The Truth About Red Wine, Heart Health & Midlife Women | Dr. Suzanne Steinbaum

Dr. Suzanne Steinbaum: 00:00:00

Are you in menopause? Are you having multiple hot flashes? Having a lot of hot flashes increases your risk of heart disease. They go hand in hand.

Roxy: 00:00:08

So what are those silent symptoms that we might not be looking for? 10,000 is the number we should hit.

Dr. Suzanne Steinbaum: 00:00:15

I mean, there's some controversy around it. Listening to your body is really interesting and can be potentially dicey. We know sitting is the new smoking, that's for sure.

Roxy: 00:00:27

In the ranking of the delivery system, is there one that's typically safer than the other?

Dr. Suzanne Steinbaum: 00:00:32

Yeah, like that Estrogen cream is super safe. An estrogen patch is super safe. Isn't that so cool? Yes. Another one of those small tips, right?

Roxy: 00:00:42

What are the labs? What are the scans? What are the metrics we should be asking our doctors?

Dr. Suzanne Steinbaum: 00:00:48

This is so much about educating yourself and really understanding how to communicate with your doctor. The Mediterranean diet that has consistently shown to decrease cardiovascular risk.

Roxy: 00:01:02

For a while now, people have been saying, oh, red wine is good for your heart. Now is this true?

Dr. Suzanne Steinbaum: 00:01:08

Everyone's always asking, what can I drink?

Roxy: 00:01:11

Exactly. Just asking for a friend. Today's guest is someone every woman over 40 needs in her corner and and in her contact list.

Dr. Suzanne Steinbaum is a New York based board certified cardiologist and one of the nation's leading voices on women's heart health.

She's been featured everywhere from the Today show to Oprah's O magazine, and she's made it her life's work to challenge the way medicine sees women and more importantly, how women see themselves. In this episode, we dive into the silent symptoms of of heart disease.

The real story on hormones and heart health, and the game changing questions women should be asking their doctors, but often don't.

We also talk about the ways women are still being gaslit and dismissed in the medical system and how you can start advocating for yourself even if you've been told it's just stress or you're fine.

If you've ever been confused, frustrated, or exhausted by the state of women's healthcare, this conversation will make you feel seen, smarter, and more powerful. Follow the iconic midlife wherever you get your podcasts and share this episode with someone you love.

Because protecting your heart is more than physical. It's personal. All right. Welcome to the iconic midlife. Dr. Steinbaum, it's a pleasure to have you.

Dr. Suzanne Steinbaum: 00:02:37

Thank you so much.

Roxy: 00:02:39

Thank you, thank you. How's your day going? You're in New look, right?

Dr. Suzanne Steinbaum: 00:02:43

I am. I am in New York and it's sunny and very, very hot summertime in New York. It's a thing It's a thing. Right.

Roxy: 00:02:53

Well, we're so excited to have you. You know, I get messages and DMs from women who listen to the show, who are asking me health questions all the time.

So I'm grateful to have you, one of the top cardiac doctors in our country, here, joining us to talk about heart health, because I know heart health is something that, you know, you know, sometimes takes the backseat when we're talking about women's health. You know, there's a.

There's a big focus on cancer and breast cancer and a lot of other ailments, which, of course, we should definitely be talking about those. But sometimes the heart gets sort of put in the background. So I'm glad you're here to discuss, because there's a lot to talk about.

Um, you know, you've said in the past that women's hearts don't just break. They're ignored, misread, and misunderstood. So what do you think is the biggest myth about heart disease in women? And especially.

Especially in midlife?

Dr. Suzanne Steinbaum: 00:03:47

than all cancers combined in: 1986

And so that research was extrapolated to women's hearts, but the research was not done on women. I always joke around that was about the same time that women entered the workforce equally as much as men.

So, yay, we got what we wanted, and we're getting the disease as well. But at that point, that research was a huge issue. The next piece is that in medical school.

And in fact, even when I was in medical school, we were not taught that women got heart disease. So the doctors themselves do not look at women as candidates of getting heart disease. It's a man's disease, according to the doctors.

And then lastly, and the third part of this problem are the women. Because when you ask women what their greatest health threat is, guess what they say?

Roxy: 00:05:03

Do they say breast cancer?

Dr. Suzanne Steinbaum: 00:05:04

Breast cancer. Yeah.

Roxy: 00:05:07

I think that's the one that gets the most publicity. Right.

Dr. Suzanne Steinbaum: 00:05:10

They did a great job. They have a great publicity campaign. But it's partially that women don't know that heart disease is her greatest health threat.

And there have been so many times I've stood in front of a room of hundreds, thousands of women and said, no, it's not breast cancer, it's heart disease. And I'll go through an hour explaining why and at the end, and I say, what is your greatest health threat?

And they all raise their hand and go, breast cancer. Like, wait, where were you? You know, we're just so indoctrinated to really focus on that.

And lastly, when we think of women's health, we really are focused on our hormones, whether it's hormones in pregnancy or hormones through perimenopause and menopause. And what we need to realize. Are you ready for this stat? 40% of our lives we spend in menopause.

70% of women, 70% will have some form of heart disease.

Roxy: 00:06:08

Oh, wow. That's a huge statistic.

Dr. Suzanne Steinbaum: 00:06:11

I mean, that's a lot huge, right? Wow.

Roxy: 00:06:15

Wow. So with midlife comes all of these shifting hormones and sleep issues and stress.

You know, so what are some of the early warning signs that we can see when it comes to heart disease? And what are women overlooking?

Dr. Suzanne Steinbaum: 00:06:31

If you have a heart, you're at risk for heart disease, plain and simple. And so I think one of the biggest issues is that women don't think it's their problem. It's everyone else's problem but their own.

And so the reality is we have to really start understanding that heart disease is our greatest health threat.

No matter what we look like on the outside, it's not really how thin we are or what our skin texture is, although that does have an impact, but it's really what's going on on the inside. And that comes down to risk factors. Those risk factors are things like high blood pressure and high cholesterol, elevated sugars.

We all got the message about smoking, and we know that being overweight isn't great, and we know that diet is bad, but stress and lack of sleep are also issues. But then we have to go back. What's our family history, and what is it a family history of? Did we have any problems during pregnancy?

Adverse outcomes of pregnancy, like preeclampsia or gestational diabetes increases our risk significantly later in life. So understanding who we are throughout our lifespan becomes really important to understand our own personal risk.

And believe it or not, something like depression increases our risk 2 times normal compared to someone who's not depressed. So how we think, how we feel, who we are, all of these things matter.

Roxy: 00:08:05

So we hear about these silent symptoms, you know, of heart disease in women that women just ignore a lot of the time. So what are those silent symptoms that we might not be looking for, but that are happening?

And how can we tell the difference between that and something like anxiety or being nervous or something. Something else that it could be misrepresented for.

Dr. Suzanne Steinbaum: 00:08:30

So some of the symptoms that we have is a chest pain, but it's not really pain. It's like pressure or discomfort.

