The Real Cause Of Your Brain Fog, Anxiety & Low Energy (It's Not What You Think) | Cynthia Thurlow

0:00 What actually is happening biologically in mid-life

0:03 that makes people feel like they're losing their edge?

0:06 Oh, I think so much of it is it's a combination of things.

0:09 I think number one, declining hormones, declining neurotransmitters,

0:14 and I think for a lot of people they think it's oh,

0:16 you know, mid-life is just about declining hormones and I'm like listen,

0:19 all of those hormones have more than one function and one

0:23 of their functions is supporting the synthesis of neurotransmitters like GABA,

0:28 which is our main inhibitory neurotransmitter,

0:30 serotonin, which is a precursor to melatonin.

0:33 I think a lot of women in in general aren't getting

0:36 good quality sleep and if you're not getting good quality sleep,

0:39 you're not going to feel like getting up to exercise,

0:41 you're not going to make good food choices.

0:43 Um we become less stress resilient,

0:45 which is um a byproduct of those neurotransmitter and hormone fluctuations.

0:50 And you know, quite honestly, we have to make different choices in middle

0:54 age than we did when we were younger.

0:56 If anyone listening is still eating and drinking

0:59 and behaving like they did at 18,

1:01 it's not going to serve you well by the time you get to 35 and up and that's

1:06 just based on all the clinical information I've been

1:09 able to watch and what I myself have experienced.

1:12 Not to mention, you know, we get declines in metabolic health.

1:15 So, women get really upset about body

1:18 composition changes and it's the hormones, it's lifestyle.

1:22 A lot of it though is this loss of muscle mass,

1:24 which I know your community is so knowledgeable about.

1:28 Losing muscle is like metabolic currency and so we get a rise in fat-free mass,

1:33 a decline in muscle mass and uh you know, the menopot starts for a lot of women.

1:39 So, we use the term multifactorial in medicine,

1:42 but there's a lot of different reasons why we

1:45 see a decline in our health in middle age.

1:47 It doesn't have to be that way, but I think for a lot of people they just

1:50 accept it for what it is and I think part

1:52 of the reframe around aging really needs to be that it's

1:57 like we have to kind of level up each decade.

2:00 We have to do things a little differently and what I got

2:03 away with at 34 is not what I get away with at 54.

2:06 And there's this big movement now that people like in their early 20s and 30s,

2:11 they're they're super health conscious.

2:12 They're focusing more on longevity and aging, which is which is awesome.

2:17 That said, like realistically, what's the age that you think people really

2:21 need to start like focusing on their health?

2:23 Like is it 25?

2:25 Is it 30?

2:25 Like what's that sweet spot?

2:27 To be honest, I I think for some people they take their health

2:29 for granted until there's an illness

2:31 or there's some type of catastrophic catastrophic event.

2:34 Before I answer the question,

2:36 what I want to say is you can always course correct.

2:38 I want the message to always be you can always make changes,

2:41 you can always course correct.

2:43 But I think by the time you're 35,

2:47 that's probably where most people see a tipping point.

2:50 They're going to see changes in their sleep,

2:51 they're going to start seeing changes in body composition.

2:55 Um you know, unfortunately, you know,

2:57 the number one endocrine disorder in the United States is PCOS,

3:00 so polycystic ovarian syndrome and a lot of people go undiagnosed.

3:04 So, they're experiencing symptoms of perimenopause

3:07 at an earlier stage than someone without PCOS.

3:11 And so because it's so poorly diagnosed and poorly addressed,

3:16 you have women that are experiencing a magnification of symptoms

3:19 at a much earlier time than the average woman.

3:23 And I think when people think about declining um hormones,

3:27 like things like estrogen, they I mean,

3:30 especially men who aren't as familiar with it,

3:32 they think about it as as far as reproductive health.

3:35 Um like how does estrogen also impact other areas of health?

3:40 Yeah, it's such a good question.

3:41 So, estrogen, just like testosterone,

3:43 just like progesterone, are systemic hormones,

3:45 but I think most people think of them in terms

3:47 of fertility or bikini medicine is what we actually call it.

3:51 So, estrogen has potent effects in the brain.

3:54 It's you know, it's a insulin sensitizing hormone,

3:57 so it's going to be important for metabolic health in the brain,

4:00 uh neuroplasticity or ability to make and rewire connections in the brain.

4:05 Um you know, we have estrogen receptors in our eyes.

4:09 They're important for um you know, retinal health.

4:13 We have estrogen receptors in our digestive system.

4:17 Um it's really intertwined with um keeping the small intestinal lining secure.

4:23 So, people have heard the term of leaky gut.

4:26 There's a lot of things that contribute to it,

4:27 but one of estrogen's roles is to keep the those gates shut, if you will.

4:31 Estrogen's involved with nitric oxide production,

4:34 so people think about it purely from a cardiovascular disease

4:37 perspective or cardiovascular health uh cuz it dilates uh the endothelial,

4:42 you know, there's there's areas where nitric oxide helps dilate,

4:45 but it's also important for innervation of the gut, so it helps with digestion.

4:49 Um estrogen's involved in uh bile production and and how

4:53 we can effectively break down and emulsify fats.

4:56 So, um there there are there literally there's not one system in the body.

5:01 It's involved in bone.

5:02 So, estrogen helps you build bones and progesterone helps you break

5:06 bones down and and that's just that's just a couple examples,

5:11 but literally everywhere in the body estrogen has a role,

5:14 as does progesterone and testosterone,

5:17 but I think we still think of these hormones

5:19 as sex hormones or simply um fertility hormones,

5:23 but it's so much more than that and and quite honestly,

5:26 men have more testosterone than estrogen do.

5:29 We have about 1/10, but men also have a little

5:32 bit of estrogen and a little bit of progesterone.

5:34 So, in lesser degrees,

5:36 um but still important in their bodies as well and there are reasons why you

5:39 can sometimes see imbalances in their bodies just

5:42 as a byproduct of our modern day lifestyles.

5:45 I would say, you know,

5:47 as a trainer and someone who's been at this for a long time,

5:49 I know you've been in the space for quite some time as well,

5:52 much longer than me.

5:53 Um I think when you when people come to me

5:56 at least one of the main things I hear,

5:57 especially from women, is hey, I want to not only um feel younger,

6:02 I want to look younger as well.

6:03 Like that's like the goal.

6:05 Whether that's having better body composition,

6:07 more muscle, better skin, what uh energy, whatever.

6:11 Um is there a way to like slow down this process so that that age that they

6:18 get potentially either pre or perimenopause becomes like later

6:22 and later in life or is that just biology?

6:24 I'm smiling because honest to God, this is I've been asked this question.

6:28 This is the third time today.

6:29 So, it's it's something people are really curious about, which I think is great.

6:32 So, in women, our pacemaker of aging are ovaries.

6:36 So, we are born with a finite amount of eggs,

6:38 unlike men, you guys replenish your sperm,

6:40 I think every 72 hours if memory serves me correctly

6:44 and it's also the most mitochondrial dense organ in the body.

6:46 So, it's like a set it and forget it.

6:50 You know, the things that can age our ovaries faster that we know clinically,

6:54 tobacco, so smoking, vaping, um alcohol use and trauma, uh without question,

7:01 definitely influences other toxins we're exposed to.

7:04 So, when they talk about what are the things

7:05 we can do to slow the aging process, I think the jury is still out.

7:09 There's certainly lab animal data,

7:12 but we can't necessarily extrapolate that to humans.

7:15 Um there's been some postulated uh examples

7:18 of like rapamycin, uh which is a drug.

7:21 Um rapamycin might be an option,

7:24 but nothing that's been definitive per se, although there's a lot of research.

7:27 Obviously, there are many,

7:29 many people that are really interested in slowing the aging process.

7:33 I think, you know, we're looking

7:34 at stem cells and other things, but definitively,

7:37 we know the things that definitely age it and I think a lot

7:40 of people probably know that like tobacco's

7:42 a bad idea and excessive alcohol consumption,

7:44 but probably don't realize that adverse childhood events and trauma will rewire

7:49 the autonomic nervous system and chronic

7:52 cortisol activation can age the ovaries.

