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today's guest is doctor poonam desai and we really broke down how south asian and middle eastern women our health concerns really differ from rest of the population what are we more susceptible to what are healthy habits that we need to start stacking earlier and we really dove into overall what women should be doing in their twenties thirties and forties optimize aging gracefully and healthy genetics kind of
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load the gun but lifestyle pulls the trigger i could tell that my brain function by evening was not what it was in the morning the minute they got an iron transfusion and they started you know replacing their iron they would come back almost unanimously and say holy
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so guys during the episode we talk about why it is hazardous for your health to actually set a traditional alarm on your phone so i want to hear from you guys how are you waking up is it naturally is it on an eight sleep through vibration is it your aa ring that's helping you wake up or are you just waking up because you've got enough sleep in so i want to hear from you guys in the comments about how you wake up in the morning and as always don't forget to like comment and subscribe we really appreciate the love and support from our community we do this for you guys i want to hear from you and i would really appreciate the support point what do you tell your friends who want to start the health and wellness journey and come from
- [01:19]
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more of the east okay great question first of all we have a lot of skinny fat okay and when we do get fat we tend to get a lot of visceral fat deposited around our bellies and and so number one it's important to acknowledge that okay so it's not because you're doing something wrong sometimes you can be but that's just the genetics we were given we're even more predisposed to cardiovascular disease to diabetes you know and i i see this all the time my husband is not south asian and i'm like god you can eat a cupcake and you'll be okay i eat a cupcake where's he from he's just white he has the
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good white jeans i know i was
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like oh you have great jeans but i like look at the cupcake and i feel like the weight's you know
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like shrinks up on you right you
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know those classic muffin top and the abdominal obesity we kind of just have it and so we kind of have to work with the genes we are given okay so i want to say people say life's genetics kind of load the gun but lifestyle pulls the trigger and we want to remember that so a few things that i tell my south asian friends is number one understand your genetics and then number two don't ignore it you really want to shift the conversation from being reactive waiting for things to happen and shift it to becoming proactive i want you to be the ceo of your own health right i want you to take charge of that so what does that mean so in your twenties you really want to start building reserve so in your twenties is not a time where you can be like oh this is going to be fine i can ignore and that's
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what most of us did in our twenties we didn't have all the information that we have available to us now
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so yeah and we were kind of told you're young everything's fine you have a great metabolism and most people in their twenties are just focused on weight right they're like i just want to be skinny and i want to fit into this clubbing outfit and that's it but we really got to change the narrative so if you're a twenty year old user you know listener what you want to focus on is building your reserve this is kind of your last chance to build bone density and what i mean by that is we peak our bone density our bone you know mass kind of peaks in your early twenties so start building your muscle reserve start building your bone density over here and this is where habits happen so this is a critical time for habits focus on your sleep focus on nutrition start building healthy habits and so that's why i tell my friends who are in their twenties and then in the thirties and forties is really a time to start thinking about where do you slow down stand healthwise get your labs done get your dexa scan if you can you know start i did mine yesterday body composition a lot of times you go to the doctor and they'll be like oh your bmi is fine bmi is not a great indicator of what's happening with your visceral fat two people could be the same bmi but one person has extra muscle and the other person has you know visceral fat so really start focusing on what the data says and really get your genetics tested if you could you know especially your snips is what we call them single nucleotide polymorphisms is how do you metabolize b twelve how do you metabolize caffeine how do you metabolize vitamin d get your iron tested because once you know your data then you can start doing something about it why are a
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lot of south asians and middle eastern people also very anemic you know again
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genetics genetics plays a huge role and sometimes diet you know there are a lot of south asians who tend to you know kind of not eat as much meat and so they're maybe not getting as much iron but genetics plays a huge huge role and i'm going to give you a personal story i actually got my ferritin tested and it was super low and so i went to go get iron infusions and after i got my iron infusions i was like oh my god is this how normal people feel because i had lived majority of my life up until you know late thirties early forties where around the daytime i was just tired i was like oh i'm just tired and i could tell that my brain function by evening was not what it was in the morning you know and i would need to take a nap i would just get tired and i kept saying what am i doing wrong what am i doing wrong like i was kind of blaming myself but in reality it was my iron and then when i started testing ferritin especially in my south asian population it was it was coming up routinely low in this and the minute they got an iron transfusion and they started you know replacing their iron they would come back almost unanimously and say holy shit right i feel like a new person and that's all that i needed to do right i
- [05:54]
A
also want to ask you about the iron conversation so when you go a little bit more towards some of the other functional medicine doctors are holistic especially with us south asians because we grew up going back home to india pakistan bangladesh whatever it is we have exposure to different sorts of parasites and you know food bugs and stuff that we catch now now if things live in our system longer those things i've heard can also feed into and destroy your iron storage your ferritin things like that so are you seeing that are you ever concerned with things like parasites in any of your patients are you not
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i could be concerned but majority of people who come to me we are just working on like the basic foundations right so while they may have gone to functional medicine doctor they may eventually go to functional medicine doctor and get into the nitty gritty details of that we're looking at people who have low iron and the first thing is okay yeah we can get to the root cause we should get to the root cause but let's just give you the iron back right now yeah sometimes it could be you know fibroids it could be like you know they have heavy menstruations it could be fibroids it could be you know there's just so much or they're just not consuming enough iron and then we go back and get to the root cause majority of people i've noticed fall into those like you know they're having heavy menstruations or during their menstruations it's dropping they're not getting enough in their diet it could be genetic related so we really do focus on the root cause but first with majority and i'd say ninety nine percent of people don't even know what is causing these symptoms right like they don't even have the data points to work
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with and a lot of i've also seen vitamin d is a big thing another thing our population we're dark skinned but we have so many issues absorbing and getting the daily dose required for
