How to transform your health in midlife | Rich Roll and Prof. Tim Spector

Summary

Podcast Summary: ZOE Science & Nutrition Episode: How to Transform Your Health in Midlife | Rich Roll and Prof. Tim Spector
Release Date: February 13, 2025
Host: Jonathan Wolf
Guests: Rich Roll, Prof. Tim Spector

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1. Introduction

Jonathan Wolf welcomes listeners to the "ZOE Science & Nutrition" podcast, highlighting the transformative journeys of guest Rich Roll and renowned microbiome researcher Prof. Tim Spector. The episode focuses on how midlife serves as a pivotal period for significant health transformations, particularly through dietary changes and enhancing gut health.

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2. Guest Backgrounds

• Rich Roll: Once an overweight individual on the verge of a heart attack, Rich transformed his life through a plant-based diet, becoming one of Men's Fitness magazine's 25 fittest men. He is an ultra-endurance athlete, best-selling author, and health podcast host.

• Prof. Tim Spector: A pioneer in gut microbiome research, Tim is among the world's top 100 most cited scientists. He serves as a professor of epidemiology and is the scientific co-founder at ZOE.

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3. Rapid Fire Q&A

[03:24] Rich Roll: "Is 40 too late to transform your health?"
Prof. Tim Spector: "No."

[03:35] Rich Roll: "At almost 60 years old, are you healthier than you were in your 30s?"
Prof. Tim Spector: "Absolutely, yes."

[03:41] Jonathan Wolf: "Is midlife too late to transform your gut microbiome?"
Prof. Tim Spector: "No."

[03:47] Jonathan Wolf: "Can the food you eat increase your rate of aging?"
Prof. Tim Spector: "Yes."

[03:53] Rich Roll: "What's the biggest misconception when it comes to changing your health during midlife?"
Prof. Tim Spector: "Rome wasn't built in a day. It doesn't happen overnight. It's about making small incremental changes and building upon them."

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4. Rich Roll's Health Transformation

Rich shares his personal journey from battling addiction and maintaining a poor diet to adopting a plant-based lifestyle. Around his 40th birthday, a health scare prompted Rich to reevaluate his habits. He recalls:

"An incident walking up the staircase where I had to take a break halfway up... everything kind of snapped into focus." [05:27]

Rich experimented with various diets, eventually committing to a fully plant-based regimen. This shift not only improved his physical health but also reignited his passion for athletics.

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5. The Microbiome and Health

Prof. Tim Spector delves into the significance of the gut microbiome—a community of trillions of microorganisms in our intestines—and its profound impact on overall health.

"They're like chemical factories... key to our healthy maintenance of normal functions." [25:07]

He explains how a balanced microbiome interacts with the immune and nervous systems, influencing everything from inflammation to aging. Maintaining a diverse and healthy microbiome can potentially slow age-related decline and enhance longevity.

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6. Diet and Mental Health

Tim emphasizes the rapid mental and physical benefits of transitioning to a plant-based diet:

"Within seven to 10 days I did feel this resurgence, the spike in my energy levels." [13:33]

Rich adds that improved diet led to better sleep, reduced stress, and enhanced cognitive function, creating a positive feedback loop that supported further lifestyle changes.

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7. Sustainable Lifestyle Changes

Both guests discuss the importance of making incremental, sustainable changes rather than adopting drastic, short-term diets. Tim relates his dietary transformation to his recovery from addiction, highlighting the power of small, consistent actions:

"Just try to do the best that you can, in the circumstances in which you find yourself... take it one day at a time." [18:05]

Rich echoes this sentiment, advocating for gradual habit formation to ensure long-term success.

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8. Exercise and the Microbiome

The conversation shifts to the role of exercise in gut health. While diet has a clear, significant impact on the microbiome, the effects of exercise are less conclusive.

"Exercise has some benefits to the gut microbiome, but if they are there, they're proportionally much less than diet." [44:06]

However, both agree that exercise offers substantial mental health benefits, enhancing mood and reinforcing healthy habits.

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9. Motivation and Habit Formation

Tim introduces a transformative approach to motivation:

"Mood follows action... the mood that is the motivation is a product of taking the action." [48:10]

He advises focusing on small, manageable actions to build positive habits, reducing the reliance on willpower. Rich adds that finding enjoyable activities, especially in exercise, can foster consistency and joy in the transformation process.

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10. Actionable Tips

For Dietary Changes:

• Start Small: Replace one unhealthy item at a time, such as eliminating fermented dairy products.
• Increase Variety: Incorporate a wide range of plant-based foods to enhance microbiome diversity.
• Add Fermented Foods: Introduce foods like kimchi and sauerkraut to boost beneficial microbes.

  "Fermented food would be the obvious one for me." [54:03]

For Exercise:

• Choose Enjoyable Activities: Engage in movements you love to ensure sustainability.
• Incorporate Social Elements: Exercise with others to build accountability and community.
• Set Reasonable Goals: Avoid overhauling your routine overnight; integrate exercise gradually.

For Habit Formation:

• Focus on Daily Actions: Prioritize what you can do today rather than planning for an indefinite future.
• Build Incrementally: Accumulate small successes to create lasting change.
• Embrace Flexibility: Allow room for adjustments and avoid perfectionism.

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11. Conclusion

The episode underscores that it's never too late to transform one’s health, emphasizing the critical role of the gut microbiome and sustainable lifestyle changes. By adopting a plant-based diet, engaging in regular exercise, and fostering positive habits, individuals can significantly enhance their physical and mental well-being, regardless of age.

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Notable Quotes with Timestamps

• Prof. Tim Spector:
  "Rome wasn't built in a day. It doesn't happen overnight. It's about making small incremental changes and building upon them." [03:56]

• Rich Roll:
  "I've become convinced that we're all kind of tiptoeing above these reservoirs of potential that we don't give ourselves credit for having." [38:13]

• Prof. Tim Spector:
  "Fermented food would be the obvious one for me... kimchi, sauerkrauts, these are amazing sources of microbes." [54:03]

• Prof. Tim Spector:
  "Mood follows action... behavior, first thoughts, feelings and emotions follow." [48:10]

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Final Thoughts

This episode serves as an inspiring testament to the power of informed dietary choices and their profound effects on overall health, particularly during midlife. Rich Roll's personal transformation, combined with Prof. Tim Spector's scientific insights, offers listeners both motivation and practical strategies to embark on their own health journeys.

