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know, women are twice as likely as men to get

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Alzheimer's dementia and their lifetime risk

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of dementia is much greater than men. The thing

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is, these things are preventable. There are things

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we can do today, if we're aware of it, to prevent

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these, to treat these, to reduce the risk and

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live a long, healthy life. Women live a third

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of their life in menopause. We want those years

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to be healthy and in good health. It's crazy,

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isn't it? Because I feel like you think of menopause

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and you think, right, I'm getting old. I'm going

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to stop my period. I'm going to get fat. And

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then that's it. End of. Yes. But there's so much

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more stuff that is actually a hell of a lot more

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serious. More important. And these are the things

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we need to be thinking about. So what should

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we do? Well, what I like to use is the pillars

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of health. So lifestyle medicine, the six pillars

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of health. And lifestyle medicine is an evidence

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-based medical discipline that looks at lifestyle

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interventions and behavior change so that we

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can treat, prevent, and even reverse disease.

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The six pillars are nutrition. Physical activity,

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sleep, stress management and mental health, social

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connections and reducing harmful substances.

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So together with other medical modalities and

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using lifestyle interventions, we can really

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help minimize those risks and even manage menopause

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symptoms. Yeah. And let's talk about those one

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by one, if you don't mind, because I think that's

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such a helpful framework. Anyone can understand

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what those six words mean. Nutrition, movements.

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sleep, stress management, social connection,

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and the reducing of risky substances, which is

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always the one that goes last, right? It's like,

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wah, wah, no one wants to hear about it. But

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can we unpack the first two? And they're not

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hierarchical, right? But can we unpack the ones

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that I think are the first that we think about

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when we think about taking control of our health?

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And that's nutrition and movement. What are the

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big points in nutrition and movement that you

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want women to understand about health in their

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40s? So these six pillars do work synergistically,

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but let's look at those two first of all. So

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nutrition is a big one. There's so much to unpack

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about nutrition. There's so many stories we've

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heard about nutrition, a lot of myths and misinformation.

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But with lifestyle medicine, what we believe

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in is a whole food. a diet that is predominantly

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plant -based, low in ultra -processed foods,

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refined sugars and carbs. Is there a special

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menopause diet? Not really. There are certain

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foods that I do encourage my patients to make

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sure they have in their diet. Like what? Give

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us some hot foods. So looking first of all, you

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know, for your bone health, for example, we want

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to be having enough calcium in our diet and vitamin

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D, although mostly we get our vitamin D from

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sunlight, but there is some in food, but calcium

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particularly. And it doesn't have to be from

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dairy. Oh man, I was going to be like, right.

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So that daily flat white back. Every day. It's

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for my bone health. This is why. I'm doing it.

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For my health. Yeah. So calcium and vitamin D.

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Next, I like to look at fiber. Fiber is so important.

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As you know, Jasmine, you know, gut health is

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good health. And we're feeding not just ourselves,

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we're feeding those trillions of microorganisms

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in our gut that help us keep our health in check.

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So fiber comes from plant -based foods. So that

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could be vegetables, fruits, nuts, seeds, herbs,

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beans, legumes. So including that in. your diet

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and most of us are not getting enough fiber in

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our diet. Then there's the protein. So we want

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to be looking at a protein that's either meat

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or animal based, sorry, animal or plant based.

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So lean cuts of meat, chicken. We want to be

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looking at fish. We want to be looking at legumes,

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tofu, tempeh, and particularly tofu, tempeh,

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edamame. These have phytoestrogens in them and

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these help stimulate some of the estrogen. receptors

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to modulate the menopause symptoms in some women.

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Flax seeds is another one as well. Yeah. And

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can you talk about phytoestrogens for women in

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menopause and perimenopause and moving through

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the menopause transition? Because I just had

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a client come in two days ago, confused about

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the inclusion of phytoestrogens in the diet.

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She said that her doctor said they are bad for

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menopause. Could you elaborate a bit more on

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that? Right. So there is this misconception that

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phytoestrogens, because they stimulate estrogen

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receptors, that they may have a harmful effect.

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There's still, unfortunately, a lot of myth about

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stimulating estrogen receptors in terms of breast

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cancer risk, cardiovascular risk and so forth.

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But phytoestrogens stimulate a different type

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of receptor. There are two types of estrogen

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receptor and they stimulate the beta receptors.

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And by doing... so they can help modulate the

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symptoms without causing that increased risk.

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And what are phytoestrogens? These include tofu,

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tempeh, soy, so anything from soy -based products,

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but you can also find them in other plant -based

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products like flax seeds, for example. Including

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these has been shown, studies have shown that

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for some women can really help, particularly

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with hot flushes, night sweats and can minimize

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their symptoms. What about if a woman is on HRT

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and then she is also eating a lot of phytoestrogen

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type food, soy based food? Can there be maybe,

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I don't know, an overproduction of estrogen?

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And is there any risk if that happens? What could

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a woman expect? to feel or, you know, what would

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happen in that situation? It's a great question.

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I must say, I'm not aware of any study that shows

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that, you know, you can over consume these foods

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or that it would overstimulate them. I think,

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you know, our body is complex, but it's also

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quite smart as well. I think it knows when you

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don't need certain foods or... receptors may

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not be necessarily upregulated if you eat more

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of these foods. So I can't give you a precise

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answer, but I will go back and look at that.

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I was just wondering, because, you know, it's

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kind of like we understand if you aren't taking

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it and it can help with, you know, the hot flashes.

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But if you are taking it, does it have the same

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effect? But, you know, that's just something

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that was popped into my head and I thought I'd

00:11:04.549 --> 00:11:07.059
ask. Very good question. And that actually reads

00:11:07.059 --> 00:11:09.019
really well into one of our tastiest features

00:11:09.019 --> 00:11:11.240
here on the show, which is called Fuel Your 40s,

00:11:11.240 --> 00:11:13.659
sponsored by The Meat Club. And they've submitted

00:11:13.659 --> 00:11:15.799
a question for you to answer as an expert in

00:11:15.799 --> 00:11:18.200
this field about how food fuels your life and

00:11:18.200 --> 00:11:20.879
your work. And this one is for you. So thinking

00:11:20.879 --> 00:11:23.120
about your work with family medicine and your

00:11:23.120 --> 00:11:25.120
work with families in general and your own family.

00:11:26.110 --> 00:11:28.269
Protein feels like such a big demand, right?

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You mentioned that you want to have diverse protein

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and you want to have fiber and some different

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types of foods on the plate. What is one tip

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that you can give to families for preparing a

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balanced meal that everyone can enjoy? So protein

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definitely is important, even for young children,

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adolescents, and of course women going through

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hormonal changes. I would say... include a variety

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of proteins. And the earlier you can include

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these in a child's diet particularly, the more

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they get used to it. You know, try throwing in

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some lentils into a pasta sauce. Try fish as

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nuggets or, you know, maybe as goujons, you know,

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something that they enjoy, something that's easy

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to dip. Use yogurt as a dipping sauce for vegetables

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or fruits. Even chickpeas. you know, boiled chickpeas,

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sprinkle some or squeeze some lemon on it, use

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that as a snack, add it in here and there and

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try a variety of different proteins. Yeah, I

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know that works in my family. Like, you know,

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it's almost like they get bored of stuff. You

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know, it's not that they don't like it, it's

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that they don't want to see it again. So I think

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that that's a very helpful tip for families.

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Novelty and curiosity. And it's such an easy

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way then to get that variety in, you know, because

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if your microbiome needs diversity, whether it's

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coming from, you know, plants, based, animal

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based, whatever it is, the best way to do it

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is just changing it up and not having the same

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thing day in, day out. Because once that sort

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of, you know, fatigue kicks in, like diet fatigue

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kicks in, you're going to be like, all right,

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okay, I'm just going to have pizza. Yeah, because

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I don't want to look at this again. Yeah, exactly.

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Exactly. And so we've covered a little bit about

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the nutrition piece, right? I would love to talk

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about the movement piece. So what is the one

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tip, the main tip you can give for women for

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how to approach movement in their 40s? If there's

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just one thing I would say. If there was one

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thing. But I'll let you say other things. But

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for now, just one thing. I would say it's strength

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training. Yes. Strength training, strength training,

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and again, strength training. Not enough women

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are doing that. It's not something that women,

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certainly of my age, have grown up with. We're

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not familiar with it. And we'd walk into the

00:13:37.220 --> 00:13:40.539
gym and go straight for the cardiovascular machines

00:13:40.539 --> 00:13:44.799
and the aerobic classes. Zumba. Yeah, Zumba.

00:13:45.139 --> 00:13:47.600
Which is still wonderful. And if you love it,

00:13:47.639 --> 00:13:50.639
please continue to do that. In the category cardio,

00:13:50.940 --> 00:13:53.820
it is great. In the category cardio. Exactly.

00:13:54.519 --> 00:13:59.600
But when we're in our 40s, as we age, we begin

00:13:59.600 --> 00:14:03.159
to lose our muscle mass. We lose 3 % to 8 % of

00:14:03.159 --> 00:14:06.200
muscle mass every decade. And by the time you're

00:14:06.200 --> 00:14:09.519
70, 80 years old, you've lost 30 % to 50 % of

00:14:09.519 --> 00:14:13.039
your muscle mass. Medicine is recognizing that

00:14:13.039 --> 00:14:16.980
muscle is more than just an organ to help us

00:14:16.980 --> 00:14:19.659
move and live independently. And to look good.

00:14:20.460 --> 00:14:26.100
To get that boobish. But aesthetic aside, muscle

00:14:26.100 --> 00:14:30.559
is actually its own endocrine organ. It helps

00:14:30.559 --> 00:14:33.960
us. It releases chemicals that are messengers

00:14:33.960 --> 00:14:37.779
to our brain, that helps with blood flow in our

00:14:37.779 --> 00:14:41.389
brain, helps with cognition, memory, mood. It

00:14:41.389 --> 00:14:47.149
bolsters our mood as well. Muscle mass also helps

00:14:47.149 --> 00:14:50.870
to keep our bones healthy. And that is so important

00:14:50.870 --> 00:14:54.710
for women in their 40s. So when we strength train,

00:14:54.769 --> 00:14:58.529
when we move those muscles and load them, we

00:14:58.529 --> 00:15:03.190
also load the bones. And that mechanical loading

00:15:03.190 --> 00:15:05.389
on the bones, that pulling on the bones helps

00:15:05.389 --> 00:15:09.570
to build bone mass and counteract that menopause

00:15:09.570 --> 00:15:12.590
effect. effect of the bone loss and it keeps

00:15:12.590 --> 00:15:15.429
our bones strong. And there's several studies

00:15:15.429 --> 00:15:19.110
showing how incorporating strength training can

00:15:19.110 --> 00:15:22.490
actually improve osteopenia and possibly even

00:15:22.490 --> 00:15:25.590
reverse it and treat osteoporosis as well if

00:15:25.590 --> 00:15:30.620
it's done safely and supervised. And of course,

00:15:30.639 --> 00:15:33.139
metabolic health, you know, our muscle is the

00:15:33.139 --> 00:15:35.879
biggest organ that uses glucose and stores it.