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vitamin d right i mean let's think about it we're supposed to be outside all day and the reality is we're not outside that often right a lot of us are working a lot of us are inside and instead of spending you know all day outside like we were meant to hundreds and hundreds of
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years ago we're also farmers and right from an agricultural background right we were
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supposed to be outside and getting our vitamin d from being outside now we're not so now that we're not outside as often as we used to be we should be supplementing vitamin d and so but for you to know how much you need to supplement you need to get your vitamin d measured right and i probably didn't even get my vitamin d measured till i was in my thirties and it was nine it was like shockingly low and that affects vitamin d it acts like a hormone it is yeah so it is affecting your immunity it is affecting your mood stress right it's affecting yeah your mood and your and and so many other things and your risk you know of getting chronic diseases maybe even your risk of cancer right so that's such an easy supplement to take vitamin d and then you want to make sure you're taking it incorrectly right because south asians are predisposed to cardiovascular disease so if you're not taking vitamin d with k then you may be depositing calcium in the wrong places like your arteries and we can't afford that as south asians because we already have i don't want to say tinier but our vessels are not as adaptive and thus we have an increased risk of cardiovascular disease another
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thing i noticed when i did my dna test and kind of got all this information back so whenever i used to go get iv's like everybody does the glutathione push i found out that i have like a lot of south asians actually have genetic snippets i shouldn't be doing that because it demineralizes me and it used to make me feel so sick every time i got that done and that's why i tell people get diagnostic testing get your actual genes tested because we are all built so differently and generally when i got that information back because the guy whose company was it was the dna company he was afghani and he said a lot of people from our part of the world cannot withhold like glutathione and therefore they have to do the precursor nac because it actually makes us feel worse and i would have never had that information had i not gotten myself tested
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right so i think the genetic testing is so important you know when i got my genetic testing done i was a slower caffeine i had a slower caffeine metabolism and here i am walking around with a venti starbucks you know and i was like oh my goodness like that what i thought was fueling me was actually hurting one of the most important aspects of our health which is sleep and i wasn't getting restful sleep because i'm walking around with a venti starbucks yeah and then so we
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talked about what people should do in their twenties so now what should they do in their thirties and the forties which is critical to their health so
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i think in your thirties you really number one start thinking about your fertility and i'm just going to come out and i'm just going to say it okay so if you want to have kids start thinking about it in your early thirties because we know by thirty two and your fertility starts to decline and then it rapidly declines by thirty seven so if that's something that's important to you now it does not have to be right it does not have to be but if having kids is important to you or you want to keep your options open this is the time to do something about it because i've seen so many people in their late thirties early forties they are emotionally stressed they are spending a lot of time and resources you know doing fertility treatments and had somebody and so many people come to me they're like why didn't somebody tell me in my early thirties to freeze my eggs somebody told me i would have done it or they poo poo it so i'm just going to come out here and say if that's important to you in your late twenties early thirties have that conversation with your physician should you be preserving eggs should you be freezing embryos is this something that's important to you because you don't want to be spending your late thirties early for you know stressing
- [11:27]
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about your fertility spring cleaning looks a little different in my house these days it's not just about organizing my closets it's about what i'm actually bringing into my space especially as someone who cares deeply about my metabolic health and lowering overall toxin burden load i've been using branch basics for almost five years and it's just one of those swaps that totally makes sense to me i used to have a whole cabinet of different cleaners all with ingredients i couldn't even pronounce and the more i learned about hormonal health and environmental toxins the more that started to bother me so i switched what i love is that everything is built around one powerful concentrate i dilute it to clean my kitchen bathrooms laundry floors even produce and makeup brushes it's plant based and mineral based fragrance free and maid safe certified which means it's screened against known and suspected harmful chemicals that we do not want in our homes or in our bodies it feels aligned with how i live i'm not extreme about everything but i am intentional and this is one of those small shifts that adds up day in and day out if you're doing a reset in your home i really encourage you to look at what's under your sink too branch basics is available at target dot com comma target in store amazon and of course branch basics dot com you can get twenty percent off at branchbasics dot com with code biohackit twenty which is b i o h e c k i t twenty after you purchase make sure you tell them you heard about them from our show because a clean home should actually feel clean also for your body i think this is a big conversation and i know a lot of the private equity backed fertility clinics which is like a dime a dozen they're on every street corner right now do not want to tell you but i think that these conversations need to be happening with educated obgyns with your general practitioner who tell you hey get ready for it now it's not something you come back for in like five ten years down if you have pcos if you have endometriosis that is a metabolic disorder it's going to affect your fertility because insulin resistance is going to affect the quality of your eggs and so they need to be educated but also with men i was talking to darshan yesterday and i think what annoys me so much is that we focus so much on women men are never going to have the twenty year old sperm back either or the thirty year old sperm so all this pressure gets dumped on the woman and why is nobody telling the guy hey buddy by the way you probably freeze your sperm as well and get clean because your sperm the older you get the dna gets fragmented risk of genetic diseases goes up and you're never going to have the same quality sperm
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ever again right no i think that conversation is true for both men and
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women thank you everything falls on us and i'm like but what about the
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other party in all of this that is one hundred percent true but with men yeah they can they could be freezing their sperm now they're probably not as concerned about doing so and the pressure does you know historically and socially fall on the woman and so i say you know what yeah the men should focus on their own thing but i'm going to talk to the woman like let's focus on us that's in your control like i don't know who you know a lot of times people in their twenties and thirties like i don't know who my husband's going to be you know right at least get
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yourself cleaned up but you just focus
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on yourself if this is important to you get your eggs frozen just know what your emh is know you know what your labs are what's happening with
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your cholesterol thyroid vitamin d thyroid is a big indicator as well for infertility which they don't test for yeah get
