Watch the full interview below or listen to the full episode on your iPhone HERE.
Stu: This week we welcome to the show Sara Gottfried MD. She is a Harvard-trained MD, bestselling author, and leading expert on hormones. She is a board-certified gynecologist who practices functional medicine, but also a regular gal—a busy working mom, constant chauffeur for my daughters, devoted wife, and spiritual seeker.
In her practice, she helps women balance their hormones naturally—starting with their fork. She has a “food first” philosophy and passionately believe that food is the small hinge that swings the biggest doors when it comes to your health.
Audio Version
Questions we ask in this episode:
- What is Healthspan?
- What are the levers that most impact Healthspan?
- How much of our health is determined by genetics versus the environment?
- What can we expect from your book Younger?
- If we could focus on just one thing to improve Healthspan, what would you recommend?
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Full Transcript
Guy
Hey, this is Guy Lawrence of 180 Nutrition and of course welcome to another fantastic episode of health sessions. Where we are connecting with leading global health and wellness experts to share the best and the latest science and thinking empowering us all to turn our health and lives around.
[00:00:30] This week we have a very special guest for you. I just loved this podcast, and it was with Doctor Sara Gottfried. Now, if you’re not familiar with Sara, she’s a Harvard trained MD with over 20 years of experience. She’s also the author of The New York Times best selling books, The Hormone Cure, The Hormone Reset Diet and her latest book, Younger.
[00:01:00] I kid you not, we had a blast on this podcast. We covered all sorts of topics from her own personal experiences to her thoughts on middle-age and how we can slow that aging process, but even from a disease-free perspective. On top of that what’s clear about Sara is that she’s a very honest, loving person, and leads by example in everything that she does. She’s putting out such a great message to the world. It was just a privilege to have her on the podcast today and share this. We even get to talk about the Costa Rican term for Avila and Tequila. It’s safe to say Stu was on fine form today as well as we kick off in 2018.
Anyway, I know you’re going to enjoy this podcast. Let’s go over to Sara Gottfried. Enjoy.
[00:01:30] Hi this is Guy Lawrence, I’m joined with Stuart Cook as always, good morning Stu.
Stu
Hello, mate.
Guy
Good to see you. A wonderful guest today is Sara Gottfried. Sara, welcome to the show.
Sara
Thank you, so happy to be here.
Guy
It’s beautiful Sara. Like Stu was just saying, we’ve been following you from afar for so long, so it’s nice to finally get round to having you on the podcast and exposing you to our listeners.
Sara
Same here.
Guy
Sara, we ask a certain question on every show and that is, literally, if you were say on an airplane or in the street and you sat next to a stranger, and they asked you what you did for a living, what would you say?
Sara
I would say I’m a troublemaker.
Stu
Yeah, that’s what we like to hear.
Sara
[00:02:30] Well, it depends on the context. What I usually say is, I’m a change agent, I am a change agent for health and wealth, because your greatest wealth is your health. Our healthcare system is broken. I really want to change all those things, I feel like that’s my mission, that’s the reason why I’m here. I does depend on context. I used to say I’m a bored certified gynecologist, I practice functional medicine. Half the people would turn on their heel and go the opposite direction, so it’s evolved over time.
Guy
Yeah, beautiful. The other question we always ask is, what led you into that in the first place? Where does that passion come from? Have you always been interested in health, or was it something you stumbled across during life? What happened?
Sara
[00:03:30] Yeah, I’m one of those people who had a crisis in my 30s. I definitely was always interested in health, I had a great-grandmother who was a whole foodist and practiced yoga, she slept on a board. She thought that sleep was the most important medicine that you can give to your body, and that you don’t find health in the bottom of a pill bottle. I grew up with that kind of environment. I didn’t really bring it home until I was in my 30s. I was practicing medicine and seeing 30, 40 patients a day, delivering babies at night, practicing gynecology, and I just hit a wall.
[00:04:30] I had a couple of babies, I couldn’t lose the weight. I was kind of a bitch. I had PMS, premenstrual syndrome. I went to see my doctor and laid out these issues that I was having. He basically told me to exercise more and eat less, and to take an anti-depressant. That’s really what got me going, because at first I was humiliated that, that’s what he was suggesting for me, but then I got angry. I got that kind of righteous anger that really can foam into revolution. And realize that so many people are being told this very same thing, and it is the wrong information.
Stu
Totally. Did you try what he prescribed for you for any period of time before the change?
Sara
[00:05:00] Hell no. Hell no. No, I went straight from his office to the lab. My hunch was that my problems were hormonal. It wasn’t that I was depressed, it was that I was stressed out, and that I had estrogen dominance, and that I had an issue with blood sugar. I had a sense that maybe those things were going on. His answer was an anti-depressant. I was running at the time, so adding more mileage was not the solution. I did not try what he suggested. I went to the lab and found that my cortisol, my stress hormone was three times what it should have been. That’s really what got me going.