7:55 And so, I think that is really

7:57 compelling and interesting information that we know definitively.

8:01 Whereas, you know, the experimental stuff that's being used,

8:03 I don't think that I definitively feel like there's

8:06 a an answer and that's not my area of expertise,

8:08 but based on the conversations I've had on the podcast

8:10 and the experts I've spoken to, there's certainly things that are postulated,

8:14 but they're not like guaranteed yet.

8:16 Like I think if we find the fountain of youth,

8:19 that'll be an interesting discovery for sure.

8:23 Well, I think what's also interesting is you can do all the things and I

8:26 think it at times there is a point

8:29 where you're running up against your genetics.

8:31 Uh I mean, at least from what my observation,

8:32 like I've seen people in my career um that are are women and that have

8:38 um they they aren't like super serious about their health, but they do enough.

8:41 They work out a few days a week,

8:42 maybe they watch their diet throughout the week,

8:44 they you know, they they go go off

8:46 a little bit on the weekends and they look amazing.

8:48 And then I've seen people that do everything.

8:50 You know, they're like super, super consistent during the week,

8:52 during the week and they're watching everything, they're not drinking,

8:55 they're not going out and maybe to the outside they don't look like they

8:58 take care of themselves as the same way as the other person who doesn't, right?

9:03 It's just a biology is a a very strange thing,

9:06 but I think the message that I'm hearing from you is that it's

9:10 way easier to um to not do certain things than to do certain things.

9:15 Like if you're somebody who's smoking a bunch of cigarettes

9:17 or vaping a bunch and drinking a bunch of alcohol,

9:20 you eating a bunch of ultra-processed foods,

9:22 like you're going to look much older than someone who doesn't.

9:25 Is that accurate?

9:26 Yeah, I think overall, I mean, obviously there's always exceptions.

9:29 Like there was always the the patient in the ER.

9:32 So, prior to being a nurse practitioner in cardiology for 16 years,

9:36 I worked in ER and a trauma center

9:39 and I just remember we'd see these like 95-year-old

9:42 ladies that had end-stage emphysema or COPD and they

9:46 would come in on their oxygen tanks still smoking,

9:49 you know, their fingers were uh you know,

9:51 from all the tar were like stained permanently,

9:54 their fingernails and everything else and I'm

9:55 like they're 95 years old and damn,

9:58 all the other than having emphysema, they are like still kicking.

10:01 It's unbelievable.

10:02 And then you sometimes see untoward things happening in younger patients,

10:06 which is incredibly unfortunate.

10:08 And so I think it's a nature nurture.

10:10 Some of it's you know, genetic determinism.

10:12 I think some of it's environmental.

10:15 I mean, obviously, there's been a lot of talk recently about like James

10:18 Van Der Beek who passed away tragically in his 40s from colorectal cancer.

10:23 And that's an example of, you know,

10:25 I've been asking all the experts on the podcast like,

10:27 why do we think this is happening?

10:28 Is it lack of fiber in the diet?

10:29 Is it, you know, the ultra-processed foods?

10:30 Is it or metabolic health?

10:32 And you know, the jury's still out.

10:34 But I think that to suggest that lifestyle doesn't play a role,

10:39 I think it's really interesting.

10:41 I I think what you can get away with a lot when you're younger.

10:43 I think that as we start seeing our mitochondria decline,

10:46 which are kind of our powerhouses of our cells, you get away with a lot less.

10:50 Like I think what you get away with at 30 is probably not

10:54 what you can get away with at 55 and be able to bounce back.

10:57 I would say one of the biggest things

10:59 that I've seen people struggle with is energy burnout.

11:04 That's mitochondria.

11:05 That's all mitochondrial decline.

11:06 Brain fog.

11:08 Um, where does the what role does the gut like play

11:12 in that when it when when it comes to feeling off,

11:15 poor energy, and just feeling like emotionally unregulated?

11:18 Yeah, I mean, I I think so number one,

11:21 you know, when when anyone says like lack of energy,

11:25 can't build muscle, really tired,

11:28 uh I automatically think mitochondrial dysfunction,

11:30 which really accelerates after the age of 40.

11:33 So there's that in the sand.

11:35 But we know that the gut produces the bulk of our neurotransmitters in our body.

11:39 And obviously, if the gut is not healthy,

11:42 and by that I mean predominantly the gut microbiome,

11:45 um you're not going to produce the types of neurotransmitters that you need.

11:48 So we talked about GABA, we talked about serotonin.

11:50 There's also dopamine.

11:51 There's a bunch of others.

11:53 Um it can also explain why sometimes people,

11:55 you know, even though they have a optimal progesterone level,

11:57 they may uh have more glutamate, which is an excitatory neurotransmitter.

12:02 If their gut health isn't optimal, they can increase, you know,

12:05 the inflammatory response and it can send off a bunch of inflammatory cytokines,

12:09 which can be irritating not only to the gut, but also to the brain.

12:12 And there's a communication superhighway between the gut and the brain.

12:15 It's called the vagus nerve.

12:17 It's the longest nerve in the body and just

12:19 think of it as a relay system backwards and forwards.

12:21 So more often than not when someone

12:23 has a leaky gut or has autoimmune conditions,

12:26 they very likely also have leaky brain.

12:28 So what's going on in the gut does not stay in the gut.

12:30 It's not like Las Vegas as people like to say,

12:33 what goes on in Las Vegas stays in Las Vegas.

12:34 It doesn't work that way in the body and certainly not in the gut.

12:37 So when I think about someone having a lot

12:39 of brain fog and more anxiety, more depression, more mood disorders, OCD,

12:43 things like that, I'm automatically thinking about gut

12:46 health because we know that at the basis, those neurotransmitters in the gut,

12:51 if they're not working properly or optimized or if

12:53 there's a lot of inflammatory things going on there,

12:56 that can get magnified and amplified to the brain.

12:59 And the other thing to think about is

13:01 brain inflammation can show up like gut inflammation can.

13:04 And so I think a lot of people walking around,

13:07 they assume it doesn't matter what you eat.

13:09 They assume it doesn't matter you don't manage your stress.

13:11 They assume it doesn't matter if you have toxic relationships.

13:14 And I'd be the first person to say,

13:16 there's a lot foundationally that has to be dialed in before

13:20 we can really get a sense of what's going on with someone.

13:23 Are you familiar with Dr.

13:23 Will Bulsiewicz?

13:24 Do you follow him and stuff with The Gut Health MD?

13:26 I love Will.

13:27 Yes, we are friends.

13:28 He's the man.

13:29 Well, and it's interesting you bring this stuff up because

13:32 I had him back on the podcast for his latest book.

13:35 And he was talking about what you just brought up with gut.

13:37 He's like, you know, like if you don't address like your relationships,

13:41 if you're not you don't have a spirituality,

13:43 if you don't have you fix you don't fix your home life,

13:45 like none of this other stuff like none

13:48 of this other stuff's going to matter because there's

13:49 going to be this lingering amount of like

13:52 pain and inflammation that's kind of pulling at you.

13:54 So I'm really glad that we're diving into this.

13:57 Yeah, I I think that I mean,

13:58 Will and I are very aligned and I I really look at him as a mentor.

14:02 But from my perspective,

14:04 I think that we haven't focused enough on these kinds of conversations.

14:08 And people in traditional allopathic medicine,

14:11 we tend to put everything in buckets.

14:12 Like this is a brain health issue.

14:14 This is a gut health issue.

14:16 This is a heart health issue.

14:17 And yet we never talk about the communication

14:20 that goes on between all these organs.

14:22 Um and how dysfunction in one lends itself to dysfunction in another.

14:26 I'll give you an example.

14:27 My husband got a pretty bad lung infection

14:30 in 2024 that necessitated essentially taking chemotherapy for 6 months.

14:35 And I was having a conversation with a a medical doctor

14:39 and I was sharing privately with him uh cuz I was like,

14:42 it's not my story to tell.

