BeewellwithMS discusses brain health and increased in prevalence neurological brain condition such as Multiple Sclerosis (MS) and how our brain works living with MS and what is the connection with our thinking, emotions, physical and general health.
8 June, 2025 Easy Explained MS by Dr Agne Straukiene
Welcome to 'BeeWellwithMS Podcast' with Dr. Agne Straukiene, where we explore managing life with progressive multiple sclerosis (MS) as you transition beyond disease-modifying therapies. Dr. Straukiene shares strategies on shifting focus from inflammation to resilience, symptom management, and building a new care model. She discusses the importance of regular symptom reviews, neurorehabilitation, occupational therapy, mental health support, and practical tips on coping with fatigue, pain, and emotional challenges. The episode includes a guided meditation session and emphasizes maintaining a healthy lifestyle through diet, exercise, and peer support.
Hello, and welcome back to Be Well in Evidence Podcast. I'm your host, doctor Agnes Stroukette, neurologist. Today, we are talking about the moment that is filled with lots of emotions, usually when we talk about the progressive MS, to the point that a person with MS journey, when the disease modifying therapies are being stopped, what's next? It can give you a lot of disappointment, a lot of disbelief that this is happening to me and I no longer have any effect from disease modifying therapies, or maybe I'm not appropriate candidate for these treatments. Everything matters. For many, that moment feels like a cliff edge, a downhill. But I want to encourage you, and I want to gently challenge this image. Because what I've seen over and over again that it can also be a pivot point. When disease modifying therapy stop, it doesn't mean that we stop treating MS. It means we shift our focus from inflammation to building resilience, from slowing relapses to supporting life. And from there, we built a new kind of care, a new model of care. So in this episode, I want to speak not just a clinician, but someone who sat in many of those hard conversations. I'll share how we navigate that transition, what support system should be in place and can be in place, and practical ways to manage symptoms like fatigue, pain, mental health, anxiety, depression, mood changes. And I'll share some hope because there is still so much we can do for you. So tune in and listen to this episode. When someone reaches the stage where their MS is progressing despite treatment, it's easy to feel like something has failed, that you have failed. But that simply isn't true. Progressive events, whether through relapse associated worsening, we call this raw or PRI, progression independent to the relapses inactivity, or smoldering MS. It's part of the natural course of the disease for many people, but not all of them. These terms are complex. They always been. But what they really mean is that changes can still be happening even quietly, silently, unseen, invisible, as we call. And while we might no longer target the immune system, we have a lot of opportunity to target you as a person. Your goals, your function, your well-being, this is time for a care team to help you not to step back and certainly not to discharge you from their MA services. That's my opinion, and I'm gonna advocate for this. So here's what I believe should be part of every progress AMS care pathway and journey. Symptom focus review at least once or twice a year. We need to regroup on your symptoms, go through the list. If you have certain measures at the clinic, score them. There are some patient reported outcome measures. In the clinic, I do MS per discuss assessment of the symptoms, And I give a score, and I redo that assessment six months later, a year later, two years later. I keep track of that because I'm interested. I want to know where I can help you as neurologist. And you as a patient should track that too. I know journaling is not the best thing to do, but it's something that keeps a momentum. You can track and record and then see what the potential triggers, and when did this start, when does it stop. All these things matter. Also, what's important is in neuro rehabilitation. So physiotherapy, in other words. There are so many things online, private physios, NHS physios in America system and Europe. You can sometimes self refer to the service. And what you get is a tackled group of exercises for certain group of muscles that can potentially improve your function. But it's you that is gonna stick to the regime and follow the program. Without you, the physiotherapist is powerless. K? So, also, what's your home environment? Can some abide appliances be fit in your house, in your flat, apartment, room, no matter where you live. That's occupational therapist assessment, and it's usual practice in in UK. Also, if the speech and language is the problem, which usually is, a lot of people with progressiveness, if you haven't noticed, they have some facial weakness, bilateral facial weakness, which really changes how they speak. They become a bit slurry. Sometimes people have lesions affecting the posterior fossa at the back of their head and within the cerebellum and brainstem, and that causes a very specific slurred speech, like drunk speech in a way. So there are some strategies, diets, advice that people would normally get from the speech and language therapist, dietitian. And there are also cognitive challenges as we all know, but use it or lose it. Do you stimulate your brain? Do you read? Do you listen? Do you watch? Do you maintain the conversations in public? Do you ring your best friend and have a chat on a regular basis? So these things matter because that's how you occupy your brain and allow your brain to function better. Now there are some team members that could also support to help you. So one of them is MS specialist nurse, MS coordinators. These are your compass through services and emotional support. Okay? So you ring them. They may not respond within the minutes you ring them, but they will in twenty four, forty eight hours, in a week, in a two weeks' time. Their responsibilities are to talk to people and give them permission and then discuss with their consultant, neurologist, or other specialists, or refer you to the and signpost you to the relevant specialists. The other important aspects in your care pathway is your mental health. Okay? So if you are depressed, if you're anxious, if there are some other serious mental health illnesses, there is help. I know there are some waiting times to get to see the specialist, but the referral needs to be done first. Okay? So because mental health is MS health. The healthier you are mentally, the better the MS is going to be. Also, don't forget the power of the peer support, the connection, the social support, self management groups, coffee groups, exercise groups, and various different charities and societies, nonprofit organizations are organizing these events, whether face to face or online. That's a common normal practice. Now let's move and look at the practical tools that may enhance your journey. You may feel it's more meaningful and maybe even giving you inspiration. First thing and the most common thing is fatigue, tiredness, exhaustion. Fatigue is not simple tiredness. For people who don't have MS fatigue, I just wanna explain that it's exhaustion. After waking up, walking to have a shower, people feel exhausted, drained. They can't function further. They need to pause, stop, regain their energy, and then go back to whatever they started. Why it happens is because of the nerve inefficiency, it says, you know, demyelination slows down the signaling process, and it impairs the energy throughout the body. Poor sleep, people not sleeping, and they are exhausted. The heat summer is coming. It's there already. People don't sleep very well because they haven't got to cooling environment to fall asleep. Maybe some cooling mattresses could help and quite often do. Also, stress and anxiety, thoughts, and emotions, people dwell on what has happened to them. If they are too excited or are they too worried and sad, you know, that all happens throughout the night, the thoughts coming and it's maneuverating on multiple things, and that keeps people awake. And as a consequence, you haven't got energy throughout the day. So those things that I ask people when they come to see me with any MS, progressive, relapse remitting, doesn't matter. I always ask, have you slept well? Do you sleep normally well? And this is where we start improving. You know? And I very precisely because I know that that's something that you could resolve very easily. Now immediate emotions. So, obviously, there are so many different therapies from mindfulness to cognitive behavior therapy, acceptance therapy, hypnotherapy, various different activities, and plus medication. So if somebody needs a medication, they need it. So serotonin needs to be replaced, and that happens when people not saying that I'm depressed. People who tend to say I'm depressed, they just probably have a low mood, but people who start stopping looking after themselves. They don't care how they look, what they ate, what they've done, when they stop being interested in your life. So these are sort of, and fatigue is another symptom of mental health, of depression quite often. So having an enhancer of the emotions and mood, whether that comes from interventions in therapy or medicine or combined approach, that could only improve your quality of life. Also, what could help everyone is pacing yourself. So people decide to do various different things, and they just go and do things, and then they can't wake up the following day because they ever done they haven't paused. They haven't paced themselves. And it's important to break the big task into the smaller chunks of the task and rest before the exhaustion. You feel your timeliness comes in, you pause and rest. You don't go into sort of exhaustion and then rest. You have to feel and work with your body and identify the time when you're picking up into exhaustion or when you're going downhill. Just before you're going downhill with energy, you then stop and pause because that's easier to replace and regenerate your energy levels. Keep cool. Use the fans, cool showers, baths, very comfortable, breathable clothes because you don't want to sweat in the synthetic polyester clothes. It needs to be natural fabric that keeps your body freshenly. Track your energy patterns. It's important to notice your peaks and dips and plan according to Wind down, evening screen reduction, pushing the phone down two hours before bedtime is super important. What do you mean at daytime? Give it time for yourself to meditate, to listen to good music, maybe. Radio, read, just lay down in bed and dream about things or have a chat with your friend, ring your friend if you can. But try not to scroll and look on the media and stimulate your brain inappropriately. That it doesn't give you any good night sleep. Also, focus on good nutrition. Eat regularly. Stay hydrated. Avoid long gaps between the meals. If you start extending I know some of you are on the intermittent diets. By this time, your body got used to that. It's not suiting everyone. You need to discover yourself. But with energy, you need regular high nutrition dense food, not sugar, not even, multiple times of the fruits or multiple fruits because that gives you fructose, and proptosis in the body becomes a glucose. And glucose is our, sugar. And you may experience a sugar crash. So sugar crash is not a good idea because it exhausts you further. So be mindful. A lot of people make mistakes. They say, oh, I eat a lot of vegetables and fruits, but, actually, two items of fruit a day is enough because otherwise, you expose yourself with a lot of unnecessary sugar, and then sugar causes more exhaustion than before before eating sugar, before exposing yourself with refined sugar or or even fruit. Okay? So two items of fruits. Don't overdo with grapes. Grits are full of, fructose, and that could give you a sugar rush, so be mindful about this. Now pain is another factor that is very debilitating and causes a lot of grief. According to Hippocratic Oath, we cannot disregard patients who suffer with pain. This is our mission to help people with pain. So pain is a common symptom in MS, and it's various different causes that causes pain in MS. So neuromactic pain is one of the commonest descriptions and problems because pain comes from the injured nerve. So it causes a lot of, pain symptoms such as burning, stabbing, pinching. There are different descriptions to describe neuropathic pain. So there are some methods and interventions to address that. Neuropathic pain responds well to pregabalin, nevapentin, duloxetine, one of these agents. This usually prescribed by family doctors, GP doctors, or neurologists. Also, spasms and cramps often in the legs and back and arms sometimes sometimes face. And what's most helpful, there are some agents that helps with the spasms, antispasmodic agents such as baclofen, tizanidine, for example. Xantivex, which is a cannabinoid synthetic. Drink? Magnesium, four hundred milligrams at nighttime. Magnesium is a vitamin is taken at nighttime. Quite often, people with MS take it in the morning, and they feel even more drowsy and tired because magnesium tends to relax the muscle cells, and you feel just relaxed. But that's that's okay for the nighttime, particularly if it reduces your spasms in the muscles. Now MS hug is another painful experience. It's a tight band around the torso, squeezes, and it's very intense. People sometimes cry because and they go to the emergency departments because they feel like they're having a heart attack. So be careful. So, again, that's responses to our antispasmodic and neuropathic painkillers. Specificity related to pain, like, when the stiffness and cramping is very intense is because the legs are presenting with the increased tone. I call this a wooden gait. People can't bend their hips or knees or they have certain position of their legs. Like, the leg is always bent. You can't extend the leg. So that's mainly because of the ongoing spasticity. And the danger I think is that it becomes a dangerous situation. A fracture, which is the fibers that connects the muscle to the bone gets stiffened, and then it's impossible then to extend the dilemma. And it's difficult to care after people who has got this problem. So, usually, the passive active movements, some physiotherapy is a good way of managing this problem. Dystonia pain, muscle blocking and twisting some inappropriate posturing of the hands, legs. People have involuntary movements that goes into the spasms, and they can't unlock their fist, for example, or the arm moves one or another direction. It's really painful experiences. So, again, we manage that with chemicals, with medicine. Sometimes Botox injections may help if it is a constant and ongoing issue. So, yes, just be mindful about this is important. Gentle movements never gonna hurt anybody, like yoga, pilates, daily movements, walking, mobility, trying to keep the momentum and walk. It improves all these symptoms from dystonia to neuropathic pain and spasming, cramping, and and spasticity. Sometimes people use capsaicin creams, and non steroidal anti inflammatory creams. Try that. If there is some inflammation going on in the joints, it may help. Some people respond to capsaicin cream, which helps to reduce a bit of neuropathic pain experiences. TENS machine, transcutaneous electric stimulation is good one for lower back problems, for shoulder pains, for bone pains. It can be effective if you use that regularly. If you suffer from migraines and headaches, there's also TENS Lloyd's machine for headaches. You push the electrodes on your forehead to stimulate for minutes. And then if you do that regularly, it may diminish the frequency of the migraines. And then if the migraine attacks start, you can reduce the pain of headache too. Alternative medicine, which is very ancient medicine, we call this alternative, but actually this is how the whole medicine started. It's acupuncture, mindfulness. These approaches are very powerful for the pain management, believe me or not, but that's proven to be effective. Okay. Now let's talk about the mental health and mood. Fifty percent of people with MS experience anxiety or depression. Sometimes it's reactive because of the new diagnosis, life change, they're upside down. Sometimes it's neurological, but always important. We can't ignore that. Common challenges are depression and anxiety, emotional changes, irritability. Sometimes people cry or laugh, giggle inappropriately. That's cerebral. That's coming from the brain dysregulation. And coming to fog, mimicking mental health some symptoms is common. Some people experience extreme fatigue, brain fog, and that could potentially mimic, depression or anxiety. So what helps is talking therapy, cognitive behavioral therapy, acceptance commitment therapy, ACT, counseling, psychotherapy, all these powerful tools. Mindfulness reduces overthinking in your mind. It's really powerful tool, very, very old fashioned. Comes from Buddhism. Nothing to do with the religion at all. He's just learning how to, experience the present moment without reacting or responding to the environment and the stimulus. Movement, walking, stretching, yoga is number one that improves the mental health if you do that regularly and you stick to the regime and the program. Nutrition, again, omega three with an d three. Gut supportive diets, anti inflammatory diets, extra virgin, very high quality of the olive oil. I've just visited Tuscany in Italy, and I learned how the oils are being produced. So it's difficult to find a good quality of the olive oil in the grocery shop. You can't produce olive oil for eight pounds per bottle. One olive oil tree produces two bottles of olive oil. So imagine the cost is high. And usually, it costs from 20 to £40 per bottle, depends where you buy, whether you live in the countries that produces the olive oil. So you're lucky because you can get cheaper from the olive oil, farmers