Guy
Yeah, fair enough. Do you think more people would respond now to the way you did, or do think we’re still openly taking that advice? Are you seeing change from your end in the US?
Sara
[00:06:00] I am seeing change. I think more people are realizing that the so-called solutions on offer from conventional medicine are sometimes dangerous. Mostly, unpalatable, and they don’t address the root cause. I think we have more enlightened consumers who can say to their doctor, “Really, I thought that anti-depressants really only work if you’ve got severe depression, and most of the time they’re worse than placebo.” People are actually saying that in their doctors office. We still have a long way to go, there are still people who, for whatever reason, respect the hierarchy of conventional medicine. I definitely see this tipping point.
Guy
Yeah, for sure, for sure.
Stu
Interesting.
Guy
Go on Stu, sorry.
Stu
Sorry Guy, after you, mate.
Guy
No, I was just going to say, it’s fascinating. Once you went on the journey and you found … I don’t agree to this. What have you found over the years since you’ve gone on, has it been a continuing learning process, you just keep discovering more? What happened from that point? I’m really intrigued.
Sara
[00:07:30]
Well a lot of things have happened. I’m a lifelong learner, so definitely … I think you guys are that way too, I’ve listened to some of your podcasts. I feel like it’s led, well to four books and to a way of thinking about our present condition, our modern life and what’s wrong, what’s right, what really needs to be reset. What’s changed? When I first started with this work it began with hormones, because I had a sense that my hormones were totally nuts and that I needed to get them back on track. That’s true for both men and women, especially in middle-age, starting in your 30s well into your 40s and above.
[00:08:00] It didn’t stay with hormones, I love balancing hormones naturally, and we can certainly talk about that today, but I got more interested as the science started to change in the gene environment interaction. I think that is such an important part of health. About 10% of disease is genetic, 90% is environment. You have so much control over that environment that’s bathing your DNA. That’s what my latest book is about, and it’s changed from there. When I got my hormones to a really good place, which was in my mid-30s, after I left that doctors office. I did a lot of work with how I interact with stress.
[00:09:00] Then I tested my telomeres, you know those little caps on your chromosomes that are a marker of biological aging as opposed to chronological aging. I just totally flunked that test. I thought I was so good, I thought my result would be so nice. It turns out that I was aging about 20 years faster than my biological age, even though I had fixed my hormones, it wasn’t enough. It’s that, isn’t quite enough, state that keeps motivating me. That was the [inaudible 00:09:01] in answer to your question.
Stu
There will probably be a million and one people now then that want to know what you did and what you changed to alter the effect of the, I guess, the degradation of your telomeres. Tell us what you did? I’m so intrigued.
Sara
[00:10:00] My short study telomeres, which I retested by the way. Before I did my latest book I was 45 when I tested, I had the telomeres of a 65 year old women. Not the result you want to get. I retested last year, and at 49 I had the telomeres of a 52 year old. I closed the gap by 17 years, hurray for that. What do you do? Well, I think there’s certain levers, that I know you guys talk about all the time, that really have the greatest impact scientifically on your telomeres and how fast your aging. Those are how you eat, move, sleep, think, supplement, detox, and change. Since I’m a change agent, I’ve got to bring that in.
Stu
[00:11:00] Absolutely. It is one of those things, isn’t it. People think, “Right, 2018, I’m going to do some radicle things for my health. I’m going to change the way I eat.” Great. But if you’re not sleeping right, if you’re stressed, if you’re exposed to environmental toxins, without being aware of it, then you may as well be at McDonald’s, because it’s really not going to help you that much I think. I was intrigued as well, because I just wanted to move onto Healthspan, which I know that you’re very much involved in. I took an online test last night actually, I took your Healthspan test. I was intrigued by some of the questions that you asked because it made me think differently, “Oh, that’s interesting.” I never associate some of those questions to my health. I just wondered if you could tell us a little bit about Healthspan, and why you think it is important perhaps to be part of your change?
Sara
Of course. Then I want to know what those questions were that got you thinking Stu.
Stu
I’ll tell you, I’ll tell you.
Sara
[00:12:00] I think of Healthspan as being the period of time where you feel fantastic. I just turned 50, I think of it as extending the best of middle-age, extending this time where you feel like you’re on top of your game. Time is still on your side. Extending that as long as possible. In my family people live a long time, they tend to live until their late 90s, then they suddenly die in their sleep. That’s how I want to die. I want to be pretty healthy, I want to be like my great-grandmother that I mentioned at the beginning. She could rock a yoga pose, and stick her foot behind her head when she was 97. That’s what I want. I don’t want to be in my 90s unable to recognize my great- grandchildren, with a rocker and hunched over with osteopetrosis. I want to be twerking at their weddings, well, maybe not twerking. You get my drift.