Transcript

[Jonathan Wolf]

Welcome to Zoe Science and Nutrition where world leading scientists explain how their research can improve your health. Rich Rolle is one of the 25 fittest men in the world according to Men's Fitness magazine. But on the eve of his 40th birthday, he was an overweight junk food addict on the brink of a heart attack. But Rich made a radical decision to transform his life. He he turned the tide. In an age where many fear it's too late. New research shows that midlife is the crucial moment to transform your health. A lot of things change around this age and one such change happens in the community of organisms in your gut known as the microbiome. With the right intervention, your microbiome can slow age related decline. You can transform your gut into a pharmacy that prescribes you the medicine that you need to age well. Today's guest, Rich Roll is proof that you can transform your health even slightly later in life. He fuels his ultra marathon fitness by eating only plants. Through his number one best selling memoir and his health podcast, Rich inspires millions. Rich is joined today by Professor Tim Spector, who's a pioneer in the new field of gut microbiome research. Tim is one of the world's top 100 most cited scientists, a professor of epidemiology and my scientific co founder. @ Zoe. You'll finish today's episode with the tools you need to transform your health, no matter your age. And if transforming your health is something you're interested in, and I'm guessing it.

[Rich Roll]

Is, as you're listening to this podcast.

[Jonathan Wolf]

Do check out Zoe's personalised nutrition program. Because committing to a change is easier when the change feels exciting. And what's more exciting than eating more of the foods you love? The Zoe app gives you a list of hundreds of delicious foods that are proven healthy to your unique biology. We take your unique Zoe test results, we combine them with our science to recommend the healthiest foods for you. Here at Zoe, we study the world's largest gut microbiome database. And our data shows that when you eat a greater variety of foods, your gut will take better care of you. That's why we believe in abundance through variety, not restriction. Doesn't that sound like a change that's easier to Commit to? Visit Zoe.com to sign up for our personalized nutrition membership today. Speaking of variety, we also just released a plant based supplement that packs 30 plants into one crunchy scoop. It's called Daily 30 and you can sprinkle it on any meal for a science backed boost. Okay, let's get on with today's episode with Rich Roll and Professor Tim Spector. Rich, thank you for joining me today.

[Tim Spector]

Very happy to be with you guys today. Thanks for having me.

[Rich Roll]

And Tim, delighted to have you as well.

[Guest Speaker]

Great to be here.

[Jonathan Wolf]

We like to always kick off our.

[Rich Roll]

Show here at Zoe with a rapid fire Q and A with questions from our listeners. And we have very strict rules.

[Jonathan Wolf]

Rich, you can say yes or no.

[Rich Roll]

Or if you have to, a one sentence answer. You willing to give it a go?

[Tim Spector]

Yeah. As a long form podcaster, this is gonna be challenging, but I'm up for the challenge.

[Rich Roll]

We know you can do it. Rich, is 40 too late to transform your health?

[Tim Spector]

No.

[Rich Roll]

At almost 60 years old, are you healthier than you were in your 30s?

[Tim Spector]

Absolutely, yes.

[Jonathan Wolf]

Tim, is midlife too late to transform your gut microbiome?

[Guest Speaker]

No.

[Jonathan Wolf]

Can the food you eat increase your rate of aging?

[Guest Speaker]

Yes.

[Jonathan Wolf]

And finally, Rich, and you can have a whole sentence. What's the biggest misconception when it comes.

[Rich Roll]

To changing your health during midlife?

[Tim Spector]

Rome wasn't built in a day. It doesn't happen overnight. And it's really about making small incremental changes and building upon them. And I think if you devote yourself to that process, you'll be able to change in ways that might astonish you. That's my experience.

[Jonathan Wolf]

I love that.

[Rich Roll]

And I think just that itself explains why you're an inspiration to a lot of people, both in terms of that sort of motivational message and also because you're a plant based, ultra endurant athlete. It's all a bit daunting, if I'm honest. As somebody who is the opposite of an ultra athlete, whatever that is, we had a lot of people who were actually specifically asking about tips on developing the willpower to make changes. So normally with this podcast, we're very focused on trying to educate people so they can make better food choices for their health based on their latest science. But I think sometimes for all of us, food doesn't really feel like a choice. It can feel like a craving that has to be met right now.

[Jonathan Wolf]

And I know you've developed a lot.

[Rich Roll]

Of insights from your own journey with addiction and recovery. You've talked about them in your bestselling memoir on your very successful podcast, and I hope that you're going to share them with us today. And we're also very lucky to be joined by gut health expert Professor Tim Spector. And Tim's gonna talk to us about.

[Jonathan Wolf]

The power of the gut microbiome as.

[Rich Roll]

A tool for change that you can still use Even as you get older. But I'd like to start right at the beginning. Rich, so today you're an ultra endurance athlete on a fully plant based diet. But you made this big pivot, I think, around the time you were 40. Could you tell us what your life.

[Jonathan Wolf]

Was like before that?

[Tim Spector]

To answer that question, I think we have to cast the gaze backwards a little bit. So leading up to that, throughout my 20s, I had a struggle with drugs and alcohol that really took me to some pretty dark places. And I was able to get sober at 31. I went to treatment for 100 days, which is a long time to be sort of voluntarily incarcerated in what's kind of a mental institution for the temporarily insane. But that really changed my life and provided me with a new set of tools around how to, like, organize my decision making and my actions. And when I emerged from that experience, building a foundation of sobriety was, like, my number one priority. And I went all in on my recovery and over the next nine or so years was very focused on that. But at the same time, I was also very intent upon reestablishing myself as a sort of respectable human being who could show up on time and be relied upon and the like and rebuild my career as a result. And during that period of time, I really overlooked my health and well being because I was so focused on that one thing. And it's only in retrospect, when I look back on it, that I realized the extent to which my relationship with food and lifestyle habits was still very alcoholic. Like I was using food to medicate my emotional state. Shortly before I turned 40, I was about 50 pounds overweight, so I wasn't like, obese, but I was quite sedentary. I'd been an athlete in college. I swam for Stanford in the late 1980s at a pretty high level, but really hadn't taken care of myself in quite some time. And I had an incident walking up the staircase to my bedroom, where I had to, like, take a break halfway up. Like, I was literally winded by the exertion of just, you know, walking up a simple flight of stairs. And I had some tightness in my chest. And it was a scary moment. Heart disease runs in my family. My grandfather, who had also been a standout swimmer, had died young of a heart attack. And so heart disease was something that my mother was always telling me, you got to be careful with your heart. And everything kind of snapped into focus as a result of that experience. And I realized that not only did I need to make some pretty significant changes, in how I was living. Like, I actually wanted to. Like, I was blessed with, like a level of willingness to actually take action on that. And I think the reason I bring up the sobriety aspect of my story is because I had had that history, like I had had that bottoming out moment where I made a decision, acted on it, and made a change that changed my life dramatically. And I felt the same energy. I was like, I think I'm having another one of those experiences. And what I learned about experience was that you need to take action quickly because these. It's sort of a sliding doors moment. Like, if you don't act upon it with some level of urgency, whatever willingness you're experiencing tends to fade pretty quickly. And I thought I kind of need detox for my lifestyle. Like, I need to kind of recreate that treatment center kind of experience, but for, like, food and lifestyle habits. And so that set in motion a series of experiments with food and diet and fitness that kind of catalyzed this journey that I've been on that took me from there to here.