and makers. If you live in the Eastern European countries, there are some companies import the olive oil, but you need to make sure that it's 90% extra virgin, clean, clear, fresh, made in Italy, Greece, or Spain. These are countries that produces the best quality olive oil. So or if you live in UK, for example, or Americas or health shops, that are selling the products of, Europe, you may find a good quality of the extra virgin olive oil. You can also listen to the episode where I was talking to Frank Lickory about, olive oil and benefits. It's a great product for longevity medicine, for healthy aging, for preventing having strokes, heart attacks, and all other cardiovascular issues and dementia. It's amazing natural for wellness and long healthy life. Now peer support, if you have emotional problems, depression, and anxiety, these are challenging situations that you require a bit of a talking therapy. Whether you're talking to yourself, you may do, or you are connected to other people and you you talk your heart out. Your heart out needs to be spoken, cried out. You if you want to sing, sing out. If you want to cry, cry out. The talking therapy, the peer support is very, very important. And just bear in mind, the emotions that are not expressed gets accumulated, and then that causes a lot of problems. So if you want to look after yourself very well and you have accumulated emotions, cry it out, talk it out, walk it out, write it out, draw it out, sweat it out, or breathe it out. Okay? So expression gets you on a better journey, so you're not spiraling down. You're coming out of this barrel. Now, what the supplements could help you with your progressive MS? We discussed about omega three, but if you're consuming a good quality extra virgin olive oil from Greece, Italy, or Spain, you're okay. But, if you don't consider on the omega three, fish oil, it helps to compensate the omega threes. With our current Western diet that's coming from US, you get a lot of omega six, but less omega threes. And to compensate that, it's useful to have extra, whether it's coming extra virgin olive oil or as a supplement. Both works. Magnesium for spasms as we discussed, leafy greens, pumpkin seeds full of magnesium. Zinc and selenium are other antioxidants. It's good for brain protection. It comes from lentils, eggs, basil, nuts. And if you are anemic, that's another common reason why people feel so fatigued and exhausted. It improves their nerve function if you take some extra iron and potassium, particularly if you have deficiency. So nutrition advice for getting extra iron is tofu, sweet potatoes, bananas. So these are foods that you could consume and get extra support. If you are supplementing yourself, always check the level. I think it's important to keep an eye on the level. Too much of a good thing can be also harmful, so be mindful about this. Nutrition wants cure MS as we know, but it can make your body much more resilient and healthy. Okay. I think it's time now. I always advocate for meditation and mindfulness, and I would like to provide you six to eight minutes guided meditation just to use that opportunity. If you listen up until the moment, I'm very grateful because you're getting all the benefits from this episode. You are going to be guided by me, and we're gonna meditate together. So use any cushion that you've got, any pillow, maybe you're in bed, maybe you're sitting. Just find this comfortable position of your body. And when you're ready, if you wish, close your eyes. But if you don't want to close your eyes, you want to watch me if you're watching me on YouTube or Spotify or many other platforms. Keep your eyes open and see what I'm doing. But in the meantime, if you don't see me, close your eyes gently, and I would like you to invite to make a moment just for you. You don't need to do anything. You don't need to move. You don't need to fix anything. You simply need to be. It's a very short guided meditation based on the yoga nidra or yogic sleep. It's one of these powerful meditation branches that really helps to unwind and rest your brain. It's a powerful tool to rest your nervous system, calm fatigue, calm your nerves, and invite the sense of the wholeness, especially very, very helpful in progress to MS. So let's begin. Allow your hands to rest by your side. Palms open. Take a slow breathe in through your nose and slowly and easy breathe out. And let's do that one more time. Take a slow breathe in and as you exhale, blow it down. Inhaling, calm. Exhaling, tension. Now breathe as you would normally breathe, and bring your attention to different parts of your body one by one. As I name them, just feel them, but no movement is required. Starting with stealing your right hand, your right thumb, your right index finger, middle finger, ring finger, little finger, your palm, your back of your hand, your wrist, your forearm, your elbow, your upper arm, your right shoulder. Feel the entire whole right arm. Now let's move your attention to the left side, your left, your thumb, your index finger, your middle finger, ring finger, your little finger, your palm, your wrist, your forearm, your elbow, your upper arm, your shoulder. Now feel both arms at the same time, resting deeply. Now bring your attention to your head, back of your head, your upper back, your middle back, your lower back, your entire spine, moving to pelvis, your hips. Bring gentle awareness of your legs starting with your right leg, your thigh, your knee, your calf, your shin, your ankle, your toes, your big toe, your fourth toe, your third toe, your second toe, your little toe, your entire right leg. Now move your awareness to the left, left thigh, your knee, your shin, your calf, your ankle, your toes, your big toe, your fourth toe, your third, and the second, and the first toe. Now bring your awareness to the entire body from the top of your head to the toes. Now scan your face. Your jaw is relaxed and soft. Your face is relaxed and the eyes are resting. Your forehead is flat. No wrinkles. Let the whole body feel held, feel supported, feel safe. Repeat to yourself gently. My body and mind is light. My breath is steady. I am safe. There's nothing I need to do. Or you may have your own words to yourself that I allow you to to repeat to yourself. Let any sensation plight. Let fatigue be met with compassion. You're not broken. You're not lost. You are a field of awareness, full of light, resilience, and rest. Now take a breath. Feel the ground underneath beneath you. Gently start wiggling your fingers, your toes. And when you're ready, open your eyes. Look around. Can you hear any sound around you? Can you see things? That was yoga, nidra. A practice that can be done anytime, anywhere. And you could always come back and listen to the same track and be guided. It helps to unwind and rest and calm the nervous system and reduce the pain and restore your your energy. So let's finalize this episode. If you are at the point where your MS is progressing and disease modifying therapies are no longer being prescribed, I want to say you clearly. You are still treatable. You are still valuable, and you're still the whole. This phase of MS isn't about giving up. It's about shifting forward towards living better, towards living healthier, towards living full on life with tools, with people around you, practices, and wisdom that uplift and empower and inspire you to move forward. Your neurologist, nurse, therapist, or peer or friend or buddy isn't there to fix you. We are here to walk beside you and help you walk your own path with strength. For more support, head over to www.bewell with MS or any charities, MS Society, MS Trust, MS Together, Shift MS, European MS platform. You'll find some guides, groups of people, reassurance that you're not doing this on your own. You're not alone at all. And if this episode resonates with you and you think you could share with anybody else that would benefit and get right help at the right time from this episode. So feel free to share, comment, and until next time. Take care. Take care of your mind, body, and your spirit. You deserve to be well, so be well. Bye for now.
25 April, 2025 Guests Interviews and Charity events
In this episode of the 'Be Well with MS Podcast,' Dr. Agne Straukiene welcomes Frank Licari, an Emmy-nominated actor and producer renowned for his work with the Blue Man Group and PBS's 'Living Longer, Living Well.' Frank shares his inspiring journey from theater to producing health documentaries, and how his personal experiences, including his brother's battle with cancer, fueled his passion for promoting wellness. The conversation dives deep into the Mediterranean lifestyle, emphasizing diet, community, and lifestyle habits beneficial for mental and physical health, especially for those living with MS.
Welcome back to be well with MS podcast. I'm your host, Doctor. Agnes Rogan, neurologist. And today, we are going to talk about exciting things. I have to say that this is the closest I've ever been to a real celebrity. Today's guest is Nona Baba, the Telly and Adi award winning actor, three time Emmy nominated host, and producer director whose career spans an incredible thirty two years across theater, television, and film. You may know him as a former blue man from the legendary Blue Man Group or from his PBS hit show on the town in the Palm Beaches, or more recently from Living Longer, Living Well, which dives into the secrets of longevity through the Mediterranean lifestyle. Frank's work is not only captivating, it's purpose driven with a mission to inspire healthier, more connected lives. In this conversation, we explore his journey from Off Broadway to any nominations, his passion for storytelling, and how film and media can be powerful tools for promoting wellness, even for those living with chronic conditions such as MS. So get coffee, maybe grab a lemon water or a green tea, and enjoy this energizing episode with this multitalented Frank Licry. Welcome to the show, Frank. Thank you so much. It's a pleasure to be here. That was a wonderful, wonderful introduction. I wish I wish I wrote my own as good as you just did for me. I appreciate that. Thank you, Frank. I try I try my best. I try my best. Oh, you did great. I would like to learn your journey of reinvention from Broadway to living longer, living well. What inspired you shift into producing health documentaries? Yeah. It's interesting. I have always been on that health kick. My whole being in the business, you always try to stay in shape and you try to stay, because you're always in front of a camera. And I'm as I hit my I'm in 52 now, about to turn 53. So as that kind of started to happen, the aging, you start to think more about your your health. But what really threw me over was my brother got cancer in 02/2019, and I actually lost my brother two and a half years ago, my younger brother. And I'm sorry to hear that. It's fine. Yeah. It it was a rough time, and it was something where I could tell he was regretful. He hadn't taken care of himself through his later years, and it really inspired me. I went through this crazy phase of, okay. I'm gonna I'm gonna go completely vegan. I'm gonna I try I was a vegetarian for a while, and I went all through this sort of map. And then out of nowhere, I've been hosting this show on PBS for many seasons, and they called me and they said, hey. Would you like to host this other show? And I said, okay. We talked about it a little bit, and it was, living longer, living well. And I have many all my family is actually in Italy, so I'm very familiar with the Mediterranean diet. I grew up eating the Mediterranean diet. That's all my mom cooked. So when we started talking about it, I said, oh my gosh. I'm this is I'm already an expert at this. I know this side of the of health. So Yeah. It threw me down this path. And so we did that show. I actually hosted a neuro arts conference in West Palm Beach last year, and I have a new show coming out that's strictly about olive oil based upon the Living Longer Living show that sort of opened up this whole world of, wow, this is how I grew up, and now I'm in America because I spent a lot of time in Italy as a child. How do I bring this lifestyle that has been around for centuries in the Mediterranean? How do I bring that into my own life, into friends' lives? And so that's been a little bit of a personal quest over the last three or so years. Frank, such an inspiring story, and it makes me think we always have this kind of deep why we're doing. And your personal experience was driven, your agenda and purpose, to not that you needed the most to live well yourself because as a performer, you have a lot of physical you need to have a lot of physical and mental effort to Yep. Do the business you do the best. And also the exposure is Italian by heritage. You by default, you already have the right set of skills and knowledge how to live well. What inspires me the most is that you are keen to share your knowledge and information with the audience that you work with. And I think nothing is more boring than receiving the leaflets about what oils to use for cooking, what type of food we should cook. If it comes in sort of a documentary film, that is already uplifting our spirits. And if it is well documented documentary film, I think we're all glued to the screen to learn more, and I'm just so proud and honored to talk have a possibility and a chance to talk to you about this into more detail. I guess maybe let's dive a little bit into lessons from the Mediterranean lifestyle. What are the most powerful lifestyles and habits you discovered? We all know that eating Mediterranean diet, which is full of the nourishing vegetables and fruits and meat and fish and all that and drizzle with the oil and oil. We've we've got this, but anything in particular that we all could learn from you that you discovered and people could apply living with a chronic conditions that is simple and convenient for majority. What are your lessons? Yeah. What's interesting, as you go, I went through Greece and I went through Sardinia and all through Italy. And now with the olive oil show, I went through almost every microregion in Italy. And the commonalities and I will talk I wanna talk in-depth about the olive oil side because there's actually things that I had no idea about until I did this particular program and produced that show. But what I found about the Mediterranean diet is first of all, if you go to Italy, the things you do not find on every street corner, as we do in America, you'll never find a gym, and you'll never find a vitamin shop. They don't exist. And I brought Americans with me when I do did the show. So my staff, my crew were looking, hey. Where's the gym? I and I started laughing. I'm like, we're in Sicily. There is no gym. This is there's not Sardinia. There's no gym here. The gym is the lifestyle, and that was the first thing I learned Is that a year and you said it best. There's nothing better than visuals. Right? We can read all we want, but when you see a hundred plus year old man or woman who is in front of you climbing mountains and doing things you're going, woah. Okay. I'm used to in America, once we hit 80, people are starting to look hunched over and they're walking slower and all these things. And I go to these places and I'm saying, how are these people doing this? And the commonalities that I found were actually more than diet. It was about laughter. It was about communing together. It was about dancing. And it's interesting that we joke around once we get older. Yeah. That's kid stuff. All the kid we look we make fun of kids who are playing. But really the lifestyle of the Mediterranean diet is also the Mediterranean lifestyle, which is, hey. It's not all about work. It's not all about getting ahead and working as hard as I can to make as much money as I can. These are communities that stick together. They sit together on their front stoops and talk, which is a novel idea. It used to happen everywhere. It doesn't happen here anymore. There's the entire lifestyle. Like, I went to Greece, and I spoke to a gentleman there who was our guide. And he and I said to him, it's funny, with all the talk I hear that Greece is economically depressed, I see people out everywhere. And he said to me, we don't care about where we live here. We only care about how we live. And they do not we say we have a word in America called skimping. We don't they don't skimp on going out, being with each other, enjoying good food, walking, which was the maybe the biggest thing. The communities are walkable. And the more walking these people do, of course, we know this now here. We have to walk 10,000 steps a day, and this is the new thing. Right? But that's what they've been doing their entire lives. And they're 95 years old and a hundred years old, and they're not on medications, and they're not worried about their backs or they're walking, and they're laughing, and there's dances happening regularly. And that was one of the biggest things I've got I got from the military. I was expecting to hear all of the food, which we like you said, we know there's research out there. But to see it, and then you realize that the Mediterranean diet is different in Florence than it is in Greece than it is in Sardinia. It's different. There's not one singular thing, but the commonality is that life is the exercise. Life is the energy we put forth in things. It's not, oh, I've gotta finish work so I can go to the gym or go get my vitamins. They're getting it through their life. And when I went to Sardini, I'm sure you saw the show, I mean, there were a hundred and 10 year old men that are still shepherds. They're living and they're walking in the now I understand we don't live in the mountains here, but you can walk. I mean, I live twenty minutes outside of New York City. You can walk the entire city. Right? Like, you can walk Manhattan from the Lower East to the Upper East in pretty easily. Most people will take Uber and taxis and subways. You can walk. And that is the thing that I found that I was the most interesting because I wasn't expecting it. It's lifestyle. It's not necessarily