00:15:35.940 --> 00:15:39.039
So it's like a sponge, you know, it just soaks

00:15:39.039 --> 00:15:41.679
that up. Yes, it does. It increases our basic

00:15:41.679 --> 00:15:44.700
metabolic rate so that we're burning energy even

00:15:44.700 --> 00:15:47.480
when we're sitting still. And so helps lower

00:15:47.480 --> 00:15:51.320
risks of diabetes, insulin resistance, helps

00:15:51.320 --> 00:15:54.019
with and also changing that body composition

00:15:54.019 --> 00:15:57.960
that I talked about that changes in your 40s.

00:15:57.960 --> 00:15:59.779
Yeah, I'm reminded of it. agree with this as

00:15:59.779 --> 00:16:01.659
well you know like if you don't have enough muscle

00:16:01.659 --> 00:16:03.779
mass you're more likely to be insulin resistant

00:16:03.779 --> 00:16:05.740
yes and that's probably why you're struggling

00:16:05.740 --> 00:16:08.500
with your weight loss is not because you you

00:16:08.500 --> 00:16:10.139
know you've got too much fat which you might

00:16:10.139 --> 00:16:12.899
have but it's the fact that the the proportion

00:16:12.899 --> 00:16:16.779
of muscle to fat in your body is off that's it

00:16:16.779 --> 00:16:19.940
that's it and that's why what we do at lift clinic

00:16:19.940 --> 00:16:22.340
with metabolic health we talk about body composition

00:16:22.340 --> 00:16:24.399
as one of our three markers of metabolic health

00:16:24.399 --> 00:16:28.539
and it's not how lean you are and it's not how

00:16:28.539 --> 00:16:31.139
muscular you are. It's the composition of those

00:16:31.139 --> 00:16:34.700
two things. Do you have enough muscle at an adequate

00:16:34.700 --> 00:16:36.980
level of body fat? Do you have enough leanness

00:16:36.980 --> 00:16:39.440
with enough functional muscle? Like it's the

00:16:39.440 --> 00:16:41.399
combination of those two things, the interplay.

00:16:41.500 --> 00:16:44.840
And under muscling is something that I see much

00:16:44.840 --> 00:16:48.139
more. much more problematic as uh as opposed

00:16:48.139 --> 00:16:50.240
to being over fat but unfortunately in the popular

00:16:50.240 --> 00:16:53.840
opinion the over fat the the overweight is typically

00:16:53.840 --> 00:16:56.059
what people see as the problem so you know we

00:16:56.059 --> 00:16:57.600
always joke at our clinic it's like we get them

00:16:57.600 --> 00:16:59.159
in for the weight loss but we keep them for the

00:16:59.159 --> 00:17:02.580
muscle you know the bait and swish um because

00:17:02.580 --> 00:17:04.680
and i and i think you you touched on a few really

00:17:04.680 --> 00:17:08.019
important factors that muscle is the gateway

00:17:08.019 --> 00:17:11.119
to bone. So if there is no muscle to protect

00:17:11.119 --> 00:17:13.759
your bone, then your bone is exposed and vulnerable.

00:17:13.960 --> 00:17:15.900
And I don't think there's enough impact there.

00:17:16.099 --> 00:17:18.900
And I really love that you mentioned strength

00:17:18.900 --> 00:17:21.740
training. So the category is physical activity,

00:17:21.799 --> 00:17:24.420
right, of lifestyle medicine. And of course,

00:17:24.420 --> 00:17:26.799
cardio is important. We all agree on that. But

00:17:26.799 --> 00:17:30.500
it cannot be the only thing. Mobility is important.

00:17:31.079 --> 00:17:33.339
It cannot be the only thing. You know, there

00:17:33.339 --> 00:17:35.599
has to be that third element, which is strength

00:17:35.599 --> 00:17:37.000
training. So I love that you singled that out

00:17:37.000 --> 00:17:39.980
very specifically. You mentioned bone. I'm a

00:17:39.980 --> 00:17:42.519
woman in my 40s. Why should I care about my bone

00:17:42.519 --> 00:17:44.460
health? I mean, like, what is it doing for me?

00:17:44.539 --> 00:17:47.490
Like, why is this important? So bone is obviously

00:17:47.490 --> 00:17:50.990
the structure of our body. And not many people

00:17:50.990 --> 00:17:53.750
know, but our bones turn over every 12 years.

00:17:53.950 --> 00:17:56.309
They're constantly building and breaking down.

00:17:56.430 --> 00:17:58.349
We've got like a bone zodiac every 12 years.

00:17:58.410 --> 00:18:01.529
All right. What bone here am I hearing? They're

00:18:01.529 --> 00:18:05.130
a living organ. They're not just hard. I know

00:18:05.130 --> 00:18:08.170
we see a dog bone. Yeah, you think that's that.

00:18:08.490 --> 00:18:11.529
They are living organs. If you cut a bone, it

00:18:11.529 --> 00:18:15.430
bleeds. Oh, I did not know that. So bones are...

00:18:15.559 --> 00:18:18.220
an extremely important part of our body. They

00:18:18.220 --> 00:18:21.740
don't just keep our structure upright and moving.

00:18:22.019 --> 00:18:25.079
They are actually a living organ themselves.

00:18:25.160 --> 00:18:28.759
There's bone turnover. Every 12 years, we turn

00:18:28.759 --> 00:18:30.940
over our bones. We build them and we break them

00:18:30.940 --> 00:18:33.859
down. And estrogen plays a really important part

00:18:33.859 --> 00:18:37.180
of this. It helps to continue that cell turnover

00:18:37.180 --> 00:18:40.700
in a positive way. However, when estrogen drops,

00:18:40.980 --> 00:18:44.220
what happens is there's more bone breakdown than

00:18:44.220 --> 00:18:49.740
there is. bone making and the bones become thinner.

00:18:50.160 --> 00:18:52.799
And particularly it's the bones that we call

00:18:52.799 --> 00:18:54.900
the trabecular bones. Those are the ones in the

00:18:54.900 --> 00:19:00.220
spine, in the wrist, in the hip joint as well.

00:19:00.420 --> 00:19:04.200
And for some women, what can happen is it thins

00:19:04.200 --> 00:19:09.119
so much that... Even a simple trip or a little

00:19:09.119 --> 00:19:13.220
tumble is enough to fracture their bones. And

00:19:13.220 --> 00:19:17.200
once a fracture happens, it's really not just

00:19:17.200 --> 00:19:22.440
painful, but you become less mobile. The incidence

00:19:22.440 --> 00:19:25.920
of being dependent on others, ending up in...

00:19:26.160 --> 00:19:29.440
nursing homes is so much higher. And there's

00:19:29.440 --> 00:19:33.180
a risk of, unfortunately, a 20 % risk of mortality

00:19:33.180 --> 00:19:36.940
within a year of having an osteoporotic fracture.

00:19:37.259 --> 00:19:40.180
And this is preventable. The problem is it's

00:19:40.180 --> 00:19:42.660
a silent disease. You have no symptoms until

00:19:42.660 --> 00:19:46.220
you do. Yes. Until that fracture. Then that's

00:19:46.220 --> 00:19:49.670
sadly too late for many. Okay, Amanda, I've got

00:19:49.670 --> 00:19:52.410
to say GYG has done it again. They've launched

00:19:52.410 --> 00:19:54.990
a new butter chicken filling and it's honestly

00:19:54.990 --> 00:19:58.210
next level. Oh my God, yes. I finally tried it

00:19:58.210 --> 00:20:00.690
last week and it's the third edition of the GYG

00:20:00.690 --> 00:20:03.490
Goes Local series. This one is my favorite yet.

00:20:03.690 --> 00:20:06.289
It's this beautiful mashup of homely Indian comfort

00:20:06.289 --> 00:20:08.789
food with GYG's Mexican flair. We're talking

00:20:08.789 --> 00:20:11.170
rich, creamy butter chicken made with tomato,

00:20:11.309 --> 00:20:13.769
butter, kasoori methi, that's dried fenugreek

00:20:13.769 --> 00:20:16.450
leaves and koya, which gives it that signature

00:20:16.450 --> 00:20:19.220
depth. And they've paired it with their perfectly

00:20:19.220 --> 00:20:21.579
grilled Guerrero chicken. That's what gives it

00:20:21.579 --> 00:20:24.039
that smoky, slightly charred kind of flavor that

00:20:24.039 --> 00:20:26.779
makes it also addictive. And here's the best

00:20:26.779 --> 00:20:29.099
bit. For the first time ever in their local series,

00:20:29.220 --> 00:20:31.000
you can actually get the butter chicken sauce

00:20:31.000 --> 00:20:34.180
on the side. Yet another reason I love GYG so

00:20:34.180 --> 00:20:36.339
much, because you can customize your order to

00:20:36.339 --> 00:20:38.960
fit your macros. It's rich, it's comforting,

00:20:39.240 --> 00:20:41.799
it's a total flavor bomb, and it's only here

00:20:41.799 --> 00:20:44.079
for a limited time. So if you haven't tried it

00:20:44.079 --> 00:20:46.980
yet, get in quick. The GYG Butter Chicken is

00:20:46.980 --> 00:20:50.400
only available from 14th October to 23rd November.

00:20:50.720 --> 00:20:54.039
Dine in, take away or order using the GYG app.

00:20:54.339 --> 00:20:56.960
Clean food, local flair and seriously addictive

00:20:56.960 --> 00:21:00.259
sauce. What more could we want? Exactly. Visit

00:21:00.259 --> 00:21:04.039
GYG across their 22 island -wide locations or

00:21:04.039 --> 00:21:07.720
follow at Guzman E. Gomez SG for all the latest.