[Rich Roll]

And Rich, can you tell me a bit about, I guess, what your diet looked like before you were climbing up those stairs? And then tell me, what did you change maybe over the next? I don't know whether this was a instantaneous or this was the next year. What did it look like? By the end of the year, I.

[Tim Spector]

Was on what you would call the window diet. Do you know what the window diet is?

[Rich Roll]

Tell me about the window diet.

[Tim Spector]

The window diet is when you drive up to a fine dining establishment, you roll the window down and they hand you food into your. That was the diet that I was on. So a lot of fast food, a lot of late night takeout in the law firm in which I was working as a lawyer, Pizza Hut, Domino's, McDonald's, Jack in the box, cheeseburgers, fries, you name it.

[Guest Speaker]

You tried them all?

[Tim Spector]

I tried them all, yeah, yeah, yeah. A lot of greasy food. So it was a big shift to actually go fully plant based. And I did it almost as an experiment to prove to myself that it wouldn't work so I could make peace with the fact that I just felt the way that I felt and this is the way I'm supposed to feel and was not expecting the sort of dramatic shift in how I felt. But I tried a bunch of stuff. You know, I dabbled in paleo, I tried vegetarian. I sort of checked a bunch of boxes. And the one thing that I hadn't done because I was reluctant to do it was to Go entirely plant based because it sounded hard. It was like, who wants to do that? Like, it just sounded difficult. And I couldn't imagine how I could ever be full or sated with anything that I was eating. So I did it kind of as a challenge again to like prove it that it wouldn't work because I really didn't want it to work. That's the truth. So I was as surprised as anyone when it actually seemed to resuscitate me.

[Rich Roll]

If you're going to describe the key components of that diet, because I think it's sort of quite powerful what you're describing about this shift so fast. What was the.

[Tim Spector]

It was eating plant foods as close to their natural state as possible, so limiting exposure to processed foods, trying to reduce the oil intake and just grazing on as many varieties of plant foods as possible. Home cooked and nominally limited processing.

[Guest Speaker]

It wasn't raw particularly.

[Tim Spector]

No, I didn't go, I never went totally raw. I ate a lot of raw foods, started doing a lot of smoothies, the base of which was always dark leafy grains, but keeping it pretty simple like a lot of legumes, a lot of beans, a lot of quinoa and variety, I think making sure that I was getting a lot of variety on the plate.

[Rich Roll]

And Tim, you're listening to this, you're a medical doctor. I think a lot of people relate to this story, right? This is a classic story of someone anywhere in the western world with the modern diet. You're obviously layering onto that also this story about alcohol and stress. It sounds like with the job that you're describing, you know, what are the implications for your health and is it really shocking that Rich would already be feeling that sort of health impact, you know, at the age of 40?

[Guest Speaker]

Well, sadly it's not that unusual and many people, you know, in the US UK on really high ultra processed food diets are feeling sick and long don't realize it until they are able to change to something else and realize that's not normal. They were in this state where the food is basically, you know, as you're describing, driving a lot of mental health issues as well and depriving you of energy and sort of sucking the life bit out of you. And it's only when you make that switch that you realize the problems that we were in. And this is comes from a level where the majority of the foods you're eating are these artificial foods rather than real foods and you're not really getting the whole plants at all in any way that if you are eating Plants, they're highly refined and lack any of the goodness in them. So it's not that unusual. And this is sadly why our gut health is in such a poor state as well. So that these foods in these states, you do see in people in their 30s and 40s who have appalling gut health because of their diets and their state. And this has effects on the whole body, not just the gut. And that's really what we're just starting to understand.

[Rich Roll]

I actually wanted to pick up on that because I was really struck by how much you were talking about sort of mental health and energy within this story. How rapidly did you see this shift? And I'm particularly interested because it's something that I think we haven't tended to associate with diet in the same way that we might understand that it affects our risk of a heart attack or something.

[Tim Spector]

Sure, it was pretty rapid. Like I said, within seven to 10 days I did feel this resurgence, the spike in my energy levels. But at the same time, kind of hand in hand with that, there was a hopefulness that I was starting to experience. I was used to eating a midday meal and being so tired, feeling like I had to take a nap and just kind of being checked out of my life. And so to suddenly be able to eat without that food coma that I was so acclimated around, almost like, you know, gave me more hours in the day and my sleep improved. And when your sleep improves, your stress levels go down. You're able to kind of navigate tricky, conflict oriented situations a little more gracefully. And of course your cognition and problem solving is better. So there was really no area of my life that was untouched. And yes, of course, we are holistic animals. We're not separated from the environment and our mental health. And what's going on in our brain obviously impacts the entire body. And my experience was, was pretty much 360 across the board. Like so many things improved as a result of that. And that gave me the enthusiasm to just say, like, oh, this doesn't need to be an experiment. How can I make this sustainable so that I can continue to learn about how to do this properly and make it work for my life? Because I want to feel this way all the time.

[Jonathan Wolf]

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[Rich Roll]

One of the things we talk about at Zoe a lot is this idea that if you want to make a change for health has actually got to be a lifelong change. There's not some sort of like quick fix diet that you go on to make things better for a month or two and then you go back. Obviously that pushes it all this effort onto how can you make something sustainable. And so I think what's striking here is you're talking not only about making this big change at this one period in time, but then you've sustained that over close to 20 years. Did you get all the benefits literally in the first seven to ten days? Have you further, have you learned more and changed more through.