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your tsh dent are you making thyroid antibodies early on let's talk about your fasting insulin are you headed towards early metabolic yeah you know insufficiency are you headed towards metabolic dysregulation because those are things that you can control if you had the data in your twenties and thirties so while you may not want to run and go get your eggs frozen let's start looking at what is your fasting insulin because we can start working on your metabolic health your cardiovascular health you know and even your emotional health you know i think thirties is a time i mean it should be at any age we should be focusing on mental health but that's a time to establish care with maybe a therapist like start working on your emotional and mental health because stress has such an important impact on your overall health that if we ignore that which south asians and middle easterns do right it's kind of like taboo to go go and see a therapist nobody talks about it so many people are doing it possibly yeah but we don't know because nobody talks about it and that should be very open like who's your therapist let's you know how did your therapy session go and once you openly start talking about it you make it okay and you encourage your friends that yeah to go take care of their mental health
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i'm laughing because i just had an idea that came to like the picture popped up in my mind we come from really stoic backgrounds like south asians middle eastern people they're like you're not going to discuss your emotions you're very stoic the women keep everything together the center of the household they're meant to be like you have to be a mom you have to be educated you have to do this we have a lot of pressure that's put on us so even online when you see a lot of creators you know these people who are like crying online stuff like that you will never rarely see a south asian creator bawling and filming herself because her mother probably like you see this shoe when take off and i'm going to come beat you with my shoe how dare you post stuff like that because culturally we're told to just keep it all together and i think we carry stress in a way because society expects so much of we're drilled from a young age you have to show up in this way and there's no other room around it yes and
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just even that conversation is so important right like what were the expectations you had as a child emotionally and mentally and how is that showing up in your thirties and adulties and how is that showing up and how's that impacting your health right because we now know connection is so important for our health and longevity and if you can't openly talk about your emotions and your stress how connected how safe can you possibly
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feel and i feel like a lot of south asians when obviously we're not talking about relationships but generally we get into marriages and we get into situations everything is like a checkbox like okay does this person go to a good school what is their career what is this what is that we don't have sometimes are not taught because our mothers didn't mirror that to us that emotional capacity to really let down our walls be really vulnerable and connect so we're keeping everything so bottled up and that's why of women women generally are more susceptible to autoimmune disease but in our part of the world it's even more likely that they develop other things along
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the way right because they don't have an outlet right they're they're not openly talking about what is stressing them out not with their partners not with their kids not with their friends because it's
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like what will people think right what
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will people think and you know maybe i should not be sharing my emotional burden with other people i don't want to burden others with my emotional burden and because i'm supposed to show up strong all the time and even i struggle with that you know sometimes i'm like i don't think somebody actually knows how i feel because i wasn't conditioned at an early age to share my emotions it was kind of like this is what we're supposed to do let's put our feelings aside and keep doing it because as immigrants we were kind of just surviving and so now we have the opportunity where we can be thriving so let's focus on thriving which is really with the next generation your children opening up and having more of those conversations that it's okay to share your emotions it's okay to be vulnerable
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so going back to what we're doing in our thirties as women so the top if you're focusing on our fertility which is a great great great place to really be looking at things and i wish somebody's spoken to me about that what are the top three tips of things that they should be doing immediately so they'll get the diagnostic testing done and then what are the three things they should be doing if they want to prepare let's say improving their fertility or getting a round of egg
- [18:55]
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freezing done so like i said in your twenties you are a building reserve and in your thirties it's time to optimize right and really build those habits so i'd say get your labs done know where you stand so that's number one number two is start focusing on your diet and muscle strength right so really getting in the protein getting in the fiber start you know going to the gym regularly start building muscle and i think that's super important in your thirties because you're about to enter forties where your hormones are going to be all over the place here you probably have your hormones working with you in your forties they're going to start working working against you so i see thirties is a time to optimize you know and so go for that run start working out build up your capacity in your thirties because you have everything working towards you here right and here people are like i feel fine i feel great i can't even believe i'm thirty i feel like i'm in my twenties that's great but if you don't optimize when you get to your forties you're gonna be like okay i i don't
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feel good i fell off the bandwagon and so and what what do we advise women in their forties so in
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your forties you really want to make sure that you are here it's where you're thinking about your fifties and what i mean for in fifties fifties you're just trying to preserve right you're like i got to preserve my brain health i got to preserve my bone health that's what's going to happen in your fifties but in your forties you need to work towards that right you know so start looking at what's going to happen in fifties and really ask yourself how do i want to age and why i think that forties is an important time for that because that's a time where you want to decide whether you should be getting on you know bioidentical hormone replacement it's a time where people are wondering cardiovascularly right right so when your hormones start changing this is when people start seeing changes in their apolipoprotein b in your cholesterol so this is a time number one is to really start focusing on okay this is my diagnostics but i need to do something about it and that could be medication that could be you know getting that dexa scan definitely be getting your dexa scan in your forties i literally
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did mine yesterday and i was surprised because a guy looked at me and he's like well you're okay but for somebody you know essentially who's working out four or five days a week you're doing the hrt all this stuff thank god i built up the bone density but he's like if you were a different nationality you'd probably be so much higher right it's a lot more work
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for us and so you know having those conversations is is super important because it's going to drive what's going to happen in your fifty sixties and seventies and i ask people you know it's not about what you want to do right now i want you to tell me what you want your eighties to look like so you're forty tell me what you want to be doing when you're eighty years old okay if that's what you want to be doing we got to start working on these things like now right now in your forties you know and that is definitely considering what's happening with your hormones let's look at your risk for autoimmune you know because that's when it starts showing up and people completely miss it and what i mean by that is pay attention to your symptoms because you shouldn't be waiting till there's something broken to fix it right so that's when i say like if something feels off it likely is off and while you may be busy caring for your family going to work you know caring about the company that you're working for right you really got to start caring about yourself and prioritizing yourself if you want to age
