Latest / The Dr Louise Newson Podcast / 45 - Inflammation, hormones and the hidden cause of chronic disease

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45 - Inflammation, hormones and the hidden cause of chronic disease · The Dr Louise Newson Podcast

• 0:00
  This is a great conversation with Doctor Robert Lufkin who is
• 0:04
  AUS doctor and he's written a book about lies he learnt at
• 0:08
  medical school. He talks about things he learnt
• 0:12
  at medical school aren't quite what he knows now, and we know
• 0:16
  this because evidence is changing all the time.
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  But he talks a lot about chronic diseases and the underlying
• 0:22
  cause being related to inflammation, something I'm very
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  fond of. So thinking about how we as
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  individuals can reduce inflammation through our
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  lifestyle and hormones, of course, really important.
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  So it's a very riveting conversation for you to enjoy
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  and to learn from. So, Rob, I've been stalking you
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  for a little while. And I read your book quite soon
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  after it came out. And to be honest, so many pages
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  I've turned down and I've gone back and read and reread it.
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  And it resonated so much with the way that my mind, my brain
• 1:00
  has changed over the last 30 years of being a doctor.
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  And when I came out of medical school, I thought I knew
• 1:07
  everything. And I thought everything I
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  learned at medical school would just put me in good stead until
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  the time I retired. And it's changed every every day
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  I learn new things from my patients.
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  And every day I learn new things from reading different articles
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  and scientific evidence and literature and reading books
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  like this as well. So your book is called Lies.
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  I taught in medical school how conventional medicine is making
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  you sicker and what you can do to save your life.
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  So it's pretty powerful cover here.
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  So can you just explain a bit about your background and and
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  then why you wrote this book, which is a New York Times
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  bestseller, I like to add. So congratulations for that.
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  I'm a practicing physician. I'm also a medical school
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  professor, So in addition to seeing patients, I also get to
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  do research and, and write papers and, and also help
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  educate healthcare professionals and, and learning about the
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  world of medicine. And, and I, I done that
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  essentially my entire career. And, and how I got, how I got to
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  this particular point is I was, I was minding my own business as
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  a medical school professor when I suddenly came down with four
• 2:20
  chronic diseases. And I went to my doctors and you
• 2:25
  know, they, they said, oh, don't worry, here's a pill.
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  You know, we're going to give you a pill for each one of
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  those. So I was given 4 prescriptions
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  were medications and and I said, you know, hey, what about
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  lifestyle? You know, I hear about that,
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  Does that work? And they go, Nah, that really
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  doesn't work. You're going to be on these
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  pills for the rest of your life. So get used to it.
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  And at that point, my daughters were in elementary school and I
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  knew enough about chronic disease that I was that I knew
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  it wasn't going to end well. And so it forced me to to begin
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  to question my own beliefs, what I've been teaching and what many
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  of my colleagues are still teaching.
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  And I realized there's been a revolution in our understanding
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  about these diseases and, and the mechanisms for them.
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  And that lifestyle actually does matter.
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  And I was able to make a few changes in my own lifestyle.
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  And Long story short, I went back to the doctors.
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  They couldn't believe it. They thought the labs were
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  broken, but they eventually, you know, took me off all
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  medications. The diseases are reversed.
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  And now I've made it my mission to help others take back their
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  health and hopefully not make the same mistakes that I did.
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  And that's why I've written the. Book it's so interesting, isn't
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  it, because I trained as, as you know, as a general physician and
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  I did lots of different jobs rotating through hospital
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  specialties. So you know, renal medicine,
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  cardiology, respiratory rheumatology.
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  And it was really exciting as a junior doctor to make a
• 3:55
  diagnosis. We'd run loads of tests with
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  people. Scans would just sort of coming
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  in. They were harder to get, but we
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  were doing scans. Once we had a diagnosis, the
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  first thing we did was think about which treatment.
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  And it was always prescribing treatment.