[Tim Spector]

I've been doing this for a very long time, you know, so yeah, I iterate, I get my blood work done. Oh, maybe too much olive oil, maybe I shouldn't, you know, like, of course, like I'm not a perfect human being. And so I've tried to continue to learn and also to figure out how to do it when I travel and you know, in situations where, you know, social situations where you feel like you need to make a compromise, all of those things, like it has to work in the context of your life. But I think to your point of making it a lifetime thing, that can sound daunting and intimidating for someone like, oh, I have to change my whole life. That's sort of scary, right? And the only way I was able to do it wasn't. I didn't make plans like, oh, I'm going to do this for the rest of my life. I always try to focus my energy on what the next right decision is. What's the good decision that I can make in the present moment? All we have is what's happening right now, right? We spend all this time, what am I going to do when I have to go to that wedding and I know they're going to serve? It's like, forget about all that. Just try to do the best that you can, in the circumstances in which you find yourself in and breaking it down into tiny little chunks and let the lifetime aspect of it take care of itself. And that's a lesson that I learned in recovery. I mean, the trope of like one day at a time I think applies in this context. And so much of what I learned in recovery has been incredibly helpful in navigating lifestyle changes like this.

[Rich Roll]

Why do you feel there's such a strong link between understanding how to shift from like the traditional diet that so many of us are having to this plant based diet? Why do you feel that's so closely linked to recovery? What makes that work?

[Tim Spector]

So I think it's multifactorial. But I would say in my experience, I never thought I could get sober. And then when I did, that was very empowering. Like, I made a huge life change that I never thought that I could. So that gave me confidence that I could make other changes in my life. But what I learned is that literally all you have is one day of sobriety every day. Like your job is to have your head hit the pillow without taking a drink. And it's very binary. It's like you're either sober or you're not. Like there's no gray area. And when I made this dietary change, I kind of needed a binary rule. And that's why plant based was very helpful to me because it's sort of like, well, I just don't eat these animal products. Let's just start there, right? And my job every day, day is to get through the day and at the end of the day, make sure that I sort of made the right dietary choices. And when you drill it down into just the bare essence of it and just focus on what's happening that particular day, it makes it a lot easier. I don't worry about what's going to happen tomorrow. We'll deal with that tomorrow. And so that's super helpful. And then also the accountability and community piece, like, you don't get sober alone. You do it as a collective. And I think if you're trying to navigate any kind of lifestyle change, it's helpful to have somebody to do it with or somebody to hold yourself accountable to. You know, we're community animals. We're best when we're a member of a tribe. And so don't try to do these things alone. You know, do it with someone in your family. And if you don't have that option, then find a friend or at least find somebody who can check in on you. Hey, that you know, that you kind of have to report to. And that's always helpful also to kind of keep you on track. And then when you, like in sobriety, if you relapse, the most important thing is making sure that you get right back to it. You can, you know, go down a shame spiral or just, you know, throw the baby out with the bathwater and say, well, that was hard, I can't do it. But I've learned like, yes. What's the next right thing? Okay, the next right thing is to make the right choice again and try to course correct as quickly as possible and learn what drove the relapse. Because I think what's under discussed in this conversation around making diet and lifestyle changes is the emotional piece. Like on paper we all know we should eat more fiber and we should eat more plants and all these sorts of things. Why is it so difficult? I had to learn about how much my emotions are caught up in the food choices that I make. And I think we unconsciously, you know, many people unconsciously are medicating their emotions through their food choices or are unduly influenced by their social environments and make choices that are not in their best interest because they don't want to upset anyone or, you know, draw, draw unnecessary attention to themselves.

[Guest Speaker]

When I had my medical episode, my shock, my equivalent, in a way of course not as severe probably, but I tried going vegan for six weeks for the same reason. I wanted some strict rules, just to say, let's change something and see what happens. So in 2011, I was doing some ski touring in the mountains high up at 11,000ft, got a funny turn, double vision, and ends up having a mini occlusion, like a mini stroke that left me with double vision for three months and high blood pressure and lots of investigations and worries about my health. And I was four years away from the time when my father had died of a heart attack. So that was my particular scare. And I was 20 pounds overweight, but otherwise thought I was quite healthy. I didn't have as bad a diet as you did because I was a doctor, you know, I thought I knew better. In retrospect, it wasn't a good diet, but it wasn't quite as bad as yours. So it was full of low fat foods and lots of carbs, lean meat and orange juice and mooselies and things like this that really bad for my blood sugar. Anyone who wants to change it is quite hard because you say, well, no one's telling you how to change and you didn't want anything gradual. You Say I want to do something immediate. And that's probably the attraction of all these kind of diets. The keto, the carnivore, whatever. It's strict rules. It's like joining a religion, you know. So I did give up all meat, you know, 99 plant based, but not, not the full vegan. And I still had fermented dairy. I find easy to give up meat, not so easy to give up my fermented dairy and my cheese. And I just wonder whether what you went through with the alcohol made you feel that if you'd sort of eaten cheese, that would have been a way, the sort of easy way back in to, to meat and things. Did you have a feeling about that?

[Tim Spector]

Yeah, because I, I am, I have an addictive nature, you know, and so actually dairy was much harder to let go of than meat. Meat. I'd been eating meat my whole life and I was like, I don't even know if I like this. I've just been, I've always eaten it. But like you, dairy was difficult. Like I had cravings, but I was like, oh, your cravings are your teachers though. Like, why do I crave this? Like, well, if I crave it, perhaps there's, you know, some kind of unhealthy relationship that I have with it that I need to look at. And it took me, you know, quite a while to kind of overcome those cravings where they didn't kind of take up resonance in my mind. But actually getting rid of the dairy was the thing that, that, that changed the way that I felt the most.

[Guest Speaker]

Okay, that's interesting.

[Rich Roll]

I'm struck rich that when you made this change, you were already entering midlife. And I think it's a time when, you know, a lot of people, including I think quite a lot of listeners, feel like, you know, I'm worried it's already too late to make a change that will stick and a change that is actually really going to be able to transform my health. I think that's definitely the way that I felt probably 10 years ago, that it was like, well, isn't my entire health set by my genes? Those are fixed. And also by sort of my upbringing, my first 20 years and sort of now I'm just on the path and I can't change it. I actually think when I first met Tim, it was one of this sort of light bulb moment where he sort of explained to me this whole new idea around the microbiome that I'd never heard of before and that because it was changeable then actually maybe I wasn't locked in as much. And Tim, maybe for the benefit of listeners who might be new and haven't heard this before, could you describe a little bit the microbiome, what it is, and then this question about to what extent is it still changeable and why does it matter for our health at the point that you're maybe at your 40s, but then also continuing, I think there'll be plenty of listeners who are in their 70s saying, well, does that mean that it's too late for me?

