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Transcript

Maximize Heart Health Through Nutrition with Michelle Routhenstein · The Menopause Disruptor Podcast

• 0:00
  Michelle Routhenstein: We often look at diets as what are we not eating or focus just on calories and not looking at the whole picture.
• 0:08
  Michelle Routhenstein: When we look at the anti inflammatory dietary index, it's actually about adding in all of the nutrients your body needs to optimally function and to optimally thrive.
• 0:19
  Michelle Routhenstein: So when you're talking about a diet, I want to remove that, I can't eat this.
• 0:23
  Michelle Routhenstein: I can't eat that.
• 0:23
  Michelle Routhenstein: I can't eat this, mindset and switch it over to, what am I eating?
• 0:28
  Michelle Routhenstein: What am I nourishing my body with?
• 0:29
  Michelle Routhenstein: What am I giving my body so that my blood pressure can come down because I'm opening up my arteries and allowing for better blood flow?
• 0:37
  Michelle Routhenstein: What am I giving my body that's going to help address underlying inflammation?
• 0:47
  Mary Lee: ​Welcome back to another episode of all things menopausal with my very amazing guests.
• 0:53
  Mary Lee: They're all amazing I love to say that but they are Because they share so much sage advice and insights onto the menopausal journey and what we can do from our health perspective nutrition movement Stress management and sleep optimization.
• 1:09
  Mary Lee: And this is one conversation with Michelle Rothenstein that you can certainly take to heart.
• 1:16
  Mary Lee: I mean that this conversation emphasizes the significance of addressing heart health and heart disease.
• 1:23
  Mary Lee: And Michelle, first will share her journey from considering a medical career to specializing in nutrition and women's heart health.
• 1:31
  Mary Lee: driven by her desire to have more preventative care.
• 1:35
  Mary Lee: And how do we do that?
• 1:36
  Mary Lee: Well, we address our cardiominabolic risks, and the critical role that Nutrition plays in addressing these heart risks.
• 1:45
  Mary Lee: Michelle will also provide her insights into familial hypercholesterolemia, which is a genetic metabolism disorder that leads to high cholesterol levels and can start in a very young age.
• 1:59
  Mary Lee: Michelle will also stress the importance of exercise or movement and how important it plays in improving arterial elasticity and blood flow.
• 2:09
  Mary Lee: She'll discuss the challenges and strategies for incorporating these exercise routines into lifestyle changes for all clients, in a way that is a tailored approach for their individual situation needs and preferences.
• 2:23
  Mary Lee: And of course, you can't talk about the four pillars of good health without addressing sleep and stress management, and Michelle will explore with us the multifaceted impact that both have on our heart health.
• 2:35
  Mary Lee: Highlighting the role of oxidative stress in the body's antioxidant restorative system during sleep.
• 2:41
  Mary Lee: It's fascinating.
• 2:43
  Mary Lee: So you're going to want to stick around for that.
• 2:45
  Mary Lee: I'm not giving it away in my intro.
• 2:47
  Mary Lee: and of course we will talk about dietary changes And I know that's not a favorite subject, but Michelle emphasizes.
• 2:54
  Mary Lee: Hmm.
• 2:55
  Mary Lee: It's not what to take off your plate It's what to put on your plate and she will emphasize the importance of complex carbs whole fats as well as the roles that emotions play in maintaining overall well being, which is also an essential component of a healthy heart.
• 3:14
  Mary Lee: But before we begin, this is what you need to know about Michelle.
• 3:19
  Mary Lee: Michelle has a master's of science, she's a registered dietician, a certified dietician nutritionist, and a certified diabetes care and education specialist, and is the owner and president of Entirely Nourished, a specialized private practice focusing on nutrition, counseling for heart health prevention, And management, she uses a science based holistic approach and educates individuals on addressing cardio metabolic risk factors for healthy hearts as they age.
• 3:50
  Mary Lee: Michelle is recognized as a thought leader in heart disease management, sharing her expertise on social media platforms like Instagram and LinkedIn, which is in the show notes and empowers followers to prioritize heart health through nutrition and lifestyle changes.
• 4:06
  Mary Lee: She also serves as a medical advisory member for the National Menopause Foundation and the Forbes Health Advisory Board and provides evidence based guidance on heart health.
• 4:18
  Mary Lee: With degrees from New York University and valuable clinical experience, Michelle is dedicated to translating nutrition science into practical, long term solutions for heart health and longevity.
• 4:31
  Mary Lee: Let's get to the heart of the matter.
• 4:34
  Mary Lee: Hello, my lovely listeners.
• 4:36
  Mary Lee: I have a great, wonderful guest with me here today.
• 4:40
  Mary Lee: And we get to the heart of the matter, no pun intended.
• 4:45
  Mary Lee: And before Michelle and I started we had a lovely little preamble where we talked about debunking the fear around food and food anxiety, but then also we share our love of talking about menopause and heart health.
• 4:59
  Mary Lee: Michelle Rothenstein, all the way from New York.
• 5:03
  Mary Lee: Thank you for being on our show and welcome.
• 5:06
  Mary Lee: Thanks so much for having me.
• 5:08
  Mary Lee: I'm excited to chat with you today.
• 5:11
  Michelle Routhenstein: Yeah,
• 5:11
  Mary Lee: We're recording this right around the summer solstice season.
• 5:14
  Mary Lee: Of course, we'll air this a little bit later, but I always find it.
• 5:18
  Mary Lee: It's a great time to do some inward reflection.
• 5:22
  Mary Lee: And that means head to toe a health check, and we're going to stop at the heart and get into those details.
• 5:29
  Mary Lee: So my first question is to you, how did you land in a career that focuses on women's heart health and particularly in the menopause years?
• 5:39
  Michelle Routhenstein: Great question.
• 5:40
  Michelle Routhenstein: So I was always fascinated by medicine and I actually started off in the pre med track at NYU.
• 5:47
  Michelle Routhenstein: And it's a track, it's not like a degree of any sort.
• 5:51
  Michelle Routhenstein: So I was always in nutrition and I had this area in my college years where I had to choose, am I going to go into the nutrition route, like a residency in nutrition, or am I going to do a doctor route and become a medical professional?
• 6:07
  Michelle Routhenstein: And I was shadowing in the hospitals in New York City.
• 6:10
  Michelle Routhenstein: And one thing just struck me, like we're living in this medical model where we're in there to treat.
• 6:16
  Michelle Routhenstein: So medicine is pushed at people with now not really ever addressing the root cause, not really looking at it as a preventative realm.
• 6:24
  Michelle Routhenstein: And so from there, I decided to go through nutrition because of the prevention state.
• 6:30
  Michelle Routhenstein: Which we're trying to achieve that's a, and then B after that, I was in my residency in clinical nutrition and we were in different rotations.
• 6:39
  Michelle Routhenstein: So kidney clinic, weight loss clinic, liver clinic, ICU, heart clinic, and everyone was having the same issues.
• 6:46
  Michelle Routhenstein: And that was cardiovascular disease.
• 6:48
  Michelle Routhenstein: And If you really look at the the glow at the statistics year after year, cardiovascular disease is the number one cause of death and mortality globally.
• 6:58
  Michelle Routhenstein: But 80 to 90 percent of it is preventable.
• 7:01
  Michelle Routhenstein: People have kidney disease, the number one cause of death is not kidney disease.
• 7:04
  Michelle Routhenstein: It's heart disease.