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  And in hospital, as you know, there's layers and layers of
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  treatment. And this was, you know, in the
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  90s, we often didn't really involve our patients.
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  We're just right on the drug chart and then they would just
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  have a, you know, to have the drugs.
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  They'd then go home with the drugs.
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  The GP would carry on the prescription and it was almost
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  like I felt I was doing the best thing for their patients at that
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  time. And I didn't even think about
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  how could we even prevent that disease happening in the 1st
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  place? What's making it happen?
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  And you know, like you, over the last few decades, the incidence
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  of chronic diseases we've just watched getting higher.
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  People are becoming sicker. Despite all these medicines,
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  despite it being, you know, in the 21st century, I feel like we
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  haven't really made the advances that we should have done to keep
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  people well. Yeah, Yeah, totally.
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  I mean, you know, some of your audience may be thinking, wait a
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  minute, you're, you're being critical of Western medicine or,
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  you know, allopathic medicine. But you're part of the problem,
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  right? You were in medical school.
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  You're teaching that you're the problem.
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  And my, my book is very critical of Western medicine and what
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  we're talking about, it is going to be critical of Western
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  medicine. But I think it, you know, in, in
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  the 20th, in the 20th century where you and I grew up and
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  essentially Western medicine was magical.
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  It transformed the lives of humanity truly around the world
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  through the pills and surgeries that were developed, made the
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  world a better place. I mean, largely through public
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  health measures, certainly, but but indeed, it really
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  transformed and elevated the life of everyone around the
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  world. And even today, if I get hit by
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  a car, I'm going to want to have that blood transfusion.
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  I'm going to want my ruptured spleen removed.
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  I'm going to want my bone set. So Western medicine still has a
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  role to play. But I think the problem is in
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  the 21st century, we're now facing this literal tsunami of
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  what you and I are talking about are chronic diseases that while
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  they were present in the 20th century, they're now they're,
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  they're, they're now in biblical numbers never before seen in
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  history by some estimates act occupying up to 80% of
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  healthcare resources. And you know, this list it,
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  it's, it's really why wide-ranging goes all the way
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  from from obesity, diabetes, hypertension, cardiovascular
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  disease, cancer, Alzheimer's disease and mental illness, just
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  to name a few. And these seem like very
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  separate diseases, but they, you know, they're, they, they share
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  a common cause. But the problem is when Western
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  medicine takes the same pills and surgeries, hey, they work in
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  the 20th century and applies them to these chronic diseases.
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  Now they they do help in the acute case and they may be life
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  saving, but the problem is in most cases they don't get to the
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  root cause and these diseases continue to progress.
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  They're sort of a Band-Aid over the symptoms and that's, and
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  that's really the problem. And that's that's what the book
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  is set out to address. And I think, I think that's what
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  you're talking about as well. It's almost got worse because
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  medicine is very siloed. You know, I really trained with
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  some amazing people to be a general physician and I had a
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  lot of interest in all the organs.
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  Whereas now it becomes everyone becomes specialized a lot
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  younger. It's a lot narrower people
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  thinking of one organ. But as you know, I've got a
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  pathology degree as well. And it's really interesting.
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  I love doing pathology because the study of disease makes you
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  think in a molecular way a lot differently to the way you're
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  trained as a medical doctor. And one of the essays that I
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  wrote for my final degree was about atheroma.
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  So the fairing of the arteries being a, a, a pre malignant
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  disease, as in something associated with cancer, which
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  people listening might think how has arteries, you know, diseases
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  of the lining of the blood vessels associated with cancer.
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  And I wrote a three hour essay on this and I was trying to find
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  if I had my exam paper anywhere because I'd love to reread it.
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  Now this was in 1992. I wrote this essay and I loved
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  it because I wrote a lot about inflammation.