14:43 At that time, it was still pretty new.

14:45 And he said to me, he was like, oh my gosh,

14:47 the fact that he got this lung infection

14:49 shows you that his gut microbiome and the lung,

14:52 you know, there's this gut-lung axis, tells you that it's off.

14:55 So he's like, these are some things I

14:57 would recommend him doing while he's doing this treatment.

15:00 And it was just really affirming to me that we have medical doctors,

15:05 and obviously I'm a nurse practitioner, but we're now having these conversations

15:09 about these communication pathways between all

15:11 of these different organ systems and how that impacts how we perceive the world,

15:15 like mentally how we see things.

15:17 And it makes sense.

15:18 I know before people kind of saw it as I

15:22 don't want to say they saw it as pseudoscience,

15:23 but they were trying to I guess like say

15:25 that you were trying to connect things that don't make sense.

15:27 But if you take take a step back and objectively

15:30 look at what stress specifically does to the body.

15:34 I mean, when I'm stressed, my body is like shut down.

15:37 I'm achy.

15:38 I can feel my heart rate, you know, elevated.

15:40 My blood pressure's up.

15:41 Like all the things.

15:42 You know, imagine what that does over years and decades of time.

15:46 And then and I've I've just seen it in in my career

15:50 where I have people doing all the right things, but their home life sucks.

15:54 And so because their home life sucks,

15:56 they can't really get anywhere because that's like the biggest thing that they

16:00 need to fix because that's what they're living with 24 hours a day,

16:04 7 days a week, you know, it's not the you know,

16:07 eating more fiber, more protein, which obviously is important.

16:10 It's like you got to have a conversation with your spouse.

16:13 You got to like get your kids into rehab

16:16 or whatever the, you know, the example is.

16:18 Yeah, I mean, it's interesting.

16:19 My grandmother, probably back in 1990,

16:22 said to me one of the single most important decisions

16:24 you will ever make is who you choose to marry.

16:27 And at that time, I was like, yeah, whatever.

16:29 I'm never getting married.

16:32 [laughter] But I will tell you that I've been married for 23 years and one

16:35 of the single most important decisions I ever

16:37 made was my choice of spouse, by far.

16:40 I did not get married as young as most of my friends did.

16:43 Um I didn't meet him until I was 30.

16:44 I got married at 32.

16:46 I had my first kid at 34, my second at 36.

16:49 And I can tell you, you know,

16:51 that makes a big difference in your quality of life.

16:53 And it doesn't necessarily mean that you have to be married.

16:56 I'm just saying like who you choose

16:57 to spend time with, whether that's your best friend,

17:00 your circle of friends, your partner, your family members.

17:04 I think that um you know, with family, we don't get a choice, right?

17:08 It's It life is a crapshoot.

17:10 But we do have a choice in who we choose to spend

17:12 time with in terms of like friends and our spouse or our partner.

17:16 And so I think that um a lot of people don't talk about that enough.

17:21 What's interesting though, Doug, is that 70% of divorces are initiated by women.

17:29 And I wonder how many women navigating

17:33 perimenopause and menopause start questioning their choices.

17:37 And and whether or not they have a partner

17:39 that can't support them as they're going through this process,

17:41 I'm sure there's some of that.

17:43 Or they're just with the wrong partner.

17:45 I think many women probably in middle age find their voice.

17:48 Maybe they didn't when they were younger.

17:50 And as a reformed people pleaser, I think I'm I'm pretty fortunate,

17:53 but um I I've watched plenty of my friends go through

17:57 some pretty horrific divorces the last few years and in most instances,

18:01 it was a good thing for them.

18:02 But I think for a lot of people, it's hard to have those conversations.

18:06 It's hard to get real with someone and say like

18:10 talk about the stuff we try to suppress and ignore,

18:13 which is much easier to dissociate, um you know, numb ourselves, um you know,

18:20 decompress and just say I'll deal with it later when,

18:23 you know, it's the big elephant in the room that we're not dealing with.

18:26 Yeah, there's so many people that they like hide behind their kids, right?

18:29 And then the kids leave.

18:30 And all of a sudden you're like, yeah,

18:32 you're stuck with, you know, each other, right?

18:35 Yeah.

18:35 Well, I can tell you it's a big adjustment.

18:37 Like we have one in college.

18:39 My youngest will be leaving for UVA in August.

18:43 And you know, we've been we've been

18:44 preparing for this mentally the last couple years.

18:48 But that that the youngest leaving, that's a big identity shift.

18:51 And even in a healthy relationship,

18:53 like I genuinely enjoy spending time with my husband over most other people.

18:58 So um we're in a good place, but it explains why I have neighbors and, you know,

19:03 how their relationships have to re out like recalibrate when

19:09 they don't they're so predominantly focused on rearing a child,

19:13 they're like, okay, now we can focus on each other more

19:16 and maybe we start traveling or we develop some other activities.

19:21 But for 20 plus years having one identity and then having

19:25 to completely kind of shift your identity, it's a big change.

19:29 Like I can tell you, I'm not mentally ready for August.

19:32 Like right now it's February.

19:34 Not ready.

19:35 Not ready to send him to college yet.

19:36 I keep saying I'm like, I'm not sure I'll be ready when I send him.

19:39 But at some point I'll have to accept this is this is part of the process.

19:43 Like if you do your job well,

19:45 you make your kid you allow your kids to develop into independent adults.

19:48 And that's something that um I've

19:52 seen plenty of really codependent relationships over

19:54 the years and like the best thing you can do for your kid

19:58 is allow them to develop into their own people and encourage them

20:02 to become strong independent-minded adults and that's a hard thing to do.

20:05 It really is.

20:07 It's so tough and especially in the world that we live in where [gasps]

20:11 it's not as easy to contain them.

20:12 You know, and especially if they have a phone

20:14 or they have access to an iPad or a computer.

20:16 I mean they got the internet that can like influence them you know,

20:19 so much on their behaviors and their decisions.

20:22 Um you know, I'm wondering like I'm wondering

20:25 what what it is about perimenopause and pre-menopause

20:29 with the the divorce like I'm wondering if it's

20:32 because you find out who you're really married to, right?

20:35 And you find out does this person actually have my back?

20:37 Like cuz I'm sure like again I I I'm sure you know,

20:40 it's it's not easy for me to comment

20:42 as a guy on women's issues as they get older

20:44 but what I'm going to say is I would imagine

20:47 that there's some emotional instability when you first reach perimenopause,

20:52 pre-menopause, menopause just cuz of all

20:54 the hormones changing like we've discussed.

20:57 And that said, if a guy is not emotionally mature and doesn't

21:01 know how to support his partner through that process there's going to be

21:05 a lot of bickering and fighting and arguing and selfishness and all

21:09 these things which leads to their partner

21:13 thinking this guy doesn't have my back.

21:15 Yeah.

21:16 I mean I think it's multiple things honestly I mean I think we

21:20 have people who are emotionally stable

21:24 that navigate perimenopause and I think we have

21:26 people who are not emotionally regulated

21:28 or stable navigating perimenopause and I would imagine

21:32 that the former is going to do a whole lot better than the latter.

21:35 Now, I have a I have a mother that was not well emotionally regulated

21:39 and I think I was out of the house when my mom was 42.

21:43 So I I just got glimpses of stuff when I was home from college or after college.

21:48 But I think that if you don't have healthy coping mechanisms,

21:52 if you don't have the ability to talk about your feelings and deal

21:56 with your[ __] I think that it makes it a whole lot harder.

21:59 Like in 2019, I always say there's

22:01 the there's the 2019 Cynthia or pre February 17th,

22:06 2019 and then the post Cynthia and I think that for me personally um

22:13 being hospitalized and being so sick and almost dying it ripped me right open.

22:17 Like I had to deal with all my[ __] and I

22:20 think for a lot of people like myself that grew up

22:23 with a lot of trauma um and I didn't recognize it

22:27 as such because that's what little T trauma does to you.