00:21:08.200 --> 00:21:10.400
Yeah. And, you know, what you mentioned about

00:21:10.400 --> 00:21:12.579
a silent disease, right? It's one of those things

00:21:12.579 --> 00:21:15.440
where you can't, you as a woman in your 40s,

00:21:15.440 --> 00:21:18.640
me the same, you can't imagine being frail enough

00:21:18.640 --> 00:21:21.720
to fall down. It's like, it almost seems fun.

00:21:21.900 --> 00:21:23.940
Yeah, exactly. What do you mean by fall? Like,

00:21:23.980 --> 00:21:27.980
how am I going to fall? You absolutely ask anyone

00:21:27.980 --> 00:21:30.019
who's had an elderly relative that's taken a

00:21:30.019 --> 00:21:32.319
fall and it becomes very real in that immediate

00:21:32.319 --> 00:21:34.900
moment for that person. And that is your future

00:21:34.900 --> 00:21:37.799
if you don't take care of it. And I saw too many

00:21:37.799 --> 00:21:40.119
of these. I worked in the elderly care for many

00:21:40.119 --> 00:21:43.529
years. It was almost daily we had a patient coming

00:21:43.529 --> 00:21:46.549
in with what we call a fragility fracture. It

00:21:46.549 --> 00:21:48.990
was a simple tumble and they fractured their

00:21:48.990 --> 00:21:51.269
hip or they fractured their spine. Fragility.

00:21:51.450 --> 00:21:54.309
I hope, may that never be written on my chart.

00:21:54.710 --> 00:21:56.349
This is the other thing, you know, like you said,

00:21:56.369 --> 00:21:59.589
you become immobile, right? You have to rest

00:21:59.589 --> 00:22:02.970
if you, you know, are okay enough to rest it

00:22:02.970 --> 00:22:05.430
off. Then when you become immobile, then you're

00:22:05.430 --> 00:22:07.049
going to lose that muscle mass because you can't

00:22:07.049 --> 00:22:10.029
use it. And then you're becoming, you know, then

00:22:10.029 --> 00:22:12.450
you're going to be, you know, having issues with

00:22:12.450 --> 00:22:14.369
your metabolic health and all the other stuff

00:22:14.369 --> 00:22:16.369
that cascades out from it. Yes. The stuff that

00:22:16.369 --> 00:22:18.069
you didn't have previously. Yeah. You have it.

00:22:18.089 --> 00:22:20.589
Yeah. I can't move. And it's scary how quickly

00:22:20.589 --> 00:22:24.470
muscle mass shrinks. I had an ACL tear after

00:22:24.470 --> 00:22:27.390
skiing injury. And, you know, I work out. I do

00:22:27.390 --> 00:22:29.450
a lot of strength training. But the amount of

00:22:29.450 --> 00:22:33.170
muscle mass I lost within a few weeks was scary.

00:22:33.309 --> 00:22:36.109
And it really made me emphasize strength training

00:22:36.109 --> 00:22:42.180
even more. patients. So yes, immobility. Very

00:22:42.180 --> 00:22:44.940
important. And even if we can't sell bones, because

00:22:44.940 --> 00:22:46.440
bones are tough, like you said, it's hard to

00:22:46.440 --> 00:22:47.839
sell. Like, hey, your bones might be brittle.

00:22:47.980 --> 00:22:49.660
I don't care. Yeah. Still want to be skinny,

00:22:49.740 --> 00:22:51.819
right? That's what we care about. So let's take

00:22:51.819 --> 00:22:54.619
bones aside. How about brain? You mentioned cognitive

00:22:54.619 --> 00:22:57.240
decline. Can you at least sell us on how muscles

00:22:57.240 --> 00:22:59.900
can help your brain age healthier? The other

00:22:59.900 --> 00:23:02.220
important thing about muscles is they release

00:23:02.220 --> 00:23:04.859
something called myokines. These are chemical

00:23:04.859 --> 00:23:07.740
messengers that help stimulate the brain, help

00:23:07.740 --> 00:23:10.900
improve our blood flow in our brain, help with

00:23:10.900 --> 00:23:13.619
the... new transmitters in our brain. And this,

00:23:13.660 --> 00:23:17.339
in return, improves our memory, it improves our

00:23:17.339 --> 00:23:20.880
brain function, and protects us against cognitive

00:23:20.880 --> 00:23:24.259
decline, which we know is increased in women

00:23:24.259 --> 00:23:28.160
after menopause as the hormones decline. I was

00:23:28.160 --> 00:23:29.859
at the gym yesterday and they've got this new

00:23:29.859 --> 00:23:31.940
machine up there. It's like only there for a

00:23:31.940 --> 00:23:33.980
week. And it was part of, I'm going to give a

00:23:33.980 --> 00:23:35.779
free shout out now. So Techno Gym, you've got

00:23:35.779 --> 00:23:38.279
to support us. And it was a Techno Gym one. And

00:23:38.279 --> 00:23:41.539
they're basically looking at, you know, how healthy

00:23:41.539 --> 00:23:44.380
are you and how you're aging. And they had different

00:23:44.380 --> 00:23:46.220
metrics. Like they had the grip strength one,

00:23:46.279 --> 00:23:48.079
which you couldn't do because they didn't have

00:23:48.079 --> 00:23:49.880
the grip strength thing. There's a cardio test

00:23:49.880 --> 00:23:51.640
you can do. Then there's a cognition test on

00:23:51.640 --> 00:23:53.319
there, like a balance and mobility. So they're

00:23:53.319 --> 00:23:55.220
checking all of this stuff. And I did the cognition

00:23:55.220 --> 00:24:01.410
test. enough, my memory was great. 100 % but

00:24:01.410 --> 00:24:05.730
my attention was not so good and I don't think

00:24:05.730 --> 00:24:08.089
we can blame muscles for that one that's the

00:24:08.089 --> 00:24:11.170
condition of modern life sadly so it's really

00:24:11.170 --> 00:24:12.950
interesting you know I was like okay the memory

00:24:12.950 --> 00:24:15.470
is working fine I'd just done my strength training

00:24:15.470 --> 00:24:18.430
session but you know the attention thing I mean

00:24:18.430 --> 00:24:20.529
I would say I couldn't keep focused on the two

00:24:20.529 --> 00:24:23.269
things they needed me to focus on I remember

00:24:23.269 --> 00:24:25.369
years ago when Spartan Race was a thing do you

00:24:25.369 --> 00:24:27.410
remember when Spartan Race was very big and I

00:24:27.410 --> 00:24:29.970
was doing the long version ones and I remember

00:24:29.970 --> 00:24:32.450
one of the like obstacles was they would give

00:24:32.450 --> 00:24:35.900
you a word and you had to remember it. At the

00:24:35.900 --> 00:24:38.559
end of the race. No. Yes, yes. And everyone had

00:24:38.559 --> 00:24:40.259
a different, or was it a word or a series of

00:24:40.259 --> 00:24:42.099
numbers? Anyway. That would be hard. Claudia,

00:24:42.140 --> 00:24:43.140
if you're listening, you were with me there.

00:24:43.420 --> 00:24:45.299
It's something difficult to remember. It would

00:24:45.299 --> 00:24:47.700
be too easy. Yeah. I think it was a series of

00:24:47.700 --> 00:24:49.839
numbers. And it's like you had to remember them

00:24:49.839 --> 00:24:51.859
in the order they were in. And then there was

00:24:51.859 --> 00:24:53.920
just a guy at, you know, let's say kilometer

00:24:53.920 --> 00:24:57.400
20 or something. Oh, my God. With your race number

00:24:57.400 --> 00:24:59.599
and your thing. And he would just have you recite

00:24:59.599 --> 00:25:01.380
it. And if you couldn't do it, drop and give

00:25:01.380 --> 00:25:04.220
me 35 burpees. Because they were trying to incorporate

00:25:04.220 --> 00:25:06.420
memory. as part of it. And especially memory

00:25:06.420 --> 00:25:08.240
under demand, right? Like, you know, with exertion

00:25:08.240 --> 00:25:09.420
and stuff like that. You know, when you're younger,

00:25:09.480 --> 00:25:11.700
okay, now we've all got mobile phones, we don't

00:25:11.700 --> 00:25:13.299
actually remember numbers. But, you know, we

00:25:13.299 --> 00:25:15.859
have to remember. I remember my parents' phone

00:25:15.859 --> 00:25:18.240
number. I say, do I? Yeah. I remember my auntie's

00:25:18.240 --> 00:25:20.799
phone number because, I mean... That's your call

00:25:20.799 --> 00:25:24.140
to complain about your friends. My emergency

00:25:24.140 --> 00:25:26.740
number. Yeah, but that stuff you don't do. It's

00:25:26.740 --> 00:25:29.019
true. We don't exercise that muscle as much anymore.

00:25:29.259 --> 00:25:30.519
We don't exercise that muscle anymore, no. And

00:25:30.519 --> 00:25:32.940
it's important to, you know, do that as well

00:25:32.940 --> 00:25:36.829
as... muscle training as well i actually use

00:25:36.829 --> 00:25:40.890
old mobile phone numbers as you know like pin

00:25:40.890 --> 00:25:43.309
codes yeah because i'm like well no one else

00:25:43.309 --> 00:25:45.150
is gonna know this no one's gonna use it we don't

00:25:45.150 --> 00:25:46.990
use it anymore but i still remember i remember

00:25:46.990 --> 00:25:50.390
yeah i know i'll find it yeah well so so speaking

00:25:50.390 --> 00:25:53.589
of muscles that we need to exercise Another one

00:25:53.589 --> 00:25:55.789
of the pillars of lifestyle medicine that I think

00:25:55.789 --> 00:25:57.990
gets kind of overlooked in the glamour of the

00:25:57.990 --> 00:26:00.829
others is stress management. And I cannot tell

00:26:00.829 --> 00:26:02.730
you enough when I'm working with patients or

00:26:02.730 --> 00:26:05.069
clients and I say, you know, hey, we really do

00:26:05.069 --> 00:26:07.329
need to work on your stress management. Your

00:26:07.329 --> 00:26:10.549
coping mechanisms are directly related to food

00:26:10.549 --> 00:26:13.250
and alcohol. We got to work on this. And I get

00:26:13.250 --> 00:26:15.750
the eye roll. Oh, yeah. Like when my kids grow

00:26:15.750 --> 00:26:17.650
up and I quit my job, maybe I'll work on stress

00:26:17.650 --> 00:26:19.210
management. Or like, what, do you want me to

00:26:19.210 --> 00:26:20.789
meditate? You know, I mean, there's definitely

00:26:20.789 --> 00:26:22.750
I feel like that one kind of gets. swept under

00:26:22.750 --> 00:26:25.029
the rug as least important. Can you talk about

00:26:25.029 --> 00:26:27.930
how that is important and some strategies that

00:26:27.930 --> 00:26:30.329
women can use to manage their stress? Absolutely.