[Guest Speaker]

Sure. The microbiome is the word we give the community of microscopic organisms or microbes that live in our gut, mainly in the lower intestine, where that's what we know about. That's where most of the action is going on. And there are trillions of these guys, about as many as there are cells in our body, and they work together. There's viruses, bacteria, archaea, fungi, and some parasites. And they're all producing chemicals. They're like chemical factories. And the chemicals they produce interact with the rest of our body, particularly our immune system and our nervous system. So they are. We're finding out that these chemicals they produce are absolutely key to our healthy maintenance of our normal functions. And if we focus even just on the immune system, we know that if the immune signals are right from the microbes, our immune system is going to be really well balanced. It's going to stop us getting infections, it's going to fight disease early on, it's going to fight cancers early on. It's going to mop up some of the debris of aging and allow our body to be really efficient going forward. So this is what we currently believe is the sort of key to why the microbiome is not just our gut or a few sporadic mechanisms in the body. It's really crucial to the whole way the whole thing functions. And it also dampens down inflammation, which is this low level of the immune system being tickled all the time, which is very common these days. And there's the common theory about aging. Accelerated aging is called inflammaging, inflammated aging. It's been a term that's there that people who have this low grade inflammation will age more rapidly. And that includes heart disease, dementia, arthritis. Just because the immune system is so preoccupied putting out fires all over the body that it can't really do its principal job of mopping up the debris from the cells or fighting those early cancers, or keeping all the blood vessels nice and clear and open and doing all the things that the immune system is really good at. So that's the concept of why our gut microbes and aging are so closely linked. And studies have been going on for a while now looking at differences in age, and it's not as clear cut as we think. So many people can maintain a really healthy gut microbiome into their hundreds, is that right? So they've done some studies in China and Italy and centenarians showing that if you look at their gut microbes, they have the same gut health as many people in their 40s or 50s. So think about, you can maintain this, but if you look at elderly populations over 75, particularly those maybe in residential homes, you see it sort of drops off a cliff. And their gut health, their diversity of gut microbes really plummets. And it's also associated with frailty increasing. And we did some studies in the twins that predated the Zoe studies showing that this clear link between gut microbiome diversity and increase in frailty, obviously this is still a new science and no one's tracked 40 year olds for 50 years down the road, so we have to make a few assumptions on the way. But it's pretty obvious that if you can maintain your gut microbes when you're, you know, from 40 and 50 years on and do it right, you can keep that going right up to be a hundred without any drop in your immune system and all the things that come from it. And that's, that's what most of the data are telling us, and particularly the, the latest Zoe data, you know, this ratio of good to bad microbes, we see, it doesn't matter what age you are, if you've got that good ratio of good to bad bugs, then you're gonna be in pretty good shape even in your ninth decade.

[Rich Roll]

And Tim, when you're thinking about Rich's really dramatic change in diet, I love this from the window diet to the plant based diet, that's definitely two quite extreme shifts. How might that have impacted his microbiome and what were the implications from that for his health? And I guess what Rich was describing.

[Guest Speaker]

To us, when we see someone shifting from a really poor diet to a really good diet, there have been a number of small studies and population studies, and some Zoe studies show you do see a really rapid change in the gut microbes. So probably you could see it imagine enriched within a week if we'd tested you at the time as you transitioned from the junk food diet to the plant based diet. And when we get Zoe members having their personalized nutrition program, those that are adhering to it, are seeing effects within a few weeks on their gut microbes. And it all fits because those same people, although it takes for us to detect it several weeks to see it, probably the changes are earlier because mood and energy in all our Zoe studies also improve within a week. So if you ask them, you can see differences in mood and energy, whether it's just by shifting your diet or it's having something like prebiotics, you can see these changes. The mood and energy comes first, actually, before you see the actual changes in the gut microbes. Which, again, goes back to this idea of how important the gut and the brain are. And energy is the one thing that doctors don't ask about, but actually is perhaps the most important global feature of how you're feeling that I think, you know, needs much more medical attention. So, yeah, in summary, these things can happen really fast, particularly if you're. You're moving from a bad place to a good place. If you are on a really good diet and you just want to incrementally do, would be harder to see that, and the differences would be more subtle. But anyone who's on a poor diet, really, they make that effort, they will see results very, very fast.

[Jonathan Wolf]

Hi, I have a small favor to ask. We want this podcast to reach as many people as possible as we continue our mission to improve the health of millions. And watching this show grow is what motivates the whole team at Zoe to keep up the really hard work of creating new episodes each week. So right now, if you could share a link to the show with one friend who would benefit from today's information, it would mean a great deal to me. Thank you.

[Rich Roll]

When is it too late, Tim? So, you know, here we're talking about making a change at 40. You're describing, like a really dramatic change here, right? You're saying the microbiome changes rapidly, like in a big way. And then you're saying the health outcome changes in a big way. When's it too late?

[Guest Speaker]

There's no evidence that it's ever too late. Because what you're doing, Even if you're 90 and you suddenly say, you know, I've been lucky, maybe on the window diet. But there these people that, you know, smoke and drink and have terrible food and they're lucky they get there, but, you know, they want to keep going, they can improve their gut microbe just as well as someone age 40 by making that change. And they will also see improvements in their mood and energy, because we're talking about instant changes in these Microbes producing chemicals. And these chemicals can instantly impact your brain and your immune system. So it's not like you've got to wait for vessels to rebuild or some major changes to structure to happen. This is. This is what's so great about the microbiome and lifestyle, is it all happens in. In real time. And that. That's why it's so much nicer to talk about this than what I used to talk about, genetics, because that. That really, really is slow. You know, it's like, well, several generations on, you know, they'll be reaping the benefits here, you know.

[Jonathan Wolf]

And Tig, could you explain a little.

[Rich Roll]

Bit this mood and the food? Because I think a lot of people listening to this and, like, I think they sort of understand that you can, like, somehow, you know, improve your heart. And this makes sense. But the mood thing seems rather magical. Like, does science understand what's going on?