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gracefully when you're so passionate about everything that you do what do you think motivates you the most to go you essentially went from being a trauma surgeon you know kind of being in the er to then moving into more of the functional alternative health sector what do you think drove that so i was
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an emergency medicine physician yes working in a level one trauma center in queens so you know like literally in the thick of it yeah and when i started working in the emergency room or i'm in the emergency department i was in my twenties and it freaking scared me because you're seeing the heart attacks the strokes the you know young people getting cancer and i'm just like oh my gosh this is really scary and how do we prevent from ending up here you know like what if we had done something differently twenty years ago why i loved what i do and did in the emergency department it was like instant gratification somebody's in pain you give pain medication somebody has appendicitis you diagnose they get treated you know they're getting a stroke you you know could immediately see the impact of treating a stroke but what i wanted to do is like okay no like there is so much more room for me to really understand how to prevent disease and i want to go back i want to study it and i want to help people not end up in the emergency department you know while sometimes you are obviously going to end up there but a lot of times people had no idea why they were having the heart attacks and the strokes are like could i have done something differently twenty years ago and yes right yes like while not everything's going to be preventable and i don't want people to live with anxiety and really to panic if we had the right tools and the right education i think there's so much
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that can be done in a really
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doing if you just had the knowledge you know and people come to me they're like i'm fairly healthy and by the time i break down their day and i was like oh my goodness like like let's change all these things to get you to a healthier place
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is there anything that shocked you about your own health that when you got you know because your doctor essentially got your own labs back or diagnostic testing
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you're like wait what okay so yes number one was my hemoglobin a one c so back then nobody was testing my fasting insulin fasting i went to the doctor in my twenties and i was like oh can you test my hemoglobin a one c and i made all my friends go so at that time i was like let's all go and we all got tested and we were like and we were south asian and they were like what is going on because we're you know we're traditionally if somebody looked at us we looked skinny we looked healthy we were going to the gym yeah but i was starting to see insulin you know resistance my hemoglobin a one c was not optimal then i looked at my cholesterol my cholesterol is elevated my cholesterol is low still elevated you know like when i went back and got tested and i was like okay i feel like i'm doing everything right my triglycerides are low i'm not really eating a lot of saturated fat i feel like i'm doing everything right but my genetics are not working with me and so i was so shocked especially when i was younger and i was like oh man like these are my genetics while there's so many amazing things about being south asian this is the one downside here and i just got to make sure that i'm taking care of my cholesterol and my you know my my fasting insulin and my glucose and really focusing on my cardiovascular and my metabolic health because let's not forget the number one killer in woman is heart disease and so i think paying attention to those markers and treating them as early as possible is important and what do you
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do in this stage of your if your life obviously you're traveling you're also super busy that helps you stay within those healthy ranges that you have tried and tested on yourself and is like it's working for me sleep okay sleep is and most of us are sleep
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deprived and most of us sleep deprived why because we have kids or we're focused on our careers or you know we prioritize all the other things and it's like oh i'll just go to bed two hours later it's fine like that's an easy place to take away from right you don't want to say no to your friends you don't want to say no to the hangout you don't want to not spend time with your kids you don't want to take away from that project at work because you know a lot of us are type a and we're driven and so we take away from sleep like oh that's fine i can totally survive on four hours of sleepy i pulled an all nighter and i used to take pride in pulling all nighters i'm like pulled an all nighter i'm going to do so well on that test no i'm not going to do well on the test had i just slept i probably would have done better on that
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test and had you known about creatine back in the day right twenty grams per day as rhonda patrick says so
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you know no matter what i'm doing i'm like okay i really got to focus on my sleep that's something that that is where the foundation is laid down like i could eat healthy the next day i can work out but none of that's going to be optimal if i didn't get the sleep the day before we know when we don't get enough sleep it's going to show up as me craving more sugar and highly processed foods the next day if i don't sleep well that night my workout that i did is not going to be optimal the next day because i didn't get that sleep you know my focus is not going to be there and so i think really focusing on sleep and i don't think enough people talk about that and take pride in that that should be like instead of saying wow i pulled an all nighter but like i consistently got seven
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eight hours of sleep yeah and is there a sleep hygiene routine that you have do you go to bed a certain time do you are you waking up a certain time any supplements that
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are working helping so these are two things that i really really think are so important going to bed around the same time i don't care what time ideally you want it to be before eleven pm or maybe even ten thirty pm but going to bed around the same time helps establish a healthy circadian rhythm now why is that important but our sardine rhythm is based on melatonin and cortisol right cortisol is your stress hormone and you want it to be optimal you don't want to be too low you don't want it to be too high but that starts with your circadian rhythm and establishing a healthy circadian rhythm so people get so caught up on sleeping seven to nine hours just recently somebody was like oh i go to bed at you know one am every day and and i get seven to eight hours of sleep and maybe it's working you know but the majority of we need a optimal bedtime and that's going to be before eleven pm at night and trying to go to bed around the same time because your body needs to know when it start needs to start working right because your hormones are reset at night your immunity is being regulated at night there's so much work that's happening it's actually one of the most active phases right of our day is our sleep so i say sleep and then number two which not a lot of people know is do not wake up with an alarm clock let's finish you gotta let your body finish that cycle right your sleep comes in cycles and if i just have an alarm clock and it just wakes me up then i didn't complete my sleep so you want to really try to naturally wake up so i stopped setting an alarm god i don't even remember when the last time i used an alarm was oh no i did i had to take an early flight which i was so upset about but i had to set an alarm
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i have to say i've had to set an alarm on this trip over here because i'm like god forbid i sleep through everything right like i'm so