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  So the cause of atheroma, this firing of the arteries, and I
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  wrote about inflammation and the cause of cancer and why cancer
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  develops. But it's going back to the
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  basics. And this is what your book does
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  because it sets out all these chronic diseases like heart
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  disease and osteoporosis and that you see even mental health,
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  non alcoholic fatty liver disease.
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  And to specialist people, they would think they're all very
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  separate conditions. But once you get down to the
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  root cause, thinking about in a cellular level what's going
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  wrong in the body, it makes sense to fix that rather than
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  wait for all the diseases to happen and then, like you say,
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  medicalize them all. Yeah, that that's, that's such a
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  great point. And it, it, it was really a wake
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  up call for me. The like to, to realize that the
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  same lifestyle changes that work for obesity and hypertension
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  also work for cancer risk and Alzheimer's disease and mental
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  illness. And it's the it's correcting the
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  same at the root metabolic dysfunction that drives all of
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  these. So it's almost like 11 size fits
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  all. And, and, and the other, the
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  other big weight recall for me was that the diseases didn't
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  start when the doctor diagnosis them.
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  You know, as a doctor, that's why I used to think, you know,
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  and, and our healthcare system is certainly set up that way.
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  You know, you don't have diabetes until your glucose or
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  your, your hemoglobin A1C crosses a certain threshold and
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  then you have diabetes and then the insurance or the payers will
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  start to cover that disease. And you know, before that, a
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  week before you didn't have it. And, and, and I now realize, at
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  least for these chronic diseases that we're talking about, they
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  don't begin when the doctor diagnosis them.
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  They begin actually days to weeks to decades before the
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  doctor diagnosis them. And if we wait until the doctor
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  says, oops, you know, you've got diabetes or, you know, oh, you
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  forgot your keys, you have Alzheimer's.
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  If we wait for the doctor to diagnose them, we'd missed a
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  tremendous. Opportunity.
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  For what you mentioned was, was prevention.
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  And that's why, you know, even Yeah, your friends would go,
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  hey, I'm perfectly healthy. I don't have a single disease.
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  Well, we're all on the path to getting the diseases because the
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  list, those chronic diseases that we're talking about,
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  statistically, those are the diseases that you and I and most
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  of our listeners will die of. And you know, we all die of
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  something, right? You know, as Jim Morrison said,
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  nobody gets out alive. So, you know, they are in our
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  future. But you know, why have the heart
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  attack at 50? Why not have it at 105?
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  You know, why get the Alzheimer's at at 60?
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  Why not get it at 95? You know, let's push them back
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  as far as we can. And that's that's why I believe
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  even, you know, quote, UN quote, healthy people should think
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  about their lifestyle because you could do things now that
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  will keep you healthy longer. It's just by doing these simple
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  things. I totally agree and it's so
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  important because you know, our healthcare system sadly is, is
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  failing like a lot of healthcare systems and it's very reactive.
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  You know, my husband said to me that he, he works in the NHS and
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  he said we haven't got time to think about preventing disease.
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  You know, we are just there to fight and help treat diseases.
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  It's different for him. He's a surgeon, so obviously he
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  can make a huge difference to people.
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  But actually I feel very strongly as a patient, we should
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  be advocates for ourself. We should be working as hard as
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  possible to help our physicians. And the problem is, I think the
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  way the healthcare systems are set up, it's almost waiting for
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  the inevitable to be happening. And then it's like, oh, it's not
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  my fault now 'cause I've got diabetes or hypertension or
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  whatever. But we need to be thinking
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  really holistically and we need to be helping as physicians are
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  our patients to understand this. Because lifestyle to a lot of
• 12:44
  people seems really scary. But actually thinking about
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  inflammatory diets, thinking about inflammatory lifestyles,
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  there's quite a lot we can do to change our habits quite early
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  on, isn't it? Which makes a big difference
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  because if we can think about keeping well in our 20s and 30s,
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  it's a lot easier to have good habits then than waiting till
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  we're in our 50s and then suddenly realizing we have to
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  change what we eat or stop drinking or smoking or whatever.