22:30 You're like, it wasn't rape or murder or suicide so it's

22:32 not that bad cuz that's what I was taught trauma was.

22:35 Um it wasn't until I got into my 40s that I really was like,

22:39 oh you're not dealing with your[ __] and so it broke me right open.

22:43 Like when I tell you I had a I wouldn't say it was a I

22:47 would say maybe a reawakening but I got really clear about what I wanted,

22:51 what I didn't want um what was acceptable,

22:54 what wasn't acceptable and it really changed

22:57 my relationships with certain people in my life.

22:59 Not my husband, I think it made us stronger but we

23:03 made a lot of changes based on that and so

23:06 I think that based on what I've seen personally

23:10 and professionally some women navigate it better than others.

23:14 I think that um you know, that emotional regulation piece is really important.

23:19 I think if you're not well emotionally regulated you're

23:22 going to struggle more um and this isn't judgmental.

23:25 It's just looking at what's happening emotionally,

23:29 hormonally, with those neurotransmitters.

23:32 If you don't have good coping mechanisms or they're maladaptive you know,

23:36 why do we see you know, the mommy drinking culture so pervasive

23:40 and illicit drugs use is quite pervasive.

23:45 Um you know, I I I think for a lot of people maybe it's

23:49 when they get into their 40s that with the loss of estrogen in particular,

23:52 they lose their people pleasing which is certainly what happened to me.

23:55 I just suddenly started speaking up and out and I proudly wear the black sheep

23:59 in my family sweater um and it becomes a running joke with my kids because

24:04 we all talk very openly about this because

24:07 I think it's important for them to understand

24:10 why there are certain family members I choose not to be around and you know,

24:15 I just wrote two really very very personal substacks

24:18 that really like blew up because people were like,

24:23 holy[ __] Like looking at you from the outside,

24:27 I would never have known all this stuff happened in your life

24:30 and I said wasn't it wasn't shared to be triggering.

24:33 It was shared more to say perimenopause like ripped the tape off my mouth.

24:38 I finally had to start talking about it and I

24:40 think that I'm healthier for it but I think a lot

24:43 of women depending on how they grew up and how

24:48 much work they have done internally may just continue suppressing it.

24:52 Like suppress, suppress,

24:53 suppress and then it shows up in like illness and divorces and other things.

25:00 Um let me be clear, divorce can be a good

25:02 thing for the right people but I think a lot

25:04 of divorces probably happen cuz people are just incapable

25:06 or unwilling to really work through their stuff cuz it's harder.

25:10 It's much harder to work through your stuff than it is to numb it.

25:14 Yeah, I mean we live in this perfectionist culture that I think people

25:19 and again divorce can be great if it's there's abuse and there's toxicity.

25:24 I'm not talking about that.

25:25 What I'm talking about is general situations where people feel

25:29 like if they bicker or if they argue with their partner,

25:31 that means that the relationship's bad.

25:33 It's like, no there's if there's tension in the relationship,

25:35 that's means you still care.

25:37 There's no tension, that's when you got to kind of worry.

25:39 I'd be like, all right.

25:41 [laughter] Like I haven't put the dishes away in like

25:42 3 weeks and my partner hasn't said anything to me.

25:44 I wonder you know, what's going on there, right?

25:47 See, apathy is a problem.

25:50 Yeah, and I think that with all the content online,

25:52 we see so much emphasis on I would say mostly a lot of it's

25:57 nutrition as far as like what you can eat how to change you know,

26:00 certain lifestyle habits to improve your health

26:03 in every decade of your life or whatever.

26:07 Do you think would you based on what you're saying is it you think it's more

26:09 important not not that the other part isn't

26:11 but is it more important to to pay more

26:13 attention to your mental health and well-being

26:15 as you're getting older so that you can be

26:18 emotionally regulated enough and confident enough to be

26:21 able to work on the other things more efficiently?

26:24 Absolutely.

26:25 I think that's a great question, Doug.

26:26 I think that you know, I have friends that are entrepreneurs that I'm

26:33 really close to like they're like sisters.

26:35 I don't have a sister so it's like if I were to have a sister,

26:37 that's how I think of them and we're

26:39 constantly asking ourselves these questions like you know,

26:44 I walked through fire in 2019 and 2020 personally and I think that if

26:50 I had not been doing the work I think things could have ended just spiraling.

26:56 And so I think that it is harder to go

27:03 to therapy or um whether it's cognitive behavioral therapy,

27:06 whether it's talk therapy,

27:08 whether you know, you need plus or minus needing medication and there's

27:11 no shame in that or people want to microdose or do psychedelics.

27:15 Whatever it is.

27:16 Like you decide that you have some stuff you need to work on.

27:19 There's no shame in that at all.

27:21 But I think a lot of people it's just too hard.

27:23 And I say this I say this with respect.

27:25 Like I have family members that I think their lives could have

27:28 been very different if they had been open to dealing with their stuff.

27:33 And so I think that I started therapy in my 20s and I really never stopped.

27:39 There's always been like iterations of like more therapy,

27:41 less therapy but I think having like being forced

27:46 to talk about your stuff is cathartic at least for me.

27:53 Um if you have a really good relationship

27:56 with your therapist or psychologist or psychiatrist or whomever

28:00 and they allow you to process and move through

28:02 things I think that that makes a big difference.

28:06 Cuz I I feel like I'm very much at peace and I can't say that that's

28:11 necessarily what patients will tell me that they

28:13 feel like where they are in their lives.

28:15 And and I think it shows up

28:17 to your point in perfectionism or orthorexia or you know,

28:23 now we've got GLP-1s so a lot of people

28:25 are just you know some people are using them appropriately, some people are not.

28:30 I'll just put it that way.

28:31 But I think it sometimes it shows up as the physicality piece.

28:34 Like people just keep trying to change things but really

28:37 they need to deal with what's going on internally.

28:39 It's easy to fixate on the external stuff, right?

28:43 Then it's much harder to fixate on the internal stuff.

28:46 Like I know that the really really hard conversations that I've

28:49 had with my husband and like every relationship has tough times.

28:53 Let me be really clear.

28:55 Even us.

28:56 Um it made us stronger.

28:57 Like some people it it goes the opposite direction but like it made us stronger

29:04 and so whatever it is that you're avoiding

29:07 discussing or addressing or dealing with I don't know.

29:12 I I I have no other way to be.

29:14 Like I'm I don't know if that's pathologic that I'm this way

29:18 but like I just don't know how else to live without processing stuff.

29:23 But I recognize like not everyone has the tools or the ability to do that.

29:28 Um and I think that's what fuels a lot of the maladaptive

29:31 behaviors we see which run the gamut from like you know,

29:35 people that fixate on every like every bit of food

29:38 that goes in their mouths has to be perfect.

29:40 It's like if you're a healthy person, you don't think that way.

29:44 Like you're like, so what I went out to dinner and I had some seed oils,

29:46 and maybe I had like some margarine.

29:50 That's what they cook my steak in.

29:52 Uh whereas I, you know, they perseverate over minutia.

29:56 Yeah, I don't know if you follow Arthur Brooks.

29:58 Are you familiar with Arthur Brooks?

30:00 Um he's become like the Warren Buffett of like happiness.

30:03 He studies happiness,

30:04 and I saw a clip and it's kind of funny we're talking about this.

30:07 I think it was this morning.

30:08 It was him and I don't know if it was Bret Contreras,

30:11 somebody was kind of commenting on it.

30:14 And he was talking about happiness and that like

30:16 men I may be getting this wrong,

30:19 but the point was I think if men are a little bit heavier,

30:21 they're they're a little bit happier.

30:22 Not like obese, but like people who aren't

30:24 so obsessive that they have like 12 abs.

30:27 And the And And Bret's response was brilliant.

30:30 He was talking about like, you know,

30:31 imagine you're going to Italy with your family,

30:34 and instead of enjoying like the food,

30:36 you're like renting an Airbnb to have your own kitchen and to cook every meal.

30:39 Like that's orthorexia, right?