00:26:30.529 --> 00:26:33.069
I mean, modern life is full of stresses. It's

00:26:33.069 --> 00:26:35.650
not something we can just, you know, unless we

00:26:35.650 --> 00:26:42.109
move to a desert island. Defense, what are you

00:26:42.109 --> 00:26:44.230
going to take with you? Yeah, not the kids. But

00:26:44.230 --> 00:26:49.529
as women, you know, most of the women that I

00:26:49.529 --> 00:26:51.529
see, you know, they're at the peak of their career

00:26:51.529 --> 00:26:53.430
if they're working or they're working towards

00:26:53.430 --> 00:26:57.289
a big project. They are looking after their children.

00:26:57.430 --> 00:27:00.230
They are looking after parents who are elderly.

00:27:02.089 --> 00:27:04.329
They often can't last. You know, women are the

00:27:04.329 --> 00:27:06.589
caregivers and they're constantly giving, giving.

00:27:06.849 --> 00:27:10.970
And when your bucket is empty, when you are dealing

00:27:10.970 --> 00:27:14.589
with a lot of stress, it has an impact on your

00:27:14.589 --> 00:27:18.190
health. So for me, I have the luxury of time

00:27:18.190 --> 00:27:22.549
with patients. I actively listen and allow them

00:27:22.549 --> 00:27:26.589
to reflect and allow them to see how, despite

00:27:26.589 --> 00:27:28.509
all the good things they're doing, how stress

00:27:28.509 --> 00:27:32.119
is. actually sabotaging a lot of their good efforts.

00:27:32.619 --> 00:27:36.680
And we try and work on their why, what's important

00:27:36.680 --> 00:27:42.269
to them. What is in their circle of control?

00:27:42.650 --> 00:27:45.490
If leaving your job right now is not possible,

00:27:45.769 --> 00:27:49.049
what else can you do to minimize that stress?

00:27:49.529 --> 00:27:52.690
What are some of the actions you can take? For

00:27:52.690 --> 00:27:56.009
some women, that might look like saying no, setting

00:27:56.009 --> 00:27:58.529
up boundaries to certain things. For others,

00:27:58.569 --> 00:28:01.289
it might be how they respond to stress, using

00:28:01.289 --> 00:28:04.150
things like mindfulness -based stress reduction

00:28:04.150 --> 00:28:07.829
mechanisms, strategies, mindfulness, meditations.

00:28:09.289 --> 00:28:11.990
might be a walk in nature to build up that resilience

00:28:11.990 --> 00:28:15.650
to cope with stress. So it's very personalized,

00:28:15.690 --> 00:28:18.450
but it is highlighting to people that stress

00:28:18.450 --> 00:28:21.730
isn't just an inert thing. It does affect your

00:28:21.730 --> 00:28:24.710
health and it can be sabotaging some of the good

00:28:24.710 --> 00:28:27.329
work that you're doing. And if you don't deal

00:28:27.329 --> 00:28:30.950
with it. It's not going to go away. I love my

00:28:30.950 --> 00:28:33.170
walk with my dog. You know, in the evening we

00:28:33.170 --> 00:28:35.970
go out, I put a podcast on, usually the 40s formula,

00:28:36.029 --> 00:28:39.509
sometimes Huberman or, you know. But, you know,

00:28:39.509 --> 00:28:42.230
I feel like it's my time to sort of get out there

00:28:42.230 --> 00:28:45.630
and just feel. at ease and get away from the

00:28:45.630 --> 00:28:47.869
chaos that's my house with the three boys. I

00:28:47.869 --> 00:28:50.009
mean, I take one little boy with me as in the

00:28:50.009 --> 00:28:52.750
dog. But one of the other things that I love

00:28:52.750 --> 00:28:55.450
and I feel like is a bit underrated is I, when

00:28:55.450 --> 00:28:57.710
I'm doing like the school drop off, it is so

00:28:57.710 --> 00:28:59.369
intense because I'm like, kids, we've got to

00:28:59.369 --> 00:29:00.990
get out of the house. We've got your shoes. Like

00:29:00.990 --> 00:29:02.710
seriously, we've forgotten shoes before because

00:29:02.710 --> 00:29:04.190
they'll just jump in the car and they haven't

00:29:04.190 --> 00:29:05.970
got their shoes on. And my kids are, you know,

00:29:05.990 --> 00:29:08.289
old enough to know that they need your shoes.

00:29:09.560 --> 00:29:12.119
And once I drop them off, like I don't even get

00:29:12.119 --> 00:29:13.740
out of the car now. I'm like, get out, you know,

00:29:13.740 --> 00:29:15.559
just leave the boot open. I'll close it myself.

00:29:15.779 --> 00:29:20.240
Just get out. I love to get in the car, play

00:29:20.240 --> 00:29:23.460
my music and sing. Not that I can sing, but sing,

00:29:23.460 --> 00:29:28.000
you know. And can you demonstrate? We want to

00:29:28.000 --> 00:29:31.799
lose money. But, you know, it's just. It's my

00:29:31.799 --> 00:29:34.220
way of just releasing it. And I'm like, you don't

00:29:34.220 --> 00:29:36.059
have to, you know, go through a whole meditation

00:29:36.059 --> 00:29:38.779
technique. It's whatever you find calming and

00:29:38.779 --> 00:29:42.740
a great way to sort of just feel at ease and,

00:29:42.759 --> 00:29:45.119
you know, get those buggers off to school. And

00:29:45.119 --> 00:29:47.079
you're a sit and scream it out type gal, and

00:29:47.079 --> 00:29:49.660
I like that. I'm a sit in silence person. So

00:29:49.660 --> 00:29:51.740
when I'm experiencing oversimulation, which is

00:29:51.740 --> 00:29:54.140
with my three kids always, by the way, I just

00:29:54.140 --> 00:29:56.789
need to be in silence. Just no one touching me,

00:29:56.809 --> 00:29:58.849
no one talking to me. And I mean, five minutes,

00:29:58.930 --> 00:30:00.690
it's not even like a whole big deal. And I don't,

00:30:00.690 --> 00:30:03.890
sometimes I would meditate, but often I don't.

00:30:04.150 --> 00:30:05.990
Like I just, you know, I consider it like my

00:30:05.990 --> 00:30:08.269
DNS time. Like I just lay on my back, put my

00:30:08.269 --> 00:30:10.859
feet against the wall and I just. luxuriate in

00:30:10.859 --> 00:30:13.220
silence. I don't know if I could do that. I've

00:30:13.220 --> 00:30:16.119
tried, but I just, I can't, I can't do it. It's

00:30:16.119 --> 00:30:18.019
wonderful. Set a timer. I'll try it. I always

00:30:18.019 --> 00:30:19.759
set a timer, which is how, you know, I don't

00:30:19.759 --> 00:30:22.339
really relax. But yeah, I mean, again, whatever

00:30:22.339 --> 00:30:24.400
it may be. It's very difficult. You know, it's

00:30:24.400 --> 00:30:27.519
finding something. Sometimes I find people overstimulate

00:30:27.519 --> 00:30:30.420
themselves without realizing. And then wonder

00:30:30.420 --> 00:30:32.819
why they're freaking out. Exactly. Exactly. So

00:30:32.819 --> 00:30:35.079
sometimes you really do need to just take a step

00:30:35.079 --> 00:30:38.890
back and say. is what I'm doing serving me well

00:30:38.890 --> 00:30:42.230
or is it not? Do I need to just change things

00:30:42.230 --> 00:30:45.470
up a little bit? Yes. What you're describing,

00:30:45.549 --> 00:30:47.789
the school drop -off and the chaos, and then

00:30:47.789 --> 00:30:50.289
I know so many women who go straight from that

00:30:50.289 --> 00:30:52.490
into high -intensity interval training class.

00:30:52.630 --> 00:30:54.569
And they're rushing into class because they're

00:30:54.569 --> 00:30:55.990
barely going to make it. They show up all frustrated,

00:30:56.329 --> 00:30:58.829
flustered. Then they have to go do 45 seconds

00:30:58.829 --> 00:31:00.990
of 90 % heart rate activity. It's like, have

00:31:00.990 --> 00:31:04.119
you considered? not doing that at that time,

00:31:04.160 --> 00:31:07.160
you know, and maybe like do your HIT on a Saturday

00:31:07.160 --> 00:31:10.099
morning when things be chill. Yeah. And maybe

00:31:10.099 --> 00:31:13.140
a husband. Some slow and steady strength training

00:31:13.140 --> 00:31:14.920
in that pocket of time. But, you know, it's like

00:31:14.920 --> 00:31:17.759
even the things that are correct, like I don't

00:31:17.759 --> 00:31:19.160
want to take that HIT away from you if that's

00:31:19.160 --> 00:31:20.839
something you love, but like maybe that's not

00:31:20.839 --> 00:31:23.160
the slot for it if it's affecting another pillar.

00:31:23.319 --> 00:31:24.940
And I think you said it really well. They're

00:31:24.940 --> 00:31:27.960
synergistic. pillars one feeds into the next

00:31:27.960 --> 00:31:30.299
they are not isolated pillars with space in between

00:31:30.299 --> 00:31:32.759
you know it's more like a i feel like we need

00:31:32.759 --> 00:31:35.480
a new word for pillars it's got to be like like

00:31:35.480 --> 00:31:38.059
mary go round of health or something reaction

00:31:38.059 --> 00:31:41.380
of lifestyle medicine yeah because you're right

00:31:41.380 --> 00:31:43.890
when you think of pillars you're like Yeah, they're

00:31:43.890 --> 00:31:47.769
just steeped in subway. And if one falls, the

00:31:47.769 --> 00:31:49.490
other will hold it up. And it's like, but you

00:31:49.490 --> 00:31:53.029
can't let one fall. Like this in this case. Okay,

00:31:53.190 --> 00:31:55.269
so let's talk about one that falls. Let's talk

00:31:55.269 --> 00:31:57.329
about the wine coping strategy that I alluded

00:31:57.329 --> 00:32:00.670
to earlier. So again, this is interrelated with

00:32:00.670 --> 00:32:03.819
stress and also with nutrition is alcohol. And

00:32:03.819 --> 00:32:06.880
girl, we've had Dr. Fung on from Oslo Health

00:32:06.880 --> 00:32:09.740
talking about alcohol at length. So I'm not looking

00:32:09.740 --> 00:32:13.440
for a whole metabolic dissertation on alcohol.