• 13:14
  Yeah, totally. I mean, even though I'm a I'm a
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  doctor, one of the wake up calls I, I realized was that even
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  though I'm a doctor, I now realize that doctors really
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  don't make us healthy, right? It's, it's not a healthcare
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  system, it's a sick care system because for the most part,
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  doctors are too busy dealing with disease and illnesses.
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  You know, like your husband, the surgeon, he's busy operating on
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  things and, and, and taking care of diseases.
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  But if I want to be healthy, a doctor's not going to do it for
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  me. Doctors can't make me healthy.
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  Doctors just make me less sick. And if I want to be healthy me,
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  I as a patient, that's on me. And that's, that's no doctor
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  can, can do lifestyle for me. That's a choice, you know, I
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  make every day when I get up, when I eat, you know, when I'm
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  going to exercise, when I go to the gym, all those things.
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  And but it's really empowering for the patient too as well, I
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  think. Absolutely.
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  And I can see that with younger generations.
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  Actually, my oldest daughters are 22 and 21 and they go and
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  exercise far more than I did as a medical student.
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  They don't smoke. They one of them doesn't drink
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  at all. The other one doesn't drink that
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  much. And you know, they're constantly
• 14:27
  looking at things. But my oldest daughter has
• 14:29
  really bad chronic migraine, and she's been under so many
• 14:33
  different neurologists and we've seen so many different
• 14:35
  consultants. And she's a trombone player, so
• 14:38
  she was getting reflux as well. So she saw a gastroenterologist
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  who gave her medication. Her neurologist wanted to give
• 14:45
  us some medication with lots of side effects for her migraines.
• 14:49
  And then she saw a respiratory person who wanted to give her
• 14:52
  other medication for her lungs. And, you know, now she's not on
• 14:57
  any medication because she's changed a lot with her lifestyle
• 15:00
  and various other supplements and various other things that
• 15:04
  she does. But it would have been very easy
• 15:07
  for her, like you say, to be medicalized on a PPI, you know,
• 15:11
  proton pump inhibitor to stop reflux.
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  The gastroenterologist said when she was 20, that's fine.
• 15:16
  She can be on it for life. And I sat there like thinking,
• 15:20
  oh, my goodness, I wouldn't want really my children to be on
• 15:24
  something for life unless they really needed it.
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  Just felt like a bit of a crutch almost.
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  And, you know, looking at her gut microbiome, looking at, you
• 15:34
  know, what she eats all sorts of things, her posture, her
• 15:38
  exercise, her mental health, all of those things are so
• 15:41
  important. But it's a lot quicker, isn't
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  it? You can get through loads of
• 15:44
  patients if you're just giving them all medication.
• 15:47
  Yeah, I mean, and, and it's not all the fault of the system or,
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  you know, the fault of doctors. I mean, the system is built into
• 15:56
  doing it the way it is. But I think part of it is
• 16:00
  patients have some responsibility for it.
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  Because I know as a patient, you know, I'm basically lazy.
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  You know, I would much rather, if I, if I have a symptom, all
• 16:10
  things being equal, assuming that they're equal, I would much
• 16:13
  rather get a pill that I only have to take, you know, once a
• 16:16
  day or even a surgery that, you know, I take a week off from
• 16:19
  work and then I'm back to normal.
• 16:21
  I'd rather do that than get a lecture about how I have to
• 16:25
  change my lifestyle and actually change who I am at the root
• 16:29
  cause. And you know, no question,
• 16:31
  everyone would rather have the pill or the surgery.
• 16:34
  But the, the problem is, it's, it's a, it's a false
• 16:38
  equivalency. In other words, in most cases,
• 16:42
  the pills and surgery are not as good as the lifestyle changes.
• 16:45
  And you know, like with type 2 diabetes, you can, you could go
• 16:49
  on, you know, insulin and metformin and these things and
• 16:53
  you, you'll, you won't die of hyperglycemia, but your diabetes
• 16:57
  becomes a chronic progressive disease going on to, you know,
• 17:00
  amputation, blindness, renal failure.