[Guest Speaker]

Well, we understand a little bit of it, but we're probably just scraping the surface of what these microbes can do, what the chemicals they can produce. But it basically comes from the chemicals they produce. As I said, they're chemical factories. They produce brain chemicals, for example, like serotonin, really important for brain and enjoyment and happiness and calm. They also produce things like gaba, which is equivalent of a Valium tablet. And body can't produce much of this stuff, so most of it comes from the gut microbes. So they will produce be producing these chemicals, which then get passed over and picked up by receptors in the brain which will change those moods. Similarly, the effect on the immune system, we would damp down inflammation, and then the brain suddenly senses, oh, there's no inflammation going on here. I don't have to be in this rather depressed state thinking I'm ill. Because the brain is just like a giant program. It's predicting what's going on. It's not often it's wrong. We think the brain is always right, but actually it's just another organ in the body, and sometimes it gets these algorithms wrong. So that's what I think that would explain these changes and why a change, getting rid of a terrible diet has such a profound rapid effect on people. And. And the brain is perhaps the first thing to pick it up because it's not getting those sickness signals from the rest of the body.

[Rich Roll]

That's fascinating. Now, Rich, when you made this big change, it wasn't only diet that you changed. I think you also made some big changes around exercise.

[Tim Spector]

The diet set in motion the exercise, though. The diet came first. And that kind of resurgence of energy made me want to move my body, and it was like one step at a time. But I started getting outdoors more. I pulled an old pair of running shoes out of the closet. My wife bought me a bike for my birthday. And it was all very casual. But I lost weight very quickly and was able to restore some level of fitness also very quickly. And it was like the lights came on. Like, I had forgotten as a lifelong athlete how much I enjoyed. And so with that, there was also kind of a recapturing of joy that I used to experience that I was reconnecting with. And then, you know, that led to a newfound kind of sense of possibility because alcoholism had sort of derailed my competitive swimming career. I suppose I had a. I had. I felt like I was not fully expressed as an athlete. And I think 40 also, you're like, you know, that's why all these guys do Ironmans at 40. And there's a little bit of that, too. A little bit of midlife. You know, you're kind of taking inventory of your life. And so that's what kind of led me towards tackling some challenges and realized not only that I had an aptitude for this, but that I really enjoyed it and ended up going on to do things I never thought I was capable of. So to your question of, is it too late? Like, I'm not a scientist, I'm a layperson. All I have is my experience. But I can tell you that these changes that I made at 40, I was convinced that I was just sort of sliding into middle age. And instead, I kind of revolutionized how I was living to such an extent that it changed my entire life and with it, my perception of, like, latent potential. And I've become convinced that we're all kind of tiptoeing above these reservoirs of potential that we don't give ourselves credit for having, let alone are we encouraged to kind of tap into them. And so I don't think it's too late. To Tim's point, like, the body is incredibly resilient, and if you can shift a gear and start to treat it better, the body will kind of respond in kind and treat you with kindness as well.

[Rich Roll]

And Rich, I wanna paint a little bit of a picture for the audience. Some of them, people will be listening on audio so they won't see what a fantastic specimen of manhood you are sitting in front of me. But also, I think, no idea about, like, what does an ultra endurance athlete mean? What is maybe the craziest thing right now that you feel that you have achieved closest chance.

[Tim Spector]

I've done a couple crazy things. I've done double Ironman distance races. If you know what an Ironman is, you swim 2.4 miles and then you ride your bike 1002012 miles and then you run a marathon. Well, I've done double of that.

[Rich Roll]

All at the same time.

[Tim Spector]

Yeah, like basically I'm just checking like a year later that's sort of a stage race. But probably the craziest thing that I've done that people know me for is doing five Ironmans on five Hawaiian islands consecutively, which ended up taking like six and a half days or something like that. So back to back to back to back. Literally just doing Ironmans for like a week essentially. And I say that as somebody who, I promise you I'm not somebody who's gifted with some kind of extreme athletic talent. I worked very hard to achieve those goals. But they are all a product of changing my diet and prioritizing my lifestyle habits. And I think I'm not here to tell anyone that they should be an ultra endurance athlete. I'm here to merely say that you probably have more inside of you than you realized. And when you kind of shift that lens and start to really think about how you're caring for yourself, these things tend to suddenly become more expressed in your life.

[Rich Roll]

I think it's an amazing story. I could also see that maybe there is this alternate outlet for some of this sort of obsessive behavior that you're describing out before.

[Tim Spector]

Yeah, there's a little light dusting of alcoholic behavior on top of that.

[Rich Roll]

This feels like a healthy way for this to.

[Tim Spector]

You know, I am prone to extremes, but that's what got me interested in like a plant based diet to begin with. Right. Like dancing around the outer edges of what's possible.

[Rich Roll]

Now, Rich, I have an investor who's going to be listening to this podcast right now and he is very serious about his exercise. He exercises a lot, you know, every day and he does, you know, some of the sort of activities you're talking about. And he insists on eating red meat every day to get enough protein to perform. And since I've got this opportunity because he doesn't listen to anything I say or Tim hasn't really convinced him. But you've done a lot more Ironmans than either of us. Infinitely more than either of us.

[Jonathan Wolf]

Is there anything you'd like to say, Tim?

[Tim Spector]

Well, the first thing I would say is it's not for me to tell him what his diet should or shouldn't be. So I'm not that person. I'm also not a scientist or a medical professional. All I can do is share once again my experience. And my experience was that I was able to do things I didn't think possible without any animal products. And I went way beyond what I had even imagined for myself. And my experiences along the way of that journey was, and this is somebody who I was a lifelong athlete. I was a competitive swimmer at a very high level at Stanford, and I was eating lots of meat and whatever. I discovered that in my 40s, I actually was recovering better in between my workouts. And that's where you make the gains. It's not the training where you get stronger. It's like the periods in between when your body is repairing itself. And my experience was that I was able to kind of shrink the period of time necessary to make those repairs, which allowed me over time to go further, train harder, push myself a little bit harder the next time. And over an extended period of time, I think I was able to realize outsized gains as a result. So my experience is that you don't need to eat red meat in order to be a competitive athlete at the peak of your your powers. And I'm not alone in that perspective. There's plenty of elite plant based athletes out there. And so I would suggest to him to hold his ideas loosely and maybe look into some other examples that are similar to my own and perhaps even tune into our mutual friend Simon Hill's podcast the Proof, where he talks about this subject matter at length as a scientist.