diet as much. Yes. As the diet is very important, and we'll get into that. But laughing, dancing, getting together regularly to me was okay. This is the commonality that I saw. Wonderful. I'll give you just a bit of experience. I just returned back from San Diego. Uh-huh. Sunny San Diego. So there was a the largest conference in neurology, so we call this AM, so American Academy of Neurology. Thousands of people come and they're all neurologists. They have very different interest in neurology. One is Parkinson's disease, another one is MS and dementia. And I had an honor to spend some time with Italian and a and a person from Greece. Yeah. Two different nations. So, Okay. So the first shocking feeling or experience was that we couldn't find a chopped tomato or a for the breakfast menu. Right? So you go into the you can get in the format of the sauce like a kitchen. But you haven't got anything to push on your plate. So by day two, we went to the grocery shop, and we bought some granolas, kefir, yogurt just to make that supply for breakfast and eat it individually. Although we were missing the opportunity to share our experiences at the table because we ended up in having breakfast in our rooms because of that sort of Of course. And then the other experience, like, culture and the the difference that I went with these colleagues of mine to the restaurant. And, again, so the communication around the table, you end up in I end up in having someone else's plates food on my plate because it's a sharing is caring. The way people communicate whilst having dinner, an extra layer. And, really, I feel so important because I end up in that getting someone else's orders on my plate. And this is an amazing experience. And I think quite often as adults, we lose our childhood joyfulness. As you mentioned, whilst we are children, we are dancing, we're playing, we are we are free. And the moment we become adults, we lose all that. And I think if you are listening to this episode, think about yourself as a child. What's the priorities and what the goals and purposes did you have at the time? Could you bring some of the domains and elements into your life as an adult? And I think the other thing that I would like to focus is that we're going to the gyms. We we have to wake up at 6AM if you live in New York. And I had another meeting with my colleague who lives in New York and says, my day starts 6AM, and I go to the gym, and I go I do all the all my day until 7PM, and then come back and I cook. This is wrong. As you mentioned, the life is an exercise. And it is such a beautiful saying. I think what we would like to learn from you, Frank, is how to tell the story. How can we use the power of the storytelling about the health? We go to the clinics and we see people who are obese and with diabetes. By the look at them, we look at them, we know loads of health issues. And then we know that the problems that they have is in lifestyle, that they have such a wrong how can we convince these patients that enter our room? How can we tell the story that is powerful and is gonna help most of the people to understand Yeah. How to manage their health? Yeah. It's interesting, especially in this country. No. I'll say I'll just say the Western world. And it's been marketed by The United States. Let's be honest. It's a it's this and like you said, we have to get up to make an effort to be healthy. Right? Then we ruin our bodies the whole day. Right? We eat fast. We eat wrong. We run through stress and physical abuse, and we sit in chairs hunched over until 07:30, eight o'clock. And then we expect that healthy meal at the end, if we have one, is gonna fix everything we just did to our life. So it's really a mental change. And I wanna add something to what you said about being a child. I don't think we lose our childlike. What we gain is inhibition and judgment. We still have the children inside of us because I see it in adults every once in a while no matter where you are. Grown men, now albeit, sometimes with grown men, it takes an alcohol or something to get them out of their shell. It's not always the best way, but it brings out this side of them that you go, oh my gosh. This is a 45 year old man acting like this. It's unfortunate that it takes that type or a sporting event to get men to get to that level of in a their they get their inhibitions. They usually have to stay so controlled, and they're not allowed to cry, and they're not allowed to do all these emotional things that are weak. But the truth of the matter is it's a mental shift. It's a mental shift in our in ourselves as much as it is our physicality. That's why I think it's important to see it. That's why I say to you when I went to Sardinia, I saw a hundred and plus year old men with this. You have to seek out these things. I think you remember when the documentary, oh my gosh, Super Size Me came out, which was the one about where the gentleman, I'm trying to remember his name, he overate on McDonald's for thirty days and changed I don't know if you saw that one, but it was a it was a it was probably I don't know. I guess it's probably you may be too young to remember it in during your studies, but I'm a little older. So for me, it was this life changing thing where it was like, we knew McDonald's was bad for us. We knew it. We all talked about it, but we still went through the drive through. And I grew up with a father who smoked and was a diabetic, and I knew it was bad for him, but I didn't realize it until he passed away at 64 years old how bad it was. And that changed my entire direction. So it was a visual thing. Right? But to supersize me, you saw what transformed in this gentleman for thirty days just eating McDonald's. That's all he ate. Morning, noon, and night. And it completely changed his entire metabolism, his body structure. And once you saw that, you went, oh, wow. Okay. Alright. Now it hit home. And I really do believe that we have to seek out those types of programs, whether it doesn't have to be mine. It could be we had if you remember the blue zone diet that came out on the on on Netflix. There are things out there, but we have to want it. Very much unfortunately, I'm sure you run into this as well. I was a teacher for a long time. I had my own performing arts school after Blue Man and saying things. You're relying on a lot of things to happen for that information to be retained and then acted upon. But when you see things or you are able to be there's nothing better than when people say I hate yoga, and then they take a yoga class and actually do it and go, oh, wow. This is not only more difficult than I thought it was. It's actually I feel different. You have to experience things. And you said at the at the lunch table, you had to go out to the grocery store or at the breakfast table, you had to go out to the grocery store. Yeah. Because we just accept status quo most of the time. We just go, okay. This is what's here. No. We have to force ourselves to do better. And and I guarantee you, if four people saw what you and your colleagues did, they probably would have went, hey. You know what? That's a good idea. You have to really allow yourself to be affected, and many times that is visually easier because sometimes we are to quote the bible, we are doubting Thomas'. Until we see it, we do not think it's true. We have to see it in real time, and that's why I think it's important to seek out programs like that. And then you have to do it. You have to do it yourself to see the effects. It's in America, we work out, but most people start on January 1 with that new that resolution. And probably about a week and a half later, they're like, yeah. No. They don't they don't wait for the transformation to start. Once the transformation starts, then it becomes an addiction. And that's the same thing that happens with bad things. Right? Once we see it transform our body, if we like it, we tend to do it again. And healthy foods are like that. Once you have that thing was, oh, I don't feel tired anymore, and I ate. And that's what happened to me in Italy. Right? You eat and you go, wait. I said, I didn't gain weight. Why didn't I gain weight? I go back home and I eat the same way, but what am I doing wrong? What am I doing different? And there we go back to, besides the way the food is processed, the lifestyle and people and you go, most of these people are thin, and they don't look as heavy as we do in America. Why is that? So it makes you questions. Traditionally, and I'm only speaking for Americans at this point, even though I'm Canadian, by the way, by birth. I speak for Americans because they don't. They've started to more now, but they don't tend to travel. They don't tend to seek out anything more than what they already know. And it's difficult to change their minds by someone like you who has the knowledge and may say it and may tell them, but it's very difficult until you see it, until you experience it. Absolutely. I I couldn't agree more. And I think just to add what you just said, I think equally people who are practicing bad habits like smoking, drinking, eating ultra processed food, they just so much get used to that. They they don't see that this something is wrong here because they get used to that sort of, slugginish crap feeling every single day because that's their norm. They don't have a vision or feeling how it would feel, like, if they've done opposite things. Yeah. And I guess, as you said, the education is super powerful. And if it is visually appealing and tells the story, it's a storytelling. And I think what you just inspired me, Frank, is when we are giving these blind leaflets with a human being in a sort of a quote say, oh, eat healthy, eat well because that will improve your outcomes. I think telling the story maybe in the format of the short video, which we these days, it's easier to create animation using AI or whatever. And maybe putting the QR code on that leaflet for them to scan and actually get into the story and understand the impact. We shouldn't be classing bad and good food because we all have, on occasion, some cheating days as we're called. Of course. But I guess, you know, as one of the specialists that I interviewed a day before, to be honest, We agreed that probably we should class foods into always and sometimes. You know? I would agree with that. I would agree with that. And I also think it's there's a marketing ploy too, right, that we have to be aware of. The it always seems like the companies that have the worst maybe the I won't mention names, but the companies that are most creating food that is bad for us have most of the marketing dollars. So there's no coincidence that when you watch commercials, even if you watch a sporting event, which I'm always shocked about, you're watching a sporting event filled with healthy individuals who are just in the at the peak of their physical they couldn't be healthier. They couldn't look healthier. And then a fast food commercial, a beer commercial, a chip commercial, and a every medication under the sun commercial comes on as you're watching these games. Even when you're watching on now we don't have as many commercials as we used to because we're watching streaming. But even if you watch, you know, what the banners are, what the pre they're always those types of commercials. You never see you're watching a soccer match or you're watching a basketball game and healthy living, or you don't see any of that. Hey. Grab a quick bite at the blah blah, and it's mind boggling to me. But it has been marketed to us as that is think about it. We call it our cheat day. Why do we call it that? Because we've been programmed to think that food is tasty. It's a treat. We've been programmed to think that is a treat for us. Right? So if my cheat day is, how do I make my body as unhealthy as I can for the next three hours? That's my cheat day. And supposedly, that's supposed to make me feel like I was a good boy all week, and now I'm going to get to eat the good food where I've been tormenting myself for six days in eating the stuff I really don't wanna eat. It's a marketing tool. Right? We have to stop calling them cheat days and treats, or I get to reward myself with a awfully fat or an Oreo cookie that's not even real food or whatever it is. Right? Those are the rewards for being really good. No. The reward should be, hey. I'm gonna eat this incredibly healthy tomato like you said, or I'm gonna go now I'm on this extreme olive oil, healthy, and there are differences. Extremely well, early harvest, high extra virgin olive oil. That to me makes me smile now. That not so much, oh my gosh. I know when I'm having a cheeseburger, it's not a treat. I'm gonna feel terrible after I'm done. Yep. French fries, whatever. I know I'm gonna feel awful. It's but it's in your brain. It's marketed as, well, this is a treat or it should and it's unfortunate. So it's a marketing thing too. So there's another way for you to visually start to change the conversation a little bit. We have to get away from that that because that's how the companies market it. Don't you wanna take a break today? And it's the KitKat bar. Right? And don't you wanna the be part of the billions who are eating at the this particular restaurant? So I think that's part of it as well. And we were wonderful marketers in America of the worst possible food you could possibly put into your body. They love marketing it. And cigarettes and beer and all the fun things. Right? Yeah. So people don't believe so disagree on that. So be selective. Use your mind. Use your experience. Use your knowledge. If you don't know, ask the doctor. Ask the nurse. Ask professional people. You know? I have patients with MS who comes in and they have breakfast and it's like cereal full of sugar. It's hard to listen to the stories, and I quite often ask people to take through what exactly do they consume, what they eat, just to have a sense and feel because the way they look, they don't look like they're eating tomato or cockamoo or any other leafy green. So then you dive deep into and a lot of consumption of sugar, which causes cancer, causes immune diseases, causes worsening of the underlying chronic diseases, etcetera, etcetera. So we have to be mindful. So although stories that are presented on the media, YouTube, various different other channels, Netflix. But the ads in between, even if they talk about the healthy living, the ads of of the chocolate bar is really not a healthy option. And you're so right presenting in a way that cheating days are not that rewarding days. They are still very negative and makes you feel awful overall. We yeah. We have to take and I know you do it, obviously. It's your profession, but we have to take charge of our own health. We really need to. When my brother was going through cancer treatments at the hospital, they were and I took him off the food, but their food was outsourced. The hospital wasn't making their own food. They were bringing in a catering service. And these cancer patients were eating, and I'm not even kidding, and it made me angry at the time. Now I can laugh about it. But I want I went in to visit my brother one of the first visits because I came home to take care of him from The States he was in Canada. He was eating they had meatloaf and just the worst possible and sodas. And I'm like, this is a you're in a cancer hospital. This is what you're eating? Didn't they they told us the first thing to eliminate would be red meat and sugar. And he was eating that at his hospital. So you can't even and, well, in this country, I don't know I can't speak for other countries. And when when I say this country, North America, Western here, where even the health organizations, I feel like sometimes, are in cahoots with the pharma organizations. And it's if I'm going in for cancer treatment, I should be eating there should be a healthy diet in the hospital. But because it's not cost effective and it's not good business, we're gonna feed you just like we feed anybody at a cafeteria at high school. And that's really what it was. It was cafeteria food. And so how do you expect people to get healthier? We have to take charge. So I took him off. I told him, don't do not deliver any food to my brother. My mother and I proceeded to make food for him every day of his treatments and brought him in fresh juices and fresh foods and things like that. Unfortunately, it was too late for him at that point, but we have to do it before that all happens. And as soon as you see yourself putting on weight, it's not about the look, and that's the other thing that we could talk about. And we are programmed that to be overweight, it's about a looks thing. It's about a aesthetic. Right? You don't look like Gisele Bundchen, so you should go throw yourself off a cliff, or you don't look like whomever. Let's use the other side, Tom Brady or whomever you wanna talk about. You don't look like Ronaldo. So whatever it isn't about aesthetic, It's about what it's doing to our bodies, to our hearts, to all the diseases that we are just enabling. Right? Because we have all of these potentials inside of us to create diabetes, n m s, and Alzheimer's, and all of these things. We can keep them at bay by keeping our heart healthy and our brain healthy, but we don't. And then we get angry when we get sick and say, why me? And why do my joints hurt? And why does this hurt? And why am I only 45 and I can't play sports like I want like I used to? And those are all the things that it's too late at that point. Right? You have to start it sooner than later before you get to that point of no return where you're too heavy that working out, unfortunately, becomes a chore, and it's like it's painful. And you get on medications to numb the pain, and there you are. Vicious cycle. So the more you are in pain, the more you're obese or overweight. So the more challenging for you to commit to the lifestyle healthy lifestyle exercise program or making food, fresh foods, it's an organic whole food for yourself because you have no energy to do that. So I guess we are biological robots, and our body functions at the molecular level. We can go and scrutinize