• 17:03
  But when you when you reverse it with lifestyle it the disease
• 17:09
  stops essentially it goes into remission and it's no longer a
• 17:12
  chronic progressive disease. So it's not not really a fair
• 17:15
  equivalency and I don't think that's being presented to
• 17:17
  patients nearly enough. Starting in April this year, I'm
• 17:22
  going back on tour across the UK with a brand new show, Breaking
• 17:27
  the Cycle, The Power of Humans. I'll be visiting 45 venues and
• 17:33
  my aim is to challenge what we've been told about humans, to
• 17:37
  unpick the science that's often overlooked, and to explore why
• 17:41
  there's still so much confusion and misinformation, particularly
• 17:45
  around hormone health. Our hormones influence
• 17:49
  everything, our mood, our sleep, our metabolism and our future
• 17:53
  house. Every single cell in our bodies
• 17:56
  is impacted by hormones, yet so many people are still left
• 18:00
  without clear answers. So in this show, I'll be sharing
• 18:05
  research, some history, the real stories, and some very
• 18:09
  uncomfortable truths. There will be moments that
• 18:11
  surprise and maybe shock you, and plenty of opportunities to
• 18:15
  reflect and ask me questions. So if you want to learn, feel
• 18:19
  empowered, and be part of a movement that's changing how we
• 18:22
  think about hormones, I'd love to see you there.
• 18:25
  You can buy tickets through the link in the show notes.
• 18:31
  Every medication has side effect.
• 18:33
  It has a risk. And I didn't really think so
• 18:37
  much about those when I was younger.
• 18:39
  You know, I've prescribed a lot of antidepressants, for example,
• 18:43
  but we know they're associated with osteoporosis, increased
• 18:47
  incidence of dementia, you know, and side effects.
• 18:49
  People often have side effects with them.
• 18:51
  And I'm not saying they're wrong.
• 18:53
  For some people they are really important, but to be just handed
• 18:57
  them out as readily as possible and looking at some of the
• 19:02
  figures for the amount of medical or medical treatments
• 19:07
  that are prescribed for chronic diseases in your country.
• 19:09
  In the US but also in the UK, we're catching up.
• 19:12
  So by the time we're in our 60s and 70s, many people are on 6-7
• 19:17
  different medications and like you say, they'll be on them
• 19:20
  forever, won't they? Yeah, yeah, that's that's
• 19:23
  definitely the thing. I mean, the the numbers are just
• 19:26
  just staggering. I mean, in the United States
• 19:28
  most people are overweight or obese.
• 19:32
  Most people have hypertension or are being treated for
• 19:36
  hypertension. Most adults, when I say people,
• 19:38
  I mean adults. But children are affected too.
• 19:40
  1/3 of adolescents in our country now have diabetes or pre
• 19:44
  diabetes and you know, it goes on and on.
• 19:47
  These chronic diseases are affecting everyone up to where
• 19:51
  90% of adults in America have at least one set symptom of
• 19:55
  metabolic dysfunction. And as you say, you know, most
• 20:00
  people take many, many. Pills for many of these
• 20:04
  conditions. One of the things that I
• 20:06
  obviously spend a lot of my time thinking about is natural
• 20:08
  hormones. And you know, we know that
• 20:11
  estradiol, progesterone, testosterone for men and women
• 20:14
  work on the inflammatory cells. They help reduce inflammation,
• 20:19
  they help mitochondria to to work and function properly.
• 20:23
  They really important actually in improving metabolism.
• 20:27
  We know that people that have replacement hormones have a
• 20:30
  lower incidence of cardiovascular disease,
• 20:33
  diabetes, osteoporosis and dementia, depression, non
• 20:38
  alcoholic fatty liver disease, the list goes on and on.