[Rich Roll]

And Tim, are you saying that people who want to be really healthy need to give up meat and animal products in the way that Rich has talked about?

[Guest Speaker]

No, I'm not saying exactly that. And our studies, and we've just done a huge microbiome study of 30,000 people, including vegans, vegetarians, carnivores, omnivores, mainly plant based people like me. And conclusions are similar to earlier smaller studies that gut health measured by this sort of the Zoe score. Good, good to bad ratio is correlated with the number of plants you're eating, not whether you are labeled as a vegan, a vegetarian or a meat eater. But it is much easier to get more plants on your plate if it isn't blocked with a big steak or it isn't or a big bit of fish.

[Tim Spector]

You're saying it's not so much about what you're taking off the plate as much as it is what you're putting on the plate.

[Guest Speaker]

Correct.

[Rich Roll]

I'd like to come back just for a minute to the exercise point that we're talking about and almost tie it back to the microbiome, because I think we've done a lot of podcasts that have talked about exercise, and I've yet to meet a scientist who doesn't tell me exercise is really good for your health. So that feels like it's pretty uncontroversial. And rich, you're describing the fact you first did diet, then you layered exercise on top. Tim, you talked a lot about the impact of diet on the microbiome. Does the exercise also have an effect on the microbiome?

[Guest Speaker]

Probably, but it's not nearly as clear cut. The studies just haven't been as good. They've done lots of studies from elite athletes to sedentary individuals and trying to work out whether the more training you do, the better your gut microbes. Hasn't been shown conclusively to be true. And certainly they looked at elite athletes and they don't find any difference in their gut microbes compared to amateurs or anything else. There's been a few mouse studies, but I'm always a bit skeptical about extrapolating from mice to humans for this sort of behavior. So my guess is, although I think we still need more science, that exercise has some benefits to the gut microbiome, but if they are there, they're proportionally much less than diet. So I don't think people that say, I'm not worried about my diet, I'm going to the gym five times a week, I'm okay, Jack, that's not going to work is my view. And I think we would have seen a big effect on exercise by now if it would have come out of these studies and we're just not doing it. People are desperately trying to find it. Because you're right, every, every doctor will tell you exercise is good for you. And I'm saying that as well. And I exercise, but I don't think it's working the same mechanisms. And it's certainly for gut health. Don't know how you feel. I mean, if you'd had a magic pill that allowed you to exercise, do you think you'd be in the same place?

[Tim Spector]

There's that adage that you can't out exercise a bad diet, you can't outrun a bad exercise. Any kind of very enthusiastic exerciser is sort of quietly telling themselves that that doesn't apply to them and it can be used as a way to kind of have a healthy appetite and enjoy foods that maybe you couldn't get away with if you weren't exercising. So in that context, exercise can work across purposes with everything that you're sharing. If repairing or really caring for your microbiome is something that we should prioritize, then we have to be careful about the stories we tell ourselves about exercise giving us permission to indulge on food. So I think that is something that I just feel like is important to flag, but I think to the point of us being holistic where the brain and the body are all connected. When you exercise, you feel better and when you feel better you have a sunnier disposition and suddenly you have a deeper sense of how you're caring for yourself. Like if you're exercising, that is an act of self love and self care that then kind of leads to better habits in other areas of your life. So I think there's a compounding effect. But my mental health is very much dependent upon my exercise routine. And when I'm not exercising consistently, like I don't feel as good. And when I don't feel as good, then it's easier to slough off on healthy habits.

[Rich Roll]

So there's a sort of positive reinforcement.

[Tim Spector]

There's a reinforcement loop, I think.

[Jonathan Wolf]

Do you know someone wanting to make positive changes to their health, maybe they talk about it, but struggle to stay motivated. Why not share this episode with them right now, Inspire them with richer story.

[Rich Roll]

And empower them with Tim's expert advice.

[Jonathan Wolf]

I'm sure they'll thank you.

[Rich Roll]

We definitely established that the microbiome is this very powerful tool to transform your health. And Tim, I love this idea that you could even be 90 and you can sort of improve it, which is brilliantly positive. I'd love to now hear some actionable tips for like showing up for this change consistently. And rich, I know you've already touched a little bit in parts already, but. But I'd love to talk about how do you find the motivation to start a change and how do you find the motivation to stick to a long term health change?

[Tim Spector]

I think the first thing I would say to that is to kind of challenge the presumption here, which is that you need motivation in order to take action. Like how do I find the motivation? You mentioned willpower earlier. How do I find the willpower to do all these things that you're telling me to do? And I think that assumption that you need motivation or willpower and you're kind of sitting around waiting for it is something that keeps people paralyzed in bad habits. And I have a mantra that I use that I think is Very helpful. And again, it's something I learned in recovery. And it goes like this. Mood follows action. So rather than waiting until you're struck with inspiration, what is the thing that you can do right now? And the mood that is the motivation is a product of taking the action. And this is something that's validated in neuroscience. Behavior, first thoughts, feelings and emotions follow. So it's about kind of reversing that equation in your mind and breaking down again, everything into tiny, actionable items. So there's a wonderful book called Atomic Habits that you've probably heard of by James Clear. And he always says, habits are the compound interest of self improvement. So you always default to your habits, and if you want to make a habit change, break it down into its tiniest sort of elements. And so when you think of, oh, my God, I have to change my diet for the rest of my life, it's all very daunting and, like I said earlier, intimidating. So I'm always encouraging people to start with very easy lifts, like, lower the ceiling on your expectations, broaden your timeline, or forget about a timeline altogether and just take one tiny little thing, like, maybe, Tim, you can get rid of the fermented dairy in your fridge and replace it with something else that might be a little bit healthier. And that's all you're doing. Just go into your pantry and like, you know what? All these chips in here, I'm just going to take them out of the house. Maybe you didn't. That was all you did that day. But you, you, like, chalked up an easy win. So I think it's about, like, assembling a lot of easy wins. And when you just kind of like, focus on tiny little things that you can master, that does have a compounding effect. And when you, when you teach yourself that you can do that, like, and you make that one little change, you're like, oh, I did that. And now that's really not an issue for me anymore. What else can I do? Let's move on to the next thing. And you just kind of build on these things. I believe that that is really how you make change. So it's about the tiny little daily habits that you're almost reflexively or unconsciously kind of indulging every single day and drawing attention to those, rather than making dramatic, wide, sweeping statements like, yes, I went plant all that kind of stuff. But I don't think that's how it really works for most people. And I think kind of just gradually leaning into this as a process rather than a Result driven by this day, I have to weigh this much. I think you're in better stead to then adopt habits with staying power. Because this is really all about sustainability and having it all kind of work in the construct of our, you know, we all have busy lives and we're all kind of doing lots of different things. So how can you create an environment that's conducive to making the healthy choices and chalk up those little wins with small little habits that you can build upon?