• 7:05
  Michelle Routhenstein: Everything that you look at in women's health in general, most people, if you ask them, they think breast cancer is what's the number one cause of death in women.
• 7:13
  Michelle Routhenstein: But it's heart disease.
• 7:15
  Michelle Routhenstein: Now tell me why is that?
• 7:17
  Michelle Routhenstein: so.
• 7:17
  Michelle Routhenstein: I really went into this field being like, there needs to be change.
• 7:21
  Michelle Routhenstein: We need to change the statistics because we can.
• 7:24
  Michelle Routhenstein: So what's missing?
• 7:25
  Michelle Routhenstein: And that's when I really did a lot more research and digging and just being with all these different cardiologists, showing that most people don't know they're at risk.
• 7:33
  Michelle Routhenstein: Most people do not.
• 7:35
  Michelle Routhenstein: Do not realize that they can do something about it.
• 7:37
  Michelle Routhenstein: And so until something happens, then people will react versus being more proactive.
• 7:42
  Michelle Routhenstein: And so I specialize in specifically women's health.
• 7:46
  Michelle Routhenstein: I do see men as well.
• 7:47
  Michelle Routhenstein: But with women's heart health, there was a large part of the research where women were not really included.
• 7:53
  Michelle Routhenstein: And we know that I'm Women heart disease actually affects women differently than men in men.
• 7:59
  Michelle Routhenstein: Most of the time It's plaque buildup in the main coronary arteries of the heart muscle in women It's actually found more in the microvascular in the smaller vessels.
• 8:09
  Michelle Routhenstein: So a lot of times it's not really identified.
• 8:12
  Michelle Routhenstein: And especially women who don't necessarily look obese or don't look quote unquote the part of heart disease, they're often neglected in the healthcare system.
• 8:21
  Michelle Routhenstein: And so my real passion is to bring more awareness, especially because during, the menopausal transition, the risk of heart disease increases tremendously because of the decline of estrogen.
• 8:34
  Michelle Routhenstein: And so we need to be aware and we need to understand like many women will come to me and say, Michelle, I didn't change my diet.
• 8:41
  Michelle Routhenstein: But all of a sudden I go through menopause and I have stubborn weight loss and I have high cholesterol and high blood pressure.
• 8:47
  Michelle Routhenstein: And we have to recognize that the dietary needs and changes that happen during the menopausal period are unique.
• 8:53
  Michelle Routhenstein: And we need to be modifying our food choices during this time period to prevent cardiovascular issues going forward.
• 9:01
  Michelle Routhenstein: And so I really spent a lot of time in this research and in this specific niche because I see the importance of it.
• 9:09
  Michelle Routhenstein: And so I'm also on the medical advisory committee board of the National Menopause Foundation.
• 9:14
  Michelle Routhenstein: And I love being there because I can really talk about this and talk about the differences because the more awareness people have and the more they understand that they can take ownership and be empowered in their journey to reduce their risk, the more lives we can save, but also the quality of life, the health anxiety gets reduced tremendously so that you can live your life.
• 9:38
  Michelle Routhenstein: But in those retirement years, happily, healthy, and with the people that you love.
• 9:42
  Michelle Routhenstein: And so I always find that this is the biggest impact group that I really can influence.
• 9:47
  Michelle Routhenstein: And I really love it because there's so many new research coming out that really speaks to women specifically in the heart health sphere.
• 9:57
  Mary Lee: Let's start.
• 9:58
  Mary Lee: That is fantastic, by the way.
• 10:00
  Mary Lee: And I'm so pleased that this kind of work is being acknowledged by the National Menopause Foundation.
• 10:06
  Mary Lee: Because as you said, heart health in women in particular, it shows up differently.
• 10:11
  Mary Lee: And oftentimes it's ignored when we feel those minor little chest pains.
• 10:15
  Mary Lee: And often it's that's just indigestion or you've got acid reflux.
• 10:23
  Mary Lee: And of course, and we can unpack that a little bit more because I am quite curious.
• 10:27
  Mary Lee: But how then now with your contribution to the National Menopause Foundation on the advisory board, how is that shaping the message that's coming out of an organization of this caliber that women are probably paying attention to quite a bit in terms of the leading research on menopause?
• 10:48
  Michelle Routhenstein: Yeah, I think it really highlights the need to speak to be speaking about this topic more on a global scale and really acknowledging that yes, menopause happens in every woman's life.
• 10:59
  Michelle Routhenstein: And while many people dismiss it, oh, you have heart palpitations.
• 11:02
  Michelle Routhenstein: Oh, it's okay.
• 11:02
  Michelle Routhenstein: It's just normal.
• 11:04
  Michelle Routhenstein: But no, there are specific implications that we need to address.
• 11:09
  Michelle Routhenstein: And that we shouldn't ignore.
• 11:10
  Michelle Routhenstein: And so by having this subcategory really puts that emphasis on, Hey, let's be aware of it.
• 11:16
  Michelle Routhenstein: So we're not dismissive because being dismissive is what can accelerate issues going forward.
• 11:24
  Michelle Routhenstein: And I always say we need to be you and you versus someone else.
• 11:29
  Michelle Routhenstein: We all have individual responsibilities.
• 11:31
  Michelle Routhenstein: So while somebody is evaluating you, what you feel and what you what's different to you is valid and anyone who doesn't give that validity is not looking at the whole picture and we need to make sure that we're really fine honing into those symptoms and addressing them.
• 11:48
  Mary Lee: So when you had mentioned, of course, it is very individualized and how it shows up and you mentioned the key ones such as stubborn weight loss, for example, or the increase in belly fat, but what are some of the less obvious, more subtle ways that menopause is affecting the body in particular showing up in her cardiovascular health?
• 12:10
  Michelle Routhenstein: So estrogen helps to make our arteries less stiff.
• 12:14
  Michelle Routhenstein: So they make our arteries more elastic.
• 12:17
  Michelle Routhenstein: So when estrogen levels decline, our endothelial health, our blood vessel health takes a beating.
• 12:23
  Michelle Routhenstein: So blood pressure can increase, but blood pressure, when it's borderline you don't really feel it.
• 12:29
  Michelle Routhenstein: You only feel it when maybe you're in a hypertensive crisis.
• 12:32
  Michelle Routhenstein: It's very high.
• 12:33
  Michelle Routhenstein: And because of this transition, it is so important that we are checking blood pressure at home.
• 12:39
  Michelle Routhenstein: And often women will say, Oh, yeah, it's high in the doctor's office, but I'm anxious.
• 12:44
  Michelle Routhenstein: I have white coat syndrome and they never check their blood pressure at any other time at home.
• 12:49
  Michelle Routhenstein: And so they're walking around with high blood pressure.
• 12:51
  Michelle Routhenstein: And when high blood pressure is present, even at borderline high levels, like 130 over 80, what ends up happening is our blood vessels can easily get a tear in the artery wall that can cause more plaque to form.
• 13:04
  Michelle Routhenstein: It can make our heart have to work harder to pump.
• 13:07
  Michelle Routhenstein: So our body compensates, but we don't feel it because our body is such an amazing organ and it's trying to do its best.
• 13:13
  Michelle Routhenstein: best to give to do what it needs to do to operate.
• 13:16
  Michelle Routhenstein: And so only until it's been like that for several years or decades, does it end up being like a stroke or a heart attack or a cardiovascular complication like heart failure.
• 13:25
  Michelle Routhenstein: So I always, it's so important.
• 13:27
  Michelle Routhenstein: And one of the biggest takeaways you can do is get a blood pressure cuff and check your blood pressure at home.