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tired so i don't want to miss my flight so those days i do set an alarm but that's all also works for my kids you know i really try not to wake them up i'm like we got to go to bed at a proper time where you naturally wake up when i need you to wake up but going and waking up my child i i just don't think her day i'm starting her day off optimally what time do you naturally
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then wake up in the mornings i've
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had to set it so that to kind of match my kids circadian rhythm so i naturally wake up around seven
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am okay which is which is great that you're naturally getting your full sleep cycle and then you're just popping up
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yeah then i wake up and i feel so great i'm like okay i'm ready to rock my day and you know my husband wakes up before me and he sets alarm and i was like yo your alarm cannot be waking me up so he kind of like does this i know vibration thing on his side of the bed for his alarm amazing and i actually sleep through the whole thing i sleep through him showering sleep through him getting ready because
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like you already have these great white jeans like do not don't disrupt my sleep now dude exactly i was like
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you are blessed with jeans i'm not and you know we know that when you don't get enough sleep it increases your inflammation and we now know inflammation can drive cardiovascular disease and well it's
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a driver of so pretty much everything
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right starts with inflammation and i'm in my forties so i'm at an increased risk of autoimmune now if i'm more inflamed i'm going to be inflamed if i don't get enough sleep and i also am salvation so inflammation drives cardiovascular disease so i was like i need my sleep your genetics may get you through this but i i need my
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i need to do my thing you're also very big on like fiber first that's a big you know thing is it for you is fiber and protein equal or is fiber essentially more more important as a bucket than protein for for you when you look at women's
- [30:14]
B
health great question okay so i'm going to start by saying protein is important so i'm not taking away any kind of you know spotlight off protein protein is important but let's be real we are not a country that is protein deficient we are a country that is fiber deficient so let's just bring the stats into play the average woman should be getting about twenty five grams of fiber per day and the average man should be getting thirty eight grams of fiber per day now do you know how many people do not make that mark ninety five to ninety eight percent of people are not getting enough fiber throughout their day right and they're getting about ten to fifteen grams of fiber so then let's look at protein you need about the rda requirement is so that's like the minimal requirement is zero point eight grams of protein per kilogram of body weight how many people are getting that majority of people are getting that minimum requirement of protein but they're not getting their minimum requirement of fiber so that's why i say we are not a country that is protein deficient we do tend to talk a lot about protein but we are a country that is fiber deficient because i can walk into mcdonald's and get chicken nuggets i can walk into taco bell and get a bean burrito but i cannot walk into either of those places and be like hi can i get broccoli can i get you know can i get asparagus it's just not as readily available as is protein you'll see billboards which you know happy meals on there but you will not see a billboard with our friend broccoli right so i think we're just not talking about enough about fiber and let's not forget our children that same statistics holds for children ninety five percent at least ninety five percent of our children are not getting enough fiber what do you do for
- [31:57]
A
for your kids to get the right amount of fiber in are you doing it through things like basil seeds or chia seeds or flax seeds or how are you getting making sure they get the right supplementation i was actually talking
- [32:06]
B
to kayla and she's like a huge fan of basil seeds so she was telling me about this basil seed is
- [32:11]
A
it was she talking about zen basil yes yeah yes yeah the woman's yeah i take that as well so essentially what i do is when i wake up is because again i i'm so tired half the time i'm running two companies i'm exhausted i'm obviously in my forties and i'm like dude i just need to get my stuff and so i literally start my day with a massive smoothie getting in about forty grams of protein and my fiber intake and i drop in two scoops of the zen basil seeds and that gets me my fiber up to where i need it to be because honestly it's about it's about convenience right i don't need to be sitting there with a measuring spoon i'm not a chef and going to measure out every single gram so i'm like what do i do that's easy that's convenient that just gets the
- [32:47]
B
job done i i like that so that's great and that works for us kind of works for us in our forties right so you want to make sure you're getting enough fiber but there's a whole nother part of fiber that's important fiber fuels our gut microbiome and we now know our gut is our second brain right right so yes you want to get the fiber but our gut microbiome also needs diversity and they needs plant diversity and people forget herbs are important for diversity you know spices are important for diversity so yes while i'm a huge fan of you know i put chia seeds in my water almost daily and i take that because i i also need i'm you know we're all working we need what's convenient with my children i'm a little different i really focus on their gut microbiome and their diversity and you know and maybe many of your listeners may be moms they want to be moms and i think think that is so important first of all it's a habit right when you expose them to different types of vegetables plants food spices you are setting them up for lifelong yeah longevity so we really diversify like we you know in the morning when i'm let's just say we're making eggs we put garlic onions rosemary bell pepper their eggs
- [33:53]
A
that sounds delicious you know because i love garlic and onions yeah so i
- [33:56]
B
put it you know and they're fry
- [33:58]
A
and you fry eggs and you put
- [33:59]
B
it in yeah like we like you know scramble eggs and we put that in there and now like you know know people are gonna be like well my kids are not gonna eat that but i started early like my one year old you have to train them
- [34:07]
A
from day one my one year old
- [34:09]
B
is just gonna eat what's what's putting him yeah front of him you know so i kind of did it with my daughter and i'm doing that with my son so we really talk about the importance of color in our in our place that was the theme for
- [34:19]
A
our dinner right was eat the rainbows
- [34:20]
B
right right and so you really want to make sure that you start very very early on so our fiber during my day you know when i'm home with my kids it comes from a variety of foods like asparagus artichokes radishes bell pepper i mean these are things that my kids are eating throughout the day and we say that's a snack you know you're hungry yeah grab some snap peas if you're hungry grab a radish if you're hungry grab a cucumber yeah an apple or you know melon like there is so much amazing food and then they develop taste buds for that whereas if i you know was putting in pretzels and chips and you know even though they could be healthy like crackers they're developing a taste for ultra processed foods but they could be filling their bellies with things that are
- [35:01]
A
going to fuel them yeah and actually sustain their energy levels as well so
- [35:04]
B
they don't crash right right and now we know a lot of you know things like adhd can be limited i don't want to say that it can be cured but you can potentially reverse it symptoms by giving a whole food diet and so you know my kids are in school we all want our kids to do well in school and so i need to fuel her appropriately so that i'm setting her up for the best outcomes no matter what she
- [35:27]
A