that to the mitochondria, which is our organelle of the cell that supplies the ATP energy for the cells to function and supply all the nutritious, rich, dense products to our cells to contract, to relax, to produce movement, to pump the heart. And these kind of nutritious food and ultra processed foods, in particular, these classed as damaging our cells in our body is only gonna harm and take all the vitality and energy that you have produced as a human being. But taking away that chance for the cells to function because you're exposing yourself with a huge amount of alcohol, sugar, processed foods. So I think what we're trying to do here with Frank is to highlight the issues. And I know multiple people now listening to us and thinking, we know that. We already know how can we change our behavior and what I guess, as we started, is your personal why. Once you find this why internally inside you, you will find how. It's their individual story to every single person on this earth. I would like to learn more about olive oils. You said you're gonna tell me the secrets. I never heard any more secrets than just extra virgin, which I purchased in the grocery. That's the problem. So, yes, I'm gonna tell you a few things that may blow your mind a little bit. But Okay. The majority of olive oil that we get in the grocery store is already rancid before we put it into our systems. We just don't know it. And so the entire and this includes all of us everywhere here in the Western world because we don't we've actually never tasted what a real good extra virgin olive oil tastes like because we've been fed such bad versions of it for so many years. And we go to our grocery store and we buy our $12 bottle of olive oil, and we think, this is great because I'm having olive oil. But the problem is if we think of olive like a juice, like a fruit, which it is, we have been eating and consuming, and I say eating because it is a food, we've been consuming the equivalent of spoiled orange juice or spoiled milk for most of our entire lives. Now I say that, is it better than consuming canola or soy? Absolutely is. Yes. But you are also consuming rancid olive oil most of the time. So I have a show coming out that will be actually, it's already out in Florida. It's gonna be coming out nationally on PBS called The World of Olive Oil. Myself and my good friend of mine, olive oil expert, Phil Bicchino, basically traveled the world talking about this and researching high extra virgin olive oil. And what I mean by that is and I'll relate it to your listeners and viewers here. So a good goodbye early harvest olive oil. That means that it's been harvested properly, and it's gotten to your table in the right amount of time, and it has been shipped, processed the proper way so that it retains its value, has a high polyphenol count. Probably, you've researched polyphenols in your research, But a an extra virgin olive oil early harvest has as many as 450 milligrams of high polyphenols per kilogram, which is amazing. So, obviously, the oleic acid and all those things that are positive for someone with MS, but a high extra virgin olive oil, a very high quality one, actually has higher content for all of the things we're talking about, which is from which is the oleic acids, which promotes the Treg. I'm not a doctor, but you know what I'm talking about, the fatty acid oxygen Yeah. Basically, for the late person audience, the polyphenols are strong antioxidants. Yes. So it it diminishes the the extensive distress at the cell level. So what I just talked about is the mitochondria, the function of the cell. So if you expose yourself with loads of antioxidants, your function is much, much better. So it has got anti inflammatory properties. That's why it's very powerful in in autoimmune conditions and inflammatory conditions like rheumatoid arthritis, MS, Crowe's disease, etcetera, etcetera. So let's dive deeper and understand from Frank how often should we consume olive oil? Does it need to come with porridge in the morning then main meal? Is it lunch and then dinner? What would be proposed advice? So as we go to this Mediterranean diet that we talked about at the beginning, the other commonality, whether you were in Greece or whether you were in Sardinia, whether you wherever you were, is that olive oil and high quality extra virgin olive oil, and we'll talk about that in a second, was consumed at every point of the day, and it's the only olive oil they use. So the misnomer you don't fry with extra virgin olive oil is a myth that was actually put out by the canola industry. You do fry with it, and the proof is not from me. It's from everyone that's ever grew up in the Mediterranean. That's all they do, and that's all they did. So they're they seem to be doing pretty well. So it's not going to kill you. It's not gonna be bad for you because it doesn't have a high smoke point like they talk about. High quality extra virgin olive oil at every meal. And I'm talking they're starting to use it again because olive oil goes back eight thousand years. So in the Roman Empire, it was more important to them than wine. And the Romans understood the difference between bad olive oil and good olive oil. They had and most people don't know this, but I'll just say it because the lay people don't. There's no black olive and green olive. It's all one olive. It's just a maturation process that's different. So there's no difference in those olives. It's one olive tree. Right? If you pick an olive at the right time, an early harvest, and you make and you know what you're doing, now they know more than they did a hundred years ago, the type of olive oil that they're making now would be the equivalent of how Americans used to drink coffee, and now they understand what a cappuccino and an espresso is. Back then, if you grew up in America, you only drank instant coffee, Seneca, all these brands. Now we understand a higher level. Or what happened with wine. In the eighties, I remember it was just table wine. Nobody knew the difference. It was either a red or a white. And now everybody knows what a Barolo is and a Sangiovese and all these other different varietals. That's happened to olive oil. So when you have olive oil, you're having it with your morning with your my, my cousin who is visiting right now from Switzerland, who I haven't seen in thirty five years, she's with me now, she pulled out olive oil. She said, do you have any olive oil? We made pancakes for breakfast. My wife makes them. She put olive oil on her pancakes instead of butter or Nutella or anything else that people would fill it with. She may she and I I don't even do that. And I was like, olive oil on pancakes? This is astounding. Oh my gosh. I've never even tried this. I've gotta try it. Because so they're putting it on ice cream. They're putting it in coffee. They're doing it because we understand now. But, again, high quality. If you're buying at the grocery store, unfortunately, I'll give you a couple of things. One tree, and this is all from my friend, Phil Bucchino. Shout out to him. He's the expert that's taught me almost everything I know about olive oil. He's my cohost on the show. One tree produces two bottles of olive oil per year. Now imagine when you think of all the olive oil I always have this when I think of chicken. Chicken is used all over the world in every cuisine, but I never see a chicken farm in America. I'll leave that information to you. Do it do with it what you will, but I feel like there's not enough chickens out there for the amount of chicken we eat. So I don't know where the chicken in our area comes from, but it's not always gonna be necessarily natural chicken. That's the way I look at it. And olive oil in the same way. We have a lot of, quote, unquote, extra virgin olive oil in America, but we don't have regulations here. So we can call anything extra virgin in the Western world. In Italy, you can't. So if you had a bad harvest, you can't go and put that in a bottle and call it extra virgin. You call it other things to fool people. Light olive oil or whatever, or you in inject it with coloring and aromas and make it what you want it to be. My new revelation is that there's only a real minimal amount of producers in the world that are making real extra virgin olive oil. I know them now. We'll be giving out those lists soon. But right now, I can tell you I did not buy olive oil at the grocery store anymore. I haven't for a very long time. I get it all imported to me from people that I know. They do the things the right way. You wouldn't even know their names, most of them. They're not mass produced. You cannot mass produce and sell an a bottle of olive oil for $8 and think that it's extra virgin because you're only producing two bottles per tree. So when you know those facts and when you watch the show, and I'll send you a link after our podcast here, I'll send you a link to watch it. When you realize what's going on with olive oil, that's also gonna change all of your habits and all of your research when it comes to that as well. So I'm, like, very excited to get this out to the world as well. And that's gonna be a full series that we're gonna go around the world and just talk about all of these things. And it's be very relatable to your audience as well. Amazing. I just thought, for my dinner tonight, I'm gonna pour extra virgin oil, which I actually purchased from Italian maker that comes in there sort of a in a very nice bottle, which looks like a vase. Yep. It has got a little plug that it's Yep. It's quite challenging to unplug it. So I think I've got the right one. So I'm gonna can I use it for you? We will talk off camera about that. I'm not gonna bad mouth anybody's olive oil, but we'll talk off camera. Alright. And then I expect, Frank, that your next serious moving away from the once you've done your olive oil is gonna be coffee beans. I hope so. I hope coffee in general, talents like espresso and the rest cappuccino in the morning. And it's such an instant to have it in the afternoon cappuccinos. Love it. So we all know that. Just to for the audience, coffee is really beneficial because, again, it's full of the flavonoids, which is antioxidant. And if you consume coffee no more than three cups a day, you prevent yourself from getting a stroke. Okay? So it's a real evidence based knowledge. There are studies done, so you shouldn't exceed more than three cups. So there is a limit, But moderate amount really gives you that nourishing preventative for developing vascular cardiovascular in stroke events, which is blocking the vessel and causing some ischemia, blood supply issues within the brain or heart. Okay? So excellent knowledge that we just received from Frank, and I would like to move into a bit of a sort of music, present movement Yes. And your your experience as a former Blue Nile group performer. What role do you think music and movement play in in neurological health and mental well-being? Because they are interconnected as we know. There's no question about it. The it's funny that I told you I hosted this symposium on neuro arts sciences in Florida last year, and it was exactly that. It was movement, music, and rhythm, and how it helps cognitive function. And so I studied music from the age of four up until today. I played multiple instruments, and one of the things that I've definitely always said is that the music in my life has informed who I am as a person and how I do things. And there is something about connecting. I think people forget that the first thing we ever hear in our lives, the first thing is your mother's heartbeat. So that's the first thing. And if you think about that, we all have rhythm in us, and there is not one child, toddler, that does not dance and bop around and skip and sing at the top of their lungs and make all of these noises that we always go, oh. As an adult, you go, can't you quiet that baby down, please? We forget that they're experiencing. And I wanna go back because you said something very interesting earlier on, and I wanted to put to forward on it, and now I'm gonna do that in this segment. We lose as adults our sense of discovery very early on, our sense of exploration because we think we know everything. And you mentioned blue man a couple of times, and the one thing about blue man, if you've ever watched the show or seen the it's yes. We make music, but the blue man character discovers everything that character uses throughout the show for the first time. So we have funny little what you might think are silly gags where we actually use a fork, but we don't know what a fork is. We have to discover it. We don't know what a balloon does. We don't know what sticks do. And so we go back to this childlike place in our lives. And when we lose that, you said it earlier, that's where things go wrong. And music, movement, singing, why do we always say, oh, I sing in the shower? Why do you think we all sing in the shower? Because we feel like no one else can hear us. Why? Because we're trained to be ashamed or to be embarrassed by the fact that we don't sound like Adele. Guess what? Not everybody sounds like Adele, and even Adele doesn't sound like Adele sometimes. And we get tricked because they go into the studio and they sound really good. You have to it's okay to make noise. It's okay to move your body more than sitting up and standing and walking in a straight line. That's why I think music and sports are very important for children. It puts a foundation into them that, yeah, it's okay to express myself by more than just talking or standing around. When you realize that you can actually dance anytime, by the way, there's nobody that says you can't dance down the street. Nobody. No one's ever put a law out that says you can't skip. We let children do it, and we go, oh, isn't that cute? But as soon as a 20 year old does it, you go, oh, they must be crazy. What what's going on over there? We should put them away. Why are they skipping? So I think it's extremely important. Again, this goes back to our mental reprogramming of what we think of as a treat, what we think of as decorum or being an adult or being, quote, unquote, civilized. Even back to your coffee thing, we're programmed to think that coffee in our country, it's all about the caffeine. It's all about the energy. It's not about anything else. It's just a k. If I'm gonna drink seven cups because I need the energy, we don't talk about the health benefits, which is why you can have horrible coffee in this country, and they don't care. It's not about taste or enjoyment. It's about pounding it back so I can they we use it like cocaine, let's be honest, in this country. Right? So we use it as a drug to keep us going. And all of these things that we're talking about, music, song, healthy eating, living, all of these things, we have made them chores. Going to the gym is a chore. It's something I need to schedule. Eating healthy is something I do, but then I give myself the treat. Dancing and skipping and singing is not for adults unless you're a professional singer. I don't wanna hear your voice. Those are all unfortunate things that we have become accustomed to, and we've allowed ourselves to say, yeah. That's a rule. But no. You don't have to save your dancing for only when you attend that one wedding per year or whatever it is that you go to. And even then, we don't know how to dance because we've stopped dancing. How many I don't know if it's women or men more, but I know men are very uncomfortable with dancing. They feel it's unmanly, and they don't they're not rhythmic because they've they've beaten it out of the themselves since the age of nine. But every baby, there are things that babies know how to do perfectly. I and we could talk technically. They know how to breathe perfectly. They all breathe into their diaphragm, not into their chest. They all dance, and they all sing. They're perfect. We as adults make them imperfect as we go because we subject them to this world that we live in with inhibitions, judgments, and no, don't do that. And we become those adults. Right? We all of a sudden, adults don't know how to dance. They don't know how to sing. They don't know how to they think eating healthy is, like, oh, it's so hard. It's not. It's actually tastier than eating bad. We cook my wife and I cook every meal at home except for maybe two a week where we go out. We cook everything, breakfast, lunch, dinner at home. And it's not a chore. It's actually we enjoy it. I actually feel like when I go to a restaurant now, I'm always disappointed, especially with the prices now. It's actually cheaper to eat healthier. It tastes better. You just have to wanna do it. You have to reprogram your body. Dance, laugh, drink coffee, make good food. It's okay. A glass of wine is not killing you. All of those things are okay. Just and smiling. I've spent this entire podcast watching you smile, which is a great thing. It's okay to enjoy what you do for a living too, by the way. It's not, my job. That's America. I gotta work for the weekend. And then the weekend, I abuse myself for two days, and then I go back to work on Monday. It's a really it's a cycle that we've gotten ourselves into. We don't enjoy our jobs. We don't enjoy our foods. We like, it's just this whole thing. It's a reprogramming. So, yes, dance and sing all the time. Beautiful. And I I just wanna summarize a little bit. Our music starts in our mother's womb. Then we have that heartbeat, which is our music to our ears. Pregnant woman has got two beats in one single body. So that's where the transition and transformation starts in people's lives, bringing into the world a baby, a child, and then resetting the whole sort of the scenery of the what is family now Yep. And then making food together as a family and being connected and socially activated with the purpose and goal and never losing the curiosity. We lose the curiosity of our life. We we feel lost. We're no longer interested in day to day sort of activities. And if you can't sing, if you've really feel like you can't sing, talk to yourself. Talk to your best friend, and that could be replacing your talking therapy with a