• 13:33
  Michelle Routhenstein: You really want that number to be 120 over 80 or less, optimally 110 over 70.
• 13:38
  Michelle Routhenstein: That really is a good indication of good blood flow.
• 13:41
  Michelle Routhenstein: And if you are someone who's always been historically at baseline, like 90 over 60, and now you're 115 over 75.
• 13:49
  Michelle Routhenstein: You're going towards a higher normal, and that's something that we need to take into account also because these ranges are very wide and we have to know what's your normal and where is it trending because those trends tell us a lot more about you and personalizing it to your vascular system.
• 14:07
  Mary Lee: So these are the cardiometabolic risks that you're speaking about then in terms of the decline in estrogen, but what are some of the other cardiometabolic risks factors?
• 14:20
  Michelle Routhenstein: So we talked about the waist circumference.
• 14:22
  Michelle Routhenstein: So I always advise to check their belt, their waist circumference, not their pants size by taking a soft measuring tape and putting it around your belly button, don't suck in, don't suck out.
• 14:32
  Michelle Routhenstein: Generally for women, we want that to be less than 35 inches for some ethnicities.
• 14:37
  Michelle Routhenstein: We want it to like South Asians.
• 14:38
  Michelle Routhenstein: We want that to be closer to 33 inches or less.
• 14:42
  Michelle Routhenstein: We also want to make sure that you're checking that every year, cause if it's trending in the wrong direction, that's a red flag.
• 14:48
  Michelle Routhenstein: That's why.
• 14:49
  Michelle Routhenstein: Other thing is gut issues.
• 14:50
  Michelle Routhenstein: So like acid reflux or motility issues, like these are signs that you may have inflammation and we need to address that too.
• 15:00
  Michelle Routhenstein: If you're having stubborn weight loss, like all of a sudden you gained five, 10 pounds, 15 pounds, and you're like, I can't get this off.
• 15:06
  Michelle Routhenstein: And I didn't really change anything.
• 15:08
  Michelle Routhenstein: Those are signs fatigue, loss of energy, fatigue, frozen shoulder.
• 15:12
  Michelle Routhenstein: There's a lot of things that are contributing here that we need to really assess what's going on and what can we do to optimize these factors.
• 15:23
  Mary Lee: So let's talk about the optimizing these factors.
• 15:26
  Mary Lee: And you mentioned that we need to make some significant dietary changes.
• 15:30
  Mary Lee: As we move through the menopausal years, but even prior to that what are some of the things that women in general should be developing or adopting in their lifestyle or in their nutrition to set them up for success for a successful menopause year so they can keep that inflammation at bay can keep that waist circumference down blood pressure in, a good range.
• 15:56
  Michelle Routhenstein: Yeah.
• 15:57
  Michelle Routhenstein: So the big thing is that we often look at diets as what are we not eating or focus just on calories and not looking at the whole picture.
• 16:07
  Michelle Routhenstein: And when we look at the anti inflammatory dietary index, it's actually about adding in all of the nutrients your body needs to optimally function and to optimally thrive.
• 16:18
  Michelle Routhenstein: So when you're talking about a diet, I want to remove that.
• 16:21
  Michelle Routhenstein: I can't eat this.
• 16:22
  Michelle Routhenstein: I can't eat that.
• 16:22
  Michelle Routhenstein: I can't eat this mindset.
• 16:25
  Michelle Routhenstein: And switch it over to what am I eating?
• 16:27
  Michelle Routhenstein: What am I nourishing my body with?
• 16:28
  Michelle Routhenstein: What am I giving my body so that my blood pressure can come down because I'm opening up my arteries and allowing for better blood flow?
• 16:36
  Michelle Routhenstein: What am I giving my body that's going to help address underlying inflammation?
• 16:40
  Michelle Routhenstein: Because there's a lot of pathways in the body that need certain nutrients and certain vitamins like selenium and vitamin A and vitamin C.
• 16:48
  Michelle Routhenstein: And if we don't get that through food, then we can also be having more of a pro inflammatory diet.
• 16:56
  Michelle Routhenstein: So many people think, well, if I don't eat processed foods and I don't eat fast foods and I don't eat junk foods, then I'm eating a healthy diet.
• 17:03
  Michelle Routhenstein: But most of the time, it's not.
• 17:04
  Michelle Routhenstein: It's that they're not really including all the nutrients they need to actually define and have an anti inflammatory diet.
• 17:12
  Michelle Routhenstein: So that's the biggest thing that we really need to be focusing on versus removing all of these things.
• 17:18
  Michelle Routhenstein: And especially in this culture where you go on the internet and everyone's don't eat this.
• 17:22
  Michelle Routhenstein: It's the it's processed.
• 17:23
  Michelle Routhenstein: Don't eat this.
• 17:24
  Michelle Routhenstein: It's going to kill you.
• 17:25
  Michelle Routhenstein: And it's Whoa, we're living in a very fear monging society and we need to remove that.
• 17:30
  Michelle Routhenstein: Because a big part of it also is we need to adapt.
• 17:34
  Michelle Routhenstein: A lifestyle and a diet that's going to be long term.
• 17:37
  Michelle Routhenstein: And if you're focusing on what you can eat and being fear monged, you're going to increase health anxiety.
• 17:42
  Michelle Routhenstein: And then at one point, you just give up, you'll put up your hands and go, I can't do this anymore.
• 17:47
  Michelle Routhenstein: Versus if you actually understand the, why, what are you eating and what balance and what quantity that's going to nourish your body, make you satiated, help with weight loss, help with inflammation, help with blood vessel health, help with optimizing cardiovascular health and function.
• 18:03
  Michelle Routhenstein: That's really where we're going to see the best results.
• 18:06
  Mary Lee: I love that.
• 18:06
  Mary Lee: Understand the why, and this is exactly what I'm trying to preach in my role as a menopause doula is that let's get you empowered with the knowledge so you can make those informed decisions.
• 18:19
  Mary Lee: And I love to put my clients in the, direction or in contact with people such as yourself, Michelle, who can really get them to understand the basic principles and then feel empowered about it rather than being preached to.
• 18:37
  Mary Lee: And I love the fact that you say, let's not worry about what to eliminate, but let's look at what we can add in for more plentiful, nutritious diet.
• 18:48
  Mary Lee: That is going to provide us with the vitamins through best through our food, of course, that we need to optimize your health.
• 18:55
  Mary Lee: So tell us about the work you do then with your clients to get them to that.
• 19:00
  Mary Lee: lifestyle and nutrition changes that they need to optimize their health.
• 19:05
  Michelle Routhenstein: Yeah.
• 19:05
  Michelle Routhenstein: So the thing is we, I, when we look at personalized nutrition, the reason why personalized helps is because everyone has food preferences.
• 19:14
  Michelle Routhenstein: Everyone has a food culture.
• 19:16
  Michelle Routhenstein: Everyone has different lifestyles, different work styles, different cooking abilities.
• 19:21
  Michelle Routhenstein: Before COVID, I worked in only in the city.
• 19:24
  Michelle Routhenstein: I had an office in the city and cardiologists were for their clients to me.
• 19:29
  Michelle Routhenstein: And.
• 19:30
  Michelle Routhenstein: Nine out of 10, put their shoes in their oven.
• 19:32
  Michelle Routhenstein: They never cooked one meal.
• 19:34
  Michelle Routhenstein: And so for me to tell them you have to cook every single meal, that's not going to work for them.