does i had a really incredible md on my show it was like last year sometime and she treats a lot she's a family practitioner and treats a lot of young kids and she was as controversial enough to say that autism and adhd is a lazy diagnosis and actually can be reversed in children and people got so mad at her on the podcast but she's like i've done it with the right minerals removing toxins putting in the right diet a lot of these kids are hyper stimulated being around the right lighting actually soothes a lot of kids so you don't need to be giving the medication there is ways around it but traditional medicine doesn't set you up for success so in her practice she is working with kids as young as like one years old and she's seen it it's tried and
- [36:08]
B
tested and you know i totally get parents are just overwhelmed right they're going to the doctors they're like this is adhd this is diagnosis here it's such
- [36:15]
A
a big spectrum as well right and
- [36:17]
B
you know you're if you're at home with somebody you know with a kid who has adhd was autumn it's difficult listen being a parent and is so hard and you get so much conflicting information and it can be overwhelming so i just say start simple just you know start taking out those processed foods and start adding in whole foods and the earlier start the easier it's going to be because if you try at sixteen they're going to like yeah okay no thank you drill those habits in drill the habits in even start in pregnancy you know what you are eating the baby is going to you know establish a taste for that so start as early and and you're an example if i'm sitting here munching on chips my kid's going to be like i have that you know baby see baby do right right one hundred percent so you have to start want that change you have to eat healthier to want
- [37:01]
A
your kids to do the same so just before we sat down and started recording for the show on this topic of like how women are have to get their bodies prepared and actually everything that happens to your health actually starts before you're even born so can we dive a little bit into that about what that even means to people listening
- [37:20]
B
you know so a lot of people ask me like when should we start our health journey what what when should we start thinking about longevity and i say mom you know parents can start thinking about their children's longevity even before they give birth your first home is your mom's uterus right that's your first home so you really want to set up that home appropriately that's also the first food like that's where your first meals are coming through right so you really want to set it up optimally so you know this can't be done like number one i don't want people to panic and if you didn't do this it's honestly it's not to say that their health is doomed but if you had the right information and if you're considering getting pregnant if you want to know a few things that you can do then this is for you you know so i never want somebody to think they did something wrong or this is for panic it's really not but what i did and what i like to think of it as is that i want to set up a really good home for my future baby so you know six months before you know anytime in your health it could start as you know like i said at birth you really want to set up your gut microbiome so again making sure you're eating the right foods because we have some data to show that the mom's gut microbiome affects the baby's gut microbiome we all now know that our gut microbiome is super important to our health from immunity to your metabolic health to even your emotional health you know your mental health all starts in the gut so you want to start working on your gut microbiome and a few things that you can do you want to avoid unnecessary antibiotics antibiotics are amazing but only when used appropriately you don't want to just take antibiotics to take them there needs to be a
- [38:54]
A
purpose when it comes to south asians we were bombarded with antibiotics because literally they gave it out to my mother was like it was like a dispensary oh here's some flagyl here's some suproxen i'm like what i used to take it almost every single week or other week and then i'm like why do i have certain health issues that have come up for me but my mom literally used it as a dispensary right
- [39:11]
B
and i mean even when i worked in emergency medicine a lot of people like i just i just need an antibiotic like my kid is has x y and z can you just give me an antibiotic and you're like no sometimes i'm like i i don't think they need it i think this is viral antibiotics are for bacterial infections i don't think your kid needs it but we were kind of and it's not the parents fault we were kind of trained to think sick give an antibiotic and we really need to move away from that so you know again avoid unnecessary antibiotics set up your gut microbiome have probiotic prebiotic foods diverse foods really feed your gut microbiome and then you know obviously if you can have a vaginal delivery because we now know exposure to vaginal microbiome is important not to say that there isn't a place for c sections you know there is place for c sections but i know people who are like i just want i just want to get the baby yeah and yeah you know and and and they think that there's no any there's no consequence there's no health consequences but now we see some studies show that maybe better to do vaginal but if it's possible again again for some people it's not and it's totally fine that is not it's not a be all but if you can you know you want to try to have a vaginal birth again avoid the antibiotics and then breastfeeding so that you know we have such strong data to show the importance of breastfeeding when it comes to the baby's gut microbiome it really helps establish a healthy gut microbiome it's a great immune modulator for the kids so those are a few things that you can start doing and then really optimizing your nutrition folate omega three s vitamin d you want to make sure all of this is optimized during pregnancy before pregnancy so that you can really again deliver the an appropriate amount of nutrients to the baby who needs these nutrients to
- [40:55]
A
develop is there any research to show that people can have if they do certain things they can breastfeed for longer they'll give them a better milk supply or whatever it may be because sometimes that's also comes down to genetics or what the mom is able to to
- [41:07]
B
produce or not produce number one it comes down to information and knowledge like first of all nobody talks about breastfeeding it's not something i even learned i didn't even learn that at all in medical school like i don't even think i learned much about breastfeeding in medical school so here i go thinking i'm like the smart doctor how hard can breastfeeding be right and i have a baby and i'm like what the you know what is this i had no idea what i was doing nobody told me how many times i should be putting the baby to the breast how to do it it was a complete like shit show yeah and i was totally taken back and i think that's important to note it is hard you nobody tells you what to do you may have some instructions from a lactation consultant right when you give birth listen after i give birth i'm not paying attention to anything i'm just in like recovery i'm like oh my god yeah i'm just like oh my god my body just went through this intense trauma yeah and here comes the lactation consultant maybe for five minutes ten minutes tells me what to do and i'm like i think i got it i think i did it but how hard could it be you know and then there's no support after i leave the hospital like who am i supposed to call like i have no idea what i'm doing and i think that's important so number one learn be educated there are support groups there's lactation consultants that you can call once you leave the hospital you can go to the pediatrician and talk about it and it's hard you have to keep putting the baby to the breast and you have to keep trying and then frequency nobody told me that you have to keep breastfeeding every two hours to maintain supply you know there's so much nitty gritty details that goes into breastfeeding hydration is important making sure you're drinking enough water making sure you're consuming enough carbs to make the milk supply i mean there was so much that went into it that nobody ever told me and i would have done all my research when i was pregnant but i didn't know how hard it was going to be you know so really even while you're pregnant just start reading about it start understanding what you have to do you know and support like there was no way i could have maintained breastfeeding if i didn't
- [42:55]
A
have a support did you end up breastfeeding baby one versus baby two longer
- [43:00]
B
or less or i'm still breastfeeding okay yeah so i'm breastfeeding right now yeah
- [43:04]
A
because how old is your son now
- [43:05]