psychologist. I'm not talking about the severe depression and No. But you the the smartest person in the room is you that could listen. Once your voice over your thought, it becomes so clear that and you can solve so many problems. And dancing, as you said, dancing is in my family. So my brother is a professional ballroom dancer. He runs his own school, and it's in our family. We have, like, Christmas, Easter, holidays, etcetera. We all dance. And my dad, he bless him. So I lost my mother a couple years ago, and there was a quite a grief and transition for all of us. And I never thought my dad is gonna start dancing. He's 70, and he's gone to the Sunday dancing class, Sunday live music, and he meets other, I don't know, historical classmates. And he just enjoys that. And what I'm trying to say, it's never too late. And his lifestyle wasn't the greatest. He was smoking. He was living sedentary lifestyle, but this shift and loss brought his intentions or brought this kind of why he needs to do this now. Yeah. So I think what from the science perspective, what I would like to add that dancing, music, it increases the neuroplasticity. The neuroplasticity is is rewiring of our brain, producing new synapses, which is our connection between one neuron to another neuron. So even if you lost the function living with a chronic condition such as MS, you may be paralyzed on one or another side or maybe lost your leg function. The benefit here, listening to the music, imagining things, visualizing. And if you can move, please do move because you're improving your brain function. Again, this is science based. It's not like what I think, but it's real. It's definitive. And I wanna add to that too. And when we talk about music, it's specifically the rhythm. Right? Our body responds to those rhythms, the frequencies because of as you said, when we go back to the heartbeat, there's a reason why dance music back when it started. If we, I'll make you laugh now if you want. Dance music had that that's a heartbeat. That's what we hear. Why we all of a sudden feel like the need to move to it is because it reminds us of our moms. It's our heartbeat. And music, I know you have it. I have it. Whenever I hear a song from ten years, fifteen years, it takes you back. It activates the memory of a time of how you were, where you were, who you were with, all of those things. So those two things, rhythm and the memory of it, are what help the MS patients. And I watched the patient I watched a piece of a doctor who sang to his patient songs that the patient would have remembered from their time period, and that patient went from not walking at all to walking. And I'm not I saw it happening. It was unbelievable. So it is it does work. I know you have the science behind it. I actually only have the visual of it, and I could tell you it works. So, yes, it's the rhythm side of things and the memory that it brings back for you. So just wanted to add that before. Yeah. And it always enhances your well-being. Always. It makes you it brings you back to being a child. You don't laugh more than you do when you dance. It just feels good. Your body's not used to it. And you sometimes you feel silly and you look at somebody else and they look silly, and then they start doing the what happens at weddings, they start doing the crazy dances that aren't really dances. They're more like cheerleading things, and you laugh at that. And then you're all of a sudden, there's 12 girls in a circle all singing a song that they haven't sang for twenty years, and then men do it and take off their ties, and that's being children. And that's okay. That's okay. With this episode, we only could just advise people to revisit you, who you are, what do you do, what do you like to do, and what limitations, what barriers and burdens do you put consciously or subconsciously on yourself to live fully with various different flavors and senses in your life to feel good about yourself and don't limit yourself. We have so many limitation from outside world. And if we start putting that sort of limitation on ourselves, we are really hard on ourselves. And then that causes various different physical restriction, mental health problems. These kind of things happen, bringing awareness to your current situation, what's surrounding, what relationships do you form, because all that matters. As I mentioned in previous episodes, that Howard study says that the life decent life that we live and makes us happy is our relationship and friendship. So let's start with this and then bring a bit of a few spices of the kindness, attention that we share our attention with others or we get attention from others. And that makes our lives really decent, smart, clever. And just to wrap up this incredible episode with the amazing Frank, what a journey. We started with olive oil and talking about the living longer, living well, And then we ended up with the rest of the Blue Man Group and all their produced nominated shows that you inspired us, as well as you're planning to do more shows on Journey on on the olive oil as well as maybe coffee beets as well, who knows? But then it inspires us to live long, live well, live with purpose. That's our agenda. Have a purpose. And Frank also reminded us that storytelling is more than entertainment. It's a powerful bridge between science, lifestyle, and hope. Whether you are living with MS or any other chronic condition, maybe you are just simply seeking to improve your well-being. And this message is clear. Your story matters, and it's never too late to reinvent how you live. So any final words, Frank, to tell people who are maybe being diagnosed with MS, who may have symptoms but never received a diagnosis, but they really like to hear from the the number see like you who's got loads of experience. I think that you hit most of it on the head there. I just think that one of the things that you when you're talking, I'm listening, and I'm going, everything you are mentioning costs nothing. Just have fun. But, yes, get back into who you are and understand that being healthy, taking care of yourself, having fun, it's not a chore. It's actually the way to live better. And so none of that costs anything. To laugh, to get together with friends, to dance, to listen to music, all of that is pretty affordable. It's so there's a lot of stress in our world that's always triggered by work and disease. And the only thing you can do is make your work happier and avoid disease. And if you can do those two things, the rest of the stuff goes away. And so I I really do wanna urge everybody, just have fun. Have more fun. Life is supposed to be that. Surround yourself with people that are fun and also better than you and learn and be curious about that. We are sedentary beings, like you said, and we tend to stick with our own little circles. And it's sometimes you have to jump out of that circle and be a kid again, explore. So that's my last advice. I don't have anything else. Wonderful. It cannot be better. So thank you for your time. Thank you for wisdom and the light, on our Be Well with MS community. If you like this episode, please share, leave the comments, review. Don't forget to check out Living Long Gap, Living Well on PBS or YouTube, and there are some new episodes that coming and hosted by Frank. So follow Frank. He's on media. I found him so excited. And he responded to me, and he makes his time. And, it's amazing. I feel lucky at the moment. So, yes, as always, stay kind to your brain, nourish your body, and keep moving forward. Until next time. Bye for now. Bye, Kiafank. Thank you. It was great. Really appreciate it. That was really fun.
13 April, 2025 Guests Interviews and Charity events
Join Dr. Agnes Straukiene and her guest, Dr. Doriana, a family physician and founder of SmplyFit Wellness, as they dive deep into sustainable weight management specifically for women living with multiple sclerosis (MS) or other chronic conditions. Explore why traditional dieting often fails and learn how to work with your body instead of against it. Discover the importance of protein, fiber, and even the role of mindset in achieving your weight loss goals. This episode provides practical tips on developing a positive relationship with food, setting realistic goals, and managing MS symptoms through a balanced diet, GLP1 agonist ( f.e Ozempic) and consistent exercise. Perfect for those looking to take control of their health journey.
Hello. It's doctor Agnes Trocchiena, your wicked MS neurologist from Be Well with MS podcast. Expect signs, sparkles, and whole lot of sass. Let's log in. Hello, and welcome back to Be Well with MS podcast. The podcast that that brings very fresh conversations about brain health, lifestyle, living well with multiple sclerosis. I'm your host, Doctor. Agnes Rugenet, neurologist. I'm a researcher, advocate, and inspiring people living with MS to take control of their health journey. Today, I'm excited to welcome my guest who brings both professional and a personal understanding to the topic of sustainable weight loss and management. Doctor. Doriana. She's a family physician, founder of Simply Fit Wellness, and she also a host of the Simply Fit podcast and a coach who helps busy women find balance with a diet, fitness, and self care without guilt, shame, or restricted diets. So in this episode, we will dive deep into what sustainable weight management actually looks like for women living with chronic conditions with HMS or any other underlying neurological or other chronic condition. We'll explore why traditional dieting fails, how to work with your body instead of against it, and how to reclaim your competence. That's the most important, no matter your energy levels or schedule. I welcome you, doctor Doriana, to this show, and maybe let's start with a brief introduction about your background, about you. Yes. For sure. Great. Thank you so much for having me, first of all. So, yes, I'm doctor Doriana. I'm a family physician based in Toronto, Canada. I actually had a family practice for fifteen years and in 2021, '20 '20 '2, I decided to switch career paths and I closed my family practice. And I started doing online coaching in this space, which basically what I do now is I coach predominantly women, but not just women, predominantly women who are very busy. They lost themselves. They they're stuck in a rut. They've gone through years of yo yo dieting. I teach them essentially how to lose weight in a way that is sustainable for them. That is not overly restrictive. And I really teach them how to make lifestyle habits and how to incorporate things like fitness and exercise and self care into their days so that it becomes an automatic part of their daily life. Because through fifteen years of practice, I had a lot of patients struggle with these kinds of issues. And and so basically what I do now is I teach them how to do that in a way that feels comfortable for them and in a way that tailors to their particular schedules. Wonderful. It's great to have you on the show. And I think the very sensitive topic that we chose to discuss today, it's not an easy one. Quite often in my clinics, I see patients, women who come in. They tried various different approaches and diets in the past, and they still have a great struggle. And it becomes a bit of a psychological issue getting to the goal that they dream about, having healthy weight, healthy appearances. Because it it really drains your energy. And I just wanna maybe just start, why is sustainable weight management an important conversation for women? How do you approach women? Because you don't want to highlight that there is a problem with a weight because everyone every woman wants to be beautiful and nice and feel good, full of energy, and produce good things in this life. And almost there is an element in the room when they come in that there is a problem. How do you approach women saying that there is a problem? How can we solve? And where this kind of sustainable weight management stands in this kind of conversation and why it's important? Yeah. It's really interesting that you bring that up because even in the last few years, the whole conversation around obesity and obesity as a chronic disease has really changed, starting with how do we approach it with patients. And so in the certifications that I've done through obesity Canada and some health coaching certifications that I've received recently, one of the key elements here is that we don't assume with any patient that their weight is something they want to discuss. And it's, it is a very sensitive topic. And so when we, as physicians or as coaches, when we wanna approach the topic, we need to ask permission. We need to ask the patient permission. Is it okay? Or do you want to discuss your weight today? Because it's if that patient is not ready to discuss it, if they're not, if they're in that sort of pre contemplative stage of change, telling them what they should do or trying to scare them into losing weight just doesn't work. It just doesn't work. So we have to be we have to approach weight loss and weight maintenance with empathy and compassion. And we really have to understand where the patient is in their journey. And that's been one of the big takeaways that I've come out with in the last few years, because when I was training, and even when I was practicing medicine for the first maybe ten years, our approach to speaking to patients about their weight was very different, right? They came in for a physical, we did their height and their weight. We calculated their BMI. They were either underweight, normal weight, obese. And we just gave them that data and said, well, your BMI shows that you're obese, so you need to lose weight. That is the complete opposite of how we approach it. And nowadays it's a very different approach. Yeah. So I think for me, that's one of the biggest changes in exactly how you said, how do we address that elephant in the room? So, you know, when a patient comes into the office, do you want to discuss your weight today? And if they say, no, I'm not ready to, it's not why I'm here, then that's fine. As physicians, they know that we're there to help them, but we also have to work at their pace and go along with them along that journey. And then as far as weight maintenance goes, it is really, I think that we have lived through years of diet culture. And so many of my clients have lived through years of diet culture. I myself have experienced years of diet culture growing up in the eighties and the nineties. And weight maintenance is the key term here because most people can lose weight. It's not the weight loss that's the problem. How they're going about that can be problematic, but how do you maintain that weight? And the next question is, what is your best weight? What weight should you be striving for? Because again, we've really stepped away from using the the BMI or the body mass index as the sole indicator or the sole measure of health. We use other measures as well. So it's not as cut and dry as it used to be. There's a conversation to have that has many elements. It's very complex and it's very individualized according to that patient and their lifestyle, their schedule, their medical other medical conditions, all those other features, their genetics. So we have to take all of that into account when we're talking about their weight, weight loss, weight maintenance. Wonderful. And I think, you briefly described that, first of all, you assess the readiness for that conversation without jumping into and advising people what they need to do. They they listen to these kind of advices millions of time. They know what they need to do. They know their problem. We don't need to highlight. But I guess, gently ask the question whether they are ready to talk about and discussing and working at the pace of individual, that woman that sits in front of you. So a lot of people with MS or any other chronic condition, they suffer from fatigue, mobility problems, some side effects from medicine that they take, usually as a part of pharmacy, primitriptyline, baclofen, gabapentin, pregabalin. There is different neuropathic and central nervous system affecting the drugs that causes a lot of extra layers and more issues with being alert. Usually, it's lack of energy, more sedentary lifestyle. So symptoms like that, how do they affect the weight and metabolism? And maybe let's delve on this kind of aspect, chronicity underlying conditions that don't allow people to focus on or maintain their healthy weight. Yeah. And I think this is really this is a booming part of obesity medicine right now. It's the understanding of what obesity is or how weight loss occurs amongst different populations. And at the end of the day, weight loss is a very simple physiologic process. We have to be consuming fewer calories than we're burning in order to lose the weight. So we say weight loss is very simple. It's just a mathematical equation. We just have to get you to burn more calories than you eat. Now, the reason it becomes very complicated is because there's a lot of things that can affect the, how many calories you're burning and how many calories you're ingesting. So for example, fatigue, feeling tired all the time because of maybe some medication side effects. Those will cause you to feel less likely to get that daily exercise in, even if we're not talking about specific, like, gym exercise, exercises you would do in the gym. But even just your neat activity, that nonexercise activity thermogenesis, like just the walking, the steps, pacing around during the day. If you are fatigued, you're much less likely to do that kind of activity. And so that can contribute to you not burning as many calories. So that's a big one. Obviously, if you're dealing with other with MS, there's other issues in terms of mobility and muscle strength and that kind of thing. So, again, it's always trying to find that balance between how many calories we're ingesting versus how many calories we're burning. But at the end of the day, the principles stay the same. If your appetite is increased because of medications, because there are certain medications and other