But also something like palpitations, shortness of breath, jaw pain, back pain, difficulty sleeping could actually be part of it, but also flu like symptoms.

I think one of the funniest things is that when I give a lecture about this and I list these symptoms to a group of New Yorkers, everyone's like very uncomfortable in their seats. They're like, yeah, we live like this every day. How do we know it's not our hearts? And this is when I think exercise becomes really interesting.

Because if you're used to doing a certain amount of activity and all of a sudden you can't. That is probably one of the most important symptoms of knowing something's going on with your heart.

Roxy: 00:09:27

So is it like getting more winded when you're working out or physically? You just cannot do like the movements and things like that?

Dr. Suzanne Steinbaum: 00:09:33

Anything.

Like if you're feeling more winded, you're feeling discomfort that you didn't have, or it's harder for you, or your, your heart's beating faster, no matter what it is, you should always feel the same that you felt the day before or two days before. Obviously, if you haven't done anything for a long period of time and you're getting back to it, you're going to feel out of shape.

But this is really used kind of as this is the bar, you know, this is what we're going to compare ourselves to.

Roxy: 00:10:04

And what about shortness of breath? Is that also could, is that something that could be a symptom of heart disease or.

Dr. Suzanne Steinbaum: 00:10:11

Absolutely. We know that you're gonna get short of breath the more you exercise. That's normal.

But if you're doing something very little, not a lot, or the same amount that you were doing and you're getting those symptoms, it's a problem, something's wrong.

Roxy: 00:10:27

You know, you've been outspoken about women being underdiagnosed and undertreated in cardiology. So how can we become stronger advocates for ourselves when we're in the exam room?

Dr. Suzanne Steinbaum: 00:10:40

This is so much about educating yourself and really understanding how to communicate with your doctor.

So much of my career I've spent really, you know, I wrote a book and I'm speaking because it's about empowering women to take charge of their own health, becoming their own best self advocate. And part of that is knowing exactly what I started with. What are your risk factors? What are your personal Risk factors in your lifespan.

What's your family history? What's your blood pressure? What's your cholesterol? What happened during pregnancy? Or are you in menopause? Are you having multiple hot flashes?

Having a lot of hot flashes increases your risk of heart disease. They go hand in hand. So really understanding all of these different components, that's the first step in saying to your doctor, these are my risks.

This is who I am. And I'm having this symptom, so I'm concerned about my heart.

Roxy: 00:11:44

See, I'm so glad you're bringing up the hot flashes and some of the other symptoms that we face during perimenopause and menopause, because this is such a transitional time for us.

And so when you're over 40 and you're going through these stages of life, how do we process, protect ourselves in, you know, when it comes to our cardiovascular health? And if we're experiencing these symptoms, I mean, how do we know the difference? Because you know that that's very common during this time.

Dr. Suzanne Steinbaum: 00:12:13

It is. It's really important to pay attention, and it's really hard to know what to pay attention to because so much is happening. Right?

And so, again, I go back to, like, the basics. Who was I on Monday and who am I on Wednesday? Do you know what I mean? And am I feeling differently? A lot of women will experience palpitations.

That's really, really common during perimenopause and menopause. Doesn't mean you ignore it. It means, got it. Get it checked. Just find out. Make sure if it's okay.

Sometimes women will say they went to their doctor, they were told they're fine, they. And they're essentially blown off. I don't like that. Get another doctor. You know, really find out what's going on.

But in understanding if your symptoms matter, see what makes them better, see what makes them worse, see if you can pinpoint it to something. Meaning if it's happening when you're lying down at night, might not be your heart.

If it's happening more often when you're exercising or when you're really stressed, it's very possible it could be your heart.

Roxy: 00:13:27

So if you're lying down, it's probably not your heart. Then if you're kind of experiencing this really, is it just because of you being more relaxed or.

Dr. Suzanne Steinbaum: 00:13:36

I'm going to give you a little Biology 101 lesson.

Roxy: 00:13:39

Please, please.

Dr. Suzanne Steinbaum: 00:13:41

Okay, now you'll get it. Okay. So the heart's job is to deliver blood. The blood carries oxygen, and oxygen is what all of our muscles need our heart muscle.

Every single muscle, right? When you exercise, when you're out and about, your muscles need more oxygen. So your heart starts pumping and beating more blood.

If there's problems with the arteries, it cannot deliver as much blood and as as much oxygen. This is a simple supply and demand equation. When you exercise, your demand goes up. If there's a problem with the arteries, your supply goes down.

And that supply and demand mismatch is what leads to symptoms. When you're lying in bed, there's no demand. You're just. You should be just calm, right?

And so the only time your demand goes up is when your heart rate goes up. What increases your heart rate? And that's when it becomes really important to pay attention to symptoms.

Roxy: 00:14:58

Okay. You know, there is so much discussion right now on hrts and bioidentical hormones.

And, you know, I think there's a lot of confusion out there because we're hearing one thing and then somebody else is saying something else. But when it comes to the heart, are HRTs beneficial to heart health? Do they actually help in any way?

Dr. Suzanne Steinbaum: 00:15:23

So the Women's Health Initiative, which was the meanest, most horrible study to ever be released, said that hormone replacement therapy, estrogen is dangerous, increases the risk of heart disease, clotting, all of this. And this is not true. This is not true. The study design was really for older women.

It wasn't looking at women who were on hormone replacement within the first 10 years of menopause, which we know for sure it's protective, but every woman's a little different. And the way that estrogen is delivered is different.

Your risk of clotting goes up if it's taken orally versus if you have it vaginally or through a patch. And what we know through menopause is that inside the lining of the artery, estrogen keeps the artery dilating, supple.

It's like it can expand and contract. It's just like our skin is supple when we're young. It's the same idea. And as we go through menopause, there are two major things that happen.

There is an increase in a hormone called endothelial in one, which makes the arteries contract, and there's a decrease in nitric oxide. And nitric oxide makes arteries dilate. So when you have the bad hormone go up and the good hormone go down, your arteries are constricted.

This arterial constriction and this stiffness in the arteries is what leads to things like high blood pressure and what leads to the Increase in the potential of developing plaque in the arteries. That lining of the artery, as it loses estrogen, becomes stiff. It's called endothelial dysfunction.

And when arteries are stiff and cholesterol goes up and sugars go up and obesity and you're not exercising as much, the potential to have these micro tears, these little tears inside the lining of the artery happens. And when those little tears happen, then that's how plaque develops and heart disease develops.

When you take estrogen, the arteries stay supple, they stay not as stiff. I always say it's the difference between a pipe cleaner that bends and a popsicle stick that breaks.

When estrogen goes down, you turn into a popsicle stick. When estrogen is up, it's a pipe cleaner, and it just can't break.

Roxy: 00:18:08

Oh, that's such a good point. So estrogen is protective in that way. Is testosterone, is progesterone, Are they all protective of the heart or is it mostly estrogen?

Dr. Suzanne Steinbaum: 00:18:21

So it's mostly estrogen, but if you have a uterus, you have to protect that. And that's when progesterone becomes important.