30:40 And that is what impacts happiness because a part of you,

30:45 and I I I share this from experience, is like why don't I just go out?

30:48 I know that food is not going to like kill me.

30:52 Why can't I just do it?

30:53 And then you you Everybody else in the family is like why don't we go out here?

30:57 It's just a And that limits your happiness.

31:00 And I dealt with that um when I was in my 20s, uh you know,

31:03 traveling on airplanes with like frozen boiled chicken and broccoli

31:07 cuz I was afraid of you know, gaining body fat.

31:10 And it wasn't for health reasons.

31:12 It was because I was mentally unwell at that time.

31:14 Yeah.

31:14 Well, it's interesting.

31:15 There was a There was an individual that I interacted

31:19 with at a business event that I spoke at last year.

31:22 And I'm going to make this totally ambiguous,

31:23 so no one will know who I'm talking about.

31:25 Um and this individual said something along the lines that when

31:28 they go to events like this, they have to run a house.

31:32 And they cook every single meal in the house because they don't

31:35 trust any of the food anywhere that they could be going out.

31:37 And I was like, oh well, like I go I said, you know,

31:39 if I'm in a city and there's a True Food Kitchen,

31:41 for sure I'm going to eat there at least once or twice.

31:43 that place.

31:44 It's a great spot.

31:45 Yeah.

31:45 And um this person was was shocked and and mentioned

31:49 that like they have no ability to do that.

31:52 And And And this is a very nice individual,

31:54 but all I could think of was it must be

31:56 really challenging to be married to someone that that happiness factor.

32:01 Like whereas when I travel, I don't even stress about working out anymore.

32:05 Like I used to be like, oh, I must exercise every day I'm traveling.

32:08 And now I'm like if I do, I do.

32:10 If I don't, I don't.

32:11 I just listen to my body, and I don't stress about it.

32:13 And so I find that makes me infinitely happier rather than putting myself under

32:18 all that pressure to do the the the right healthy thing at that moment.

32:23 I'm like, I'm going to go walk outside in the sunshine.

32:24 I'm 3 hours behind my normal time zone.

32:27 I'm going to get more out of me getting light exposure than I am going

32:30 to the gym and like having a really

32:32 tough workout this week or today, for that matter.

32:36 Yeah, I mean, it's really interesting.

32:37 It's like the goal of many people is to be as fit as possible,

32:41 and that's why they make these sacrifices.

32:44 And yet I would argue a lot of these people

32:46 are more mentally unwell than the people who haven't

32:49 made any kind of lifestyle decision because of the obsessiveness

32:53 and the compulsiveness and the lack of real interpersonal relationships.

32:58 And I think, you know, a good a good thing's always get taken too far.

33:01 I think it's been a great thing that we focused on eating less processed foods,

33:04 eating more protein, more fiber, but we've like you know,

33:09 I think when we when when you look at like banning

33:11 food dyes and doing all this, and I'm sure that they're harmful.

33:13 I have no idea.

33:14 I've never read the research.

33:15 But like why don't we ban cigarettes?

33:17 Why aren't Why isn't alcohol illegal?

33:18 Like stuff that is known Cuz the alcohol lobby's too influential.

33:22 Right.

33:23 I mean, that's that's unfortunately that's how

33:25 things work here in the United States.

33:26 It's like how influential is that lobby?

33:29 That's I think that contributes to a lot of why

33:32 we probably will never we probably won't see another prohibition,

33:37 you know, that was at the 1920s, but I think you know,

33:43 the health and wellness space is interesting to be

33:45 a part of because there's extremes on every end, right?

33:49 Um I mean, I love the fact that generally when I'm in events,

33:51 no one drinks alcohol, so it's like that's normalized.

33:55 I love that there's a thoughtfulness about food, like quality of food.

33:58 I appreciate that.

34:00 But sometimes I see some extreme behaviors where I just think,

34:02 God, that's got to be miserable.

34:04 Like I don't perseverate over some of the things that other people do.

34:10 And I don't know if it's because of where I am life stage-wise,

34:12 or I'm just more pragmatic as I get older.

34:16 Um I was telling someone I can put together

34:19 like a 40-g meal pretty easily in the airport, and people were like, what?

34:25 And I was like, yeah, I mean, I tolerate a little bit of dairy,

34:27 so I'll do like, you know,

34:28 some stick cheeses and you know, I always carried salted pistachios.

34:33 And I was explaining how I can get 40 g of protein, and they were like, no way.

34:36 I'm like, you know what?

34:37 I can do that pretty easily.

34:39 So when people say like there's no clean options,

34:42 I'm like, I think you just have to reframe things.

34:45 And you know, you're you're traveling.

34:46 It's not going to be like sitting down

34:48 at the Four Seasons and having this like elaborate meal.

34:50 You're just you're limited in what you can do.

34:54 Yeah, it's like you can you just find the best option you can at at the place.

34:57 Like so, like if I'm at a burger Yeah, if I'm at a burger spot,

35:01 like I'll get like a burger with maybe some bacon and avocado.

35:04 I'll like not eat the roll, and I'll get like either a side of fruit

35:08 or I'll eat like half the fries it comes with.

35:10 And it's I'm like, it's not going to kill me.

35:11 It's like an extra maybe 200 calories than I would have eaten,

35:15 which at the end of the day like it's nothing, you know?

35:18 Yeah, my husband was laughing at me because I think I was in Charlotte,

35:21 North Carolina's airport, and there aren't a lot of places to eat that are

35:24 you don't have to sit down and like have a regular meal.

35:26 And so I was starving in between flights,

35:29 and so I went up to this one restaurant and said,

35:32 can I get a naked burger with just some bacon?

35:34 And they were like a naked burger with bacon, and that's all you want?

35:37 And I was like, yeah.

35:39 So they brought it out, and they're like,

35:41 this is like the status plate we've plated it all day.

35:44 And I was like, it's totally fine.

35:45 It's good for me.

35:46 It works.

35:47 So there's there's ways around things,

35:48 but I I think that the orthorexia thing is probably fueled by social media.

35:54 I think people look at what other people are doing,

35:57 and then they feel a sense of whether it's comparisonitis or just feeling

36:02 like they're not living up to other people what other people are doing.

36:04 I'm like, listen, what people put on social media is the highlight reel.

36:09 Like when I put a photo up, I don't put the bad photo up.

36:11 Although I do have a bad photo up on Instagram from my hospitalization,

36:14 and there were no good photos from the hospitalization.

36:16 I looked bad.

36:17 Um But the point I was making is most people

36:20 what they show on social media is the highlight reel.

36:23 They don't show the They don't show

36:24 the shady stuff that's going on behind the scenes.

36:27 They don't talk about the bad stuff.

36:29 Most people don't.

36:30 Or the negative things, or you know,

36:33 any of the other like feelings that we have as we're trying to navigate life.

36:39 Yeah, when you're single, it's way easier to like be orthorexic,

36:42 I feel like, because there's you're not impacting other people.

36:47 It's just kind of you.

36:48 You can do your own thing, and then you can justify it however way you want.

36:51 And my experience when I did that, like I was just completely miserable,

36:55 which is why I have a bias towards not being that way anymore.

36:59 Um and I think it it changes when you

37:01 when you have like if you got if you're married,

37:03 and if especially if you have kids, you know,

37:05 I think your world view on that stuff changes.

37:08 Not to say that you shouldn't prioritize eating healthy.

37:11 It's more like there's other people to consider besides just yourself.

37:16 And it's like really hard to justify certain things.

37:21 Like, you know, I I buy regular chicken.

37:24 Like do I I do I I know that there's probably hormones pumped in it.

37:27 I know that there's probably the animals are treated horribly, but I'm like,

37:30 you know, 25 g of protein in chicken is 25 g of protein,

37:34 and I'm going to cook it,

37:36 and it's like $5 a pound cheaper, and I'm okay with that.

37:40 And there's a lot of people that are like, oh my god, you're crazy.

37:42 And I'm like, I don't care.