B
my son is now twenty months a little over twenty months so i'm still breastfeeding amazing i think i just had it that i was gonna go as long as i could right so with my daughter i went until i think she was twenty months nineteen to twenty months and with my son i'm still going so ideally i want to go to at least he's two years old if possible like no pressure if it's possible that's great if it's not affecting my mental health if it's not affecting my physical health i felt like i that's that i want to give him for his longevity but yeah you know
- [43:35]
A
the other thing i was reading this book that babies first foods are also so important so a lot of times when kids are starting to move over to solids the first thing they want to give them is a mashed potato or a banana when instead they're like if you give them things like organs or or protein first that's actually better for building their baseline health you know
- [43:53]
B
i think we need a lot more data and when it came to you know my two kids and it was their first meal i was just focused on okay i want to make sure they don't choke like that was like a huge concern of mine especially as an er doctor and i just wanted to make sure that it wasn't processed like i tried to cook it at home actually the first food i gave both my children was something called kitcheri
- [44:14]
A
yeah of course i love kitchen and
- [44:15]
B
i had lentils i had a little rice and so it wasn't like the traditional give one food at a time i put a you know diverse yeah a bunch of foods in one meal and gave it to both of them as their first meal but it doesn't have to be that you know you're right it could be a protein it could be a brock a smashed steamed broccoli you know but that's a conversation with your pediatrician but i think giving whole foods exposing them to a diversity is so important at a young age
- [44:41]
A
it also helps develop their taste buds and tolerance for different things because if they just eat the same thing all the time then they become really fussy eaters and then they grow up and they become these young adults who are just not willing to try stuff which makes sense them really nutrient deficient later
- [44:54]
B
and again it's exposure and you know one important thing that i do with my children is sit with them when they're eating dinner and i'm eating whatever they're eating so again that's important they see me eating it they're eating it whereas if i just put them on the table i'm like eat and just sat there they're gonna be like you know they really need to see you do it and anybody who has kids toddlers they they copy everything you do correct so even you know i walk i work out in front of them actually and i want my daughter to see that you know working out is important taking care of your body my son you know he can't talk but if i say can you do a push up he can get up and try to do a push up because again that's important they need to see you taking care of your body so they understand the importance of them taking care of their body what do you
- [45:33]
A
think you love most about your career
- [45:37]
B
oh wow you know i think the most important thing and i was actually just telling my friend yesterday is that i can make a difference i can help somebody and i'm making a difference and that that feeling i think really shapes my own health and longevity waking up and knowing that i'm doing something powerful something impactful that can change the trajectory of somebody's life right you know your health is really your greatest wealth and so to know that i am managing somebody's greatest assets and wealth health is is a feeling that i think helps my own emotional and mental health
- [46:14]
A
and when you're seeing patients and they essentially come in and if you get a patient who's like hey doctor poonam this is what i want to be doing and you sit down and you have the diagnostic with them you're like this is what your blood workers markers are and stuff and if they're just constantly pushing back how do you deal with that because a lot of people do not want to hear what's wrong with them they don't have the discipline to be like now i'm going to go change it up they just just unless they're at like that like at the end of like having heard everything
- [46:40]
B
and they're really frustrated great question first of all somebody's coming to see me i think they've made a decision to focus on their health so coming to see me in terms of longevity medicine if they're coming to see me in the er no no you know but i think a great example of this is actually my husband you know so i do all these things and he's kind of like i am happy just where i am and if i think about any of this for many people it can be anxiety ridden right it could drive their anxiety and so i really try to meet the person where they're at like okay you don't want to do these things so what what will feel comfortable to you what is going to produce the least amount of anxiety so that we can be starting to move a certain direction you know in a direction that's leading to health but i really try to meet my patients where they're at i have people who are just like i've done all of this now let's talk about a peptide you know and let's talk about a supplement which i think is at the end of the conversation and that patients who i'm just like okay let's talk about managing the high blood pressure let's talk about removing ultra processed foods from the diet so you know really meeting the person where they're at is so important when you're practicing medicine are
- [47:47]
A
you what are some of the things that most commonly people walk in to your office with that are things that you're able to help them reverse like the three top things okay so the
- [47:55]
B
number one and people are always shocked when i say this and i start with what kind of coffee are you drinking in the morning this every single day and that's why some of you whatever you're doing every single day let's focus on that because that is something that if you make better or eliminate can make a huge impact in your health if you're going to mcdonald's once every month i don't care go doesn't doesn't change the needle that much but if you're drinking this thing every single day and your coffee could be a powerful tool in your longevity it could be a powerful antioxidant or it could be a toxin right and so that's where i start with like let's talk about what you're drinking in the morning where does your coffee come from is it full of pesticides and toxins what are you putting in your coffee right yeah if sure you have great beans you have great coffee but then we're adding this unhealthy creamer we're adding tons of sugar maybe you're getting an espresso which is just a cup of microplastic
- [48:54]
A
are you going to starbucks and picking up are you and you're loading yourself
- [48:57]
B
getting a frappuccino you know are you getting the matcha latte from starbucks starbucks which is pumped with syrup you know it's in a to go cup that's lined with microplastics so really just understanding that one thing that you're doing every single day and how do we make it better and so i start with their morning cup of joe and people are just shocked and they're just like oh my goodness okay that's that's what i have to change like i thought you were going to tell me all these other things i'm like no let's focus on this coffee right now because that's how you start your day you are setting yourself up metabolically for the entire day with that first thing you start with and for majority of us it's a coffee right right so are you starting with a sugar high a glucose surge you know as adults a lot of us become lactose intolerant are you putting milk in there and you know really disturbing your gut health so a lot of that goes into that conversation and what are some of the
- [49:42]
A
things that you've been able to reverse successfully that you're like you know what going this functional route establishing the right lifestyle practices really was able to reverse certain markers or chronic diseases or or metabolic issues that were coming up in
- [49:55]
B
somebody body there's one thing like i think almost every single person walks away with whether you're talking to me at a dinner table about health or whether you're my patient i think one thing they walk away is just to be mindful about what you put into your body right your body is a temple and just like your car which has a tank you're not going to put skittles in there because your car's not going to go anywhere right think of your body and they take care of it as you would take care of your car you know everything that you you're putting in could either hurt like if i put skittles or if i put potato chips in the car in the tank it's going to hurt my car it's going to damage my car in the same way ask yourself everything that you're putting on or in is this helping me is it harming me and it could totally like in there are times where i just love cookies i'm gonna put it i'm like okay i had a cookie but i thought about it right and i'm like okay i'm gonna have some broccoli before i have it and then i'm gonna make a better decision later on you know but mindfulness i think is one of the most important things for health and longevity that's a really good one for