Testosterone has another mechanism, but when we really focus on arterial health, we're really focusing on that estrogen component.

Roxy: 00:18:37

You know, it's like you're saying every woman is different, so it's kind of a balance. And I think, you know, you have to talk to your doctor about these things about, you know, if you want to go on the HRT or not.

But it was interesting. I actually got my yearly mammogram yesterday, being a good girl because everybody should always do their screenings. Don't skip, ladies.

But I was talking to my doctor, and I think maybe because she is so hyper aware of breast cancer, because that is, you know, her specialty, she actually, you know, advised, don't do it unless you have to, and if you do it, do it for a short period of time. So again, like, it's so confusing to me.

Dr. Suzanne Steinbaum: 00:19:18

That's not really what the data shows. And it's an interesting time to speak to. Yesterday, a group of colleagues went to the FDA to remove the black box warning off of vaginal estrogen.

There has been a black box warning saying, this is dangerous to take. Since the Women's Health Initiative, this, as I said, was the meanest thing to ever happen. And yesterday, two hours of the most articulate argument.

I am so proud of these doctors to really have not only stated the reasons why it's wrong, but really talked about the personal impact it's had on their own families and patients, which was just amazing to listen to. And the point is that, as doctors. Remember when we started this, I said the research. The research.

The research that was done made doctors believe this is gonna give my patients breast cancer, but it's not true. And more research that's out there really shows that that's not the case.

And so I'm not sure if I would say that this doctor is really looking at you individually and looking at the different ways that estrogen could be delivered to you intravaginally. Cream is so safe for the majority of women that I don't know if we should put that kind of estrogen in the bucket of what she's talking about.

You know, the delivery system and who that individual patient is matters a lot.

Roxy: 00:21:02

In the ranking of the delivery system. Is there one that's typically safer than the other?

Dr. Suzanne Steinbaum: 00:21:08

Yeah, like, an estrogen cream is super safe. An estrogen patch is super safe. Du a V, which is an oral A Hormone replacement, actually has been shown to prevent breast cancer.

So there are many different types of estrogen. There's many different types of hormone replacement.

And really, having a doctor that can talk through this complicated, complicated story is the most important. And one thing I think is important to bring up.

You're talking to your doctor who's so obsessed about breast cancer, about hormones, and then we talk to the doctor who's so obsessed about, let's say, your endocrine system or your rheumatologic system or your heart or your risk of breast cancer. Like, everyone is compartmentalized in this conversation.

You need to find the doctor that knows you really well, who also knows hormones really well, and that's the doctor that you have to talk to.

What I think is also interesting, one more point is when you talk to all of these doctors who, again, spoke at the fda, and when you talk to myself, how much time we were taught about menopause in medical school, I don't know, like an hour. Every single one of these doctors became so educated, and a lot of times self educated.

Now, there's different classes and programs and courses and fellowships, But a lot of these doctors were about the same age. We had to learn preventive cardiology. We had to learn about hormones.

They really are experts in the field, and it's the kind of field that's so complicated that I think you need an expert.

Roxy: 00:23:07

You know, I think that's a great point, too, that you're bringing up, is that so many doctors are not even educated about menopause and peri. Perimenopause, especially because that's kind of seems like the black hole to a lot of people. You know, it's like, are you in it? Are you not in it?

Is it, you know, happening? Is it not? So I do think, you know, there needs to be more. More education for doctors, right, to kind of understand what is happening.

Even female doctors who actually are going through the same process.

Dr. Suzanne Steinbaum: 00:23:38

One of the most interesting conversations I ever had was on a panel with a group of doctors, all women. One was a urologist focusing on women, very interestingly, in menopause. Urinary tract infections, so incredibly common.

But vaginal estrogen prevents urinary tract infections. Oh, so simple, simple problem solution, right? And so there was this urologist, there was a menopause specialist, a gynecologist, myself.

And the urologist said, I don't know why we're thinking of menopause as being an issue. It's just normal, like, get over it. And everyone went, I thought, oh, my God, someone's gonna absolutely kill her. You know, it was.

It was interesting, but she went through school training when that's what it was thought of.

What I think is interesting is that we're not gonna call this an illness, but we are gonna call it a transition time that has a profound impact on health, whether it's heart disease, cognitive issues, bone health, urinary tract infection, I mean, sexual health, and let's talk about quality of life with sleep. I'm going to go back to cognition, but mood disorders, hot flashes, all of these things, this transition.

And we joke around, if this transition happened to men, it wouldn't necessarily be in this situation. And that's a little bit from how the healthcare system and the pharmaceutical industry, you know, it's just a different dynamic.

And so I don't want women to think they're sick, but I want women to realize that there is a way to prevent all the disease processes that you're about to enter by simply treating the problem and the root cause. And the root cause, oftentimes is hormonal fluctuations and the reduction of estrogen.

Roxy: 00:26:00

Absolutely. You know, with lack of sleep. Because lack of sleep, lack of sleep is such a big part of perimenopause and menopause.

Can the lack of sleep actually affect your heart health?

Dr. Suzanne Steinbaum: 00:26:16

You know, I think this question is so important because we're one being, right? All of this is me, not from here up, not from here down. And you bring up a point that is really, it matters for everyone to understand.

When you don't sleep, what happens? Well, there's an Increase in blood pressure. There is an increase in the potential of gaining weight and obesity.

There is the increase of inflammation. There is potentially the increase of cholesterol. I mean, then there's a decrease in cognition.

I can go through the loop, but it's a lot about the stress hormones, epinephrine, norepinephrine, and the real tough one, which is cortisol. Cortisol increases inflammation. And what is this maelstrom do? It actually leads to heart disease.

When you think about the training that goes on, I believe it's the CIA, Navy seals. There was a study looking at really sleep deprivation and what it does to people.

But 100% when you look at sleep deprivation and what it does to us, cholesterol goes up, blood pressure. You cannot manage blood pressure if you're not sleeping. And we know that a little bit. We see that in sleep apnea.

But there's also this profound impact it has on every, every aspect of us and our wellbeing.

Roxy: 00:27:47

Absolutely.

You know, and I'm glad you're bringing up the inflammation and the cortisol of it all, because that is stressful on the heart and oftentimes again, it's sort of overlooked or pushed aside.

So what lifestyle changes actually make a difference when it comes to lowering cortisol and lowering your inflammation and helping relieve some of that stress?

Dr. Suzanne Steinbaum: 00:28:13

It starts with the second you wake up in the morning.

Roxy: 00:28:19

Not getting on that phone. Right.

Dr. Suzanne Steinbaum: 00:28:21

I keep saying, if we start every day, good morning and welcome to a brand new day. Fake it till you make it. There is something to be said about that.

There's this incredible study that showed as we age, we become naturally more pessimistic and that people who are optimism optimistic have longer lifespans. So I am not kidding when I tell you get up and smile no matter what, because that actually decreases the cortisol.

And as your day goes on, every single choice you make, from what you eat to how you choose to move, I can tell you the relationships you have. Think about, you know, that person that sucks the energy out of you versus that person that just makes you happy.