00:32:13.640 --> 00:32:17.500
But how bad is it really? You mentioned reducing

00:32:17.500 --> 00:32:20.880
exposure to risky substances. Talk to us about

00:32:20.880 --> 00:32:23.339
alcohol as that substance. What are we looking

00:32:23.339 --> 00:32:26.420
at? What are the tradeoffs? WHO say there is

00:32:26.420 --> 00:32:30.400
no safe limit for alcohol. Here in Singapore,

00:32:30.539 --> 00:32:33.960
the guidelines are two drinks for men per day,

00:32:34.099 --> 00:32:37.819
one drink for women per day. We all have different

00:32:37.819 --> 00:32:41.099
alcohol tolerances. What I notice, especially

00:32:41.099 --> 00:32:45.000
in the 40s, women notice that they just don't

00:32:45.000 --> 00:32:47.559
metabolize alcohol as well. If you don't notice

00:32:47.559 --> 00:32:49.140
that, I feel like you have to be lying, right?

00:32:49.259 --> 00:32:51.660
No, I mean, honestly, honestly, like raging in

00:32:51.660 --> 00:32:55.750
my 20s would put you in a coffin today. And although

00:32:55.750 --> 00:32:59.730
alcohol may put you to sleep, it actually disrupts

00:32:59.730 --> 00:33:02.049
your sleep. I had wine yesterday. I was up at

00:33:02.049 --> 00:33:04.349
4 a .m. I was like, fuck me. Like they're kind

00:33:04.349 --> 00:33:06.079
of like. I don't know, I was just wide awake

00:33:06.079 --> 00:33:08.440
and I thought, oh man, I didn't even realise

00:33:08.440 --> 00:33:10.460
how much I was drinking because I thought I was

00:33:10.460 --> 00:33:12.460
having one glass. What I didn't realise was the

00:33:12.460 --> 00:33:14.799
waiter kept coming and topping up my glass and

00:33:14.799 --> 00:33:16.480
then would ask my husband, do you want more?

00:33:16.640 --> 00:33:18.299
And I was like, hold on, why is my glass still

00:33:18.299 --> 00:33:21.079
so full? And then I realised that he was just

00:33:21.079 --> 00:33:22.880
pouring it in and my husband goes, well, it looks

00:33:22.880 --> 00:33:26.990
like I'm drunk. Yeah, the 4 a .m. wake up, never

00:33:26.990 --> 00:33:30.809
a good sign of quality sleep. So alcohol, you

00:33:30.809 --> 00:33:32.269
know, when we're going through perimenopause,

00:33:32.410 --> 00:33:35.849
it actually can make your symptoms much worse.

00:33:35.890 --> 00:33:40.130
Your heart flushes, your mood changes, and it

00:33:40.130 --> 00:33:44.130
increases your insulin resistance as well. So

00:33:44.130 --> 00:33:48.210
it can have these metabolic consequences. Not

00:33:48.210 --> 00:33:51.509
only is it extra calories, and depending what

00:33:51.509 --> 00:33:53.789
you're drinking as well, often cocktails are

00:33:53.789 --> 00:33:59.210
loaded. full of sugar as well. And that disruption

00:33:59.210 --> 00:34:03.609
of sleep and the dampening of mood as well. So

00:34:03.609 --> 00:34:08.409
many negative effects from alcohol, plus it is

00:34:08.409 --> 00:34:10.849
a carcinogen, you know, it does increase your

00:34:10.849 --> 00:34:13.969
risk of cancer as well. I had a client who was

00:34:13.969 --> 00:34:16.590
like, right, okay, I've stopped drinking, but

00:34:16.590 --> 00:34:18.949
then, you know, every time I go out, sometimes

00:34:18.949 --> 00:34:22.460
I need a cigarette. And if that person wasn't

00:34:22.460 --> 00:34:26.260
smoking, then wanted chocolate or something else.

00:34:26.360 --> 00:34:29.719
It's like, I need advice. How does somebody who

00:34:29.719 --> 00:34:33.559
needs something bad to do as a coping strategy,

00:34:33.760 --> 00:34:36.440
how can they move forward? Like, do they really

00:34:36.440 --> 00:34:38.199
need advice or can they pick up something that's

00:34:38.199 --> 00:34:41.860
not so bad? I mean, this is really difficult.

00:34:42.059 --> 00:34:46.599
This is, we're talking about. People using these

00:34:46.599 --> 00:34:49.460
methods as a coping strategy. And it's stepping

00:34:49.460 --> 00:34:52.519
back and saying, why do you need a coping strategy?

00:34:52.840 --> 00:34:55.639
What is it that you're trying to cope with? And

00:34:55.639 --> 00:34:59.679
looking at that first of all. And then working

00:34:59.679 --> 00:35:04.869
with a practitioner to help them reduce. They're

00:35:04.869 --> 00:35:08.030
smoking or drinking and finding other ways to

00:35:08.030 --> 00:35:13.050
manage their coping. This takes a lot more work.

00:35:14.829 --> 00:35:17.730
It's understanding why do you want to change

00:35:17.730 --> 00:35:21.369
and what is it you need to change and then small

00:35:21.369 --> 00:35:26.519
steps making those changes. For me, I feel like

00:35:26.519 --> 00:35:30.079
my vice is coffee. Oh, not a vice. That's health

00:35:30.079 --> 00:35:34.119
care. Mental health care. Okay, 101. At least

00:35:34.119 --> 00:35:35.440
my vice is a good one. It's the timing of coffee.

00:35:35.800 --> 00:35:39.860
Yeah, you're right. It's the timing and the amount.

00:35:40.340 --> 00:35:43.019
I don't drink. I should 12. So, you know, I feel

00:35:43.019 --> 00:35:45.219
like that's pretty good. That's great. Sometimes

00:35:45.219 --> 00:35:48.579
I might sneak in a before one. Generally, it's

00:35:48.579 --> 00:35:50.880
12. Yeah. And I was just listening to my buddy,

00:35:50.980 --> 00:35:53.519
Dr. Mike Israel. Love him. Are you familiar with

00:35:53.519 --> 00:35:57.219
Dr. Mike? Is his real name? Isriatel. So he's

00:35:57.219 --> 00:36:00.400
a PhD, not a physician. Not a medical doctor.

00:36:00.500 --> 00:36:02.099
Definitely not a medical doctor. This dude is

00:36:02.099 --> 00:36:04.159
jacked on anabolic steroids. And that's kind

00:36:04.159 --> 00:36:06.420
of part of his trope is like he talks about his

00:36:06.420 --> 00:36:08.699
life on steroids and whatever. But he has a company

00:36:08.699 --> 00:36:11.460
called RP Strength. Free shout out. And anywho,

00:36:11.500 --> 00:36:15.260
he was just on Dr. Gabrielle Lai's podcast talking

00:36:15.260 --> 00:36:17.760
about caffeine. Yes. And one of the things that

00:36:17.760 --> 00:36:19.519
I think is important to hear, you're hearing

00:36:19.519 --> 00:36:21.639
me defend my vice, by the way. So this is why

00:36:21.639 --> 00:36:23.920
we're having this conversation. Yeah. Is because.

00:36:24.460 --> 00:36:26.659
Just like there's differences in how we metabolize

00:36:26.659 --> 00:36:28.639
alcohol, there's differences in how we metabolize

00:36:28.639 --> 00:36:30.880
caffeine. And you kind of know it if you're being

00:36:30.880 --> 00:36:32.739
honest with yourself. You know if you have that

00:36:32.739 --> 00:36:34.739
first cup of coffee in the morning and it just

00:36:34.739 --> 00:36:37.099
kind of gets you going on with the day. Or if

00:36:37.099 --> 00:36:39.099
you get up and you're jittery and you're like,

00:36:39.119 --> 00:36:41.329
okay, now we're ready. Probably you're not a

00:36:41.329 --> 00:36:43.769
superb caffeine metabolizer. Probably you should

00:36:43.769 --> 00:36:46.550
definitely limit to that amount or less and that

00:36:46.550 --> 00:36:48.510
timing or less. And again, I'm not saying that

00:36:48.510 --> 00:36:50.590
you should use caffeine if you're a great metabolizer.

00:36:50.630 --> 00:36:52.449
But, you know, there are differences that if

00:36:52.449 --> 00:36:54.630
you're tuned in, you can kind of tell if it's

00:36:54.630 --> 00:36:56.889
moving you toward your goals. I've never gotten

00:36:56.889 --> 00:36:58.570
the shakes. Actually, no, I said I think I've

00:36:58.570 --> 00:37:01.150
gotten the shakes once. But generally, I'm like,

00:37:01.170 --> 00:37:03.789
I'm OK with coffee. Oh, my dear husband. Oh,

00:37:04.030 --> 00:37:07.329
my gosh. I mean, he's like. It's like it kills

00:37:07.329 --> 00:37:10.090
him, that first cup. You know, let's put it out

00:37:10.090 --> 00:37:11.650
there. He's in the restroom within a second.

00:37:12.139 --> 00:37:13.400
And then he's like shaky the rest of the time.

00:37:13.440 --> 00:37:16.139
I was like, maybe not that for you. Maybe not

00:37:16.139 --> 00:37:19.420
breakfast fast. Oh, man. All right. So this is

00:37:19.420 --> 00:37:21.039
the next section of our show where we love to

00:37:21.039 --> 00:37:23.719
do this kind of fun, hotter hype. Meaning we're

00:37:23.719 --> 00:37:25.699
going to give you a hot topic in health, and

00:37:25.699 --> 00:37:27.539
you tell us if you think it's hot. Like, yeah,

00:37:27.559 --> 00:37:29.420
there's data behind that. It rocks. Or if you

00:37:29.420 --> 00:37:31.039
think it's hype. And then you can tell us why.