37:44 Like I think you have to make the right decision for yourself,

37:47 your sanity, and your budget.

37:48 Like I have two adult sons.

37:51 Let me tell you, my grocery bills when they're

37:53 both home are obscene cuz they eat so much protein.

37:56 And I've had to have conversations with them.

37:58 I'm like, I don't ever want you to lack for high-quality food,

38:02 but you know, it's interesting.

38:04 My older son, who's a sophomore in college,

38:07 um and plays lacrosse, like now he cooks independently.

38:10 He has his own apartment with some roommates.

38:12 And he was talking about what his food prep is like,

38:14 and he literally takes like 5 lb of ground meat,

38:17 cooks it up, cooks a bunch of like starches,

38:21 and that's his food prep for the week.

38:23 And he was explaining to me how there's

38:24 one grocery store in the town where he goes

38:27 to college where he'll shop when they have

38:29 discounted like It's not like when I say discounted,

38:31 it's like they have a sale on meat.

38:33 He'll go and buy a bunch.

38:34 And I'm like, I think that's great.

38:37 Like to be aware of being able to feed yourself is important,

38:41 but the reality's of you know, what I spend on like grocery bills is insane.

38:48 Like my husband and I at the peak of when both my boys were home,

38:51 and they were both in high school, it was bananas.

38:54 And And now my 18-year-old, who's 190 lb and 6 ft tall,

38:59 and does mixed martial arts, and he's super super muscular,

39:03 uh you know, the It's like we've just we've started

39:06 buying liquid egg whites because the kid eats so many eggs.

39:10 So he has so many eggs a day,

39:12 and then he does he's tops off with egg whites before bed

39:15 on top of all the other things that he eats for protein.

39:18 And my husband and I are just like, we have to go to Costco because of him

39:21 because the volume of protein that he consumes is obscene.

39:26 I mean, I'm glad he eats healthy.

39:27 Let me be really clear,

39:28 but uh anyone that's listening that has or remembers what bills were like

39:33 when their kids were teenagers or has teenagers or has friends with teenagers,

39:39 you know, they just eat a voluminous amount of food, and it's non-stop.

39:42 Well, you're one of three boys.

39:43 I'm sure your mom and dad probably felt 100%.

39:46 Yeah, it was it's expensive to feed.

39:47 And I think you brought up a good point

39:49 in that way I think Costco can be a game-changer for people.

39:55 They have grass-fed options that are super affordable.

39:57 You can get wild-caught fish and everything in between.

40:00 So, something that will fit everyone's budgets.

40:02 But, I think like if you can get like lean ground beef, like 90/10, 95/5, 93/7,

40:10 and like rice, I mean, that can be like a solid a solid meal for people.

40:15 No, that's pretty much what Jack eats.

40:17 And then, the younger one likes pasta.

40:19 That's like a bit He always talks about how

40:21 his carb macros he prefers pasta for replacing glycogen.

40:25 And it's hilarious.

40:27 I mean, I watch him he cooks He like cooks up stuff up,

40:29 and then he sets things aside for school.

40:31 He takes it to school.

40:32 He goes with Pyrex, big Pyrex containers that he heats up at school.

40:36 And you know, he's in a cutting phase right now, which is hilarious.

40:41 And so, he's, you know, being like, you know,

40:43 really conscientious about the carb to fat ratio for things.

40:47 And I was like, "Good lord." I was like,

40:51 "As long as we're not being restrictive."

40:53 The bodybuilding diet's definitely like a different animal.

40:56 I remember when I first started eating like a gym bro, there was like no fat.

41:00 It was like I hired a coach, and it was like,

41:02 "All right, you're going to eat chicken, rice, like broccoli,

41:04 and then oatmeal and egg whites." And it's like

41:07 I remember somebody saying like like whispering in my ear,

41:09 like you're not going to be the healthiest, but you're going to be really lean.

41:12 And I was like, "Oh, this is exactly what I want." Because I mean,

41:15 I think it's healthier than obviously than most diets,

41:17 but you're not I mean, most of them there's not a lot of like fat.

41:20 It's more It's just carbs and protein.

41:22 Well, and that's kind of where the other night,

41:25 um we have family dinner every Sunday night,

41:26 and usually it's steak and something else.

41:29 And so, we all sat down, and my son asked, you know, we had green beans.

41:33 And so, he's like, "Did you put anything

41:34 on it?" Cuz he's being mindful of the carb intake.

41:37 And usually we'd use like olive oil and salt.

41:39 And so, you know, he took his portion,

41:41 and then we put olive oil and salt on the rest.

41:43 And we just kind of shook our heads.

41:45 We're like, "All right.

41:46 Well, whatever, you know." You're in a cutting phase right now.

41:50 But, it's it's fascinating.

41:51 But, I think it's I think it's really important when you're modeling behavior

41:55 for kids that you yourself kind of check yourself about how you eat.

42:00 Like, I know I'm known for intermittent fasting,

42:03 but I always explain to my kids like why I was doing it.

42:06 And obviously now I do a lot less of it.

42:08 But, I would say to them, like, "This would not be a strategy for you.

42:11 And here's why.

42:12 You're still growing." I mean, at the time, you know,

42:14 10 years ago, they were you know, like 10 and 8.

42:17 Now, they're a whole lot older.

42:19 But, you know, understanding like I'm

42:21 not purposely withholding food for a reason.

42:24 It's just this is part of what's in what we do when we intermittent fast.

42:27 But, I think especially probably even for girls,

42:30 you know, that modeling of behavior is really important.

42:33 Cuz I I grew up with a mom who I

42:35 think her father made her feel badly about her weight.

42:38 So, she was very sensitive about her weight

42:40 and would always comment about other people's weight.

42:43 Which then, you know,

42:44 even though she never commented about me or my body or my brothers,

42:48 I think it there was always that like

42:50 awareness of my mother's perception of obesity.

42:54 And her perception of what that was.

42:58 Yeah, and I'm glad we're we're talking about all this, cuz

42:59 this is like real life of like what people deal with.

43:02 Like, what what you're describing in your family

43:04 situation with your kids and the way you eat.

43:07 Like, this is why people I think struggle.

43:09 They either struggle because they over-obsess

43:12 about like eating organic versus non-organic,

43:14 and then financially they burden themselves.

43:16 They like are like, "Oh my gosh,

43:18 like I I I can't eat this, can't eat that." And it's like

43:20 the the real life situations are like the ones we're talking about now,

43:24 which is why I think managing stress

43:26 and emotional regulation um are getting older.

43:29 Like, do you think that like, you know,

43:34 stress is like this the thing that constantly

43:37 sabotages more health issues than people realize?

43:41 Probably.

43:41 I mean, uncomfortable feelings maybe is the way that I think about it.

43:44 Like, what drives a lot of bad

43:47 behaviors is not dealing with uncomfortable feelings.

43:49 Like, the numbing, whether that's over-exercising, watching porn,

43:55 um drinking too much alcohol, using illicit drugs, shopping, addictions.

44:00 It's a way to like release dopamine and makes people feel temporarily better.

44:04 Or, in the case of like overeating like carbohydrates, you know,

44:08 releases a little bit of serotonin, so they feel good.

44:12 I I just think that a lot

44:13 of those numbing strategies are really just numbing feelings.

44:17 Like, there's a an amazing clinical psychologist, Joan Ro- Dr.

44:21 Joan Rosenberg, who I adore.

44:23 And she wrote a book talking about exactly this.

44:25 And I have like read it and reread it like 10 times.

44:28 It's like always in my auto audible,

44:30 um so that I can like listen to a chapter when I need to hear it.

44:34 But, I think a lot of what is at the basis

44:36 for stress in our lives is just uncomfortable feelings.

44:42 Even if it's something as small as like,

44:44 "I need to have a discussion with my neighbor because I'm upset about X,

44:47 Y, or Z." It's like, "I'm upset about that.

44:49 I'm going to have a beer." You know, it's like,

44:50 "Let me deal with this later." And you know,

44:53 I'll be the first person to say as an entrepreneur,

44:55 I'm in the midst of a book launch.