chronic conditions that cause appetite increase. Sometimes in, in those patients, they have to be on those medications. That's not an option to manage that condition. So how do we then help them to lose the weight? Again, then we have to talk about, okay, let's talk about hunger cues, listening, listening to those hunger cues. How do we there's lots of tips and tricks about eating food without eating too many calories. So I think it just highlights this concept that weight loss from a mathematical perspective is actually very simple, but it's not easy because you have so many other contributing factors that can affect things like your energy output, your exercise output, your hunger, the drive to eat, the emotional stress, or maybe that the mental health stress that comes with having a chronic condition, and sometimes using food for comfort for that. So it is a very psychological process, as well as a physiological process when you're talking about weight loss and maintaining that weight loss. Yeah. Absolutely. And I guess when we live more sedentary lifestyle, where we move less, our metabolism is slower. So the digestive system is slower, so it's more correlation of the fats in subcutaneous fats and also visceral fats, which is even more harming to the outcome if you have organs surrounded with the fat. So it's more harmful than just having subcutaneous extra layers and fats. Yes. Yeah. So I guess the research behind the scenes suggest that, as you mentioned, the psychological factors plays a critical role in sustainable weight loss. I think it's important to highlight something else is that there is this misconception, And I know this is, I work a lot with perimenopausal women and menopausal women. And there's this misconception that as we get older, our metabolism declines. But in fact, our metabolism does not significantly decline until we're probably in our sixties. And even then it's not a significant decline. So for years, I think we've been using this, you know, this, oh, my metabolism is slower because I'm aging. So that's why I can't lose weight. And it's, it's just impossible. What we know is that our metabolism, that basal metabolic rate is largely genetically determined, and there's not a whole lot we can do about that. However, there are other ways that we can slightly change that metabolism, which is good to know for people. Because if people are struggling with chronic conditions or they are on medications that are making weight loss more difficult, it's helpful for them to know how can I increase my metabolism a little bit so that I can get the best bang for my buck? So things like eating more protein. So if you're not meeting protein requirements, a simple thing we can do is to eat more protein. Why? Because the thermogenic effect of food is the actual burning of calories as we're eating. And we actually burn more calories eating protein than we do other macronutrients. So simply by making a small change to your diet, like adding some protein, can help to increase that metabolism slightly. The other thing we can do is lift weights or do weight training because having more muscle means we increase that metabolism a little bit. So that's another key thing that we can do, even if, even in patients who are struggling with other aspects of, of weight gain. Things like that neat activity that we talked about, the pacing, the walking, the step counts. Being aware of those things and being aware of that activity and conscientiously trying to increase it can help increase your metabolism a little bit. So if we can increase that metabolism a little bit and simultaneously adjust the calorie intake, then we've got the solution for weight loss and how to maintain it. But I think it's critical for people to know that because to me, knowledge is power. And when people are walking around thinking that their metabolism is just broken and there's nothing they can do about it, it takes power away from them. And then they think there's nothing they can do. But if they have this information, it's, oh, hold on a minute. There is something I can do. I'm not destined to gain weight just because I'm aging or just because I'm perimenopausal or just because I have a chronic condition. There are things that we can do to help these sort of basic, the contributors to our metabolism and our weight. That's very interesting. So also according to the literature, every single human on this earth gains one or two kilograms a year, and that pauses from age 55 onwards. So whatever we do before age 55 has got a huge influence on our metabolic health and our just general sort of health and weight, if that makes sense. And you're you're completely right in terms of the rich protein diet would help us to less accumulate fats. Because if we are consuming carbohydrates that in our body is being converted into the glucose sugar and that this arranges the metabolism of the fats, you have layers and layers of fats inside the body. So it's critical thing. And I think as we started with the psychology factors that helps us sustain the weight loss, equally having a goal set and realistic expectations are crucial for the weight maintenance among women. The research categorizes women into maintainers, regainers, and stable health weights individuals, emphasizing that unique psychological struggles faced by each group. Another study reveals that motivation based focused strategies can be as effective as traditional skill based approaches in maintaining ways while suggesting the need for programs that cultivates internal motivation rather than teaching skills. So it feels we need a goal. We need some purpose and motivation behind all these kind of strategies. Would you agree on what would be your sort of experience? How do you work with your clients in setting the goals and motivation? And from here, I would like to pause. No. This is not an advert. I'm not selling anything. It's just to let you know that, I lost my video, during this, interview. And we didn't even notice because our conversation was so flowy and natural. We were just chatting around. Dorianna felt that this is what I've done, for purpose without coming and saying, oh, you you lost your video. So she thought this is, this is what I meant to do anyway. So so she just being polite and me not noticing what's going on on the screen, getting into the conversation, thinking about what the questions to ask, how to finalize our key points, how to summarize the the discussion. You know, these things happen. So, yeah. So enjoy the rest of the conversation. You will see my picture instead of video, but if you are listening this, it's fine. But if you're watching on the YouTube, probably you're gonna lose my gastriculation and moving arms, because I love to do that, very often. I'm not Italian, but I I somehow got this in me, and I use my body to express myself. So if you don't mind, next time, on the YouTube channel, you'll see me moving, I'll be more mindful seeing well, noticing if, my video disappears. It was just a fault, on the Zoom call at the time. But never mind. I used some visuals to fill in some gaps, so enjoy the rest of the conversation. So just to remind you, I asked Dorianna how to set the goals and bring the motivation to lose the weight. Yeah. This is I think this is, like, my passion. This is the this is my this is what I do. This is what I love to do. And this is my favorite part of the program because when I work with clients, we work on three things. We work on their nutrition and their diet. We work on their fitness and we work on, I call it self care. But what that self care component is really based on is the psychology of eating. And so there is a huge weight loss that I think gets ignored by a lot of diets and programs. And that is, first of all, I want to teach you how you're getting into this calorie deficit. I want to teach you those basic skills so that you're not relying on me to just tell you what to do. And then when we stop working together, you have no idea why you did it. So that's number one. But the second part is the psychology of eating is very complex. And if we're not addressing that, then we're missing a whole piece and we're probably missing the long term success. So when it comes to changing behaviors around eating, I want to know, and I talk to my clients about what is your relationship with food like? Are you using food for comfort? Maybe that's what you were taught growing up. Every time you had a bad day or if you experienced some sort of trauma, you were given food for comfort. We talk a lot about identity shifts, right? So we know that in somebody who is making a big change. Okay. So they're trying to lose weight. This is something they've dealt with for many years. We need that person to actually believe and make an identity shift from somebody who can't lose weight, who's struggled to lose weight. I can't do this. This is I've failed so many times too. I am now a person who lives a healthy lifestyle. I make good choices and we need to, what I do with my clients is I really tell them and teach them how to focus on becoming that identity. Because we know that people who accept that identity, even if you don't believe it at first, but if you can keep telling yourself, this is who you are, then the decisions that you make are going to be based on that new identity. That's a really important piece as well. The other thing I always think of that's really important and my clients and I talk about it a lot is what is your why? What is your why? And we when we say that I'm not talking about, part of it might be, I wanna wear that dress in the summer that used to fit me. And I wanna, I have a wedding coming up and I wanna be able to wear a certain outfit, but your why are things like, you know what? My father passed away at an early age from cardiovascular disease and I don't want that to repeat itself. So for me, the why for that particular client, it could be, I wanna live longer and I want good quality of life and I wanna avoid cardiovascular disease. For some people, it might be, I wanna be able to pick up my grandkids without having to huffing and puffing and being a short of breath. I wanna be able to travel, maybe for some people. Right? I wanna be able to retire, travel, and walk in countries and explore. And at this weight, I can't do it. So if you really dig deep into people's purpose, their why, their identity shifts, it gives those goals far more importance. As opposed to just saying, I need to lose weight because my doctor told me, or I need to lose weight because I wanna wear this bathing suit in August. We really have to focus on and think about why and what change this is actually gonna make in that person's quality of life. With this weight management, once you start seeing the results, I think it brings a lot of happiness, but we really need to not forget about the eighty five year Harvard study, which suggests that number one thing that makes us happier in life is not your weight, is not your appearance, is not what you're planning to do. But one simple thing is our happy relationship. And it's a big study. What do we do with ourselves? Who are we surrounded by? Who are the people? What are you pouring on your plate? Is it plenty of respect that comes from your environment and people that you are being supported? Do you have a big chunk of the attention? What is right for you? And the sprinkle of the kindness, I think. These kind of things are super important to live a really happy life. And I think we we may overdo and focus too much on and set these kind of agendas in our lives and never read that agenda. This is another, caveat that it's really difficult and challenging, although you have all these intentions and maybe motivation, but it's still quite difficult to achieve. So what is the nonrestrictive approach to eating? Can you explain what that looks like in practice? What simple things that people could do to help themselves? Yeah. I'll definitely explain that. And I also think I love the fact that you brought up this, what actually makes you happy at the end of your life. And I think one of the relationships that's included in that is your relationship with yourself. A lot of the work that we do is how do you talk to yourself? How do you view yourself when you're eating? Maybe when you've eaten food that is not aligned with your goals. Is that okay? Do you give yourself grace? Do you love who you are? And then what is your goal? Is your goal to just hit a certain number on a scale? That is not your best weight. Your best weight is not determined by a simple number. Your best weight is the weight where you feel good inside and out. You feel good physically. You feel good mentally. You're confident. You have good self esteem. You don't have medical conditions, but it's not necessarily the weight that you were when you were 25 years old. And so that just touches upon, cause you had mentioned being realistic with these weight goals and these, your ultimate end goals. And I think that's really important for people to understand. So in terms of sustainability and overly restrictive, the number one reason why diets fail is because they are overly restrictive and they are behaviors that you cannot sustain the rest of your life. And, and we know that now there's so much research to show that things like a plant based diet, the Mediterranean diet, these are diets that are probably the healthiest diets that we can follow in terms of our longevity and our risk factors for disease. And they're not, they're certainly not low carbs. Like they're not restricting any particular food. It's just about the quality, the type of food you're eating. And so I feel like a lot of people who have struggled with weight and yo yo dieting have been told this narrative that if you want to lose weight, you have to cut out this food group. Carbs have always had a bad rap. If we look at the calorie content on a gram per gram basis between carbs, fats, and proteins, fats have the highest number of calories per gram, not carbohydrates. So why are we eliminating carbohydrates? It's just these misconstrued narratives that have been spun around and circulated. So what I teach people is when we restrict something that persists. And so we don't want to be over restrictive. We want to learn how to eat foods that we love and we enjoy in moderation and moderation is moderation. So how do we know how much food we're supposed to eat? How do we know when too much is too much? So it takes some work, right? It means that we usually track and weigh food for a while, but that's a learning tool that we use as well, because I don't want you to take anything out of your diet. I want you to learn how to incorporate it into your diet. Because the minute you can do that and reach your goals, then you can do that forever. You said that very nicely that you you have to feel good inside and outside, reestablish your relationship with yourself first and then the rest, including food. I think there are great failure I see in my practice that it's a very wrong relationship with the food to start with. So people are consuming a lot of processed ultra processed food before they consume their very rich nutritious meals. So there's different behaviors in drinking loads of sugar drinks, energy drinks, etcetera. So how important is intuitive eating versus structured meal planning for women with chronic condition? It's interesting. I think intuitive eating is this thought or this practice where you eat when your body tells you to eat, you eat how much feels good to you. In my experience, this is just anecdotal. I think that intuitive eating can be a reason that people go in circles. Because they think they're doing the right thing. They think they're eating the right way. And in fact, when I have clients track their food intake for a week, usually I would say nine times out of 10, my clients are eating way too little protein, way too little fiber. And the other thing, because you mentioned what's the difference between intuitive eating or having well balanced meals. So many women, they go through the day without really having structured meals. And so they come home and they think, gosh, I haven't eaten all day. I'm starving. And then they over consume calories in the evenings. Now psychologically, they think, I haven't eaten anything today. I really haven't eaten very much. Because they haven't eaten during the day. And then they're making up for that and ending up in a calorie surplus in the evening. So if that's an issue, then having those structured meals can be very beneficial. Because it means that you're actually consuming good quality nutritious food. You're hitting some protein and some fiber targets during the day, which then avoids the over that really strong hunger late in, in the day where those cravings or that psychological feeling that you've been deprived all day. And now you just wanna eat everything. With chronic conditions, I think it's just also beneficial for it's just that sort of that feeling of satiety and everything is just a little bit more level, right? You're avoiding those really significant peaks and valleys of hunger and then blood sugar dropping and feeling irritable. And it's so much more sustainable to have a meal structure plan where you are fueling your body throughout the day, as opposed to just doing what you think works. Does that make sense? Yeah, totally. And I guess we're coming to the conclusion that again, it's very personalized During some people who's got a very enhanced awareness of their body needs, who are super mindful, who's got plenty of time in this world, they probably can go with intuition and watch their portions, watch their time of the day they need to eat or their body needs to eat. But if you look at the general population, including ourselves, we are busy with our families, with our life's work, etcetera, patients, clients, whatever. We do have lack of awareness of our body needs, and we quite often forget to eat in a timely manner. So structure is an amazing rescue for most of the people that they if you haven't got that awareness. We have these kind of wearable devices, Orang watches that