00:37:31.219 --> 00:37:33.159
Okay. So you're not limited to a one -word answer

00:37:33.159 --> 00:37:35.579
or anything like that. All right. Perimenopause

00:37:35.579 --> 00:37:40.860
supplements. Hype. Why? I think there's been

00:37:40.860 --> 00:37:44.619
too much marketing, I'm afraid, with perimenopause

00:37:44.619 --> 00:37:48.559
supplements. Supplements are not governed by

00:37:48.559 --> 00:37:52.420
any body. We don't know what's inside them. And

00:37:52.420 --> 00:37:55.539
I just fear that women go for these supplements

00:37:55.539 --> 00:37:58.139
without... actually getting the real help they

00:37:58.139 --> 00:38:00.340
need. It's periwashing, is it? Is that what it's

00:38:00.340 --> 00:38:01.920
called? What is periwashing? I like, is that

00:38:01.920 --> 00:38:03.420
one of the new? I think there's a term, it's

00:38:03.420 --> 00:38:04.960
like periwashing. You know how there's the pinkwashing?

00:38:05.079 --> 00:38:07.559
Yeah, greenwashing. Pinkwashing. But yeah, no,

00:38:07.679 --> 00:38:09.800
there's, I think there is a specific term for

00:38:09.800 --> 00:38:11.619
it where they're just marketing everything. Menomarketing?

00:38:11.760 --> 00:38:14.500
Yeah. Oh, I like that. I think it might be menomarketing.

00:38:14.579 --> 00:38:16.340
I think you're right. But, you know, it's like,

00:38:16.480 --> 00:38:18.340
oh, it says this is for perimenopause, but, you

00:38:18.340 --> 00:38:23.019
know, actually it's just vitamin D. And I'm not,

00:38:23.039 --> 00:38:24.619
you know, I'm not against supplements. I think

00:38:24.619 --> 00:38:26.670
some women definitely need. them, but it's a

00:38:26.670 --> 00:38:28.510
supplement to supplement everything else you're

00:38:28.510 --> 00:38:31.429
doing and making sure you monitor, you know,

00:38:31.429 --> 00:38:34.130
get a blood test first, find out what is deficient

00:38:34.130 --> 00:38:38.130
and talk to a practitioner who is menopausal

00:38:38.130 --> 00:38:41.150
aware and has the qualifications to guide you.

00:38:41.250 --> 00:38:43.909
It may be those supplements are actually doing

00:38:43.909 --> 00:38:46.150
more harm than good. There are some supplements

00:38:46.150 --> 00:38:48.469
where we actually need to watch liver function.

00:38:48.630 --> 00:38:53.340
They may interact with your medication. Of course,

00:38:53.340 --> 00:38:56.619
when women are vulnerable, they will go and when

00:38:56.619 --> 00:38:58.440
they're desperate to get some help, they will

00:38:58.440 --> 00:39:00.880
go and purchase these products. So I just, you

00:39:00.880 --> 00:39:02.920
know, a caveat, just be careful what you're buying.

00:39:03.139 --> 00:39:07.000
Yes. And do talk to a practitioner first if you're

00:39:07.000 --> 00:39:10.280
really unsure. There are some supplements that

00:39:10.280 --> 00:39:13.239
do wonderful things, definitely, that I advocate

00:39:13.239 --> 00:39:17.780
for. Yeah. See what you're into. I'm with you.

00:39:17.820 --> 00:39:19.400
One of the things that drives me crazy about

00:39:19.400 --> 00:39:21.960
the supplement industry is how much money it

00:39:21.960 --> 00:39:25.199
takes from people, meaning they redirect resources

00:39:25.199 --> 00:39:27.280
that they should be spending on other aspects

00:39:27.280 --> 00:39:29.239
of their health care into these supplements that

00:39:29.239 --> 00:39:31.940
don't do what they think it's doing. You know,

00:39:31.980 --> 00:39:33.659
I won't call it out, but there's a very popular

00:39:33.659 --> 00:39:36.300
greens -based supplement that people love. And

00:39:36.300 --> 00:39:37.840
one of the things I always hear is like, oh,

00:39:37.860 --> 00:39:40.599
before then, I can never get a good bowel movement.

00:39:40.659 --> 00:39:41.820
Like, it really helps me go to the bathroom.

00:39:41.960 --> 00:39:45.039
And I was like, it's fiber. So it's not that.

00:39:45.340 --> 00:39:47.480
That greens powder is not magic. It's a fiber

00:39:47.480 --> 00:39:50.360
supplement. And it's very expensive. You can

00:39:50.360 --> 00:39:52.619
get a fiber supplement a lot cheaper. It's veggies.

00:39:53.460 --> 00:39:55.880
Eat those. And people think, oh, it's a supplement.

00:39:55.880 --> 00:39:58.000
It's not a medicine. So it's a good thing. It's

00:39:58.000 --> 00:40:01.500
a good thing. Yeah, it's like, eh, anyway. All

00:40:01.500 --> 00:40:03.300
right, next one. And this alludes to our previous

00:40:03.300 --> 00:40:07.019
conversation. Red wine as heart healthy. Hot

00:40:07.019 --> 00:40:11.019
or hype? Hype. Really? Yes. But the Respatrol.

00:40:11.579 --> 00:40:14.260
But that's why, right? So Amanda, you know how

00:40:14.260 --> 00:40:15.760
I've been on this journey about improving my

00:40:15.760 --> 00:40:17.559
sleep? Oh, you have been obsessed about it lately.

00:40:18.159 --> 00:40:21.820
Well, I have found something that has been incredible.

00:40:22.760 --> 00:40:25.340
Cozy Earth bed sheets. That's saying a lot because

00:40:25.340 --> 00:40:27.280
you are really picky about your sleep setup.

00:40:27.539 --> 00:40:29.980
Exactly. These sheets are made from bamboo viscose.

00:40:30.019 --> 00:40:33.699
They are naturally breathable and I get the perfect

00:40:33.699 --> 00:40:37.159
night's sleep. They keep me cool all night. Oh,

00:40:37.199 --> 00:40:39.199
and I've been eyeing the pajamas too. They are

00:40:39.199 --> 00:40:42.469
so chic and super cozy. It's a total game changer

00:40:42.469 --> 00:40:45.429
and so relaxing for the evenings. And what's

00:40:45.429 --> 00:40:47.989
crazy is that Cozy Earth actually ships to Singapore,

00:40:48.170 --> 00:40:52.250
orders over $560 ship free, and in the US orders

00:40:52.250 --> 00:40:54.730
over $50 ship free. And did you know you can

00:40:54.730 --> 00:40:58.849
get your biggest ever discount, 41 % if you use

00:40:58.849 --> 00:41:03.070
code TFF today. So head over to CozyEarth .com

00:41:03.070 --> 00:41:06.500
and use that code TFF today. So many other things

00:41:06.500 --> 00:41:09.159
you could do for your heart health is what my

00:41:09.159 --> 00:41:12.800
answer would be. I mean, if you choose to drink,

00:41:12.860 --> 00:41:17.159
fine, just be mindful of it. But I wouldn't be

00:41:17.159 --> 00:41:19.119
drinking red wine just for your heart health.

00:41:19.159 --> 00:41:21.179
There's so many other things you can do for your

00:41:21.179 --> 00:41:25.880
heart health that have amazing benefits. So,

00:41:25.920 --> 00:41:29.940
yeah, for me, it's more a hype. Yes, there is

00:41:29.940 --> 00:41:33.239
a ritual, but people say you can get that from

00:41:33.239 --> 00:41:36.260
eating grapes. Yeah. Yeah, I mean, that's where

00:41:36.260 --> 00:41:38.039
it comes from in the wine. You should have a

00:41:38.039 --> 00:41:40.219
cup of the ethanol, by the way. So that's not

00:41:40.219 --> 00:41:42.889
what's giving you the nutrients. All right, BMI

00:41:42.889 --> 00:41:46.289
as a reliable indicator of my health. Hot or

00:41:46.289 --> 00:41:51.349
hype? It is a hype. Big time. Thank God. You

00:41:51.349 --> 00:41:53.250
know, we spoke about body composition, and I'm

00:41:53.250 --> 00:41:55.550
afraid BMI doesn't take that into account. It

00:41:55.550 --> 00:41:58.050
is what all the studies are based on. Because

00:41:58.050 --> 00:42:00.110
it's easy. Because it's easy, quick to measure.

00:42:01.030 --> 00:42:04.690
But it does not reflect, your weight does not

00:42:04.690 --> 00:42:07.909
reflect what your lean body mass is, what your

00:42:07.909 --> 00:42:11.150
fat mass is, and where that fat mass is as well.

00:42:11.469 --> 00:42:14.809
So definitely we should be doing body composition.

00:42:15.150 --> 00:42:17.010
Is it different here in Asia? I'm wondering,

00:42:17.170 --> 00:42:20.849
is the BMI standard globally? No, there is an

00:42:20.849 --> 00:42:23.309
Asian BMI. There is an Asian BMI. So the Asian

00:42:23.309 --> 00:42:27.349
BMI scale is lower thresholds for overweight

00:42:27.349 --> 00:42:29.780
and then for obesity as well. Yeah, damn, I'd

00:42:29.780 --> 00:42:33.280
probably be, you know. Yeah, so overweight for

00:42:33.280 --> 00:42:37.119
Asian is 23 .1. No. For Caucasian is 25. Okay.

00:42:37.320 --> 00:42:40.940
Obese for Asian is 27 .1. For Caucasian is 30.

00:42:41.139 --> 00:42:45.280
Where do I fall under? As in, am I Asian or am

00:42:45.280 --> 00:42:47.260
I Caucasian? I mean, I'm not Caucasian, but you

00:42:47.260 --> 00:42:49.480
know. Yeah. I don't know, like. That's a really.

00:42:49.860 --> 00:42:51.840
That's a bit different. It's not Asian Asian.