• 20:42
  And it's you know, if it was a new drug that was a public
• 20:45
  health medicine that I had just said, look, Rob, I've got all,
• 20:49
  I've got this one treatment that we can give to people or three
• 20:53
  because there's three hormones. But even if you look at
• 20:56
  estradiol and then testosterone for men to make it even simpler,
• 21:01
  it has all these disease modifying effects, but most
• 21:06
  people can't access it because it's cheap, It's not pharma,
• 21:09
  it's not patented, you know. So there's a big resistance
• 21:13
  globally for people to have hormones back, although we've
• 21:17
  got good evidence how important they are to reduce instance of
• 21:20
  inflammatory disease. Yeah, that's such an important
• 21:23
  area. I couldn't agree with you more,
• 21:25
  Louise, on that. Yeah, absolutely.
• 21:30
  So, but I think this is where like my work, your work to
• 21:33
  educate people as in patients but also healthcare
• 21:37
  professionals is really important.
• 21:39
  And I think as a healthcare professional, you want to keep
• 21:42
  that professional curiosity. And somehow that seems to have
• 21:46
  gone in some people. I feel like often people are on
• 21:50
  a bit of a treadmill and they do something because they've always
• 21:52
  done it because they've been told that it's the right thing
• 21:55
  to do. And I I'm very challenging
• 21:58
  because I like to challenge myself.
• 22:00
  But I think it's a good thing to challenge guidelines, challenge
• 22:04
  scientific literature, challenge what others have done because
• 22:08
  we're learning and changing all the time.
• 22:10
  And I feel sad that some doctors, clinicians have sort of
• 22:15
  stuck in a rut. They don't want to be challenged
• 22:18
  or or think differently somehow. Yeah.
• 22:21
  And I and I, I, I would suggest those challenges are becoming
• 22:26
  even greater now, as we, you know, as we accelerate into the
• 22:31
  age of artificial intelligence, we're now having science being,
• 22:36
  being developed by artificial intelligence so that the pace of
• 22:40
  discovery is increasing. I, I'm certainly feeling it.
• 22:45
  And, you know, each week there's new information.
• 22:49
  And, you know, some, some optimists are even saying that,
• 22:53
  you know, we're accelerating so fast that within the next 10
• 22:57
  years, we'll have as many scientific discoveries in the
• 23:01
  next 10 years as in the last 100 years.
• 23:04
  And it's, it's really a, a unique time in human history
• 23:08
  where with artificial intelligence and quantum
• 23:10
  computing, we're, we're, we're approaching a singularity in
• 23:15
  many ways, as many authors talk about.
• 23:17
  It's interesting, isn't it? Because on one hand we're really
• 23:19
  advancing and it's wonderful. But the other hand, I look back
• 23:23
  to when I was growing up in the 1970s and people weren't
• 23:28
  overweight, people weren't obese, people were healthy.
• 23:31
  You know, they weren't all lit going to the gyms like people do
• 23:35
  now, but they were doing a lot more physical exercise just
• 23:37
  day-to-day with gardening and being outside and walking and,
• 23:42
  and whatever. And I look back and think, what
• 23:44
  a shame because they had, they got it right really.
• 23:47
  They didn't have these inflammatory diets, they didn't
• 23:50
  have all the drugs because they weren't all available then.
• 23:53
  So something has really changed over the last 30-40 years.
• 23:57
  So and they, it was quite a simplistic life, but.
• 24:00
  Yeah, yeah. And it's it's fascinating to
• 24:02
  speculate. I mean, nobody really knows the
• 24:04
  answer, but you can, as you say, you can, you can plot the graph
• 24:08
  of obesity. You can plot the graph of of
• 24:11
  diabetes and these other chronic diseases.
• 24:14
  And going back to the 80s and 90s, there's a hockey stick kind
• 24:18
  of, you know, sharp uptake in these diseases.