• 19:39
  Michelle Routhenstein: So there needs to be a personalization factor.
• 19:41
  Michelle Routhenstein: There's other clients of mine who they have a big family and they don't want to cook one meal separate from everyone else and they shouldn't.
• 19:49
  Michelle Routhenstein: I don't support being a short order cook.
• 19:51
  Michelle Routhenstein: So you have to really meet people where they are and really also assess what do we need to prioritize?
• 19:58
  Michelle Routhenstein: Right.
• 19:58
  Michelle Routhenstein: So if someone comes to me because they have stubborn weight loss and I look at their lab report and I look at their medical history, and there's a lot of signs that they have insulin resistance, that's what we're going to prioritize first.
• 20:10
  Michelle Routhenstein: So it's about prioritizing what we need to do to first in order for the other things to fall in place.
• 20:17
  Michelle Routhenstein: A big thing that we need to also recognize that we often forget about is our body's needs.
• 20:24
  Michelle Routhenstein: So we live in this very fast paced culture where no one really is being mindful to, am I hungry?
• 20:31
  Michelle Routhenstein: Am I satiated?
• 20:32
  Michelle Routhenstein: It's Oh, I always eat, I always skip breakfast, or I always eat at nine, 12 and seven, or they don't really go into, well, am I hungry?
• 20:41
  Michelle Routhenstein: What is my body saying?
• 20:43
  Michelle Routhenstein: So it's really important to really go to that aspect.
• 20:46
  Michelle Routhenstein: And this is a really important aspect of hunger scale on a scale from one to 10, one being that you are.
• 20:51
  Michelle Routhenstein: You're so hungry and 10 being your you over eight, you really want to be between a four and a six when you're slightly hungry you eat, and then you stop when you're a six when you're slightly satisfied, and this understanding of the principles of metabolic grade and how your, what your body needs are, so important.
• 21:09
  Michelle Routhenstein: So, I talk a lot about this mindful strategy, I talk about what foods we need to add to the diet, but really personalize to make sure this is a long term gain.
• 21:18
  Michelle Routhenstein: A lot of times I'll ask can you do this in six months?
• 21:21
  Michelle Routhenstein: And if the answer is no, we pivot.
• 21:23
  Michelle Routhenstein: There's no, if you can't.
• 21:25
  Michelle Routhenstein: And do something for if you feel that you can't do this in the future, there's no point in just doing it temporarily there for heart health.
• 21:33
  Michelle Routhenstein: If you get your labs to be optimal for in three months, but then they go off the charts the following year, you're not doing any benefit.
• 21:42
  Michelle Routhenstein: You need to be looking at this from a long term lifestyle plan.
• 21:46
  Michelle Routhenstein: And so making sure it's sustainable is key and also making sure that you're not doing a million things at once.
• 21:51
  Michelle Routhenstein: People are like, oh, well, I want to lose 20 pounds.
• 21:54
  Michelle Routhenstein: And I'm like, we need to go slow and steady 0.
• 21:57
  Michelle Routhenstein: 5 to 1.
• 21:57
  Michelle Routhenstein: 5 pounds per week is important.
• 21:59
  Michelle Routhenstein: So you don't have scarring of the liver.
• 22:01
  Michelle Routhenstein: It's sustainable and you don't lose muscle.
• 22:03
  Michelle Routhenstein: And a lot of times people want to have lost the 20 pounds yesterday, but it's really important to do this in one to two, three habits.
• 22:11
  Michelle Routhenstein: per one to two week time period to make them long term habits, because that's how you bring activity and make this a long term game.
• 22:19
  Michelle Routhenstein: So I work with individuals to personalize that so that they're really honing in, not being overwhelmed, being empowered, but also understanding why and understanding, Hey, where are we starting from?
• 22:31
  Michelle Routhenstein: But also.
• 22:32
  Michelle Routhenstein: being an advocate for yourself.
• 22:33
  Michelle Routhenstein: If you don't have a medical background, it's hard to know what tests do I need?
• 22:37
  Michelle Routhenstein: It's hard to know what questions to ask.
• 22:39
  Michelle Routhenstein: It's hard to know a lot of these things that are so important for you to know to be your own advocate.
• 22:46
  Michelle Routhenstein: A lot of times we wait for the doctor to call us to say our cholesterol is high.
• 22:50
  Michelle Routhenstein: I don't think most people know the doctor calls you when your cholesterol is so high.
• 22:55
  Michelle Routhenstein: Hi, it needs a stat in, they don't call you when your cholesterol is borderline and you can do dietary changes.
• 23:01
  Michelle Routhenstein: They wait until that cholesterol, maybe it's 140, which is very, high.
• 23:05
  Michelle Routhenstein: Same with blood pressure.
• 23:07
  Michelle Routhenstein: The doctor may say, Oh, you're a little nervous.
• 23:09
  Michelle Routhenstein: We'll monitor it.
• 23:10
  Michelle Routhenstein: Well, if you come back in a year and you've never monitored it, and now you've been walking around with high blood pressure, you're in trouble.
• 23:16
  Michelle Routhenstein: Instead of waiting for us to be monitoring it, we should be taking it at home.
• 23:20
  Michelle Routhenstein: We should be implementing nutrition.
• 23:22
  Michelle Routhenstein: We should be getting a copy of our.
• 23:24
  Michelle Routhenstein: labs, comparing it from year to year and being proactive.
• 23:28
  Michelle Routhenstein: Cause that's the only way to truly reduce heart disease.
• 23:30
  Michelle Routhenstein: You have to understand this aspect of your, health.
• 23:35
  Michelle Routhenstein: And you have to be a part of a healthcare team.
• 23:37
  Michelle Routhenstein: Who's willing to give you that time and attention to lean it.
• 23:41
  Mary Lee: Yes.
• 23:42
  Mary Lee: So good.
• 23:44
  Mary Lee: I love all of those key elements.
• 23:47
  Mary Lee: You said it's setting goals, all smart goals.
• 23:52
  Mary Lee: if this can be achievable or not, but it's that shared decision making throughout that is the theme here, is that you sit down and you don't dictate, an authoritative figure, you must, that they are very much a part of the journey of making those informed decisions so that they can, like you said, be their own advocate and proactively take a role in their health instead of waiting for.
• 24:17
  Mary Lee: The shoe to drop.
• 24:18
  Mary Lee: Oh, there's the sign that I need to make a significant change.
• 24:22
  Mary Lee: And sadly, I grew up with two parents who lived that way and didn't realize that their food consumption and what they chose to eat and the over processed foods and then the after work drinks and smoking would actually come to bear and they would have I had a lot of heart issues that was almost at a point where it was too late.
• 24:42
  Mary Lee: And I made it my mission that I wanted to help women take control of their body so that they can have an empowered life and live well beyond the mid, the midlife years.
• 24:54
  Michelle Routhenstein: Yes.
• 24:55
  Mary Lee: But there were two things that you had mentioned that I want to just touch on because They were quite curious to me.
• 25:01
  Mary Lee: One was the liver scarring.
• 25:03
  Mary Lee: When it went back to reference, when a person comes in, they want to lose weight and they want to lose it quickly.
• 25:08
  Mary Lee: So what does liver scarring mean in terms of their weight loss approach?
• 25:14
  Michelle Routhenstein: So when you are doing things in extreme and you're deprived body of all the calories and nutrients it needs, it's a heavy task on your body.
• 25:24
  Michelle Routhenstein: Okay.