sort of sends us a reminder. And we probably need to utilize these kind of devices to let us know whether to move, to exercise, to do little steps because we spend a huge amount of time sitting. That's a rescue, a plan for us. And, again, some people may find this annoying, and they don't want to have any more notifications and reminders when to move and beat. But I guess it needs to work for you as an individual. On the other hand, talking about the what sort of nutrients people should consume more, I guess we're gonna talk about this in more detail to support better energy for patient with a long condition. But I just wanna highlight before we go into that that it's impossible to eat too much fat because we we can do that with the carbs and all the cookies and snacks and all the processed ultra processed foods, but it's difficult to eat only fats and we're never gonna over consume fats. And by the way, fats are essential for our brain function. We need fats. We need a good fats just for the brain to function. So maybe let's dive into sort of a once are these specific nutrients or dietary habits that support better energy level and symptoms living with the chronic conditions? Yeah. And I think that it's not just fats that are hard to over consume, and it's actually whole food. It's been shown that people have difficulty overeating and over consuming calories when they're eating whole foods. Because think about it. Think about eating a whole bowl of broccoli, right? It's very hard to eat a full bowl and you actually feel unwell after a certain point. But think of a whole bag of chips. Those are very easy to consume. And that's where this eightytwenty percent rule comes in. So I'm a big proponent of everything in moderation because that's what keeps it sustainable. If I tell you, you can't eat any chips or any chocolate or any ice cream, you're most likely to get to a point where you're strict and then all of a sudden you binge. But the thing is, yeah, we need to be aware of how much we're actually eating. Because we might think we're eating only 20% of those ultra processed foods when really maybe we're eating 40%. And that's where tracking comes in. So just like you mentioned, the Oura Ring and these kinds of devices, in my practice with my clients, it's tracking, it's a food tracker. And yes, it's tedious. And I tell my clients from the outset, it is tedious behavior to have to track and weigh your food. However, think of it like you're learning a new language. It takes time, it takes work, it takes study for a little while, and then it becomes second nature. So after a month of tracking, you're gonna know what three ounces of chicken breast looks like, or you're gonna know what a cup of, a cup of pasta, how many calories that has, how much protein it has. So the tracking and the awareness becomes very important there. In terms of nutrients, I think that we get very overwhelmed, especially in social media. Right? If we watch, if you're on Instagram or TikTok or any of these apps, you can be completely overwhelmed with nutrient, with supplements and vitamins and what supplements am I supposed to take. And by the end of the day, you'd have a list as long as your arm. We need to focus on basic things because most people who are getting lost in, in the weeds of all of this stuff, they're not doing the basic things. So we need to focus on protein. Are we getting enough protein? And for the general female population, we're looking at roughly 0.7 to one gram of protein per pound of your ideal body weight. So there there's a range there. But protein is number one, because we need protein. We need protein to build muscle. We need protein to feel full. We need protein to again, help with our metabolism. The second one. So there's three macronutrients. We talk about carbohydrates, fats, and protein. But there's one nutrient that I call the fourth, my the fourth macronutrient, even though it's not technically, and that's fiber. Because most North Americans are vastly under eating fiber and fiber is so important. Right? Fiber protects our bowels. It it prevents colon cancer. It can reduce cholesterol, and most people in North America are not hitting their fiber targets. So when we talk about fiber for women, we need to be aiming between twenty five grams and thirty five grams of fiber per day. So those are the macronutrients that we need. So those are the nutrients our body needs in the biggest amount to survive. Generally speaking, if you're on a weight loss journey, if you can figure out what that calorie deficit is for you in order to lose weight or even to maintain weight, And in that calorie range, if you can hit your protein and your fiber targets, generally speaking, your carbohydrates and your fats will balance out fairly nicely. So I think people become so obsessed with counting that they're, they have this attitude of I'm gonna start a diet on Monday, so now I have to count every single thing and they're tracking their carbs and their fats and their protein. And, and we just remember, we have to remember to keep things simple. Cause simple is doable, right? Focus on your calories. Calories are king when it comes to weight loss. Focus on your protein, focus on your fiber. If you do those three things, then chances are chances are you're going to be very successful. Yes, Totally. And we tend to eat on our emotions. Okay. It's very much stress management, I think. And as we said, you won't overeat protein, fats, these kind of good nutritious things. It's impossible to do that. But it's very easy to overeat on processed and ultra processed food. And also bear in mind that if you are combining your physical activity at some level of exercises two to three times a week, that requires extra protein because the least you want is you are with exercises, you are obviously focused on your fat in your body as well as your muscle. And if you are underdoing your protein in your body, so you're burning not only the fat, but also a muscle, which you really you really need that muscle. So can we emphasize on this a little bit? People who are not careful that they become slimmer, but slimmer from the perspective of losing the muscle bottom. And it's funny you bring this up because I'm trying to get into the habit of not using the term weight loss, but instead using fat loss. Because weight is just the number on the scale, but our weight can be affected by many things, right? It can be affected by if we're retaining water, how much salt we had, if we're, if we're about to, if women are going to have their cycle. What we want is fat loss when we're talking about losing fat tissue, especially in people who are struggling with obesity. So we want to preserve muscle. We want to lose fat. And it's interesting because you work with a population who may be in some cases are going to be maybe limited in terms of physical activity as they see it. But I think that there's something to really comprehend here. And that's the fact that once again, the messaging that we're getting very often is you have to be in the gym for an hour at a time, or it doesn't count. You have to be lifting weights five days a week, or it's pointless. We know that we don't need to be doing that kind of work to make it effective. If you can lift weights four days a week, fabulous, but you don't have to. So again, it's about starting where you are now and then working up to the minimum. The American Heart Association recommends one hundred and fifty minutes of exercise a week. That's usually they're referring to like moderate aerobic activity. But the other piece that we need to remember is our strength training, especially in women, especially postmenopausally. And I think even more importantly, if you do have a chronic condition such as MS, because we need to make sure that your muscles are as strong as possible. Your balance is good. Your mobility is intact. So even doing things like Pilates, some strength training, whatever that looks like, working on balance, working on proprioception, these are going to be activities and exercises that are going to contribute positively to how you manage your chronic disease. And I think that's really important when you look long term. And don't forget to consume a lot of protein in particular if you do exercise, and it's improving your Absolutely. It's improving your neuroplasticity. It's improving your function. It is modifying your deceased territory living with chronic condition such as MS or any other neurological or other, let's say, musculoskeletal rheumatoid arthritis. Everything that you do in this life do matter. And in particular, if you're a woman, we are different from men. Biologically and metabolically, we have estrogen, which drops as we go through the phases in our lives, and it changes our body shape. It changes collagen. It changes how we look. It does cause a bit of a weight gain where we go through these things, but we're really bringing that mindfulness approach and understanding of our bodies actually helps us to navigate through. If we are each woman in this world, including Dorianna and myself, if we were not too careful, we would be obese. We would be really overweight, and and that applies to any woman. But it's just what do you do? What relationship do you form around you, outside, inside? And then what do you do to help yourself to have that sort of nourishing good quality of food? And lots of questions around what diet specific diet in MS, for example, are available. What evidence do we have? There are loads of diets around and you name it. But I guess you you have to find this individual diet that suits you. And let's bring this elephant in the room and talk about these kind of very trendy approaches these days. I there's little some questions that I'm sure, Dorianna, you do too about the GLP one and the GIP receptor agonist that is an easier way to suppress the appetite, slow gastric emptying, and improve insulin sensitivity. What are the constant problems? And I I I've got your table prepared to be honest, to contrast other ways of managing weight. For example, intermittent fasting versus the Moderna. But I would like to listen to your opinion on that, and I will then tell mine if that okay. Let's talk about this. Yeah. Absolutely. Hot topic at the moment. It is. It's a it's a hot topic. So it I feel like the world of obesity medicine is changing for the better, and I'm one of the people who really believes that these GLP one medications are life changing for some people. I do also think that there's gonna be many iterations of them. They're gonna improve as time goes on because they are fairly new medications. Do we have long term data? We don't have tens of years of data, but the data that we do have looks promising. So I think there's a few things to to remember. The first one is that in order to be given a GLP-one, you must meet criteria. Right? These are not medications that are supposed to be handed out to people who want to lose the last ten to fifteen pounds, for vanity weight loss. That is not what we're talking about. These medications are specifically supposed to be used in people who have obesity. And obesity, the definition of that has now changed. It is carrying excess adipose tissue that is causing medical problems. Okay. So you have medical conditions as a result of the excess adipose tissue. These are the people who are supposed to be considered for GLP one. And for the audience, can I interrupt you slightly? Ozepic or Mangero drugs we're talking about. So these are classes GLP one. So just for the audience that they know what we're talking about. Yes. It's going on. Yeah, exactly. The second thing I think that everybody is talking about is once you start these medications, do you need to take them forever? And the answer to that is likely yes. And that receives a bad rap. However, we have to also think about it in terms of, we now know that obesity is a chronic disease. Obesity is not something like a wart on your skin that you treat and it goes away. Obesity is chronic. It waxes and it wanes. So if we think of things like hypertension, diabetes, those are chronic diseases oftentimes that we need to treat long term. So obesity is no different in that respect. So the answer to the question, do I need to be on a GLP-one forever? The answer is likely yes. However, I think this is the backside of this story. And this question is, so I get my GLP-one medication. I lose weight and off I go. And I think that is absolutely not the way these medications are meant to be used. So yes, you may have to be on it long term. Whether you are or not, to me, doesn't change the fact that if you are on a GLP-one medication for weight loss, you still must be addressing the lifestyle changes, the habits, the strength training, the therapy with, in terms of addressing the psychological aspects of eating. Because at some point, if you do decide to come off those medications and you have not addressed those issues, then then of course we know you're going to gain the weight back. Right? It's like saying to somebody who has hypertension because they're eating too much salt, take the medication that'll control it. But once you take the medication off, just go back to your regular diet. Of course, that's not going to work. So in an ideal world, these medications would be prescribed with a personal trainer and a therapist to, to discuss the emotional and the psychological aspects of eating. Of course, that's not how they're always, how they're always prescribed, but it's super, super important to understand that this these medications are for a specific population. And when they are prescribed, they should be taken in a way that is an adjunct to all the lifestyle changes and behaviors that should also be taking place. Absolutely. And I just gonna strike the importance that consume protein if you are on GLP one. Okay? As you're heading into that risk of losing fats very rapidly, very effectively, at the same time, losing muscle volume. Because you eat less as simple as that, you you have less hunger, you eat smaller proportions, the average caloric intake drops naturally without needing conscious restriction being on this drug. Some reports suggest that people only eat once a day, and it's a no, unintentionally. It is just so natural. But if you are eating once a day, make sure that your protein level is one gram, as you said, one gram per kilogram of your healthy weight. So that's the consumption if you're doing so. Why is that? You really don't want to exhaust your body and become slimmer, but in the compensation of losing your muscle that you require the most. And in particular living with a chronic condition, my chemist. Yes. But be careful from this perspective. Absolutely. Absolutely. And another thing too is Oh, sorry. Go ahead. I couldn't No. I just wanna I'm just gonna compare a little bit what is if you are let's say you are aiming to lose 10 kilograms. So the calculation suggests that one kilogram fat, you need a 7,700 kilocalorie deficit. So if you want to lose 10 kilogram in the compensation of the in in the matter of the fat, so you need a 77,000 kilocalorie deficit. And it's over six months, the calculation suggests of 1,283 kilocalories per week, one hundred eighty three kilocalories per day. So with Monjaro or Zenbic, typical daily calorie deficit is around from 300 to 600 kilocalorie per day. With intermittent fasting, which is very cheap way of managing your weight, skipping meals, for example, breakfast, leads to reduce intake of your food, but that lets also to decrease your kilocalories a day from 200 to 500 kilocalories a day. It's a very similar approach of managing your weight with intermittent fasting. It's much, much cheaper. But again, it's very individual, isn't it? It is. And I think that there's also a big misconception when it comes to intermittent fasting, which is maybe interesting to your audience. Intermittent fasting out of all of the sort of fad diets that we hear about, I think intermittent fasting is one that could work for some people. And the reason is because there, there isn't anything that's magically happening during the hours you're fasting. Right? We all fast at some point in the day because we sleep. But the fasting itself is not necessarily what's causing the weight loss. It's the fact that it's time restricted eating. So if you're only eating between a certain time between two, two times in your day, you are more likely to eat less calories. So you're inadvertently putting yourself into a calorie deficit. Now that being said, if I said I'm intermittent fasting, my eating window is between twelve and six, but I consume 300 calories in excess of my maintenance calories every day, I could very easily gain weight. Even though technically I'm fasting, I'm not eating outside of the times between twelve and six. So I think if intermittent fasting is a method that people choose, it's absolutely fine. It works for some people. It gives them that kind of hard line in the sand when they can eat, when they can't eat. But it's really because you are getting into that calorie deficit. So this is the other thing is if you're not spacing those meals out among your whole day, because now you're intermittent fasting, we need to make sure that you're getting the protein and fiber requirements in your time restricted eating window. Absolutely. And, maybe just to list a few side effects from GLP one agonist. So are you aware of any side effects? So people should be concerned if they are self medicating, which is possible in our country in England with other side effects from taking Yeah. The most so the most common ones that you're gonna hear about are nausea. That's a very common one. And for that reason, we ideally, you really should be given this medication under the supervision of a physician because you can adjust the dosing, you can start low, go slow. There was and have been cases of earlier on, they were talking more about risk of pancreatitis, some concerns around thyroid cancer. I think for the most part, those have been shown to be quite, quite rare. The thyroid cancer issue, obviously, if you have any history of thyroid cancer to