That shifts your cortisol level, you know, how you interact with every aspect of your life. There's a study that looks at job stress. It was a nurses health study, and it showed it was looking at nurses who really are under a lot of stress.

And in this study, there was a 30% increase in risk for heart disease for people who are under stress at work. So it's about how you move exercise, but throughout your day, you can't sit all day. We know sitting is the new smoking, that's for sure. Right.

It's about how what you eat, but how you nourish yourself. You know, it's not the calories in, calories out concept.

It's the quality of that food you put in your mouth and really how you're going to nourish your body. Right. It's about stress management and it's about your relationships and your job and your point of view and your perspective.

And it's about how well you sleep and when you go to bed. Every little part of the day impacts your heart.

I'm going to tell you, I always say live from the heart because your heart is like the metronome of your life. It is carrying the good times and it is carrying the bad. And the idea of being heart sick and of really feeling heart throbs.

Like we understand as women, we do live from the heart. We carry all of this in our hearts. And so how we choose to live our perceptions, it matters more than you could ever imagine, you know, in midlife.

Roxy: 00:31:08

We're also taught we need to lift heavy weights. You know, that's like the exercise that is recommended to us. So A, does that help our heart health or B, and B, should we also be doing cardio?

And how much cardio, how much weightlifting? What can really keep our hearts healthy when it comes to exercise?

Dr. Suzanne Steinbaum: 00:31:29

I think this is another great question because there's always. Everyone has their perspective.

And so when we think about heavy weights, that's really good to prevent osteoporosis and that's the reason behind healthy weights. When we look at the recommendations by the American Heart association, we look at big picture.

It's 30 minutes, five days a week of moderate intensity exercise. So this doesn't mean like back in the day, we exercise till we vomited or else we didn't exercise. Right?

Roxy: 00:32:00

Totally.

Dr. Suzanne Steinbaum: 00:32:00

That's not what we need to do. It's really exercising at this very moderate intensity zone.

And that's when you feel like you're a little short of breath, but you can finish a sentence. So like this, that means you're in that moderate intensity zone. So that shortness of breath isn't. It's just a little bit.

And for 30 minutes, five days a week, that's the cardio piece. We want to do weightlifting at least two days a week of major muscle groups.

I talk to women a lot about making sure your joints can really manage heavy weights. I wouldn't force heavy, heavy weights. If you have crickety knees and Crickety hips, you know, be careful.

But weight training, twice a week, really, 12 to 15 repetitions for at least two sets. But you want to. You want to lift weights till failure. And that's really what the heavyweight concept is about. This idea of getting to failure.

Heavy weights for someone who's been lifting weight for years is different than heavy weights for someone who just started. So let's not think of heavy weights. Let's just think of not being able to. If you could do it for 30 reps too late, it's really about that 12 to 15.

And the other part of your question, does that help your heart? And the answer is absolutely yes. And I really want to explain this because I think it's such an interesting piece. We have two sets of muscle fibers.

We have the slow and the fast, and we build up the slow when we lift weights. Mitochondria, which are the energy storage cells, get built up in those slow muscle fibers.

So they only get built up when you lift weights, but they get used by your fast muscle fibers, the ones that you need for cardio exercise. So to get into shape, you need a lot of mitochondria. And so when you lift weights, you get into better shape faster.

Roxy: 00:34:11

Oh, that's really interesting. Yeah.

Dr. Suzanne Steinbaum: 00:34:13

Isn't that so cool how the body does that?

Roxy: 00:34:16

The body is so intelligent. Yes.

Dr. Suzanne Steinbaum: 00:34:18

You know, it's so smart, Right? Who thought of that? Right?

Roxy: 00:34:22

Exactly. Like, this is genius.

Dr. Suzanne Steinbaum: 00:34:25

This is brilliant. So, yes, the answer is yes, but not for a reason that's intuitive. For this incredible reason that I just wanted to share.

Roxy: 00:34:36

Yeah, no, that's amazing. You know, there's a lot of. Also a lot of chatter around biohacking and superfoods and supplements.

So how do those things play into keeping your heart healthy? Like, are there certain supplements we should be taking? Are there foods we should be eating?

Are there biohack tricks that we should be doing to keep our hearts healthy?

Dr. Suzanne Steinbaum: 00:35:00

It's so funny. I did one of the first preventive cardiology fellowships in the country, and it was like.

I keep saying it was 20 years ago, but honestly, I've been saying 20 years for, like, the past 25 years. So I don't know how long it's been. It was a long time.

Roxy: 00:35:17

It always feels like, you know, it's the 80s or 20 years ago.

Dr. Suzanne Steinbaum: 00:35:21

Yeah, it's kind of like that.

Roxy: 00:35:24

Totally.

Dr. Suzanne Steinbaum: 00:35:25

So we called it prevention. Now it's called biohacking. But it's something that's been around for a really long time, and I think that's such a Cool phrase.

But when it comes down to it, we've known a lot of this stuff for a really long time. And these superfoods, it's really based on antioxidants. You know, it's really based on all these different components that help dilate the arteries.

It comes down to everything that we've talked about so far. How do we keep the endothelium healthy? How do we keep the arteries healthy? How do we build up mitochondria? Ha.

All these things that we're talking about now, let's call it biohacking for a second. There are certain supplements that we know help build up mitochondria. Nac nad, those sort of things.

If you lift weights, you're also building up mitochondria. There are ways to do it that we can figure out most of the time internally, but sometimes supplement wise. When we think about superfoods.

Omega 3 is a superfood right now. Omega 3 is something our body doesn't make, so we have to get it by food. What's really interesting is it's variably absorbed.

Somebody can be eating salmon three days a week and have an amazing omega 3. Somebody could eat it three days a week and have a low omega 3. So we're not 100% sure.

But what's great is that you can get it checked through a blood test. That might be a supplement you need. Does everyone need an omega 3 for biohacking? Not necessarily.

Because if you're eating a healthy diet and you're absorbing enough, you might not need it.

So when we go through this concept, I take it back to what we know, which is there is such a thing as personalized preventive strategies, and there is not one size fits all of biohacking that's needed for everyone. I think what becomes really interesting and what I really love are all these wearables. It makes some of my patients insane.

I'm like, take it off, you're fine. But we know things like heart rate variability. Heart rate variability is connected to our autonomic nervous system.

That autonomic nervous system is the sympathetic, the fight or flight, and the parasympathetic, which is really the resting one. The parasympathetic is in charge where. When we're in great shape or when we're resilient.

And so when you have a high heart rate variability, it means that your parasympathetic nervous system is in charge, which is great. I get texts and emails all day long. My heart rate variability is 16. Oh, my God. Am I Dying and it's like, okay, what's happening?

Because everything affects the heart rate variability.

But if you understand yourself and you say my heart rate variability goes down when I drink three glasses of wine and it goes up when I don't drink wine, you're in control of your heart rate variability more than you know. And what you have to understand is all these devices in biohacking are almost irrelevant if you're not self reflective.