• 25:25
  Michelle Routhenstein: So it can cause, so fatty liver and.
• 25:29
  Michelle Routhenstein: and scarring and cirrhosis happen a lot of times when it's very fast weight loss, that can actually increase the risk of fatty liver disease.
• 25:38
  Michelle Routhenstein: And so we don't want fast, we want slow and steady in order to avoid that scarring and that impact on the liver.
• 25:47
  Michelle Routhenstein: And then
• 25:49
  Mary Lee: Stanton's, we hear it all the time.
• 25:53
  Mary Lee: I think it's a pharmaceuticals favorite, right?
• 25:55
  Mary Lee: Put you on Stanton's as soon as we have any indication that there's something going wrong.
• 26:00
  Mary Lee: My husband being one of those people he's healthy as can be, but cholesterol was just creeping up again.
• 26:06
  Mary Lee: He's at that age where this is going to happen.
• 26:10
  Mary Lee: And he's, he told his doctor, no, I'm not going to go on them.
• 26:14
  Mary Lee: I'm going to work with my wife and we're going to have a nice balanced diet.
• 26:19
  Mary Lee: Diet, nutrition, I'm going to make some smart food choice changes and get a little bit more cardio exercise in, as well as weight bearing exercise.
• 26:29
  Mary Lee: We'll get into that as well, but statins, let's talk about that and maybe debunk some mistruths about them.
• 26:39
  Mary Lee: And if it's be all end all for our health.
• 26:42
  Mary Lee: So what can we do to avoid the inevitable?
• 26:44
  Mary Lee: And again, advocate for our own health when we feel that's probably not necessary.
• 26:49
  Mary Lee: Okay.
• 26:50
  Michelle Routhenstein: So it really depends on the person.
• 26:52
  Michelle Routhenstein: There are a subgroup of individuals who have a condition called familiar hypercholesterolemia.
• 26:59
  Michelle Routhenstein: And this is a genetic metabolism disorder of lipids.
• 27:03
  Michelle Routhenstein: So your body can't break down the LDL cholesterol.
• 27:08
  Michelle Routhenstein: And so from a young age, even as young as seven, eight, your cholesterol levels are so low.
• 27:14
  Michelle Routhenstein: So it's usually diagnosed when LDL is above 190 milligrams per deciliter.
• 27:20
  Michelle Routhenstein: And it's usually seen as young as a younger person.
• 27:25
  Michelle Routhenstein: It's not everyone.
• 27:26
  Michelle Routhenstein: It's a small percentage of our population.
• 27:28
  Michelle Routhenstein: But if in those individuals, our medical guidelines are, you need a pair of nutrition alongside statins.
• 27:35
  Michelle Routhenstein: And so I look at it as a an adjunct therapy, and I don't shame anyone who needs to go on statins.
• 27:42
  Michelle Routhenstein: I think that it can be really a life saving drug.
• 27:45
  Michelle Routhenstein: There are many people who don't need statins because they can lower their LDL cholesterol, their ApoB levels, their non HDL cholesterol with nutrition alone.
• 27:56
  Michelle Routhenstein: And so I always say, start with diet and nutrition, but really focus in on the statins specific foods you need to add to your diet to optimize them.
• 28:05
  Michelle Routhenstein: A lot of times when people are hesitant for statin, but they've had high cholesterol for many years, you may want to consider getting a coronary artery calcium score to assess for advanced plaque formation in the arteries.
• 28:17
  Michelle Routhenstein: If that is there, it's usually an adjunct therapy.
• 28:21
  Michelle Routhenstein: Now there aren't with nutrition.
• 28:23
  Michelle Routhenstein: So you can be on a stat and still have a heart attack.
• 28:25
  Michelle Routhenstein: I've seen many people who've been on a Senate for 15, 20 years, still have a heart attack because lipids are not the only component of heart disease, blood pressure, diabetes, blood sugar, inflammation, oxidative stress, endothelial dysfunction, and a lot of things that increase the risk of cardiovascular disease.
• 28:41
  Michelle Routhenstein: So just to look at cholesterol by itself is not looking at the whole picture of things.
• 28:47
  Michelle Routhenstein: But.
• 28:48
  Michelle Routhenstein: Some people tolerate statins.
• 28:50
  Michelle Routhenstein: They're doing fine with it, and it's okay for them.
• 28:53
  Michelle Routhenstein: I'm not against statins, and I think anyone who says you should, no one should ever go on statins is not looking at the science based evidence, but there are people who don't need the statin.
• 29:03
  Michelle Routhenstein: I've helped many people get off of statins.
• 29:05
  Michelle Routhenstein: I work with people who are statin intolerant, who cannot, when they have Statins, their liver enzymes go up, they have mental health issues, they have their blood sugars go up, they have muscle myalgia, they have muscle aches, and in those individuals, we need to find alternatives to help them, if statins is medically recommended.
• 29:25
  Michelle Routhenstein: But I don't think there's anything wrong with going on a statin if that's what works for you, and that's what's needed in your medical plan.
• 29:32
  Michelle Routhenstein: But I always encourage, if you're on a statin, you should also pair nutrition.
• 29:36
  Michelle Routhenstein: A lot of times, if you've had a cardiovascular event, the doctor wants you on a statin, and you pair nutrition, You can usually go on the lowest dose.
• 29:44
  Michelle Routhenstein: So like a five milligram dose of a statin where the side effects are really limited.
• 29:49
  Michelle Routhenstein: There's no real side effects at that low of a dose.
• 29:52
  Michelle Routhenstein: And so you're still getting both types of benefits from a research standpoint.
• 29:57
  Mary Lee: So to recap, then they're not necessarily bad can be very helpful, but if you're on them, obviously, like you said, pair it with good nutrition.
• 30:07
  Mary Lee: So you're still being proactive and preventative.
• 30:11
  Mary Lee: But can you, can get off them with improved nutrition and lifestyle.
• 30:18
  Michelle Routhenstein: You can, it's, it just depends on your risk factors.
• 30:21
  Michelle Routhenstein: So when we look at ranges, if you are someone who has a high lipoprotein A, which is a genetic risk factor for atherosclerosis, we want LDL to be less than 70, if you have a high calcium score, we want that to be less than 50.
• 30:35
  Michelle Routhenstein: And so depending on where you take it.
• 30:36
  Michelle Routhenstein: start.
• 30:37
  Michelle Routhenstein: And depending on your risk factors we need to look at the whole picture because it's important that we, also need to look at your metabolism of LDL excretion.
• 30:47
  Michelle Routhenstein: Some people I've seen with diet alone, lower their LDL in six months by 60 to 90 points.
• 30:54
  Michelle Routhenstein: And I've seen other people where it's a little more stubborn.
• 30:56
  Michelle Routhenstein: And so we have to also realize there's an individual makeup here that we need to recognize.
• 31:01
  Michelle Routhenstein: And we need to monitor to make sure that we're still targeting at LDL with which whatever path is right for you.
• 31:08
  Mary Lee: Okay.
• 31:09
  Mary Lee: But pairing it then with nutrition, with lifestyle changes, such as the exercise is probably just as important.
• 31:17
  Mary Lee: And I want to touch on that next.
• 31:19
  Michelle Routhenstein: Yeah.
• 31:20
  Mary Lee: So when you work with your clients and in the field that you do on the advisory committees do you.
• 31:28
  Mary Lee: Do you get into the aspects of, exercise and making recommendations to clients and on the advisory board that exercise also plays a critical role, even though nutrition seems to be first and foremost, the key.