Stu
Yeah, I do, I do.
Sara
[00:12:30] The official definition is that Healthspan is the period of time that you live disease-free as opposed to disease-span. The important piece here, which I think maybe the questions we’re provoking in you, is that there’s sometimes a decade, or two, or three where you can have inflammation in different parts of your body, especially your brain. It’s flying below the radar, you don’t know it’s happening. It could be the environmental toxins as you mentioned, it could be the heavy metals that you’re exposed to, it could be that you suck at dealing with stress, and that’s creating all kinds of problems with your gut. All those things can be happening below the radar and lead to disease. That’s what we want to turn around.
Guy
What questions sparked your interest Stu? Can you remember? I’m curious too.
Stu
[00:13:30] Yeah, I can. It was very much a family focus, community focus, and I think, external support. In terms of, are you married, have you got a wife, what’s your connection with your wife? That led me over into podcasts that we recorded recently about the Blue Zones and how community and support are very much one of the pillars that led to these longevity, I guess, areas around the world. For me, that social, mental community aspect is really, really important, because I can see as the years progress and technology becomes more prevalent, that kind of stuff’s disappearing. We’re so insula with our devices.
Sara
Totally.
Stu
[00:14:00] Very intrigued about that side of things, and made me thought, “Oh, yeah, am I really getting enough support from my wife?”
Sara
[00:14:30] Well, here’s the cool thing. For a guy who wants to improve his health, being with a woman is the best thing that you can do. Being married to a woman really makes a difference in terms of your social genomics. Now, for women I wish the reverse were true. I mean, I love my husband to death, but it turns out that being with your girlfriends is what really improves your health.
[00:15:00] You’re getting to a bigger point, which I think is really fascinating. This isn’t just like some woo-woo idea, this has hard science, which of course, is the sexiest. We have hard science showing that the people you surround yourself with change the way your genomics expressed, it changes the way your DNA is expressed. That can happen pretty fast. You know that old idea that the five people you spend the most time with, those are the ones that really change the way your DNA is expressed. If you hang out with smokers, you’re more likely to be a smoker. If you hang out with people who are addicted to sugar, you’re more likely to eat sugar. If you hang out with dudes like you, you’re more likely to up-level your health, and that’s a very good thing.
Guy
Totally.
Stu
[00:15:30] Yeah, it’s interesting. I was, again drawing from previous podcasts, so intrigued, and I guess, elated to realize that the way you think and the way you feel has direct impact on your chemistry, your biochemistry. You can actually think yourself to a healthier you. It’s there, it’s been proven. Very, very interesting science.
Sara
[00:16:00] It is very interesting. I think that’s also a sacred opportunity. In conventional medicine we look at something like depression. This feeling of being cut-off from your heart, being cut-off from joy. We quickly just try to adjust the neuro transmitters. We go to this place of, “You don’t have enough serotonin, you don’t have enough dopamine, lets change those [inaudible 00:16:09].” Whereas, we have to look at this in a much more integrated holistic way, just as you were saying. People are more likely to have depression when they get exposed to certain toxins, so we have to look at the toxins, we have to look at the sleep, we have to look at the social interactions. We certainly need to look at the food and start with that.
Guy
Totally, yeah. It’s fascinating.
Stu
Exciting stuff.
Guy
[00:17:00] I was just saying off air, Sara, you know I just came back from Costa Rica, and I was in a Blue Zone, and I was off the peninsula of Nicoya. You start to see firsthand what’s going on, and it’s quite incredible. There’s 90 year olds just on their pushbikes cycling around and they’re laboring off the land. They hang out in the afternoon and you do see them commute round and they’re having a conversation. There’s this very simplistic approach to many other things. You just go, “Wow, it’s beautiful.” You can kind of feel that way of life happening. It’s just so different from what we have in Australia and the US. You’ve got to think, “Wow, that has to have an impact.” There’s just no doubt. Well, they’re living … they’re centenarians, they’re disease-free. It’s pretty amazing. It’s pretty amazing.
Sara
[00:18:30]
It is totally amazing. We have a lot to learn from them. Part of the better message that I heard, and what you just described, Guy, is this humility. We’re so happy to have this modern lifestyle. My daughter just got the latest iPhone and she’s blissed out of her mind. Is that really health? Is that really creating what it is that we want? I haven’t been to Costa Rica, I would love to go. I’ve studied quite a bit the Ikarians, so these people from a mountainous village in Greece. They have a similar experience, it’s another Blue Zone just like in Costa Rica. They call it, the island where people forgot to die, because they live so long. There’s no word for retirement, because everyone keeps working. They’re super social. They have hundreds of different types of greens that they forage. They drink these wild herb teas. They have this nutrient-dense diet that for whatever reason is harder for us to get to.