- [50:55]
A
people to walk away with it's one is like you said what are you doing to start your morning routine like really focus on that and that can really impact the rest of your day or correlate to your health and then the little habits that add up and if you are going to binge on something how are you offsetting that right
- [51:10]
B
like and it's totally okay i don't want people to think they can never have a cupcake they can have a cookie listen i eat my cupcake and i eat my cookie but i am super mindful about everything that i drowned it and i don't want my my children to feel deprived right they have the cookies they have the cupcakes but they know like on our way to the ice cream store and actually you know had i want to say almost a viral reel where we were going to the ice cream store and we're eating broccoli cuz i was going to have ice cream she's going to have ice cream so to have been like let's have some fiber to decrease that glucose surge let's eat something healthy you know let's have a healthy fat protein or fiber before we give ourselves ice
- [51:41]
A
cream the ice cream that they're going to want to have anyways right okay i'm going to do do a quick rapid fire round with you you work twenty four hour ships sorry you work twenty four hour shifts in the er when you are forced to have a bad night of sleep what is your fifteen minute emergency reset to protect your mitochondria from the oxidative stress of a
- [52:00]
B
night shift so i think when i was working in the er sometimes they're twelve to twenty you know sometimes they were all nighters as a resident but i don't think i was thinking about my mitochondrial health so that's that's number one majority of people who are doing these chef work i don't think the average person is thinking about the mitochondrial health but if you are a shift worker or if you are somebody who has done a twenty four hour shift or has stayed up for whatever extended periods of time what is something you can do number one is you want to make sure that you are eating in the right place so i usually try to eat based on my circadian rhythm not what i'm doing throughout those twenty four hours so if i'm supposed to be sleeping at night and i'm up doing a shift i'm not going to be eating during that period or it's not eating aggressively so really try to eat according to the time you're going to go to bed some other things that you can do is number one focus on your mental health as you stay awake longer you are not going to be making great decisions right so you need to have a routine before you go into that like okay i'm going into twelve hour shift or twenty four hour shift it's gonna be crazy here are the things i'm going to eat now because if i'm left to make a decision at game time then i'd be like give me the potato chips bring them over because i am hungry and i'm not thinking and i can't think clearly you know right and so i think having a plan before you go into it is so important map out your meals and then a lot of us rely on caffeine right we were like the celsius and the red bulls and all these crazy things they can really really damage our health so if you need to stay awake make sure that you've properly slept you know the night before the night before or whatever leading up to the shift and then have caffeine away from when you're supposed to go to bed like if i'm getting off my shift at eight o' clock in the morning i'm supposed to be in bed by nine o' clock i am not going to be having a caffeine at six am right so really just making you're drinking that caffeine make sure that it's coffee organic it's not a celsius not a red bull but you're drinking it at the right time so that you can set yourself up to recover and then there are those like little details right you can have creatine that can help you with jet lag or can help you with those nights that you need to stay up you want to make sure you're optimizing your vitamin d your nutrition so all those things i think go into it number one tip
- [54:04]
A
tried and tested that people listening to this show can go to improve their mitochondrial health health every single not because they're in an extreme condition like you were twenty four hour shift but something that works to improve your mitochondrial health
- [54:16]
B
i'm going to say this again i i think sleep okay i think we are not focusing enough on sleep so really sleep and one thing people don't realize if you are routinely snoring you're not getting proper sleep so if your partner's snoring you're snoring your kids are snoring do something about it and i think a great thing is my friend and i actually went to go sleep together sleep together we were we were actually in a room together we were traveling together and she's sleeping in the same room as me and i woke up in the morning i was like i have something to tell you like i think you're not getting proper like sleep i heard you snore like three days in a row now and i was like let's get that checked out so just having that conversation with your partner or whoever your kids that sleep is the most important thing you're a
- [54:52]
A
busy mom what is the one biohack you've had to let go of because it wasn't a practice it wasn't practical for a parent and what did you
- [54:59]
B
replace it with oh my god i think we should talk about all the things i've had to let go of listen i love red light masks i love red light hats that is one thing that i'm not gonna be able to get to all the time you know so what do i do instead like those things like the vibrator plate and the you know and and all these things that i'm like i don't have time to do everything so focus on nutrition okay that is going to get moved the needle so much further so you know get whole foods fiber protein fibers like just focus on the nutrition you may not get that you know skin peptide or that red light hat or the red light mask or the vibration plate or just try to
- [55:35]
A
do just nutrition whole food as a menopause certified expert what is the biggest mistake you see women in their thirties making that sets them up for hormonal crash in their forties
- [55:48]
B
i think not thinking about their metabolic health you know do you have extra vistal fat what is your fasting insulin where are you going metabolically because your metabolic health is so closely linked to your hormone health you can set yourself up up to be metabolically stable and optimal then when you get to your hormone health you're just having to work on the hormone health whereas by the time people come to me in their forties i'm like whoa whoa whoa let's look at your cardiovascular health your metabolic your hormone health where there are people who come to me who've worked on all of that in their thirties and then i'm like okay here is a little bit of bioidentical hormone replacement and here are a few other adjustments we need to make right but we're not starting from you
- [56:22]
A
know step baseline that we had is there any researchers studies i wonder just just curious from my own perspective on hrt done in specific dosages or a certain way in south asian and middle eastern populations that have better outcomes than dosing us like the average white person
- [56:37]
B
i think first of all dosing is very very specific to the patient's history it's very very personalized but i do think we need more research on it you know there is some research some to show that south asian women do go through menopause a little earlier than the average woman but i think we need so as it is we don't have enough data and then right when you think about salvation women i think the data is even less right i
- [56:59]
A
wonder if there will ever be a focus group that focuses on you know a certain part of the world dosing them differently on hormones and seeing what the outcomes may be for all the genetic preconditions of their disposition right no
- [57:10]
B
i i can't wait put in where can people find you you can find me on social media doctor punambasai sepstack doctor poonambasai yeah thank you so much
- [57:19]
A
for taking out time in austin and coming on the show i really wanted to sit down with you and i'm glad i was able to so thank you for fitting this in and guys i hope you enjoyed the episode