00:42:51.960 --> 00:42:54.920
Yeah, it's not East, traditional East Asian,

00:42:55.019 --> 00:42:56.800
you know. That's a really great, that's a question

00:42:56.800 --> 00:42:59.150
for Tyler. That is a good question. Do you feel

00:42:59.150 --> 00:43:03.469
some BMI at all? Yeah. Okay, my kids are a perfect

00:43:03.469 --> 00:43:05.409
example. Yeah, I think they split the difference,

00:43:05.530 --> 00:43:07.510
right? So it's like somewhere around 24. I don't

00:43:07.510 --> 00:43:10.369
know. But yeah, but again, this is why BMI is

00:43:10.369 --> 00:43:13.269
not helpful for the majority of us. And just

00:43:13.269 --> 00:43:14.429
for those listening that aren't familiar with

00:43:14.429 --> 00:43:16.969
that term, it's body mass index. And it refers

00:43:16.969 --> 00:43:19.889
simply to a ratio of your height to weight. So

00:43:19.889 --> 00:43:21.730
I love when folks come in and they have some

00:43:21.730 --> 00:43:23.650
weight loss with us and they say, my BMI went

00:43:23.650 --> 00:43:25.809
down. And I was like, no, no, yes, because that's

00:43:25.809 --> 00:43:28.179
what weight loss is. Less weight on your height.

00:43:28.320 --> 00:43:30.019
Like your BMI will always track with your weight.

00:43:30.079 --> 00:43:31.719
That's all it is. And you know, there are some

00:43:31.719 --> 00:43:37.860
women and men that are skinny fat. Yeah. In the

00:43:37.860 --> 00:43:41.920
Indian culture, that's a big thing. Like, you

00:43:41.920 --> 00:43:44.519
know, they might look skinny, but where's the

00:43:44.519 --> 00:43:46.960
muscle mass? And then what's going on? Yeah.

00:43:47.000 --> 00:43:49.639
And here in Singapore, I think a study recently

00:43:49.639 --> 00:43:54.820
released on Chinese ethnic women who are young,

00:43:54.880 --> 00:43:59.059
who look slim, Their muscle mass is really huge.

00:43:59.780 --> 00:44:02.260
We see it every day. It puts them at risk. Every

00:44:02.260 --> 00:44:06.320
day. Yeah. And stunned to find out that that's

00:44:06.320 --> 00:44:10.679
a risk. We had a patient earlier this week, came

00:44:10.679 --> 00:44:13.980
in 47 .5 kgs on the scale, which for my American

00:44:13.980 --> 00:44:16.059
listeners, it's very small. It's very, very small.

00:44:16.519 --> 00:44:18.679
By any standard, whatever height, it's still

00:44:18.679 --> 00:44:21.800
very small. And she was overjoyed by it. But

00:44:21.800 --> 00:44:24.170
then we demonstrated to her that her... appendicular

00:44:24.170 --> 00:44:27.309
lean mass index was 5 .1. And again, for doctors

00:44:27.309 --> 00:44:28.849
listening, you're about to fall out your chair.

00:44:28.929 --> 00:44:31.329
For lay people listening, it means that she's

00:44:31.329 --> 00:44:33.769
severely under -muscled, almost at the threshold

00:44:33.769 --> 00:44:38.670
of sarcopenia in her 40s. And body fat, 36 .7%.

00:44:39.340 --> 00:44:42.320
You know, above what would be considered the

00:44:42.320 --> 00:44:44.739
healthy range. And with that muscularity problem,

00:44:44.920 --> 00:44:47.719
I mean, this is a really metabolically deficient

00:44:47.719 --> 00:44:50.639
body composition. But we couldn't talk her through

00:44:50.639 --> 00:44:53.099
it because she saw that 47 .5 on the scale. She

00:44:53.099 --> 00:44:54.579
was like, but I'm doing great, right? I was like,

00:44:54.639 --> 00:44:58.760
not, no. But yeah, I mean, that weight is not

00:44:58.760 --> 00:45:00.280
an overweight weight, if that's what you're asking.

00:45:00.300 --> 00:45:02.079
That's basically the sort of thing that leads

00:45:02.079 --> 00:45:04.769
to... insulin resistance, prediabetes, and diabetes.

00:45:05.030 --> 00:45:08.070
Yes, hugely. Yeah, and osteopenia and osteoporosis.

00:45:08.070 --> 00:45:10.130
I mean, that's a recipe for it right there is

00:45:10.130 --> 00:45:11.750
the light body weight with the under -muscling.

00:45:11.929 --> 00:45:14.429
But yeah, so get your bones strong, get your

00:45:14.429 --> 00:45:17.090
muscles up. All right, so another Hotter Hype.

00:45:17.090 --> 00:45:19.469
And this one, Dr. Sundus, you might break our

00:45:19.469 --> 00:45:23.550
hearts, okay? Stress scores, recovery scores,

00:45:23.949 --> 00:45:27.590
body battery reads from our smart watches. Hotter

00:45:27.590 --> 00:45:31.300
Hype, Hotter Hype. It's a tricky one. It depends

00:45:31.300 --> 00:45:34.900
how you interpret data. Okay. Tell us more. I

00:45:34.900 --> 00:45:39.639
would say hot, but only if you don't get obsessive

00:45:39.639 --> 00:45:43.059
about your data. So for some, this is amazing

00:45:43.059 --> 00:45:46.260
to have those scores because it can really help

00:45:46.260 --> 00:45:48.960
you get in tune with your body and realize, okay,

00:45:49.099 --> 00:45:52.920
today is a good day for training. Today, I need

00:45:52.920 --> 00:45:55.980
some recovery time. But for some, it can be quite

00:45:55.980 --> 00:45:59.199
an obsessive thing to look at your scores. be

00:45:59.199 --> 00:46:02.519
very stressful it can add to your stress it would

00:46:02.519 --> 00:46:05.480
be ideal if we can tune in and learn without

00:46:05.480 --> 00:46:08.300
these devices how do I sleep today let me look

00:46:08.300 --> 00:46:11.739
at my watch like not how am I feeling do I feel

00:46:11.739 --> 00:46:14.059
rested what time do I go to bed so maybe that'll

00:46:14.059 --> 00:46:16.039
help but yeah I totally get that because I mean

00:46:16.039 --> 00:46:17.780
to be honest I do get a little bit obsessive

00:46:17.780 --> 00:46:19.760
you know I do love to track my sleep and all

00:46:19.760 --> 00:46:21.119
of that stuff I don't know you'll see that on

00:46:21.119 --> 00:46:25.079
my stories every now and again But I do listen

00:46:25.079 --> 00:46:26.860
to my body. Like sometimes I'll look at my watch

00:46:26.860 --> 00:46:28.559
and it will say you had a shit sleep. I feel

00:46:28.559 --> 00:46:30.380
great. You know, I'm going to ignore that and

00:46:30.380 --> 00:46:32.900
just pretend it was, you know, maybe that late

00:46:32.900 --> 00:46:35.079
dinner I had because I was out with some friends

00:46:35.079 --> 00:46:37.800
or whatever it is. But generally, I will go by

00:46:37.800 --> 00:46:40.500
how I'm feeling. But I do like to show to my

00:46:40.500 --> 00:46:43.300
husband, look how I, yeah, look how recovered

00:46:43.300 --> 00:46:45.980
I am. And back to that example about the mom

00:46:45.980 --> 00:46:47.880
going from the school pickup to the HIT class.

00:46:48.139 --> 00:46:50.360
So let's say you wake up with a recovery score

00:46:50.360 --> 00:46:54.190
crap. Your sleep was crap. on your schedule today

00:46:54.190 --> 00:46:57.509
is drop off the kids, go to this class. Maybe

00:46:57.509 --> 00:46:59.389
you could pick a different class today because

00:46:59.389 --> 00:47:01.829
it's not going to help your recovery to go into

00:47:01.829 --> 00:47:04.349
another super high heart rate bout of exercise.

00:47:04.690 --> 00:47:07.170
Perhaps today would be the day to kick back with

00:47:07.170 --> 00:47:09.289
a walk in nature, maybe do some low intensity

00:47:09.289 --> 00:47:11.849
zone two. So it would help you formulate a better

00:47:11.849 --> 00:47:14.409
program, I think. But you're right. I think on

00:47:14.409 --> 00:47:16.670
the flip side of that, you wake up, your sleep's

00:47:16.670 --> 00:47:17.809
crap, your recovery's crap. You're like, well,

00:47:17.809 --> 00:47:20.050
I'm skipping the gym. And that's the more honest

00:47:20.050 --> 00:47:21.610
response, I think, for most people. It's like,

00:47:21.670 --> 00:47:24.050
well, I'm not recovered, can't do anything. What's

00:47:24.050 --> 00:47:26.599
more important then? Exactly using that example,

00:47:26.699 --> 00:47:29.019
you know, you slept crap, but you've got a class

00:47:29.019 --> 00:47:32.480
booked. You know, what's more important there?

00:47:32.860 --> 00:47:35.159
What would you say to somebody who is like, right,

00:47:35.219 --> 00:47:37.159
okay, we're looking at the lifestyle pillars,

00:47:37.380 --> 00:47:39.280
even though they're not pillars, but, you know,

00:47:39.320 --> 00:47:41.739
do I go with my movement, which obviously is

00:47:41.739 --> 00:47:44.940
important? Do I go with my sleep, which is...

00:47:45.289 --> 00:47:48.429
Also important, like how much weight do you give

00:47:48.429 --> 00:47:51.230
to each thing, each pillar? Ideally equally.

00:47:52.309 --> 00:47:57.750
But it really depends on the patient sitting

00:47:57.750 --> 00:48:00.809
in front of me. You know, which pillar is important

00:48:00.809 --> 00:48:02.829
to them? Which one is actually, are they ready

00:48:02.829 --> 00:48:05.349
to make some changes in? I can easily say to

00:48:05.349 --> 00:48:08.230
you, you need to strength train. But if you are

00:48:08.230 --> 00:48:11.889
so stressed, you're sleep deprived. You can't

00:48:11.889 --> 00:48:14.090
get to the gym. OK, we need to work on those

00:48:14.090 --> 00:48:19.150
first. So it's where are people ready to start

00:48:19.150 --> 00:48:21.869
making some changes? Of course, as a physician,

00:48:22.010 --> 00:48:24.329
I can guide them and say, look, we're not going

00:48:24.329 --> 00:48:26.909
to be able to do this if we don't do this. But

00:48:26.909 --> 00:48:32.289
are you ready to make changes in this area? So

00:48:32.289 --> 00:48:35.650
in this example, they're sleep deprived, but

00:48:35.650 --> 00:48:38.449
they've got a class. Is that class actually going

00:48:38.449 --> 00:48:41.360
to benefit them in that moment in time? Great

00:48:41.360 --> 00:48:43.940
physical activity is wonderful, but is it just

00:48:43.940 --> 00:48:46.760
going to add more to their stress? Is it going

00:48:46.760 --> 00:48:51.539
to add more to their mood that's already down?