Guy
Totally. I have a good friend that goes there every year, [Icharea 00:18:42].
Sara
Oh, yeah?
Guy
Yeah, yeah. He absolutely loves it.
Stu
It sounds like he dips his toe into longevity and then he just goes back to his iPhone.
Sara
And then you came back to Australia. Did you change anything, was there anything that you did after going to Costa Rica?
Guy
In terms of my own life?
Sara
Yeah. Get anything [inaudible 00:19:07]?
Guy
The biggest thing, because they have a saying and I can’t remember what it is, about pure life and living authentically. That kind of sat with me a lot, and then it … go on Stu.
Stu
That and Tequila. He loves Tequila now.
Sara
Pure Avila and Tequila. There we go.
Stu
Yeah, perfect. That could be a tee shirt, couldn’t it.
Guy
I actually did drink Tequila. I was at a Joe Dispenza retreat and it was actually Joe who brought the bottle of Tequila. I just had a couple of Tequilas with him one night, which was pretty interesting. Good Tequila is a good thing I thought, it helped me relax for sure.
Sara
I think it’s a super food.
Guy
Yeah.
Stu
Yeah, I think so too. A shot in the morning will set you up for the day.
Sara
Yeah, exactly.
Guy
Mentally. That was my takeaway from that Costa Rica trip anyway, for sure.
Sara
Love it.
Guy
Definitely.
Stu
[00:20:30] Just touching on the Healthspan again. I kick myself for asking this question because it’s just ridiculous, but are there any quick fixes that you think you could implement or you should perhaps zone in on outside of your … Because we’ve got so many things to change, I’ve got to change my food, I don’t know how to exercise. Should I be working on my sleep first? What do you think the most important levers are in terms of really impacting our Healthspan?
Sara
[00:21:00] Yeah, well the levers are the ones that we talked about earlier. Certainly, the way that you eat, move, think, supplement, detox. The way you change, the way implement, the way you operationalize. I love this question about quick fixes, because I really appreciate that when people are making changes, they want momentum, they want the wind at their back as they’re making that change. If you don’t see progress you’re going to bail, so I totally get that. A couple of things. I’ve got a three-way tie for a quick fix, is that alright?
Guy
Yeah.
Stu
Yeah, absolutely.
Sara
[00:21:30] That’s the best I can do. The first one is flossing. I feel like flossing is this unglamorous thing that people don’t talk about enough. It turns out that it reduces mortality by 40% to 50%. It’s pretty amazing what a difference it makes. You have to do it twice a day after a meal. I was actually sitting in a dental hygienist chair earlier today, my teeth are really clean.
Stu
Sparkling, sparkling.
Sara
[00:22:00] They’re so bright. I was thinking, “You know what? Getting your teeth cleaned, flossing, it’s better than plastic surgery.” If you want to lengthen your Healthspan and you want to stay young. I think the are, or why is much higher on flossing than it is to go get Botox or some other cosmetic procedure. That’s the first one.
[00:22:30] The second one is my latest obsession, which is intermittent fasting. I’ve been studying intermittent fasting for a couple of decades. People have been talking about it since, I don’t know, the ’40s or something. I’ve been really doing it in a serious way. I have an App that I use to photograph my food. I absolutely love it. I feel like it’s maybe the best reset button for your DNA and for those telomeres that we were talking about earlier. It cleans out all the debris, it takes out the brain trash, it really gets you into a biochemically enlightened state. I use this 16:8 protocol, we can talk more about that if you want.
[00:24:00] The last thing, and I don’t know if you’ll agree with this one, but I think exercise is just like … If I think back and put my hormone hat one, there is no medicine, there is no drug that can trick your body into thinking it’s younger like exercise. For me, I gained weight with my first book, in part because I was sitting and writing so much. I was still working full-time so I’d come home at the end of the day, and have a glass of wine, and sit down and write. Sitting makes you fat and inflamed and gives you diabetes. It just makes you ugly and ridden with disease. Not sitting is the first step. I got a treadmill desk and now I do 2,500, 5,000 miles per book. I’m totally addicted to it, it’s like my gateway drug, I spin a couple of hours a day, I’m so into this. You guys probably have a lot to say about this, but I think exercise is another quick fix.
Stu
Well then, on that subject of exercise I would be intrigued then as to which camp you sit in, in terms of endurance exercise and resistance training, so lifting weights, things like that.
Sara
Yeah, I’m in all camps.
Guy
Good answer.