• 31:46
  Michelle Routhenstein: A hundred percent.
• 31:47
  Michelle Routhenstein: So we look at.
• 31:48
  Michelle Routhenstein: Right.
• 31:49
  Michelle Routhenstein: So nutrition is influenced by physical activity, influenced by sleep, influenced by stress.
• 31:54
  Michelle Routhenstein: There's all these things you can't look at your lifestyle and silos.
• 31:57
  Michelle Routhenstein: Everything is correlated.
• 31:59
  Michelle Routhenstein: So definitely, I think a big part of it though, and I like to really bring this up is that many people think that if they are really active, then they're, and they don't eat processed foods or fast foods, then they are free of heart disease and heart disease.
• 32:13
  Michelle Routhenstein: happen in any shape and size.
• 32:15
  Michelle Routhenstein: I've seen athletes, I've seen many athletes have heart attacks from that plaque buildup because they aren't pairing nutrition with exercise.
• 32:23
  Michelle Routhenstein: So if you're doing a lot of exercise, but you're not adding in nutrition afterwards for proper fuel and recovery, that can actually lead to oxidative stress, which increases plaque formation in the arteries.
• 32:35
  Michelle Routhenstein: So it needs to be balanced.
• 32:36
  Michelle Routhenstein: appropriately for you.
• 32:38
  Michelle Routhenstein: But exercise is very important, a big piece of it and all types of exercise.
• 32:42
  Michelle Routhenstein: So I look at exercise in three buckets.
• 32:45
  Michelle Routhenstein: We have aerobic exercise, we have resistance exercise, and then we have stretching.
• 32:50
  Michelle Routhenstein: And everyone looks at stretching as not really a category, it's its own category.
• 32:55
  Michelle Routhenstein: Especially during menopause, when our arteries are more stiff, when we stretch our arteries are more elastic, it allows for better blood flow.
• 33:03
  Michelle Routhenstein: Super important to also prioritize that in that, in those three types of exercise.
• 33:08
  Mary Lee: Oh my goodness.
• 33:09
  Mary Lee: I, when you say that, I think of so many of the runners in my running club, they used to run with, and we're talking almost 30 years ago now, if not more, I'm dating myself, but we were all like long distance runners.
• 33:22
  Mary Lee: We would be training for the marathons, half marathons, 15 Ks.
• 33:27
  Mary Lee: And our mindset, or at least with these older gentlemen who I ran with, and they were probably 20 years, my senior, the mindset was, we don't have time to stretch stretching is for sissies.
• 33:38
  Mary Lee: Let's just run and run ourselves ragged.
• 33:41
  Mary Lee: We'll just keep clocking extra miles so we can sit down and have a couple of pints of beer or those donuts at the end of the run.
• 33:49
  Mary Lee: You're like, oh my gosh, I gave into it.
• 33:53
  Mary Lee: I don't know, maybe for a couple of months.
• 33:54
  Mary Lee: And after that, I said, No, I just feel like so crappy.
• 33:58
  Mary Lee: I've put in the work to get this nice run in.
• 34:01
  Mary Lee: I'm feeling super strong.
• 34:03
  Mary Lee: Why would I blow it?
• 34:04
  Mary Lee: And one donut after the run.
• 34:07
  Mary Lee: And so it's so true what you say about the three.
• 34:10
  Mary Lee: I love that, that you broke it down into three areas.
• 34:14
  Mary Lee: I teach, I love to teach bar classes.
• 34:16
  Mary Lee: And one of the things that we always say when we do the stretching portion after the resistance training or the weight bearing work is, it takes strength to stretch.
• 34:26
  Mary Lee: And I think that is more than just a physical strength, but a mental strength to stretch because when we stretch.
• 34:34
  Mary Lee: We really feel where the body is holding on to extra emotions or extra resistance or extra pain.
• 34:45
  Mary Lee: We haven't worked something out.
• 34:47
  Mary Lee: There's some inflammation may be hitting, especially in the hips for women.
• 34:51
  Mary Lee: So when you have your clients come to see you and say, Oh Michelle, oh my gosh, I've made all these changes to my diet.
• 34:58
  Mary Lee: I'm feeling good.
• 35:00
  Mary Lee: I'm exercising.
• 35:02
  Mary Lee: But what do you tell them when they said, when they're ready to start incorporating a better workout or a better activity into their, lifestyle, better movement, to help them get past those hurdles that sometimes exercise just might say, okay, X nay, I'm stopping there.
• 35:20
  Mary Lee: I'll do the food changes, but I'm not sure about the exercise.
• 35:24
  Michelle Routhenstein: So it really is meeting each client where they are.
• 35:27
  Michelle Routhenstein: So there's some clients who come and they're working out for two hours in a day, every day.
• 35:31
  Michelle Routhenstein: And they're like, I don't have time to worry about nutrition because I'm exercising for so long.
• 35:36
  Michelle Routhenstein: We need a balance, right?
• 35:37
  Michelle Routhenstein: So that is actually reducing their exercise time to allow for more quality of life and improvement.
• 35:43
  Michelle Routhenstein: Other people hate the gym.
• 35:45
  Michelle Routhenstein: If you eat the gym, you are, you should never buy a gym membership.
• 35:50
  Michelle Routhenstein: I want to know what you like to do.
• 35:51
  Michelle Routhenstein: I want to know what brings you joy.
• 35:53
  Michelle Routhenstein: If you like going for a walk in nature, you can make that a little bit more brisker over time, but first we need to anchor it in.
• 36:01
  Michelle Routhenstein: Where in your day, maybe it's after your biggest meal.
• 36:03
  Michelle Routhenstein: Can you walk for five, 10 minutes?
• 36:05
  Michelle Routhenstein: If you're very sedentary, we look at small things to change if you are already walking, but you don't do any resistance, maybe you get the hand, the wrist or the ankle kind of weights that you can attach and you can walk with them to help build resistance exercise within your regimen.
• 36:22
  Michelle Routhenstein: So I'm very big about anchoring activity, but understand.
• 36:25
  Michelle Routhenstein: Where do you start?
• 36:26
  Michelle Routhenstein: Cause everyone starts differently.
• 36:27
  Michelle Routhenstein: Some people love exercise and they just never paid attention to nutrition.
• 36:30
  Michelle Routhenstein: Other people want or into nutrition, but don't really love exercising.
• 36:34
  Michelle Routhenstein: So finding where that balance is and making sure that it's anchored and it's something you enjoy doing, because if you don't enjoy doing it, it's not going to be long term and then it's not really fruitful or helpful for your cardiovascular health or your overall health.
• 36:49
  Michelle Routhenstein: And as women, especially in the postmenopausal phase our bone mineral density gets depleted so quickly and we have to look at functional medicine and functional motility.
• 37:00
  Michelle Routhenstein: And so we need to be looking at muscle mass and preventing osteoporosis, which is a risk factor for heart disease.
• 37:06
  Michelle Routhenstein: And so we have to be including it, but that inclusion will differ from you to someone else.
• 37:12
  Michelle Routhenstein: Based off your likes, your interests, what's available to you, what's accessible to you, and what works within your schedule and your timeframe.
• 37:19
  Michelle Routhenstein: And that's so important when we talk about any lifestyle change, because if you just copy what your friend is doing, but you hate doing it, it's not long lasting and it's not enjoyable or improving your quality of life.
• 37:32
  Michelle Routhenstein: We really need to look at all of these factors to build a plan that works for you long term.