• 24:21
  Fatty liver disease, non alcoholic fatty liver disease
• 24:24
  didn't exist before the 1980s. Now in the United States, it's
• 24:28
  the number one cause of liver failure or liver trans.
• 24:30
  And you know, it has nothing to do with alcohol.
• 24:32
  It's fructose, you know, and but I but overall there, you know,
• 24:37
  there's so many, so many possibilities of what this this
• 24:41
  could be. You know, certainly the
• 24:43
  lifestyle factors that you and I talked about are, you know, what
• 24:47
  first and foremost there, but you know, many people are, you
• 24:51
  know, suggesting all kinds of different things.
• 24:54
  But, but hopefully, hopefully the challenge, you know, as we,
• 24:58
  as we get this unprecedented intellectual power with AI and
• 25:03
  other things, we'll begin to see these trends reverse.
• 25:06
  And it's really, it's remarkable.
• 25:07
  One of the trends has actually begun to reverse in the United
• 25:11
  States. The, the obesity trend that took
• 25:14
  off in the, you know, in the 80s and 90s going straight up
• 25:18
  essentially like that for the first time in 30 years is now
• 25:23
  showing evidence of levelling out.
• 25:25
  There's report in the Journal of America Medical Association and
• 25:29
  a couple other metrics that show at least in America, the number
• 25:35
  of people that are overweight and obese is, is beginning to
• 25:41
  actually not slow down, but actually decrease.
• 25:44
  And, you know, a lot of people are, are, are, are attributing
• 25:49
  that to the GLP one agonist, which is probably true, you
• 25:52
  know, but it's interesting to see these, you know, these
• 25:56
  effects, whatever they are, we're, we're at least beginning
• 26:00
  to see some change, which is wonderful.
• 26:01
  So there's a lot more we need to do.
• 26:04
  Before I end the podcast, I always ask for three take home
• 26:07
  tips. I want to ask you three things
• 26:10
  that you think will make the biggest difference to the future
• 26:13
  generation of doctors because as doctors we do have a
• 26:16
  responsibility for our patients, their families and and so forth.
• 26:21
  So what three things do you think of so important for the
• 26:24
  new generation of doctors to learn?
• 26:26
  First of all to. To embrace an understanding of
• 26:30
  metabolic health and these, you know, these root causes,
• 26:33
  mitochondrial health, you know, we're talking about doing
• 26:36
  mitochondrial transplants now, you know, who knew, you know,
• 26:39
  for longevity and stuff, bracing metabolic health and
• 26:42
  understanding that embracing lifestyle and you know what
• 26:48
  patients can do as far as prevention and, and really
• 26:53
  becoming aware of that and you know, and, and accepting that
• 26:57
  knowledge is changing rapidly. And whatever we know today,
• 27:00
  whatever we believe to be true today, you know, a large
• 27:04
  percentage of that is going to be proven wrong just because our
• 27:07
  models of, of the world are, are, are getting, you know, are
• 27:13
  continually improving. One last tip, not only for
• 27:16
  medical students and but for everybody, especially people as
• 27:21
  they get older and older, is to lift weights.
• 27:24
  It's something I never, I never even thought of.
• 27:27
  I never considered it wasn't a part of medical school unless
• 27:29
  you were an orthopedic surgeon. Nobody lifted weights.
• 27:32
  But I think now, you know, I everybody should do it.
• 27:35
  It's a, it's the the secret longevity trick.
• 27:39
  If our nursing homes had weight rooms, there'd be a lot fewer
• 27:42
  people in nursing homes, you know?
• 27:44
  Yeah, it's a. Great tip.
• 27:46
  I do a lot of yoga, but I have been starting to do weights as
• 27:49
  well just to join in. So it's so important.
• 27:52
  But thank you so much for sharing your knowledge and
• 27:55
  wisdom. It's been great.
• 27:56
  Thanks, Rob. Thanks so much, Elise.
• 27:58
  I. Appreciate it.
• 27:58
  It's been a wonderful conversation.