Sara
I swing all ways. I have exercise agnostic because … I think you can overdo it. I’ll probably get into trouble here, but I did crossfit for a while and that was not a good fit for me because I’m a total stress junkie and it kind of just pushed me over the edge in terms of my joints. I was probably doing something wrong with my form. Definitely resistance training improves your memory. I’ve got a chapter on that in my new book, Younger, and how a single session of resistance training improves your memory, and it is measurable. I’m also a big fan of adaptive exercise, I like long slow endurance. In part, it depends on your stress levels and also your DNA. Which is the best fit for you. I’m one of those people who has a 50/50 split with exercise, where I do really well with endurance, that long slow exercise, which is why the treadmill desk is such a good fit. I also do really well with resistance training. I’m in all camps.
Guy
Yeah, its interesting. I had a DNA test and I was in the camp where do I short things, lift heavy things, avoid endurance, pretty much.
Sara
Subversive training.
Guy
[00:26:00] Yeah, yeah. That’s how I train, and I feel so much better. You kind of intuitively think about it when you doing it. It almost gave me reassurance to affirm what I was already feeling, so it was a good thing for sure.
Sara
[00:26:30] It’s nice to get that kind of feedback. There’s Olympic athletes who are sprinters, have a similar genome as what you described, Guy. They do really well with those bursts of explosive energy. I think a lot of people have a sense of what it is that they need to be doing, what’s the best fit for their body. Then there’s other people who are just too busy and too stuck in a really busy mindset to break out of it and do what their body needs. I want to love-up those people too, because I used to be one of them.
Guy
Totally. You created and open loop for me as well and I think just for our listeners as well. There’s one thing I want to mention as well, my wife’s going to be very happy you mentioned flossing by the way. She’s a naturopath and she’s on to me.
Sara
She’s a flosser?
Guy
Oh my God, totally. She’s on to me about it every single day, and hearing it from you as well is probably going top tip me over the edge, so she’ll be pleased about that.
Sara
I’ll be emailing you about your accountability for sure to make sure you’re flossing.
Guy
I just wanted to close the loop on the fasting and who you incorporate it into your life. I know a lot of the listeners will be intrigued by that. Would you mind just sharing how you do it?
Sara
[00:28:30] Sure. Yeah, I’ve tried a lot of different ways and my particular story is that I’m a pretty busy mom with school age kids. I’ve tried the, finish eating by 8 o’clock and then don’t eat again until noon the next day. That doesn’t work so well for me. I’m kind of cranky in the morning and more inclined to yell at the children. What works for me is to finish eating by about 4:00 p.m. and then eat again at 8 o’clock. That gives me more sustained energy. I’ve got a lot of issues with my blood sugar metabolism. I’ve got seven different genes that basically program me to be a 200 pound diabetic. That’s the protocol that works best for me. That eight hour eating window, 16 hour fast is what seems to work really well for me. Now on the other hand it makes me a social pariah, right? I had all these parties last weekend, I had to RSVP and say, “Okay, it looks like dinner’s at 8:00 p.m. I’m intermittently fasting so, I’m not going to eat, I’ll sit there and drink Tequila, or sparkling water.” It’s a little hard socially but that’s what works.
Stu
When you pick up in the morning with your first meal of the day at 8 o’clock, is there specifics on what you eat, in terms of, is it more fat-based, or is it more of a carbohydrate-based breakfast?
Sara
[00:29:00] Yeah, I’ve tried a lot of different things because I think you guys might be guilty of this too, I’m constantly experimenting. Life is one big experiment. I wish I could tell you that it’s more fat-based and that I’m a keto convert, like a [inaudible 00:29:06] fundamentalist and it is the best thing. It turns out that I didn’t do well with keto, there’s 10 different gene variants that make it very hard to be successful on nutritional ketosis. I think I probably have one of those.
[00:30:00] I tend to have my first meal a little more carb-based in part because after I drop off my kids, that’s my two hour exercise window. I know I’m burning those carbs pretty fast. I’ve also tracked my blood ketones, and after a 16 hour fast I’m in mild ketosis. I feel like I’ve got a little room to eat some carbs. I don’t eat much in the way of carbs, because I just do well with them. I don’t eat grains because it basically makes me inflamed and gain weight immediately. I have things like sweet potatoes or I’ll make a … I think you guys have a protein powder. I have a protein powder that I mix with cashew milk or almond milk and I’ll add some bananas, something like that, some chopped nips.
Guy
Then do you practice the 16:8 daily, seven days a week?
Sara
[00:30:30] I do. I do. It’s interesting, the data on longevity shows that if you do it once a week, that’s actually sufficient to slow down the aging process. I want to be more aggressive. Two days a week seems to make a difference for weight loss. I did two days a week it didn’t do much with my weight. When I do it every day it really helps me stay at my lean body mass that I like the most, so I do it every day.
Guy
Yeah, fair enough.
Stu
[00:31:00] I think it’s very much like you said, it’s self-experimentation it’s figuring out what works for you and how you feel when you implement these different strategies as well. We’re all so radically different and we simply cannot apply a blanket approach, it just doesn’t work.