You've gotta become a journalist of your own life to understand who you are, to know how to use those biohacking tools or these smart devices or tracking devices to your advantage. And unless you have that self reflection, it's just a lot of stuff.

Roxy: 00:39:16

Absolutely.

You know, I'm glad you brought up alcohol because, you know, it's just the ever present debate, alcohol and how it affects us and perimenopause, menopause, midlife, but also how it affects the heart. I mean, you, for a while now, people have been saying, oh, red wine is good for your heart. Now is this true?

Are there better alcohols to drink than others as it relates to heart health?

Dr. Suzanne Steinbaum: 00:39:45

Just asking, always asking, just asking for a friend. Why can't I drink?

Roxy: 00:39:48

Exactly, just asking for a friend.

Dr. Suzanne Steinbaum: 00:39:54

So it goes back to what we call the French paradox. And the French paradox said French people are drinking red wine and living longer.

Well, back in that time when this French paradox was established, it was when we were comparing French people to sort of what Americans were doing and we were eating an American diet that mostly was supersized, higher in sugars, more sedentary. And in this French paradox, we were saying French people drank wine and smoked and they live longer. It must be the wine.

Well, okay, let's just go back on that because in red wine we know that there are antioxidants. We know, actually, I believe it's a Burgundy, that there's a lot of different components that are actually really healthy for our hearts.

Resveratrol is one of them. And these things help to dilate the artery. They're really good for the endothelium.

Antioxidant oxidants prevent LDL from oxidizing and leading to plaque formation. So wine has a lot of great stuff in it. You'd have to drink a lot of wine to get a lot of the high intensity benefits.

Which again, goes back to biohacking.

There are some high concentration products out there with resveratrol and an absorption kind of resveratrol that's really healthy for the lining of the artery. Increasing nitric oxide Helping the arteries dilate. So there are benefits. But when we look at.

And this, honestly, this study came out recently from the American Heart association, when we look at the benefits versus the risk, it doesn't necessarily pan out. And for many years we said for women, a four ounce glass of red wine versus for men, a six ounce glass of red wine is fine. I'm sorry.

I think men were allowed 8 ounces and women were allowed 6 ounces. That was really what it looked at. We are allowed less because our livers don't process alcohol as well as men.

And so that's what we used to recommend. And now American Heart is saying maybe it's not necessary.

We know alcohol in excess can lead to something called the holiday heart syndrome, which is atrial fibrillation and arrhythmia that is actually very commonly triggered by alcohol. And then the other piece of it are the sugars, which kind of is really answering your question a little bit.

So we have a lot of good stuff from wine, but it's also higher in sugar than some other alcohols like tequila or vodka. Clear stuff, gin, things like that. Less sugar content, but higher in alcohol content.

And so, you know, in the big picture, which one is better to drink? It depends what your goal is if you want a low sugar. But having a lot of alcohol isn't great either. Right.

And so I think what we've come to understand, especially, especially through menopause, we talk about tolerance. Your tolerance goes down. Your liver's metabolism of alcohol gets more challenging as your. Your body shifts in terms of lean muscle mass and fat mass.

The whole concept behind alcohol becomes more challenging. And. And women tend not to really be able to process it as well through that menopausal process. So those are the facts.

What you do with that information, I think becomes very personal.

Roxy: 00:43:56

Right, I know, you're right. You could go many different ways with that. Right?

Dr. Suzanne Steinbaum: 00:44:01

Yeah. I don't know what the take home is here, but I'm going to say less is more.

And if you don't drink, starting to drink to protect arterial disease is not really what I'm suggesting.

Roxy: 00:44:13

Right. Is it a good idea to take resveratrol supplements?

Dr. Suzanne Steinbaum: 00:44:18

Kind of getting so obsessed with this topic because I studied it years ago and years ago it didn't pan out to really show to have that significant of a benefit. And there are ways that I actually look at this. It's called arterial dilatation. Brachial arterial dilatation.

I have different tools in my office that I can actually use to help See if some of these supplements do lead to benefit. There's a company that I've just been introduced to that has. It's called a raceid form of resveratrol.

And this specific form of resveratrol is actually very absorbable. So you don't need as much to have as much of a benefit.

Meaning in the past we needed so much resveratrol to really have an impact of the arteries that it was almost impossible to get. And what I'm seeing through this supplement is you actually need less.

You can get it in these high concentrated, highly absorbable form and it increases nitric oxide and it decreases the endothelial in one which is exactly what happens during menopause. So I started taking it myself. I am going into my fourth month. I have a little bit more energy and I'm actually doing better on the peloton.

I go on the peloton as my way to see if there's an increase in my VO2 max. Am I doing better? And I'm seeing some subtle improvements. So there might be an impact of resveratrol. It just matters on the type.

The name of this company is Vinia. It's an interesting look it up. I'm just putting it out there. Possibly this form is better. I like to say I'm not selling anyone's.

I'm just doing the research and doing it on my own and trying to find out what works and what doesn't.

Roxy: 00:46:25

No, that's a great idea. I mean, why not test it out personally and see? Right?

Dr. Suzanne Steinbaum: 00:46:30

That's why I have all these toys on my body. Because I like to see how it works before I recommend it to you. Anyone?

Roxy: 00:46:36

Oh, that's great. So how do we know if we're absorbing?

Because everyone has a different absorption rate when it comes to like supplements and vitamins and things like that. So how can we tell the rate at which we're absorbing things? And is there a way to improve that if we need to?

Dr. Suzanne Steinbaum: 00:46:55

So I don't think we can tell. What you're asking about is metabolism. I don't think we can tell the metabolism of things, but we can tell levels.

And I find this interesting that this isn't more part of our conversation that we really can check our blood tests. We can check for vitamin D, magnesium, omega 3. We can check for coenzyme Q10.

We can actually just do a simple blood test and find out what our levels are. I think that's really important to understand. That's for some supplements. We can't Tell it for everything, like resveratrol.

Right now we can't, but I can tell from the testing that I do that really looks for arterial dilatation.

Roxy: 00:47:49

That's a good point.

So when we are going into our doctor's office and we want to know how healthy our heart is, what are the labs, what are the scans, what are the metrics we should be asking our doctors.

Dr. Suzanne Steinbaum: 00:48:04

So this becomes really interesting because kind of like the conversation that you had with your doctor about hormones and breast cancer. It depends a lot on who your doctor is and, and what your doctor's training is, what your doctor's background is as a preventive cardiology.

I come to this conversation with a lot of different kinds of testing that can tell me about arterial health. But let me give you the standard, and then let me tell you what I do, and then let me tell you where you can find out a little bit more, actually.

So everybody needs to know their cholesterol. It's a cholesterol panel. There's some advanced testing that tells you your sizes of cholesterol, your particle sizes.

It tells you about inflammation in the arteries. And this advanced testing also tells you some genetic markers.

I think everyone needs a lp, lipoprotein, little A, that is a genetic marker that actually increases your risk of early heart disease.