00:48:52.360 --> 00:48:55.559
Exercise, on the other hand, is helpful if you

00:48:55.559 --> 00:48:58.059
do it earlier in the morning than at night. So

00:48:58.059 --> 00:49:01.219
maybe choose a class that's less intensive, as

00:49:01.219 --> 00:49:04.300
we said. Maybe go for a walk instead. If it really

00:49:04.300 --> 00:49:07.019
is your only chance to do that class, and it's

00:49:07.019 --> 00:49:11.530
strength training. Skip the speed. Then go for

00:49:11.530 --> 00:49:14.150
it. Maybe don't, you know, push yourself as much

00:49:14.150 --> 00:49:16.650
as you normally would, but do push yourself and

00:49:16.650 --> 00:49:18.590
then think about, okay, I'm going to have an

00:49:18.590 --> 00:49:21.650
earlier bedtime. 9 p .m. New bedtime, everybody.

00:49:21.989 --> 00:49:25.250
9 p .m. I wish. I hope that day is upon me soon.

00:49:26.570 --> 00:49:29.349
It's always been upon me. I can't, like, 9 o

00:49:29.349 --> 00:49:33.699
'clock, I'm yawning away. Our last hotter hype,

00:49:33.760 --> 00:49:35.199
and this kind of circles us back to the first

00:49:35.199 --> 00:49:38.179
question about supplements. Iron infusions if

00:49:38.179 --> 00:49:41.820
you have demonstrated low ferritin. Hot. Definitely.

00:49:42.820 --> 00:49:45.199
If you can take iron orally and it's absorbed

00:49:45.199 --> 00:49:48.360
orally, then absolutely. But if there's issues

00:49:48.360 --> 00:49:51.440
absorbing it orally or side effects absorbing

00:49:51.440 --> 00:49:54.360
it orally, then an iron infusion can be really

00:49:54.360 --> 00:49:57.599
helpful for women. We know a lot of women do

00:49:57.599 --> 00:50:01.280
have heavier... bleeds during perimenopause and

00:50:01.280 --> 00:50:05.960
that can really affect their iron level. And

00:50:05.960 --> 00:50:08.199
so we need to top that up and then obviously

00:50:08.199 --> 00:50:11.460
work on the root cause of why they're iron deficient.

00:50:11.579 --> 00:50:13.980
Absolutely. And I think, you know, for the listener

00:50:13.980 --> 00:50:16.440
out there right now in her 40s, you know, taking

00:50:16.440 --> 00:50:19.159
diligent notes on this episode, but now she's

00:50:19.159 --> 00:50:21.659
feeling completely overwhelmed. OK, there's six

00:50:21.659 --> 00:50:23.539
pillars you got to think about. There's BMI stuff.

00:50:23.619 --> 00:50:25.460
There's like something with my lean mass. I don't

00:50:25.460 --> 00:50:29.329
even. What are the two things? that she can do

00:50:29.329 --> 00:50:33.570
this week to start improving her health for perimenopause?

00:50:33.949 --> 00:50:36.489
Yes, women do get overwhelmed. And when I see

00:50:36.489 --> 00:50:38.409
them and go through a lifestyle medicine consultation,

00:50:38.730 --> 00:50:40.650
it's like, oh, goodness, I've got to change this,

00:50:40.730 --> 00:50:42.809
this, this, this. And I'm like, no, we're going

00:50:42.809 --> 00:50:46.389
to do it one step at a time. As I said before,

00:50:46.550 --> 00:50:48.829
what's important to you? What's your health goal?

00:50:49.210 --> 00:50:51.289
Where are you in your health journey right now?

00:50:51.800 --> 00:50:54.300
Let's pick one pillar, two pillars. Let's pick

00:50:54.300 --> 00:50:56.420
one change or two changes. What are you ready

00:50:56.420 --> 00:51:00.559
to make? And let's start making those changes.

00:51:00.639 --> 00:51:02.780
Let's make sure they're sustainable, they're

00:51:02.780 --> 00:51:05.980
consistent, so they become a daily habit. So

00:51:05.980 --> 00:51:08.840
it's really hard for me to say two things. But

00:51:08.840 --> 00:51:13.030
I would say in perimenopause, in your 40s. Definitely

00:51:13.030 --> 00:51:14.929
strength training if you aren't doing already

00:51:14.929 --> 00:51:18.650
and start small, you know, start by doing some

00:51:18.650 --> 00:51:21.329
body weight exercises, use some resistance band,

00:51:21.690 --> 00:51:25.090
carry your shopping, start small and then build

00:51:25.090 --> 00:51:29.269
up. And the second one would be probably, I'd

00:51:29.269 --> 00:51:31.869
say sleep, because most of us are not getting

00:51:31.869 --> 00:51:36.300
enough sleep and not working on our sleep. That

00:51:36.300 --> 00:51:39.760
will help build, improve your mood, improves

00:51:39.760 --> 00:51:43.920
your weight as well. All our hormones, our appetite

00:51:43.920 --> 00:51:46.519
and satiety hormones are released during that

00:51:46.519 --> 00:51:51.599
time. It will improve our cognition and also

00:51:51.599 --> 00:51:53.860
our stress management. We become more resilient

00:51:53.860 --> 00:51:57.159
to stress as well if we can prioritize that.

00:51:57.530 --> 00:51:59.730
I do think, though, you know, if you are strength

00:51:59.730 --> 00:52:02.510
training and you get decent sleep, I feel like

00:52:02.510 --> 00:52:04.829
you're naturally going to make better choices

00:52:04.829 --> 00:52:06.570
with your food. You know, because you're going

00:52:06.570 --> 00:52:08.469
to be thinking like, look, I'm waking up now.

00:52:09.389 --> 00:52:12.730
I should probably do something better with my

00:52:12.730 --> 00:52:15.349
food choices. And when it comes to sleep, you're

00:52:15.349 --> 00:52:17.610
not going to just reach for, you know, the quick

00:52:17.610 --> 00:52:20.929
and easy processed snack that's just, you know,

00:52:20.929 --> 00:52:23.929
there. And, you know, you've actually got that.

00:52:24.250 --> 00:52:26.750
that patience and that time to really sort of

00:52:26.750 --> 00:52:29.250
think, right, okay, now I'm fully energized.

00:52:29.650 --> 00:52:33.809
I will make a nice meal. I will go for the unprocessed

00:52:33.809 --> 00:52:35.869
option and I will get my fiber in and I'll get

00:52:35.869 --> 00:52:38.150
my protein in. And I think you're not thinking,

00:52:38.210 --> 00:52:40.289
you know, like what's quick, what's easy. You've

00:52:40.289 --> 00:52:43.190
actually got that capability to make the better

00:52:43.190 --> 00:52:46.010
choice. Yeah, it really buffers you. And we know

00:52:46.010 --> 00:52:51.599
people who are sleep deprived do. you know unconsciously

00:52:51.599 --> 00:52:55.400
eat more calories absolutely and make wrong not

00:52:55.400 --> 00:52:58.300
as healthy choices there's so many studies out

00:52:58.300 --> 00:53:00.440
there you know you will choose more carbohydrate

00:53:00.440 --> 00:53:02.940
heavy foods you will choose more sugar rich foods

00:53:02.940 --> 00:53:04.880
you'll choose more processed foods like all the

00:53:04.880 --> 00:53:06.559
things you said in that very first thing about

00:53:06.559 --> 00:53:09.460
the type of diet that will help you is not what

00:53:09.460 --> 00:53:11.400
you choose when you're sleep deprived and that's

00:53:11.400 --> 00:53:13.570
a sad truth that's right Well, again, you've

00:53:13.570 --> 00:53:15.510
given us so much to think about today and we

00:53:15.510 --> 00:53:17.329
really appreciate your expertise in this area.

00:53:17.449 --> 00:53:19.130
But I would love to know, you know, personally

00:53:19.130 --> 00:53:22.710
from you, for women in their 40s, what's your

00:53:22.710 --> 00:53:25.389
40s formula? How would you give women advice

00:53:25.389 --> 00:53:28.070
to thrive in this decade? So what I would say

00:53:28.070 --> 00:53:31.389
is while you're navigating perimenopause and

00:53:31.389 --> 00:53:36.489
menopause, see it as an opportunity to look at

00:53:36.489 --> 00:53:41.739
your health, your holistic health overall. Yes,

00:53:41.739 --> 00:53:46.280
absolutely get some help with your symptoms and

00:53:46.280 --> 00:53:48.980
improve your quality of life. But look at the

00:53:48.980 --> 00:53:51.440
bigger picture. Think about those long -term

00:53:51.440 --> 00:53:53.300
health risks that are silent, that you may not

00:53:53.300 --> 00:53:57.119
feel. Educate yourself about them. Get tested.

00:53:57.460 --> 00:54:00.780
Know what your risks are for them. And there

00:54:00.780 --> 00:54:04.119
is plenty you can do out there to minimize those

00:54:04.119 --> 00:54:07.239
risks. Look at those six pillars or six cogs

00:54:07.239 --> 00:54:12.840
of health and see. What is important to you right

00:54:12.840 --> 00:54:15.780
now? Where are you ready to make some changes

00:54:15.780 --> 00:54:20.000
that will be sustainable? And think about what

00:54:20.000 --> 00:54:22.639
kind of life would you like to have in your last

00:54:22.639 --> 00:54:24.920
10 years of your life? You know, women are living

00:54:24.920 --> 00:54:28.159
till into their 80s, 90s. We want to remain well

00:54:28.159 --> 00:54:30.940
and healthy and do the things we enjoy and love

00:54:30.940 --> 00:54:36.860
and be independent for as long as possible. That

00:54:36.860 --> 00:54:39.679
would be my message to women. I love that. Think

00:54:39.679 --> 00:54:41.940
about who you want to be in the future and work

00:54:41.940 --> 00:54:44.360
toward that, right? Start today. Exactly. Perfect.

00:54:44.699 --> 00:55:24.849
Thank you. Thank you so much. Thank you. with

00:55:24.849 --> 00:55:24.929
me.