Sara It doesn’t work. Even what worked for you five or 10 years ago may no longer work for you, because your expo sum, that collection of exposures and what environment you’ve put your DNA in, that’s changed, since five or 10 years ago.
Guy
Totally. We can actually forget that we can become quite stubborn and forceful on different approaches, but we might feel like cramp. Maybe there is a transition in you’re cutting out processed foods and sugars for sure, but beyond that I think, how do you actually feel is a great indicator and it can be ignored so often. You know.
Sara
[00:32:00] It can be ignored. I think we’re conditioned to ignore it. I went through medical training, right? I had 13 years of ignoring any message sent from my body. Like, go to the bathroom, get some sleep, call someone you love, I ignored all those messages for so long that my body is like, “Conversation? There’s no conversation happening between my brain and the rest of my body.” We have to relearn how to do that. We have to set up those pathways again.
Guy
Yeah, 100%.
Stu
I’d like just to talk a little bit about your book, Younger. I’m always excited when experts like yourself write a book, because I think, “Right, there’s all the good stuff in there.” It’s a bit of a reference manual for me and go back to this stuff continually throughout the year. What can we expect from Younger?
Sara
[00:33:30] Yeah. Well the book is about how to slow down aging. I think you have to look at that broadly because for some of us, especially a middle-aged woman, one of our big motivators for wanting to stay younger is to not let our body weight set-point keep climbing as we get older. The book is for people who want to lose weight, who want some strategies that have been proven to keep the DNA on the straight and narrow. So that you’re not losing five pounds of muscle every decade, starting at age 35. You’re not gaining body fat as you get older, because that’s kind of the default after 35. A lot of people don’t realize that until they wake up one day and they step on a body fat machine and they’re like, “Oh no, this is really bad news.” That’s one piece.
[00:34:00] Another piece is folks like my husband, who is a serious athlete, and started to notice effects of aging in his 50s. He wanted some strategies to really make his body believe that he’s still a 35 year old super athlete. There’s strategies for people like him. He does intermitting fasting, he now eats two pounds of vegetables a day, mostly because I cook them for him. He is doing centuries almost every weekend, well, not every weekend. He loves to cycle about 100 miles at a time, he really loves exercise.
[00:35:00] It’s also for people who are just feeling like their memory is not what it used to be. They walk into a room and they’re like, “Why did I come in here?” That’s kind of scary. Nobody wants to go down that path. I’ve got a whole chapter on what’s been proven to make a difference in terms of your genes that control the memory process, especially in the hippocampus, that part of your brain that does memory consolidation and emotional regulation.
The book is really designed for people who want to make sure that time is on their side. In that age range of 35 to 55 plus, and they want a scientific method, a seven week protocol to keep those telomeres long and lovely. Like, slow down that aging process.
Stu
In terms of a set point, we’re going start somewhere. I’m going to read the book, but I don’t know where I am so I’m going to need to get some testing just to see where I am on my health journey. It’s a minefield out there, you’ve got conventional medicine versus the new functional medicine and all the tests that are available there. Where do people like me, the Joe Public, the guy on the street, where do we start with testing? What do we do?
Sara
[00:36:30]
Well it depends on how much cash you have, and also how motivated you are. For people who don’t want to spend much money, you could certainly do an approximation. You did my Healthspan score, so you can go to healthspanscore.com maybe we could do a link with this podcast. Or you can get an approximation of your aging process, how are you doing. What I think is best, in an ideal world, is a combination of some blood testing, maybe some urine testing together with some DNA testing. Now you don’t have to do DNA testing to benefit from my book, I wrote it both ways, so that you can get a lot from it if you have done DNA testing, but also if you haven’t. I think that snapshot of blood work together with your genome testing is the best way to look at your aging process. It tells you where you are right now and also what’s your trajectory, what’s the blueprint for you and then how is that DNA being expressed.
[00:37:30] To get a little bit more specific I would say, for sure look at blood sugar, because blood sugar tends to start changing in your 40s. That’s responsible for about 60% of dementia. 60%. It’s amazing the same enzymes that are involved in blood sugar control are also involved in the beta amyloid that collects in Alzheimer’s disease. My fasting blood sugar when I was in my 30s totally sucked, I checked it three times because I thought there was something wrong with my result. I’m not talking about the normal range for 95% of Americans or Australians, I’m talking about the optimal range. A fasting glucose, we use milligrams per desolator here in the US of 70 to 85. Then you can also do a hemoglobin A1C, which is a three months summary of where you are with your blood sugar. Most of us are not doing a great job with our blood sugar.
[00:38:00] Then vitamin D is another really important one. I like to do stress measurements, I don’t like to go just based on how do you feel about stress. I want to know the hard data. Those are a few examples.
Stu
Okay. Stress measurement, that’s again just provoked a question. Tell me how you measure that?