I think everyone needs an apoe, which is also a genetic marker that can tell you your risk for early heart disease and Alzheimer's, as well as your risk for diabetes or metabolic syndrome. I think everybody needs to have their thyroid checked as well as just a standard cbc, standard blood counts.

I also think it becomes important that we look at inflammatory markers. Hscrp, high sensitive crp, which becomes really relevant.

And then those other things that I Talked about, Omega 3, vitamin D, magnesium, we can check them. It's important to get them checked when you are young. Everyone needs a baseline. If you start having symptoms or family history that starts at age 20.

When you start going through perimenopause, you need other testing, an echocardiogram, which is an ultrasound of the heart. And then you need to understand sort of functionally how well you're doing.

I do a very sensitive test in my office called a cardiopulmonary exercise test that we look for things like VO2 max, but we test for other metrics that can actually determine if you have microvascular disease or problems with the arteries to see how well they dilate, if the endothelium is healthy. I think that's really important. A lot of people talk about A calcium score, which is a CAT scan.

No dye, no contrast, that looks for calcification in the arteries. I have mixed feelings about that.

Calcified arteries tell us that there is evidence of plaque in the arteries, but it doesn't tell us about soft plaque. And soft plaque is really what's vulnerable that can break off and lead to heart attacks. It also tells us about early heart disease.

That early heart disease is developing, and that's done through a CAT scan angiogram called a clearly scan.

So there are multiple different things I talk about functional, physiologic, anatomic, genetic, metabolic, and really this understanding of all different components of our heart, our last being inflammatory, that tells us exactly what's going on with our heart. In this part of my career, I'm not only seeing patients. I launched a technology company and it's called Adesso. Adesso means now in Italian.

And we have an app called My Adesso that's actually in the app store that goes over all of this. It's not only about education, but it's about testing. We have a website, Adesso Health. All this information is there.

I do believe that education and empowerment is the most important thing. And I am truly, truly dedicated to helping women get as healthy as they can be. And so check it out, it's there for you.

And, and really understanding where you fit in in terms of your own personal risk becomes so important. And that's what begins our journey on the app. It's the Adesso Heart Score. So you can understand what your own risk is.

Roxy: 00:52:48

That's great. What are three like, for the women that are listening today, what are three things that they can do tonight?

Like today, as they're listening, when they get off, what can they do to three things that they could do to improve their heart health?

Dr. Suzanne Steinbaum: 00:53:04

I believe that exercise is the best medication. So if you're not exercising 30 minutes, five days a week in that moderate intensity heart rate zone, tonight I want you to get up and go for a walk.

Like, just go for a walk. And I want you to really figure out what that moderate intensity zone is.

If you don't have a watch, you know, figure out with your breath what that feels like.

The next thing is pick the one thing that you know you're not doing well, whether it's you're sneaking a cigarette every so often, which, like, I hear people say it doesn't really count. I'm like, no, no, it really does count.

You know, it does or it counts or you're drinking that one to two glass of wine like every night instead of on the weekends, or you're not sleeping enough, like pick that one thing that you know that you don't really like to admit or tell anyone and think about doing one small thing to improve that one thing.

So if it's sneaking ice cream at night, you know, sitting on the couch after 11 o', clock, go to bed earlier, cut out the ice cream, like figure out a way to just change that one thing. What's so interesting is if you change that one thing, you start feeling better. And as you start feeling better, you want to do the next thing.

And so the healthier you feel, the better that you feel, the more that you want to do to become healthy.

And the last thing I think becomes really interesting, which is really trying to figure out how to actually get up every day with a smile on your face and mean it. And I think that it really matters what makes us happy.

I think that the idea of happiness is sort of elusive all the time, but understanding that in so many ways it's a mindset and picking that one thing that really bothers you and somehow turning it around that you can actually create good hormones to be released in your body instead of those stress hormones to really find a way to get up every morning with this sense of gratitude and appreciation, to kind of live life with this feeling of purpose and happiness. And if you can do that, it actually will help you live longer, happier. And that's truly what this is about. It's about living from the heart, quality.

Roxy: 00:55:55

Of life and having a great life, you know? Yeah, it's true, it's true. So I would love to know how you are living iconically during this season of life.

Dr. Suzanne Steinbaum: 00:56:07

I think what's interesting for me, many years ago I saw this study about really living people who live life with passion and purpose that are really living a purpose filled life no matter what it is. I mean, if it's charity, it's your job, it's mother, whatever it is, but it's your thing.

And I've really realized how much, how important that is for me. I was working in a hospital and for 20 years saying one in three women die of heart disease more than all cancers combined.

And I did the craziest thing. I left the hospital and launched a technology company. And it was like, what are you thinking?

You know, like this is when you're like, you're supposed to slow down. And then I'm surrounded in a room with a bunch of entrepreneurs in their 20s and I'm like, what am I thinking? This is crazy.

But for me, it was like, I'm just, this is my purpose. This is my reason. I have an amazing son. I adore and love him. Motherhood is everything, everything to me for him.

But for me, having this impact on women's healthcare and for changing healthcare for women in this country and improving their quality of life means everything. And instead of slowing down, it's ramping up, but it's living life with a purpose and with passion.

And I know by the statistics that if you do that, if I do that, I'm going to live life longer and with greater vitality. And I'm hoping that's what happens. Even on those stressful days of startup land, you know, what would you say.

Roxy: 00:58:01

To women out there who are searching for purpose and trying to find what that is and what that means for them? Because a lot of women feel lost or confused or, you know, they've given so much of their lives to other people.

Taking care of kids, taking care of partners, maybe working, like, you know, crazy hours, just doing things for others, you know, not really doing it for themselves. So what would you tell them?

Dr. Suzanne Steinbaum: 00:58:26

I really think it's such a universal thing, I mean, for all women of all walks of life across the world, that we tend to just put ourselves last. It's so interesting. I mean, working, family, friends, everything. It's like, I'm doing this, I'm doing this, I'm doing this.

And like, all of a sudden, it's like, okay, now I'm doing for me. We squeeze us into the checklist, right?

And so at some point, everyone has to have that moment where you sit down and you think to yourself, if there was no one else, no one else on the planet but you, what is it that you would want to do? And that's what you put on the top of the list. Just for a little bit.

Not every day, not all the time, but make it important to you, make it worth it to you. I always say, and I do this now. Exercise for me is so important. I have meetings all day long, I promise you. Exercises in my meeting calendar.

It's not an extra. It's important enough that it is on the calendar. And that's what you have to start doing, is put yourself on the calendar just like everything else.

And that one thing that's going to make you feel so happy, you've got to add that to the top of the list.

Roxy: 00:59:53

And don't feel guilty about doing that, right?

Dr. Suzanne Steinbaum: 00:59:56

Oh, my God, no. You've paid your dues. Please. And you know what? We're talking about happiness. This is about quality of life.

Everyone should have a little bit of quality of life in there. And that's what you got to figure out, what is going to make me happy?

Roxy: 01:00:12

Absolutely. So what would you tell your 25 year old self about taking care of your health?

Dr. Suzanne Steinbaum: 01:00:21

Well, I'm going to tell you what I was doing at that age.