• 37:38
  Mary Lee: So good.
• 37:39
  Mary Lee: It's all good.
• 37:40
  Mary Lee: Everything I preach and more, but you're just validating it.
• 37:43
  Mary Lee: That's why the experts come on my show to reinforce what I keep saying.
• 37:48
  Mary Lee: We've talked about obviously the nutrition part and we've talked about an active lifestyle, but you've mentioned a couple of times now, oxidative stress.
• 37:56
  Mary Lee: And of course we can improve that or reduce it, if you will with our food choices, lots of great anti inflammatory foods to help tackle those radicals.
• 38:09
  Mary Lee: But the role of sleep and stress management, let's talk about that a little bit and its importance on our heart, health.
• 38:18
  Michelle Routhenstein: Yeah, definitely.
• 38:19
  Michelle Routhenstein: So when we're awake, our brain is firing neurons.
• 38:22
  Michelle Routhenstein: It's in a very oxidative state just by being a human, right?
• 38:27
  Michelle Routhenstein: When we sleep, we have an antioxidant restorative system.
• 38:31
  Michelle Routhenstein: That's where our antioxidant defense system gets actually brought to life.
• 38:37
  Michelle Routhenstein: So if you're sleep deprived, your oxidative stress is so much higher.
• 38:42
  Michelle Routhenstein: If you have sleep apnea, so if you're snoring or really tired during the day, or you're waking up a lot at night and you're diagnosed with sleep apnea, that's one of the highest risk factors for oxidative stress because your body is searching for oxygen in the middle of the night and it can't and it can't get it.
• 38:58
  Michelle Routhenstein: So that's going to increase blood pressure because your body is going to constrict the arteries to give your brain.
• 39:04
  Michelle Routhenstein: As much oxygen as it possibly can.
• 39:07
  Michelle Routhenstein: So sleep is so important because it, A, helps with the antioxidant defense system, but it also restores our functioning.
• 39:14
  Michelle Routhenstein: And it also helps with blood pressure control, satiety and appetite hormones.
• 39:20
  Michelle Routhenstein: It helps with cortisol levels.
• 39:22
  Michelle Routhenstein: A lot of times if you don't sleep well.
• 39:25
  Michelle Routhenstein: You may be craving some high carbs the next day, or you don't really, your body can't tell you when it's hungry or full.
• 39:31
  Michelle Routhenstein: So it's going to also impact your nutrition.
• 39:34
  Michelle Routhenstein: Now I know though, that many times women will say to me, I sleep, I go to bed just fine, but at 2 or 3 AM I wake up and I can't go back to sleep.
• 39:44
  Michelle Routhenstein: That's a very big complaint during the menopausal period.
• 39:49
  Michelle Routhenstein: And a lot of times when I assess what's going on, it actually has to do with a couple of factors.
• 39:55
  Michelle Routhenstein: One, it could be stress.
• 39:56
  Michelle Routhenstein: So, the stress their, mind is still on.
• 39:59
  Michelle Routhenstein: And so, once it, once you wake up, it's on, it's not going back to sleep, you're fired.
• 40:04
  Michelle Routhenstein: But there's also certain nutrients like magnesium and B vitamins that are needed for melatonin to be naturally produced in the body.
• 40:12
  Michelle Routhenstein: So, if you don't have those in sufficient quantities, after you've your body's so tired, it sleeps, and then it wakes up You up because you don't have the appropriate nutrients to keep you, asleep.
• 40:24
  Michelle Routhenstein: So I'm very big on nutrient sufficiency because it really helps to address a lot of the mepo menopause symptoms that occur because our nutrients actually change during the menopause period of how much we need.
• 40:38
  Michelle Routhenstein: certain things.
• 40:40
  Michelle Routhenstein: And I think that this is something that no one really talks about.
• 40:42
  Michelle Routhenstein: It's well, I eat healthy.
• 40:44
  Michelle Routhenstein: Why is all these things happen?
• 40:45
  Michelle Routhenstein: Oh, it's just estrogen.
• 40:46
  Michelle Routhenstein: Yes, it's estrogen declining, but it's also your body's needs are changing and we need to be more adaptable to what those needs are to prevent these things from causing issues.
• 41:00
  Mary Lee: So good.
• 41:01
  Mary Lee: You've said this a few times and it's worth reiterating as we age and through the menopausal years our nutrition needs change That is so key.
• 41:12
  Mary Lee: And it's, I've been dealing with clients who just feel that and, we all agree the estrogen, of course, egress from the body has a cascading effect, the receptors in the body are not receiving that estrogen signals to optimize its function.
• 41:26
  Mary Lee: And it's going to adjust.
• 41:27
  Mary Lee: The body is a very wise, machine and it can adjust, but the, we overlook often.
• 41:35
  Mary Lee: those supplements, the nutrients that we need, as you mentioned, the vitamin D vitamin B and magnesium.
• 41:43
  Mary Lee: So I want to put it out there for the listeners.
• 41:45
  Mary Lee: If I were to say, if we had to, and this is probably a difficult question, but the five top supplements, whether we get it in our food or as a supplement What would be the five top that we need to optimize in our body to help with our menopause transition?
• 42:03
  Michelle Routhenstein: So I would just put a question when I say the minerals, it's not a supplement.
• 42:08
  Michelle Routhenstein: It's actually through food because anybody tells you that everyone needs to be on the top five supplements is not really doing justice because it can change based off the medications you take, your medical history, your diet.
• 42:24
  Michelle Routhenstein: Supplements are intended to supplement your diet because let's say you avoid certain foods or you're allergic to certain foods, then we can supplement the, diet through a supplement, but that needs to be personalized and discussed with your personalized care team, including your registered dietitian.
• 42:42
  Michelle Routhenstein: I wouldn't really.
• 42:43
  Michelle Routhenstein: Really say, Oh, everyone needs the same supplements.
• 42:45
  Michelle Routhenstein: But with that in mind, we need to make sure that you're getting enough, but calcium, vitamin D, magnesium, potassium.
• 42:53
  Michelle Routhenstein: We also want to make sure that you're getting enough selenium.
• 42:56
  Michelle Routhenstein: We want to make sure that you're, there's so many nutrients.
• 42:59
  Michelle Routhenstein: There's also, we want to make sure that you're getting enough of manganese.
• 43:03
  Michelle Routhenstein: and folate.
• 43:05
  Michelle Routhenstein: While those nutrients may be only talked about during the pregnancy years, they actually are super important for the endothelial health for your arteries to vasodilate and open up and allow for good vascular.
• 43:20
  Michelle Routhenstein: vascular health.
• 43:21
  Michelle Routhenstein: So it's not about, Hey, everyone needs to go on these vitamins.
• 43:26
  Michelle Routhenstein: There's all, these vitamins are important.
• 43:27
  Michelle Routhenstein: I can list you a million more.
• 43:29
  Michelle Routhenstein: Vitamin C is important.
• 43:31
  Michelle Routhenstein: All of these glutathione is important.
• 43:34
  Michelle Routhenstein: Quercetin is important.
• 43:36
  Michelle Routhenstein: Lavanols are important, but we can get this all through our food.
• 43:39
  Michelle Routhenstein: And when we get it through our food, our body knows what to do with it.
• 43:42
  Michelle Routhenstein: It's in a whole food matrix that allows for absorption of these nutrients in the best way.
• 43:48
  Michelle Routhenstein: Omega 3 fatty acids.