Sara
[00:38:30] Oh yes. I used to do cortisol testing, I’d get cortisol at four times during the day. Right when you wake up in the morning, before lunch, before dinner, before you go to bed. I like that, there’s some problems with it. I also like blood testing but most people don’t want to get stuck four times in a day. Measuring an AM cortisol is the universal language of physicians. That’s what I started with when I was in my mid-30s, and I found my level was three times what it should have been. High cortisol is a real problem. Half of people with degression have hight cortisol. How many of them actually get their cortisol tested? Not enough.
Stu
I’m just going to interrupt you very quickly and show you on the screen, and obviously our audio listeners won’t be able to see that. That is my … I don’t know whether you can see that?
Sara
Oh. What the hell is happening at night?
Stu
[00:39:30] Yeah, that was a while ago. Something went a little bit wrong there. I think I was 10 times over the level. Yeah, I just felt like I had come out of such an intense meeting into a boxing ring and so I was punching away. At 10 o’clock at night when I was trying to wind down when I was watching TV. I understand when you’re saying your cortisol was three times the level, I was just, “What’s going on in my life?” That kind of stuff is so important to get on top of. I had a phone call from my naturopath and she said, “I’ve just got your cortisol results through, we really have to talk.”
Sara
That was her voicemail, I love it.
Stu
Yeah, it was.
Sara
That’s a really common result. Are you more of a night owl? Do you have a lot of energy at night? Was that a non-typical day for you, or common?
Stu
That was a result, I think, of experimenting with my diet, and changing my exercise routine in ways that just didn’t work for me. I just think my drenol’s exploded and just went, “No, you can’t do …”
Guy
And probably having the genome that doesn’t complement it either, right? There was this triple whammy.
Stu
Yeah, that’s right. I basically went super low-carb and went super heavy into crossfit and ignored recovery time, and just crashed.
Sara
Are there men out there who don’t ignore recovery time? That’s what I want to know.
Guy
I am one of them. I have too much recovery.
Sara
[00:41:30]
Oh, we should talk. Well thank you for sharing that, because I think so many people have that experience. You have an inverted curve, where you’re way too high. At night your highest cortisol should be when you first wake up in the morning and you should be like a flower that opens during the day and then closes at night. Rather than watching TV at night, one of the things that I think is more helpful is to have these active ways of unwinding. My husband, who’s a super jock as I mentioned, I’ve got him taking hot baths with Epsom salt every night. He probably doesn’t want me saying that publicly, but it’s made a big difference in his stress response. The point is, I think measuring your stress response is so important, so by any means necessary.
[00:42:30] I happen to like dried urine testing because that gives me a lot more information than just the cortisol testing. Dry urine also tells you about metabolized cortisol as well as the free cortisol, which is what you get with saliva. I have this little thing called the Wellbee, if you can see that, and this is a continuous heart rate variability monitor. It’s another way of looking at the balance between your sympathetic nervous system and your parasympathetic nervous system. I love it because it basically sends me a notification if I’m too stressed. I got into a fight with my husband and I got this little notification, ” Your stress level is 60% or higher.” I was like, “Honey, we have to stop arguing.”
Stu
That’s right. Let’s run the bath.
Sara
Yeah, let’s run the bath, totally. Let’s have some chocolate, that helps cortisol.
Guy
How do you handle your stress on a daily basis, personally?
Sara
[00:43:30]
Oh, honey. How much time do we have? It’s a lifelong project, right? I’ve tried a lot of different things. I became a yoga teacher, because I’m kind of a type A personality. I love yoga, I love how it makes me feel, and so of course I’m going to become a teacher, and go through the teacher training. I like adaptive exercise, yoga and Pilates is really helpful for me. I also love spinning, and I love weight training, and I love a lot of other things that are maybe not as good for my cortisol, but I have to make sure I get that recovery time in.
[00:44:00] A big part for me is, I really like HRV testing, so heart rate variability testing I think is super valuable, especially if you’re an athletic type. It can tell you a lot about recovery and what kind of state your body is in, and how hard, how aggressively you can push that day. A lot of my exercise is guided by my HRV in the morning. I take a number of adaptogens, like I really love Rhodiola, that works really well for me. I like Phosphatidylserine. Just as you can’t find the answer to health in a prescription pill bottle I don’t think necessarily that supplements are the way to go. I think they’re more of a bridge to get to a better place.
[00:44:30] Mindset is a lot of it, clearing out those people that are toxic, the social genomics, having your configuration so that you have a day that fills you up instead of sucks you dry. Then, I’ve got two kids and a big source of stress is having teenagers in the house. Getting more skillful and going on vacation without them.
Stu
[00:45:00] Well that would be nice, wouldn’t it? How nice would that be. I’ve got three little girls and I just tell them, “Guys, you got to be nice to dad, because you’re sucking the life out of me.”
Sara
Did you see my cortisol test?