Roxy: 01:00:25

What was, what was Suzanne like at 25?

Dr. Suzanne Steinbaum: 01:00:28

I was in training. I was on call every fourth night overnight. I was living on jelly beans and coffee.

And I was incredibly like unhealthy in terms of taking care of myself. But I was 25, exercising, going to dance classes, staying up all night, did nothing. Right.

And what I would have told myself, slow down, because that body of yours has to last your entire life. And what you do today is going to matter a lot in 5, 10, 15, 20 years. So start taking care of yourself now.

And I think the other thing that I would definitely say, doing more doesn't mean you're doing better. And it took me a really long time to realize, slow down. You don't have to do 150 things in one day. You can actually do 100.

But be focused and you might get more done. We multitask. And there are studies that showing multitask does not mean you're being more efficient.

If you're more focused, you're more efficient and you don't have to work as hard. And it took me a really long time to really realize that.

Roxy: 01:01:46

That's such a good point too, because it's like productivity is like the center of, of all of this. You know, it's like, how can we be more productive? How can we get more done? You know, like more, more, more, more, more.

And it's like, just take a minute and take a breath and enjoy the moment that you're in. Right?

Dr. Suzanne Steinbaum: 01:02:05

Absolutely. And that's the other thing. Mindfulness is something that I never understood at 25. You've got to be where you're at. Be where you're at.

And that has been the mantra of my life. When I was being a Mom, I was 150% with my son. When I'm at work, I'm 150% with my patients.

And that mindfulness allows you to show up for everybody because all it takes is attention. And where your attention goes is what gets affected. It's all this concept of energy. Where you put your energy is what is impacted the most.

And I find it fascinating. My son is 18. He says to me, mom, you were always around. I literally am not going to tell him any different. I'm just like, okay, okay.

And if he feels that way, that's just amazing. You know, it's quality time, Right?

Roxy: 01:03:12

It's not quantity, it's quality.

Dr. Suzanne Steinbaum: 01:03:15

Mindfulness, attention, being present, all of that. That's what we have to do for ourselves.

Roxy: 01:03:22

Yes.

Dr. Suzanne Steinbaum: 01:03:23

And as you go through this transition, just turn it around and put it on you. Be present, be mindful, be there for yourself.

Roxy: 01:03:31

Great point, great point. Well, on the iconic midlife, we like to end things with a game, a rapid fire game. Are you up for it?

Dr. Suzanne Steinbaum: 01:03:38

I think so. Go ahead. All right.

Roxy: 01:03:40

All right. Okay. So this game is called Heart Smart or Heart Nope. So heart Smart is you support it.

Heart nope is it's a myth or a waste of time or possibly even bad for you.

Dr. Suzanne Steinbaum: 01:03:54

Okay, okay.

Roxy: 01:03:55

The first one is taking 10,000 steps a day.

Dr. Suzanne Steinbaum: 01:04:00

I mean, hard smart, but yeah, good, do it.

Roxy: 01:04:05

10,000 is the number we should hit.

Dr. Suzanne Steinbaum: 01:04:07

I mean, there's some controversy around it, but I would tell you, you know, this is from a really long time ago, and that's kind of what we're saying is where our target might be a little less than that. I'm going to tell you this. The more you move, the better it is. And if we say 10,000 and we hit 8, awesome. If we say 8 and we hit 5. Nope.

So hold the bar higher. Right, Right.

Roxy: 01:04:38

You want to get above the 5,000. Okay, good to know.

Dr. Suzanne Steinbaum: 01:04:44

Okay.

Roxy: 01:04:45

Red wine for heart health.

Dr. Suzanne Steinbaum: 01:04:48

Yeah, that's a. You know, listen, I live in New York. When you ask people if they drink in New York, they're like, no, just a bottle of wine with dinner. Right.

When you go anywhere else, maybe in California, too. Anywhere else in the country, do you drink? No means no, right? I think that like everything, moderation becomes so important.

And I think if you have a glass of red wine with dinner, nothing is going to happen to you. But that's not often what happens. And so it's really about moderation and understanding what's the best for you.

I will tell you, there are people that drink red wine, and the nitrates in the red wine, they're feeling foggy or stuffy or not. Well, don't drink it. It's not good for you. And everyone is different.

As we go through menopause, you know, metabolism changes, then that's a hard nope, you know, don't do it. But if you do, and it's a wonderful Friday, Saturday night, you might have a glass of red wine. Knock Yourself out.

Roxy: 01:05:59

Good advice, good advice. HRTs in your 40s.

Dr. Suzanne Steinbaum: 01:06:03

Well, again, everything in my land really comes down to this personalization and understanding who you are. If you're in your 40s and menstruating, it's not HRT that you would need. It was. It's birth control pills. Right.

So HR2 happens after you're done menstruating. What I will say is if you go into menopause in your 40s, it's early. It's early menopause.

So being on hormone replacement, I would absolutely recommend it because early menopause leads to heart disease, osteoporosis. I mean, it's really, really hard on your body. So menopause in the 40s. Yes, yes, yes. Heart smart and healthy to.

To go on hormones, but not if you're menstruating. It's a different deal.

Roxy: 01:06:54

Okay. Different deal. Magnesium for sleep.

Dr. Suzanne Steinbaum: 01:06:58

Magnesium is really. I love magnesium because it actually slows the heart rate down and actually prevents extra beats.

So for women going through menopause who get palpitations, magnesium is really helpful. The marketing behind magnesium for sleep is just a branding.

Marketing amazingness because what it actually does is it impacts the heart and slows it down and it makes you feel calmer.

Roxy: 01:07:24

Oh, interesting. That's why you can kind of lull to sleep maybe a little easier, right?

Dr. Suzanne Steinbaum: 01:07:28

Yes.

Roxy: 01:07:29

Okay, good to know.

Dr. Suzanne Steinbaum: 01:07:31

Isn't that so cool? Yes. Another one of those small tips, right?

Roxy: 01:07:34

Yes, I love that. And these kind of like nutrients that maybe we don't talk about as much too, you know.

Dr. Suzanne Steinbaum: 01:07:40

Right, right.

Roxy: 01:07:41

Cutting carbs to lower blood pressure.

Dr. Suzanne Steinbaum: 01:07:44

Huh? That's interesting. Well, I'm not sure about. So carbohydrates, depending. Simple carbohydrates are high in sugars and so that's not good for us.

Sugars oftentimes leads to belly fat and leads to inflammation and all of that will increase blood pressure. That being said, complex carbohydrates, things like quinoa, amaranth, spelt like all of these, like ancient grains, super fabulous for you.

Decreases and it actually improves sugar metabolism, decreases cholesterol. This is great. This is not going to increase belly fat and so that's not going to increase your blood pressure.

It's actually been shown to decrease your blood pressure. It's part of the dash diet and Mediterranean diet and both of these diets have been studied and it actually decreases blood pressure.

Roxy: 01:08:44

Okay, good to know. Let's see the. Oh, high intensity interval training. HIIT training. Heart healthy.