44:57 There's probably a lot of nights where I'm like,

45:01 "Oh, I got to get this next thing done.

45:02 I got to get this next thing done." So,

45:04 I think workaholism or workaholics can also be a way

45:07 of not dealing with, um you know, being busy.

45:10 You know, the concept of being busy can sometimes be

45:13 a sign of people just not dealing with their feelings.

45:17 It's like easier like I used to work for a large cardiology group.

45:21 And I just remember there were certain docs that were always at work.

45:24 Like, they were always in the office.

45:25 They were always in the hospital.

45:26 They didn't go home at 5:00 or 6:00 at night.

45:29 They were always always always working.

45:31 And one of my colleagues said, "Well, just think about it this way.

45:34 Some of these people don't have anything to go home to.

45:36 Or, they don't have a healthy relationship.

45:39 And so, they avoid going home." And they just keep working.

45:43 Like, "Oh, I'm needed at work." So,

45:44 it's the justification for not being at home.

45:47 Cuz at home they would have to deal with probably some uncomfortable

45:50 feelings or an unhealthy relationship or a combination of all the above.

45:54 But, I think that's what drives a lot of the bad behaviors we see.

45:59 And I say bad as in not pejoratively, just like maladaptive behaviors.

46:04 Yeah, and so I I what I'm gathering is people are, you know,

46:07 after listening to this, they're like, "Man,

46:09 like I feel like my body is turned me.

46:11 I feel like I'm experiencing these symptoms that we've kind

46:15 of been off and on talking about." The first thing they

46:18 should probably address is just getting really honest with themselves

46:21 and kind of looking at it from a multi-pronged approach, right?

46:24 Like, not just looking at the health and the exercise, which is important,

46:27 but like, what are they What else are they hiding from?

46:30 Yeah.

46:31 Well, and there's like shame.

46:32 I mean, shame goes along with a lot of these behaviors, shame and secrecy.

46:36 And I always say that a lot of what perpetuates,

46:42 um you know, uncomfortable feelings is shame.

46:45 Like, people they're just like they feel badly about themselves.

46:48 So, it's easier to numb it.

46:50 Like, I had a parent that was a long-term alcoholic.

46:53 And I think underneath a lot of his behavior,

46:55 it wasn't until unfortunately until he passed away that I was,

46:58 you know, knee-deep in his stuff.

47:01 And I was like, "Oh my god,

47:02 I finally realized why my dad was so hard on us about his grades." Shame.

47:06 It's like certain things that my dad was really hard

47:09 on my brother and I about was shame and secrecy.

47:12 It's like you start to see it's like the you know,

47:16 it's like you start to fully see someone for who they are.

47:18 And you're like, "Oh, I understand this behavior so much better now."

47:23 But, I think for a lot of people,

47:24 shame and secrecy drives a lot of the decisions that we make.

47:29 Not necessarily that they're necessarily good decisions,

47:31 but I think shame is at the crux of a lot of a lot of this.

47:37 Do you think that [sighs] I mean, with like your parents,

47:41 like was it normal to be like unhealthy though in their 60s?

47:45 Like, I feel like it I feel like it was kind of you're like made fun

47:48 of if you went on like on a diet back in the day and ate healthy, right?

47:51 Um well, like my mom was a So, my grandfather literally came over on a boat.

47:57 So, my mom was truly like the first first generation of of that.

48:01 And you know, we had a garden.

48:03 My mom, you know, cooked all of her own food.

48:06 Um you know, we had wheat bread, which back in the '70s no one had.

48:10 My mom made us eat liver.

48:11 I mean, it was very progressive.

48:14 Like, I would almost describe it as kind of crunchy, uh before her time.

48:19 Uh but, I think that you know,

48:26 it's interesting how our our parents' choices influence our lives.

48:30 Like, my parents were very focused on being a healthy weight.

48:34 That was very important to them.

48:35 In fact, I remember when I went off to college,

48:37 my father's last words to me were not Don't get pregnant or anything else.

48:41 It was like, "Don't get fat." "If you need,

48:44 I will get you a gym membership." My dad was so worried about that.

48:48 And it makes me laugh now.

48:49 But, for whatever reason, for my parents,

48:53 it was very important that my brother and I be a healthy weight.

48:57 And so, we had like lots of vegetables and, you know,

48:59 lots of protein and you know, I had I had a salad before every dinner.

49:03 I was drinking milk until I think I was 18 years old.

49:06 So, which is why I probably still don't like milk like at all.

49:09 Because you know, it was like it was expected.

49:12 This is what you're going to consume before dinner.

49:16 And how has that like shown up for you, um like later on in in life?

49:21 Cuz I feel like sometimes um when people like caregivers talk to their kids like

49:26 that, it can create like all kinds

49:29 of mental health issues if they're not careful.

49:31 I mean, it's interesting.

49:32 I think that, um I grew up with parents who obviously were not healthy together.

49:39 It was like oil and water.

49:40 So they got divorced when I was seven and I

49:43 just remember that um achieving was very important to my parents.

49:48 So like being good in school, um running for student office, being well-liked,

49:54 like there was a lot of external pressure to perform and I don't think I

49:59 realized until I was probably my late 20s

50:03 how pervasive and how much that influenced me.

50:07 Um I didn't have a a dysmorphic body image, thank God.

50:11 I think I was just too I'm just feisty.

50:15 Like even at a young age,

50:16 my mother would say that I would I had a very strong sense

50:18 of who I was and what I wanted to do or not do, which probably helped me.

50:23 I think that it maybe if I were a different personality of person,

50:28 I probably would have internalized a lot

50:30 of my mother's insecurities about her weight.

50:33 Um But I I do recall being in my late 20s and then

50:38 I was very aware of how much [snorts] pressure my parents put on us.

50:42 Like you know, to achieve achieve achieve, you know, go to these, you know,

50:46 strong universities, have a good job, you know, marry the right person.

50:50 I mean, these are all things parents, I think for the most part,

50:52 they want their kids to be successful and I get that.

50:55 But I think it was more of a reflection of the shame

50:58 that they felt that somehow I was an external validation of them.

51:02 Like me being successful was demonstration that they were successful as parents.

51:09 I think that it wasn't until I was a parent

51:11 that I saw my parents for who they were.

51:15 And that was hard.

51:16 I'll be honest with you cuz I I would

51:18 do anything for my boys and my parents you know,

51:23 there were a lot of not so healthy things that happened that I

51:26 could then objectively see and it changed my relationship with them permanently.

51:30 To be honest, to be totally transparent.

51:32 to discuss you said something that's really important that I think is

51:35 part of a big part of this conversation that we're having is

51:39 that a lot of stress from people mid-life that can cause health issues

51:44 we've been talking about is like their kids and it's like the level

51:51 of success their kids have is that means how they are

51:53 as a parent and I've seen so many parents over the course

51:56 of my life be afraid to like reach out and ask for help

51:59 if their child is struggling with addiction for instance because they are like,

52:02 "Oh my gosh, if I admit that my son or daughter has a problem,

52:06 does that mean I'm a moral moral failure as a parent?" Um like

52:10 how have knowing what you've you've done a lot of work on yourself,

52:13 you've got two kids on your on your own,

52:16 um married, like you've healed a lot of stuff.

52:19 Like how do you view all of that now?

52:21 Um [sighs and gasps] you know, it's it's interesting.

52:25 I I can view my parents objectively.

52:27 Like I understand and have a lot of empathy for my dad cuz

52:31 I think my dad grew up with a lot of emotional and physical abuse.

52:35 And I I think my dad was on the spectrum and I think

52:39 his alcoholism was PTSD from Vietnam and because he just felt socially awkward.

52:44 So I have a lot of empathy for that because I

52:48 think that would make it really hard to navigate the world.

52:51 I think my mother uh who is a narcissistic personality disorder,

52:57 um I think she did a lot to be to go out of her way

53:02 to be mean towards my dad and just has a a meanness about her, a cruelty.