Stu
[00:45:30] Yeah, exactly right. This is because of you. Now eat your dinner. It’s so true isn’t it? It’s discovering and understanding of the things that work for you, the things that naturally make you feel happier and healthier. Allow you to sleep and rest throughout the day. It’s interesting because I like to lift weights two or three times a week. This morning, because of this interview, I went extra early to the gym. Totally out of my routine and I am very routine driven. I got there, and because I’m lifting really early, I had nothing. Couldn’t do it, nothing here.
Sara
Yeah, zero, yeah.
Stu
Just finding what works for you, I think, and do more of it.
Guy
And go on with it.
Sara
There’s a lot of wisdom in that. I’m not saying that everyone should try my particular configuration. I think what’s important is to create this A La Carte Menu of, “Okay, here’s the 10 things that work for me.” And to keep siphoning through them and make sure that you’ve got the right dose of them, for you.
Stu
Yeah, I think so.
Guy
Totally. Great answers. Guys I’m just aware of the time, Sara. We have a couple of questions we ask everyone at the end of the show as well, just like at the beginning.
Stu
Well done.
Guy
This first one is, what are your non-negotiables to be the best version of yourself daily?
Sara
[00:47:30] Well this is a good one. Love, is the first thing that comes to mind. Like mostly being a beacon of love, not waiting for it to come to me. Love lights on my family every single morning, no matter what. Another, I would have to say, is intermittent fasting. I’ve really found that it is a technique that’s common, most people know about it, very few people do it right. It’s really made a huge difference for me. I can’t wait to go check my telomeres again, because I am sure that intermittent fasting is really good for the … Then the last thing I would say is exercise. I just feel like the hormonal balance that I have right now, the stress resilience, the embodiment, the feeling of really being alive in my soul is driven by exercise. I just absolutely love it. Those are my non-negotiables.
I’m a high-maintenance person, so I’ve got a long list of non-negotiables. I think I’ll cut it off there.
Stu
Yeah, that’s brilliant.
Guy
Oh, beautiful, beautiful. The last question is, what’s the best piece of advice you’ve ever been given?
Sara
[00:49:00] I got this advice from one of my mentors. This is like … I’m going to quiet down a little bit, because this is really potent for me. Before I went to medical school, I learned about this Doctor named Christiane Northrup. She is a women’s health physician based in Maine. I just love the way that she took care of women, she really believed in women’s power, and divine feminine. She said something that just really hit me hard, and that is, “Women are expected to be wholly in the workplace.” Like this beacon of light, and then they are expected to come home and be wholly in the home front, with no model of wholeness or holiness. So her advice was, you have to create that model of wholeness.
[00:49:30] I heard this a few decades ago, and it has stayed with me, because I really feel like, whether you’re a woman or a man, whether you’re a jock or you hate to exercise, we all need that model of wholeness. That is the horizontal for all the verticals that we’re talking about today. What does wholeness look like for you? What is your model of wholeness? How do you define it? How do you defend the boundaries on it?
I would say that’s the best advice I’ve gotten. It was more like a comment about the problem of modern life. This advice of create your model of wholeness really stayed with me.
Guy
Beautiful.
Stu
Yeah, it makes sense. Brilliant.
Guy
Fantastic. Thanks for sharing. Just for everyone listening, now you obviously had the new book out, Younger, which came out … Well, I can say last year now, because we are now in 2018. If they want to grab a copy of that and learn more, where would be the best place to send them for the book, or find out more about yourself too, and all the work you do, Sara?
Sara
[00:50:30] Yeah, so probably saragottfriedmd.com is the best place to go, that’s the mothership. We’ve got a separate website for the book, Younger. The best place to get it is Amazon, I know Amazon isn’t as popular in Australia. I think you guys have done better at keeping Amazon from taking over all the independent bookstores. Hopefully, your local bookstores will carry it. You can read more about it at saragottfriedmd.com.
Guy
Beautiful.
Stu
Fantastic. We will share those links away.
Guy
The quiz you took Stu, is on the …
Stu
Yeah, I took the quiz last night. For everybody that hasn’t, doesn’t know anything about it, where should they go?
Sara
I’m pretty sure this aural has cracked healthspanscore.com. You might be able to get to it from saragottfriedmd.com too. Yeah, I should know that. Maybe we can put it in your notes, and I’ll confirm it.
Stu
Okay. Sounds good. Fantastic.
Guy
Fantastic. Yeah, beautiful.
Sara
Well thanks guys.
Guy
You’re so welcome. Thank you for giving us your time today, I really enjoyed that, Sara.
Sara
My pleasure.
Guy
That was awesome.
Sara
Thank you so much.
Guy
Thanks guys. Have a good one.
Stu
Brilliant. Thank you, you take care, bye-bye.
Guy
Bye-bye.