[Rich Roll]

I'd love to just follow up on this thing about how you describe exercise. Actually providing you with this sort of support for your mood that it sounds to me is like helping to enable all the things that you're describing. So if you were to give advice for someone who's trying to, let's assume they're not like a super sophisticated athlete, but maybe they're like, oh, I'd never even thought that I could use exercise in some way to sort of support my mood to achieve change. What would you say to them to.

[Tim Spector]

Find a movement practice that you enjoy? So what's the best exercise? What should I be doing? Well, what's the thing that you like doing? And if you enjoy it, you're more likely to kind of invest yourself in it it and make it kind of a sustainable habit in your life. So think about what it is that you actually enjoy and find a way to incorporate that into your life in a way that's not disruptive, overly disruptive to your daily schedule so you won't abandon it on February 1st. You're like, okay, I can't do this anymore. And find people to do it with. Make it a community oriented sort of thing so that you're kind of sating yourself with human connection at the same time that you're moving your body and set reasonable goals or don't set any goals at all. Just do it for the sake of doing it. And that could be a walk in the woods or walking the dog around the block. It doesn't have to be any kind of big daunting thing. But I think it's important for everybody to understand that in terms of healthspan extension and longevity, there is no more powerful lever than exercise. It's never too late to start. And it doesn't mean again that you need to go and be an ultra endurance athlete. It just simply means that you have to find a way to exert yourself. And I think if you find something that brings you joy in the process of doing it, you're more likely to stick with it.

[Rich Roll]

I think it's beautiful. Tim, final simple question for you. What is one type of food that someone could add to their diet tomorrow that could improve their gut health?

[Guest Speaker]

Fermented food would be the obvious one for me. A lot of people don't have much in the way of fermented foods. Fermented vegetables, the kimchi, the sauerkrauts, these are amazing source of microbes and will help your inflammation, which should, in theory, you know, reduce the speed of aging.

[Rich Roll]

Amazing.

[Jonathan Wolf]

Rich. Tim, I'd like to try and do a quick summary.

[Rich Roll]

We covered a lot of stuff in this episode, so definitely let me know if I've missed anything. I'm gonna try and pull it together. So my biggest takeaway was that Rich was on the window diet, which I'd never heard of before, which meant that all your food came in through the window of the car and then into your mouth. And this is a pretty terrible diet to be on. I also really struck this idea about medicating your emotions with your food choices, that this food becomes this thing that's really linked to how you feel and it's giving you this sort of short term boost, which I think we can all identify with. But then you're describing just how bad an impact it was having on you. I think my other key message that I took away is it's like never too late to make a change. We're talking here about making this change in midlife. But I think I'm also hearing from both of you that it's almost never too late to make a change that can be profound. And a lot of this comes from this realization that our microbiome is so important in our health and unlike our genes, it's not fixed. And I think Tim was describing some of the science, Rich, to go with your experience of how your mood could actually change in seven to 10 days because of the way these chemicals from this bacteria were changing. And that then it gave you sort of energy, it affected your sleep, and that then that it's itself sort of gave you the positivity to do more exercise, which then sort of became this reinforcing loop. We talked about meat, and I definitely took away from you, Rich, that you can do the sorts of things that you're doing without eating meat. That on the other hand, what I hear from Tim, it's not like you have to give up meat. The point is that once you really reduce the meat in your diet, suddenly you're creating all this space to eat all of these plants that are having the Positive side. Then we talked about how you think about willpower coming from a lot of your own experience through recovery, which I'd never heard before, and that a lot of the things that I take for granted, you're like, well, actually, I think that's wrong. So, for example, take it one day at a time. Don't think about making a permanent life change. Actually just say, I've got each day to do this. That rather than saying I need to wait till I have enough willpower to do it, actually it's the complete reverse. Your mood follows action. So do something, something. And actually, in a sense, if understood rightly, your mood will improve and that will give you more of this willpower to go for it. And that if you relapse, then start back on the course. And so it's just very different from this New Year's Day. Make this big crazy plan and then sort of give up.

[Jonathan Wolf]

And it's okay to start with an.

[Rich Roll]

Easy win, I think you said. So again, it can be sort of incremental, step by step, because you're building on this. And then finally, my takeaway was one of the things that's interesting about exercise is not just about long term health, actually can provide a lot of mental support for you to actually be doing these other positive things with your life. And so you're describing that actually exercise helps to support your mental health, that helps to support your diet and maybe to wrap up, you were saying, like, if you want to get into exercise, find a movement practice that you enjoy. So it's for something that you are actually going to enjoy doing it that you can incorporate into your life. You're not gonna give up after a month. It's not disruptive. Find people to do it with. And then finally, I love this idea. You said set reasonable goals or no goals at all. And all of this just increases your chances of success. Did I manage to.

[Tim Spector]

That was great. Will you now come to my podcast and do a synopsis summary at the end of every conversation? Cause that was fantastic.

[Jonathan Wolf]

Now, if you listen to the show regularly, you already believe that changing how you eat can transform your health. But you can only do so much with general advice from a weekly podcast. If you want to feel much better now and be on the path to live many more healthy years, you need something more. And that's why more than 100,000 members trust Zoe each day to help them make the smartest food choices. Combining our world leading science with your Zoe test results, Zoe is your daily companion to better health for life. So how does it work? Zoe Membership starts with at home testing to understand your unique body. Then Zoe's app is your health coach, using weekly check ins and daily guidance to help you shift your food choices to steadily improve your health. I rely on Zoe's advice every day, and truly, it has transformed how I feel. Will you give Zoe a try? The first step is easy. Take our free quiz to find out what Zoe Membership could do for you. Simply go to Zoe.com podcast, where as a podcast listener, you'll get 10% off. As always, I'm your host, Jonathan Wolf. Zoe Science and Nutrition is produced by Julie Pinero, Sam Durham, and Richard Willin. The Zoe Science and Nutrition Podcast is not medical advice and if you have any medical concerns, please consult your doctor. See you next time.