53:07 And so it's harder to reconcile that um for me personally because my dad

53:14 tried to go to therapy and my dad went to therapy for a long time.

53:17 I'm not sure how effective it was,

53:19 but I'll be totally [clears throat] transparent.

53:20 He went to a psychiatrist and every time he'd talk about

53:22 with the psychiatrist and he talked about and I was like,

53:24 "Dad, he's more like your drinking buddy.

53:26 Like I'm not sure he's actually helping you process any

53:29 of these emotions cuz when I go to my therapist,

53:31 she has me talk about I don't want to talk about.

53:34 Like it's like scratching the the wound.

53:36 It's like let's scratch the wound a little bit and see

53:38 what how much blood comes out." Um with my mom,

53:41 I think she was truly incapable is truly incapable of uh being

53:48 able to to look at her behavior and to make sense of it.

53:51 So, you know, for me objectively,

53:53 like I can objectively say this, it doesn't make it any easier because some

53:58 people get the parents that they they

54:01 they have such close relationships with their parent.

54:03 I'm not sure how close you are to your parents, Doug, but like,

54:06 you know, Father's Day and Mother's Day

54:07 comes and holidays and it's always, you know,

54:09 huggy kissy emotional and I've just never felt that way

54:13 and so I've always felt tremendous guilt on those kinds of events,

54:18 around those kinds of events.

54:19 But I but I have because I've done so much work,

54:22 I said to my husband, "If I can't guarantee my kids grow up differently,

54:26 then I won't have kids." So how do you how have you flipped that on its head?

54:31 Like if your kids were to struggle in school for instance,

54:34 would you see that as a failure on your end?

54:36 No.

54:36 I mean, I would say that there's something going

54:38 on with them that they need to work on.

54:40 Like my I I have a a son that um got a like a gut infection

54:46 and that showed up in like he was

54:49 developing some OCD tendencies that were really maladaptive,

54:53 like washing his hands 100 times a day and like I was trying to explain

54:56 to the pediatrician before we got a referral to someone that could help him.

55:00 I was like, "We're going through like two rolls of paper

55:02 towels a day." Like just to give you some idea.

55:06 So I didn't see that as me struggling as a parent.

55:09 It was more like how can I help him?

55:12 Because I don't want this to become a larger issue because I love him so much.

55:16 I'm like, "We're going to get him the help he needs to better

55:18 understand the behavior and in the meantime get him in with a functional

55:22 integrative doctor who can figure out what's going on physically for him so

55:26 he can deal with these kind of emotional urges." And that helped enormously,

55:30 but I think that if my child were struggling in any capacity,

55:34 my my tendency is to help get them

55:38 the help that they need so they can be successful.

55:41 Like it's always the reframe is always like,

55:43 "What can I do to help them be successful or fix what is

55:48 the whatever they're having an issue with." is what I'm trying to say.

55:51 I I think that I think that uh my boys

55:56 certainly grew up in a different environment than I did.

55:58 I grew up in a very volatile, abusive, both physically and verbally,

56:04 house and like my kids have not grown up that way.

56:06 So they have a very strong sense of themselves.

56:08 Like things that my 20-year-old says,

56:10 I'm sometimes I'm taken aback at his emotional maturity, even as a male.

56:14 Like people always say, "Oh men, you know,

56:16 are so much less mature than girls." I'm like,

56:18 "I don't know if I believe that cuz my kids are pretty

56:20 damn mature for their ages." And so I think that I look

56:25 at it as how healthy my boys are is is a reflection

56:30 of how much I ensured they did not grow up in the same environment.

56:33 So anything is figureoutable.

56:36 Like that was always my feeling is that anything they do um is figureoutable.

56:41 Like my kids tell me a lot and I think they tell me a lot because they know

56:44 that it's a safe place to talk about like

56:47 talk about real problems or real issues or you know,

56:51 sharing things that are going on for their friends in a in a very secure way.

56:57 Like they're not disclosing things that their friends don't want them to share,

57:00 but being able to share things about their lives in a very safe place.

57:03 Like I couldn't have done that with my parents.

57:05 My parents were very judgmental.

57:07 Like very judgmental.

57:10 So like bringing this all home,

57:11 let's just say somebody runs into you at a coffee shop.

57:13 They're like, "Cynthia, you know, I heard you on Doug's podcast.

57:16 Great episode.

57:17 Loved the dialogue.

57:18 I heard, you know, I heard that you talked about the importance of like stress

57:21 and taking care of your personal stuff

57:23 as it relates to aging and mid-life stuff.

57:26 I didn't hear as as much about nutrition.

57:27 Like what what should I do?

57:29 Like what are a few general things you tell people that they should do as far

57:34 as their nutrition and how they eat

57:35 that can help them with their aging process?" Yeah,

57:38 I mean, I think first we have to track

57:40 because you can't improve upon what you don't measure.

57:43 So I think macro tracking and remember it's just for a couple days,

57:47 not in perpetuity and forever cuz that's that's exhausting,

57:51 but you know, getting a sense of where you are with your protein intake,

57:55 getting a sense of where you are with your fiber

57:56 intake and I make the argument that the standard American diet

58:00 is devoid of protein and I think tracking macros is really

58:04 important and getting a sense of where you are with protein.

58:07 We know we need more protein with aging, not less.

58:10 Meaning anywhere from 30 to 50 g in a meal.

58:13 And then getting really granular about fiber and I know that probably Dr.

58:18 B did a great job explaining this, but because

58:21 the standard American diet is so devoid of fiber,

58:24 I think people have gotten to a point

58:26 when they start reintroducing it into their diet,

58:28 they can have symptoms and so I think there are ways to introduce fiber that is

58:33 less likely less likely to be bloating

58:37 and to cause symptoms certainly suggestive of intolerance.

58:41 If you've been consuming 5 to 10 g of fiber

58:44 a day and you try to get to 25 to 30, which is what most experts recommend,

58:48 there's definitely going to be a period in between where you're going to have

58:52 to do that really low like low and slow is really the strategy.

58:57 I mean, other than that, I think it's really,

58:59 you know, asking yourself like are you hydrating your body?

59:01 Like really keeping things simple.

59:04 Um I think alcohol is really not our friend

59:07 and I think for a lot of individuals,

59:08 it's not until they get to middle age that they start having worsening of sleep,

59:13 more anxiety uh related to alcohol.

59:16 So really examining your relationship with alcohol to see,

59:19 you know, is it serving you?

59:20 Is it something you just have once or twice a year,

59:22 like at a wedding or celebration?

59:24 Or is it something you're doing more frequently

59:26 and that's worsening your sleep and worsening your stress response.

59:30 So those are some kind of key things to think about that you have to track

59:34 before you can adjust and I think just

59:36 far too many people are under nourishing their bodies.

59:39 That's the other thing that I would

59:40 say whether they're intermittent fasting but you have

59:42 a really tight compressed window and you're not

59:45 eating at least 100 grams of protein a day.

59:47 That's definitely a problem.

59:49 Well Cynthia, this has been awesome.

59:51 I love love our conversation.

59:54 I love you know the stuff that you shared your vulnerability.

59:57 I think we're going to get a lot of value out of this conversation.

1:00:00 You have your new book the menopause gut.

1:00:03 It's going to be out what end of end of April, right?

1:00:06 April 28th, 2026.

1:00:08 Oh, that's exciting stuff.

1:00:10 Yeah, I'm excited.

1:00:11 This has been a book.

1:00:12 I have literally poured my heart and soul into.

1:00:15 It's really a love letter to women from you know,

1:00:18 being in medicine for over 25 years and to be

1:00:21 honest it's the first book that's really speaking

1:00:23 to the changes that are happening for women and their microbiome

1:00:26 that really impact literally every system in the body.

1:00:29 Awesome.

1:00:30 Well, I'll be sure to link it in the show notes.

1:00:33 Proud of you.

1:00:33 Thanks for coming back on the show and once again,

1:00:36 I think the audience get a lot of value out of this.

1:00:38 Thanks so much Doc.

1:00:39 So good to connect with you.