Dr. Suzanne Steinbaum: 01:08:52

These are, you wish I would say this was supposed to be a fast thing, right?

Roxy: 01:08:58

I'd rather hear you like your expertise, so it's fine.

Dr. Suzanne Steinbaum: 01:09:03

Giving you like a 20 page synopsis. Hit intervals for athletes is great.

And I talk to women who've been like, college athletes are training their whole lives, and they're like in their 50s and 60s and they're killing it. And for them, high intensity intervals are wonderful.

If you're starting out or you're really in this place of, I say in the thick of menopause and you haven't gotten it all figured out yet, just focus on that moderate intensity. You don't need that high intensity until you actually get into really good shape. Then that high intensity brings you to the next level.

But really high intensity, it's just not good for you in that, like, icky phase. I. Okay, I just coined a new menopause term, like in that icky phase. The icky phase.

Roxy: 01:09:58

We know this icky phase well, you.

Dr. Suzanne Steinbaum: 01:10:00

Know exactly what I'm talking about. Just stay in that moderate intensity zone.

Roxy: 01:10:04

Okay? Cold plunges heart healthy.

Dr. Suzanne Steinbaum: 01:10:08

This is part of that biohacking. If you make me go do a cold plunge, I will never speak to you ever again. Like, it's not for me again. This is an individual thing.

It's really helpful for. It's an anti inflammatory, really helps the autonomic nervous system.

A lot of women I take care of have Raynaud's, which is spasm of the arteries and the fingers and toes where their hands and feet get really, really cold in the cold. Have you heard of this?

Roxy: 01:10:43

Yes, I've heard of that.

Dr. Suzanne Steinbaum: 01:10:45

Do not do a cold plunge. Like, no. Right. So again, it gets back to this personalization.

The concept for many is, especially people that are working out a lot, anti inflammatory improves the parasympathetic nervous system. For me, nope. But for some, yeah, it could be great.

Roxy: 01:11:08

Okay, now rate these in order. The keto diet versus the plant based diet for heart health. Is there one that's better?

Dr. Suzanne Steinbaum: 01:11:17

Plant based, plant based. I will never change my mind.

Roxy: 01:11:21

Really. So. Okay, that's good to know. So no keto for heart health. It's gotta be plant based.

Dr. Suzanne Steinbaum: 01:11:28

Okay, so let's talk about this, because here I go again.

You know, it's really interesting because we talk about the education and what people are really pushing, and one of the things that's come up in the menopause community is really talking about high protein diets. Protein is so important for us, but there are different kinds of proteins, saturated fats, you know, what we get from.

I Always say it's like two eyes, four legs, a mother. That's a saturated fat. Right. So that includes dairy products because it comes from something with two eyes, four legs, and a mother. Right.

But that's also chicken, turkey, red meat, all of that. People think that chicken is good and better than red meat because it's lower in fat. It is still a saturated fat.

So there's difference between high protein things that we get from legumes, beans. I swear I live on chickpeas. I do not eat meat. I don't eat meat. I do eat fish.

And so when I talk about high keto, we've got to really discuss what that means. Is that a high saturated fat or are we talking about high protein and low sugar?

Because low sugar I agree with 100%, but I don't agree with this really high saturated fat. I really like the idea of mostly vegetarian. And I. What I believe in is.

Sorry, vegetarian, but what I believe in is the Mediterranean diet that has consistently shown to decrease cardiovascular risk. That's high in omega 3 fatty acids.

So that's fish, olive oil, flaxseed, avocado, really good fats, complex carbohydrates, but really low in saturated fats and really, really low in sugars.

Roxy: 01:13:28

Mm, that's a good point. Okay, so the hummus. And we can still get a lot of the protein from that kind of a diet.

Dr. Suzanne Steinbaum: 01:13:34

Yes. So I'm not really a cook, chef, anything. I just miss that gene and had no interest. So I actually get delivered to me a high protein vegetarian diet.

And I am really getting like 20 grams of protein in an all vegetarian. And it's a lot of different kind of legumes, beans, like you mentioned, hummus, that sort of thing.

And I make sure to get on my own fish and that Omega 3 component.

Roxy: 01:14:09

Okay, good. Okay, last one. Listening to your body over lab work.

Dr. Suzanne Steinbaum: 01:14:16

Ooh. Listening to your body is really interesting and can be potentially dicey.

Roxy: 01:14:25

Okay, good to know.

Dr. Suzanne Steinbaum: 01:14:27

Because when we talk about high blood pressure, we call it the silent killer. Sometimes you can't feel it. High cholesterol, you don't know. You can't feel it. You never know.

And so I am literally talk about constantly, like this idea of living from the heart. So listening to your body is one of the most important things to do.

But when you think about what is going to affect you the most, that you might not know, it actually comes from the blood work. And I really, really want everyone to know. You've got to know your family history.

You have to understand that piece because one of the most common things I hear from women is I eat well and exercise and although my family history is really bad, I take care of myself. So it doesn't matter. It does, it does. What you're doing for yourself makes you healthier, but it doesn't mean you might not need medication.

It doesn't mean you're a failure at trying to prevent disease or taking care of yourself. It's just sometimes those genes are so powerful that you can't get the cholesterol down and you might need medication.

So how you feel like demote your brain a CEO for real and listen to your heart in the most profound way, which is what's the impact of these blood tests on my heart?

Can I develop heart disease and all of those things and make choices that are really going to help you live the most vital, healthy life you can for as long as you can? That's what we really want to talk about.

Roxy: 01:16:12

Great advice. So impactful. And thank you so much for joining us today. I mean, your words have been so important to hear.

I mean, I know a lot of women suffer a lot because they just don't know. So this knowledge is everything. So will you please tell everybody where they can find you?

Dr. Suzanne Steinbaum: 01:16:30

Absolutely. You can find me. You know the standard ways on Instagram and LinkedIn and Facebook. DoctorSteinbaum on Insta.

I also have a website, Dr. Suzanne Steinbaum, you can check out Maya Deso as well with all of this information and I love to hear from you on hear from you on social. So come find me.

Roxy: 01:16:54

Wonderful. Well, thank you so much. It was such a pleasure to chat today and thank you for joining me. Iconic Midlife.

Dr. Suzanne Steinbaum: 01:17:00

Thank you. This was super fun. Thanks for having me.

Roxy: 01:17:04

That was Dr. Suzanne Steinbaum and if you're anything like me, you're watching. Walking away from this episode with a new sense of clarity, power and a few questions you're ready to take to your next doctor's appointment.

This is what the iconic Midlife is about. Not just aging well, but living boldly, asking better questions and refusing to be overlooked or underserved.

You can find Dr. Steinbaum's work and resources linked in the show notes and I highly recommend following her for insight, advocacy and real talk on women's health. If this episode resonated with you, text it to a friend, tag us in your takeaways and leave a review.

Every share helps this show reach more women who deserve to feel empowered in this season of life. Follow the show, spread the word and remember, we're not doing midlife quietly. We're doing it on our own terms.