• 43:50
  Michelle Routhenstein: Also, if we get it through food, that's much more safer than if we get it through a supplement, because we've seen new research that shows that A lot of them go rancid.
• 43:58
  Michelle Routhenstein: And so now you're having oxidized supplements in your system, which can lead to more oxidative stress and increase LDL cholesterol.
• 44:05
  Michelle Routhenstein: So I'm very big about, if you can get it through food, that's my preferable way.
• 44:09
  Michelle Routhenstein: But if you're vegan, or you're going to have to supplement with a lot of supplements because you can't get that through non animal.
• 44:17
  Michelle Routhenstein: foods like zinc and B12 and omega 3s.
• 44:20
  Michelle Routhenstein: So we have to really personalize the supplements to you.
• 44:24
  Michelle Routhenstein: More is not better and I often see this, well, oh, I'm taking all these things and they're advertised to be heart healthy.
• 44:31
  Michelle Routhenstein: It's, not very well regulated.
• 44:32
  Michelle Routhenstein: They can really does stick a lot of false claims and they just put a little bit of a tag.
• 44:36
  Michelle Routhenstein: They're saying this has not been evaluated by the FDA.
• 44:40
  Michelle Routhenstein: And so that kind of takes away their liability.
• 44:43
  Michelle Routhenstein: So we need to be really mindful of what we're putting in our body and really focusing on the nutrients through the food, which is so abundant in our food supply.
• 44:52
  Michelle Routhenstein: And then supplementing is needed.
• 44:53
  Michelle Routhenstein: I do recommend supplements to my clients, but on a personalized level, based off of their medications, their diet, their lifestyle, and what they really need.
• 45:02
  Mary Lee: Yes, and working with their health care team, like you said, fantastic.
• 45:06
  Mary Lee: That is such valuable information alone.
• 45:08
  Mary Lee: And we're hearing this more and more.
• 45:10
  Mary Lee: Get the nutrients and supplements through the food source first and foremost, which means eating your, eating a more plentiful diet that will, that is rich in those vitamins and supplements that will enable us to, absorb them into the body effectively.
• 45:27
  Mary Lee: And that, of course, would be our, colorful vegetables, as we say, all the colors of the rainbow and eating our proteins.
• 45:36
  Mary Lee: Exactly.
• 45:37
  Mary Lee: Our proteins.
• 45:38
  Mary Lee: Yeah.
• 45:39
  Michelle Routhenstein: So our complex carbs that have been getting a bad rap recently and our whole fats, they all matter.
• 45:46
  Michelle Routhenstein: They're all essential macronutrients that we need in our body.
• 45:50
  Michelle Routhenstein: So
• 45:50
  Mary Lee: good.
• 45:51
  Michelle Routhenstein: So
• 45:51
  Mary Lee: good.
• 45:53
  Mary Lee: We're going to have so many gems of information in the show notes.
• 45:57
  Mary Lee: But before we get there, I want to ask you what book you're reading and what does that tell us?
• 46:03
  Mary Lee: about you or a recommendation that you could make for our listeners about what you're reading.
• 46:11
  Michelle Routhenstein: I'm reading.
• 46:12
  Michelle Routhenstein: So I got gifted recently a book called just one heart by Dr.
• 46:16
  Michelle Routhenstein: Jonathan Fisher.
• 46:17
  Michelle Routhenstein: He's one of the kindest cardiologists I've had the pleasure to know.
• 46:21
  Michelle Routhenstein: And he wrote this book about the emotional side of heart health and how we.
• 46:27
  Michelle Routhenstein: While he acknowledges, we need to prioritize balanced nutrition.
• 46:30
  Michelle Routhenstein: We need to prioritize sleep.
• 46:32
  Michelle Routhenstein: We need to prioritize all the other aspects of healthy living.
• 46:35
  Michelle Routhenstein: The emotional component is so vital.
• 46:38
  Michelle Routhenstein: And what's so beautiful about how he writes is that it's not just the negative emotions that we want to reduce.
• 46:45
  Michelle Routhenstein: It's about the positive.
• 46:47
  Michelle Routhenstein: Emotions of gratitude and joy and just good resilience and emotional health, which we really need and he takes and I love it because all of my clients come to me, most of them with a lot of health anxiety, and we don't really take into the fact of this anxiety and emotional well being enough.
• 47:08
  Michelle Routhenstein: And I spent a lot of time building confidence with my clients by explaining the why behind my recommendations so that they're an empowered person on their team.
• 47:16
  Michelle Routhenstein: They're active in their team to understand, okay, this guy fearmonged me, but he's wrong because I know that this does this, and this in my body.
• 47:24
  Michelle Routhenstein: And so they stay on track longer.
• 47:26
  Michelle Routhenstein: And so that's my way of dealing with a lot of health anxiety around food.
• 47:30
  Michelle Routhenstein: But just emotional health and social connections and all of that is.
• 47:34
  Michelle Routhenstein: It's such an important piece of this, and he really describes this beautifully in his book.
• 47:39
  Michelle Routhenstein: And so I'm enjoying it.
• 47:41
  Michelle Routhenstein: He's gifted it to me and I'm going to be talking to him about it on my Instagram page once I finish reading it.
• 47:47
  Mary Lee: Nice.
• 47:48
  Mary Lee: And speaking about your Instagram page, tell our listeners where they can find you, Michelle.
• 47:54
  Michelle Routhenstein: So you can find me on my website at entirely nourished.
• 47:56
  Michelle Routhenstein: com.
• 47:58
  Michelle Routhenstein: I'm also on Instagram at heart.
• 48:00
  Michelle Routhenstein: health.
• 48:00
  Michelle Routhenstein: nutritionist.
• 48:01
  Michelle Routhenstein: I'm also on Facebook at entirely nourished, and I'm also on LinkedIn at Michelle Rothenstein, but just join my email list.
• 48:08
  Michelle Routhenstein: Cause that's where you'll get all of the information anyway.
• 48:11
  Michelle Routhenstein: And that will really help you just get heart disease prevention tips in your inbox.
• 48:15
  Mary Lee: Beautiful.
• 48:16
  Mary Lee: We're going to get those, great links in our show notes.
• 48:18
  Mary Lee: Our listeners can join, sign up and start getting to know themselves inside and out, starting with the heart and really being proactive in the decision making about their lifestyle changes Michelle, I can't thank you enough for reaching out and being on the show.
• 48:35
  Mary Lee: Just packed full, so many great gems of information.
• 48:39
  Mary Lee: I don't know so many great clips that you said.
• 48:41
  Mary Lee: I don't know which one I'm going to pull out for you for your opening clip, but so good, I'm so thrilled to share this information.
• 48:50
  Mary Lee: It's been wonderful having you here.
• 48:52
  Mary Lee: Thanks so much for having me.
• 48:56
  Mary Lee: Thank you for tuning in to another insightful episode of All Things Menopausal.
• 49:01
  Mary Lee: If you enjoyed today's episode and want to stay connected, be sure to follow me on Instagram for daily tips and updates.
• 49:09
  Mary Lee: For even more support and community, Join our Facebook group, Personal and Universal, where we share experiences, advice, and empower each other through the transformative journey.
• 49:21
  Mary Lee: And if you found value in today's episode, please consider leaving a review on Apple Podcasts.
• 49:27
  Mary Lee: Your feedback helps reach more women who can benefit from these conversations.
• 49:32
  Mary Lee: Okay, my lovelies, until next time, stay empowered, stay informed Remember midlife should be the best life and it will be.
• 49:42
  Mary Lee: Namaste.