avoid, and then issues of gastroparesis. And the gastroparesis, which is basically like a slowing down of your stomach, that's one of the ways that GLP ones work. The best advice is your body the best. So you be aware of the symptoms, be aware of the potential side effects. And when things feel like they're significant and it's not normal side effects, obviously to seek medical attention. But those are probably the most common ones. Another one that kind of has less to do with the physical part, and I've had a couple of clients tell me this, is that it took away the joy of eating, if that makes sense. Because we forget that eating is part of our social culture. It's something we love to do. And so for some Yeah. And I've had a couple of clients say to me that the GLP ones worked great. They lost weight. It did reduce hunger, but it reduced that sort of joy that they got out of eating and then they didn't like that. So that's another potential side effect that I've heard of. Yeah. Yeah. It's a low percentage of the pancreatitis. Yeah. Thyroid so we're talking about one to two percent as a side effect from taking one Jarrow or Ozempic. So it's just being aware of that. If you start feeling symptoms of indigestions, constipation, maybe vomiting, you really need to take some advice and ASAP. Okay? So you may require some investigations for that. I was just gonna say, obviously, we yeah. I didn't mention blood sugar, but, obviously, monitoring your blood blood sugar and being aware of symptoms or signs of hypoglycemia. Yes. Yeah. When intermittent fasting side effects, hunger, irritability, headaches, migraines, fatigue, some menstrual in irregularities, if you are extending that period of time more than fourteen hours of not having any food that could change your menstrual cycle. But is it these are very rare, but it's possible. And if you are planning to become pregnant, trying to conceive, probably choose another way of using your weight or try not to exceed more than fourteen hours of fasting or maybe use some, fasting mimicking diets only, what, five days every six months or so. There are so many different ways of managing your weight, believe me or not. Also, intermittent fasting could change your sleeping pattern. So you may have a follow-up insomnia. So, again, any intervention, it's not an easy one. It's always you have to be watchful for any potential side effects, but some supervision, having some medical input, I think, doctors who are prescribing medicine are automatically responsible of everything. Having a close contact and getting in touch with your own doctor who's prescriber of the GLP one, I think, is very important. If you can, do try not to do that on your own. And in particular, if you have underlying comorbidities, underlying diseases such as diabetes, in particular, because of the it's this drug has been used in diabetes management. Or if you don't have diabetes, your sugar may drop because this is originally being used in diabetes patients and discovered as a potential weight management drugs. Okay. Let's move into unless you have anything to add, Dorianna, anything The only thing I wanted to add because I feel like there's a world of obesity that people who either they don't know that this is part of the obesity symptomatology or they're not obese and so they've never struggled with this. But just one last thing about GLP-1s and what they actually do to help people is, I don't know how much you talk to your patients about food noise. And food noise being a very common symptom among people struggling with obesity. And that is this constant, it's this constant conversation happening in their head about food. Where their next meal is going to come from. What am I eating? Is this healthy? Is this that? How much should I eat? I shouldn't be eating this. So in somebody with obesity, the majority of their day, they've got this kind of conversation happening in their head. And it is so significant that it can impair their functioning. The GLP ones help with food noise. And that's again, another one of the ways that they work so well. And when you speak to people who are on these medications, it's like they have entered a new world. Like they don't know, they've never known what it's been like to live in such a quiet mental space where it's not constantly thinking about food. So I just wanted to mention that as another, another way that the GLP ones work, because we often forget that people with people struggling with obesity, that's the psychological part of it. Right? When we see the physical signs, we see the symptoms, we see the physical part, but we really don't appreciate what's happening in the brain until people who are on these medications experience this, and that can be so liberating for them. Absolutely. I never heard about the flu noise, but it does really make a sense. You just gave me a sort of different perspective. I totally get get people. It's quite traumatic. Yes. And you go into these kind of obsessive thoughts, which psychiatrists would understand very clearly and how to overcome that. I guess we're moving into a bit of a mindset. How can women develop positive relationship with their body even if it is changing? We are changing. This is a good question. Yes. Such a good question. Go into that. Excellent. Yeah. Mindset work takes time. So I really want people to understand this. You've spent the last probably decades criticizing yourself, trying to lose weight from a form of pun as a form of punishment or trying to lose weight in a way where you treated yourself very punitively. And so it's going to take time to reverse that or to change it. And that's okay. So we need to understand that this is a process. It takes time and we have to be patient. But I think the biggest lesson I've learned since coaching patients is that number one, you must come to this journey from a place of self love. If you hate yourself, it's far more difficult to be successful. Right? Think about like when we're, even when we're just trying to teach our children lessons, right? There's a certain way that we can get that message across. If we're constantly yelling at our kids and telling them that they're awful and they're doing terrible things and they're lazy and they're that's going to impact them far worse than saying, look, this is what happened. Let's learn from this. How can we change this behavior? What would make it better? And I think that's super important for people to understand. So wherever you are right now, whatever your body looks like, remember your body, your weight does not reflect who you are. Right? It's not a moral compass and we need to distinguish those two things. So we're going to come at it from a place of self love. And then there's a lot of mindset work that needs to be done. So we, we need to explore things like, are we using food as emotional support? Why is that? A lot of times it's because we're just not good at sitting with uncomfortable feelings. And so what we do is we automatically reach for food. Okay. So maybe what we need to do is learn how to sit with feeling uncomfortable, whether that's feeling upset, angry, lonely, stressed, bored, Those feelings can be addressed and managed without food. How do we do that? What strategies and tools do we have? There's lots. The other one for me, a big one is viewing food and compartmentalizing food as good food and bad foods. So there's good food and bad food. And the reason I don't like that is because if we call a food good, then usually what we're implying is you're good when you eat that food. And if we call a food bad, think of a chocolate bar, then you're bad for eating that food. That's not true. You're not bad because you ate a chocolate bar. The chocolate bar is just a chocolate bar. Food is neutral and we need to start to change the narrative around food. Right? We know that there are foods that help us to acquire our goals. And I like to call them sometimes foods and always foods. So there's foods that we can have all the time. There's foods that we wanna have only sometimes as opposed to good and bad, take the morality out of food. So that's another big one. I think that can help to change people's mindset and shift that. Mhmm. Amazing. I'm just listening as making some notes and you reminded me of a couple of stories and I just gonna summarize that in a minute. But just to emphasize, trust yourself and love yourself, and don't lose your identity. Okay? You already got a diagnosis, chronic condition, so quite often people lose themselves. They start believing that this condition and disease is who they are. That's the very wrong fact and know who you you're married, John and Thomas, Peter. Right? So you don't lose your identity. Also, there was a a one example that I would like to share with my audience, a mission of mine. If you're listening to this episode, send my love to you and hi, and I know you're doing well and you do your best. But just an example, a person who's got problems with obesity, right, or overweight, they tend to share the love to the environment. They send me letters, praises, and whatever. They send letters to CEOs saying how wonderful service they had. And one day, I met with this person and I said, look, can you send a letter, love letter to yourself? The love you're sharing with them I love that. With everyone else just right now to yourself, this kind praising letter. And then this is your journey begins of managing your health, your weight, and everything else in your life. So basically Beautiful. I totally agree with what all you said and it resonates. And I bet she would, she probably had, or he, I would bet money on the fact that they probably had a hard time writing that letter. Right. Because it's it, most people have a hard time being introspective and finding positive things. We're really good at finding the negative things. And that's another reason why remember that fat loss, weight loss, obesity, it's not just about the loss of fat. Right? We need to also remember this journey is about all of the non scale wins that we get with this. Even if your scale moves this much, if you all of a sudden now are you're able to lift slightly heavier weights, your mobility has gotten better. You feel more confident. Maybe you have a bit more energy. Those are all wins that are not tied to a scale that deserve as much celebration. Right? Those are measures of success. I've had patients tell me even they had to, they got, they noticed that their watch, they had to tighten up their watch a little bit more. The scale didn't show any change, but they were like, oh, I get to tighten up my watch another notch. Or I had a, another client of mine who said she's a teacher and she'd have to walk upstairs. And every time she got to the top of the stairs, she couldn't participate in a conversation with the other people there because she was out of breath. In the matter of three, in a matter of three months, she was able to get up to the top. She didn't have to go to her classroom to catch her breath. She could actually partake in conversation. That is a huge non scale win. So we have to remember that it's not just about the numbers. And I totally agree. And I think let's don't get obsessed. But let's give a toss to our audience. I just come up with one idea based on what you said. So I would like everyone who's listening and who's like me, likes to document things and write things and summarize, do the tables. And if you that person, I would like you to do a table. What Dorianna just said, your list sometimes on one side, on the left, and then on the right side, you make another column, you say always. And you do that for food that you consume. Okay? So we no longer as we agreed here that we no longer divide food into good and bad because it has got a bit of a negative connotation, so we don't want that. But we can say sometimes and always. Right? So we do that with the food and nutrition as a meal time. On the other page of your on your notebook, you write symptoms. How do you feel right now before you're gonna go on this journey of whatever it takes you to be healthy? So we're talking about the dieting and exercising. And if you combine that together and having nutritious rich food. Right? So you then list your symptoms that you have always and sometimes, and redo that again in three to four months' time because we know that this is the shit that happens to many people when you're following certain plan. And then you write your symptoms sometimes, always. And I bet your symptoms that were always gonna shift into sometimes. I'm pretty sure. Would you agree, Dorianna? Would you I Yeah. I % agree. I would actually be really excited to see the results of that. That done. So in the after this show has been published, send your notes and show us how this shit happened in your life. And you're gonna you're gonna thank us. I'm pretty sure. Yeah. I love that. I love that. Brilliant. Yeah. So maybe final words in terms of the what steps people should take to implement these kind of changes. That maybe final words of encouragement, navigating waste management, living with chronic condition. Yeah. So I think that, the first thing to remember is that I love what you said about this not being your identity, your chronic condition not being the soul your soul identity. Remember and maybe you do need to sit down and journal or just jot down, even on your phone, just in your notes, but the things that make you who you are. Right? And I know that's one of the activities that I have my clients go through. What makes you unique? What makes you special to other people? Because that's the identity that we need to remind ourselves of. And then the next thing is think about what your long term goals are. And I like to have, actually, what I've asked my clients to do lately is to make a vision board. So they can do it on Canva online or they can do it old school like pen and paper, but a vision board of the version of yourself that you want to become by 2025, by December 2025. And then what are the things that you can do to get there? And the biggest piece of advice I wanna give people is start where you are now and just take small baby steps. Right? We do not have to make a three sixty change in the next three months and change everything about everything in order to see change. All we need to do, as James Clear says in Atomic Habits, it's 1% different or 1% better every day. So maybe today that looks like having an extra serving of vegetables. Maybe today it looks like having a little bit more protein. Maybe it looks like getting a couple thousand steps in or doing some mobility work. So instead of thinking about what do I need to take away, what do I need to take out of my diet? What do I need to take out of out of the bad habits I'm doing? What can you add? What can you change? What can and it doesn't have to be something major because the accumulation of those tiny little changes over time make a big impact. So that would be, I think, my number one recommendation or piece of advice is just to break things down into small steps, make them achievable, make them doable. And if we break them down into small steps, then they become sustainable. Wonderful. Such a refreshing and inspiring conversation. Thank you so much, doctor Dorianna, for sharing your wisdom, reminding us that health it isn't about perfection. It's about showing up for yourself in sustainable, kind, loving, empowering ways. And to our listeners, if you're feeling that this episode encourage you to rethink how you approach your body, your food, fitness, or maybe just rethink again that it's not a journey that you do that on your rose. How many people are affected? So many people are on the same journey, and they have this noise in their head that reminds about everything, what they've done, good or bad. But maybe, as Dorianna said, it's a small change, and consistency is important because it really makes a huge difference. So if you want to learn more about doctor Dorianna's work and connect with her for couching program or her podcast. So, Doriano, where people could find you? Any website that you could share or any resources? Yes. Absolutely. So I'm on Instagram and LinkedIn at Doctor. Doriano. So it's a D R D O R I A N A. I also have a website which is simplyfitwellness.teachable.com. And the simply has no I. And it all can be reached it's a long story. I can also be reached by email at drdorianasimplifitwellness dot com. And any of those, any of those avenues can be used to reach me. I also have a podcast, the Simply Fit Wellness podcast, which might be a good resource for people just to I've got podcast episodes on nutrition, but also I have quite a few on, on the emotional and the psychological part of not just eating, but just self care. So that could be another resource for people. So check out the links in the show notes, and, I hope you enjoyed this episode. Please subscribe to Be Well With MS and share it with your friends. Either review, if it helps to to many people, we're gonna celebrate and actually having your comments, maybe your notes with sometimes and always would would help us to grow, reach more people, and we could be satisfied that actually reach so many hearts and souls today. So thank you for tuning in to Be Well with NS Space Cast. Until next time. Take care, take care, and keep choosing that makes you feel well and your own way. Thank you so much. Thanks, Orianna. Thanks. Thank you for having me.
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Show Host and Founder
Hi there! I’m Dr. Agne Straukiene, a neurologist, researcher, and MS specialist. As the host and founder of the #BeewellwithMS podcast, along with expert guests, I share knowledge to guide your MS journey. My commitment to MS care was recognised in 2022 with an International MS Brain Health Team award. I am a certified Brain Health Ambassador for the European Academy of Neurology (EAN).
I am co-creator of tools like the MS Infoflex database, MS Connect app, MS Patients Know Best, Augmented reality motor function assessment in MS (Strolll). I strive to simplify MS self-management.
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