Prioritizing health through sleep and nutrition

[00:00:00] Cynthia Thurlow: You can take all the hacks and all the supplements, but if you’re still not sleeping, not managing your stress, you’re eating an ultra processed diet and you don’t move your body, it’s not going to make any difference. And so I remind people that the basics still matter. I always say, don’t major in the minors.

[00:00:21] Peter Bowes: Hello and welcome to the Live Long podcast, I’m Peter Bowes. This is where we explore the science and stories behind human longevity. The goal is to optimize our healthspan and master the aging process.

[00:00:35] TIMELINE: This episode is a co-production with the Swiss longevity biotech company Timeline. We’re in Las Vegas at a forum, the annual Longevity Fest meeting of the American Academy of Anti-Aging medicine.

[00:00:46] Peter Bowes: Cynthia Thurlow is a nurse practitioner, nutrition expert, and a leading advocate for those health issues and lifestyle solutions that affect women. With two decades of clinical experience. She combines conventional medicine with functional nutrition and focuses on addressing issues like weight gain, lack of energy, and food cravings. She is the author of Intermittent Fasting Transformation, The 45 day Program for women to lose Stubborn weight, Improve Hormonal Health, and Slow Aging. Cynthia, it’s great to see you.

[00:01:24] Cynthia Thurlow: Thanks so much for having me.

[00:01:25] Peter Bowes: And I say that you. Well, you practice functional medicine, but it is a combination, isn’t it, of functional nutrition and kind of conventional medicine that most people will understand. How do you combine the two?

[00:01:40] Cynthia Thurlow: Well, I think that like I would explain to any patient, it’s really taking the best of both worlds. Like there is clearly a place for conventional allopathic medicine. But when I think about things from a functional perspective, we’re really looking at a root cause approach. And it all starts with nutrition. And this is something that, you know, I did not learn as a nurse or a nurse practitioner, but through many, many years of working predominantly in cardiology and seeing lifestyle mediated diseases, it became evident to me that we needed to look at things a bit differently if we wanted to get on top of what is evolving as a metabolic health crisis here in the United States.

[00:02:17] Peter Bowes: Exactly. It’s interesting you say everything starts with nutrition because there are well recognized pillars of of longevity and good health. Of course, nutrition is one, but exercise, sleep, social connections I think is increasingly understood as a very important. But you put nutrition at the top, or at least at the start.

[00:02:35] Cynthia Thurlow: I think I would probably say if I were to pick one of all of those, I would say sleep really begets every other foundational pillar. I don’t think it’s sexy. I think for a lot of individuals, they think sleep is, you know, I’ll sleep when I’m dead, I’ll sleep when I retire, and when I’m able to help patients understand that sleep is really at the root of every health related condition that we’re looking at. I would say sleep and nutrition kind of go hand in hand.

[00:03:02] Peter Bowes: Yeah, I think I would agree with you. You have a bad night’s sleep, you have a bad day and you don’t eat well. You tend to eat more sugar because you need some energy and you’re less inclined to exercise. So everything revolves around getting a good night’s sleep.

[00:03:14] Cynthia Thurlow: Absolutely.

[00:03:15] Peter Bowes: Let me talk about your own personal background, because I think a lot of your thinking in this area is based on your own personal experiences and your own ill health at times. Just tell us a little bit about that journey and how it’s brought you to this point in your career.

[00:03:31] Cynthia Thurlow: Yeah, I mean, I think for me, I was always healthy in my 20s and 30s. And then like most women, you get into your 40s and you suddenly become a little weight loss resistant. Your sleep is terrible. You just don’t have the energy that you used to have. And so I come from the place of if I was not aware of what to expect in perimenopause, the ten years preceding menopause, how can I expect my patients to? But I think the story that story that you’re probably alluding to is, five years ago, I spent 13 days in the hospital with a ruptured appendix. Had I not been as healthy as I had been, I might not be sitting here having a conversation with you. And so, you know, from my perspective, it’s incredibly humbling to spend time in the hospital. It’s also incredibly humbling when you have as much knowledge as I had by that point. And so from that point forward, I really dedicated myself to ensuring that I could spread as much good information, positive, empowering information for women that are navigating perimenopause and menopause. Because, you know, five years ago there just wasn’t enough information. And I think a lot of women suffer needlessly.

[00:04:34] Peter Bowes: Interesting point you make about being in a relatively or generally a good, healthy state when something happens to you and something can happen to all of us at any time, we can be hit by something that even if we have lived the best life, it’s still going to hit us. And of course, I think we all learned this the hard way during Covid and during the pandemic that those of us that were reasonably well and healthy and didn’t have those underlying conditions were better able and to cope. And that’s really part of the message, isn’t it, because something in the future is going to come and affect all of us. Now, hopefully there won’t be another pandemic, but in terms of personal health, the better state we can be in now, the better state we are in to fight whatever comes our way.

[00:05:17] Cynthia Thurlow: Absolutely. And I think for a lot of people, it’s not until they have an illness or they have an accident that they realize that that really, you know, going through those experiences, getting through them just really further validates taking good care of yourself. It’s not an excuse to not continue taking good care of yourself. It’s with the understanding that had I been the average 47 year old, I might not have gotten out of the hospital and I would have had more subsequent complications. But I think the point I’m trying to make is that you can be healthy and still have a health care hiccup, but, you know, the ability to navigate away from there, saying, I don’t want to go through that again. So what am I going to do differently moving forward?

[00:05:55] Peter Bowes: You’ve worked in emergency medicine, which must be one of the toughest coalfaces, if you like, of the healthcare systems. How has that influenced your thinking?

[00:06:06] Cynthia Thurlow: Well, I think it validated that at that time in my life, I was a total adrenaline junkie. I loved the excitement. I loved the variety, I liked the unpredictability. And at that stage of my life, I didn’t have responsibilities to children or a husband. And so for me, it was a kind of a natural navigation away from that into cardiology, which is also adrenaline fueled, you know, lots of instability with patients. And, you know, to me, it was just it was the most exciting place to be where I got the most intellectual stimulation and rigor. And I think also because my personality is such that I really like being challenged. And, you know, that’s a running theme you’ll see throughout my life. So I gravitated towards specialties where you were really, really challenged emotionally, intellectually, spiritually to process everything that you’re dealing with day to day.

[00:06:56] Peter Bowes: Did it teach you anything about people and how they live their lives?

[00:07:00] Cynthia Thurlow: Absolutely. Well, and I think, you know, when I started in medicine, it was 1997 and medicine was practiced differently than, you know, certainly the metabolic health crisis wasn’t nearly as pronounced as it is now. And so what did it teach me about people? I think irrespective of social class of race, gender? I think all people fundamentally have a desire to be cared for. I think all people fundamentally want to get better. I think all people fundamentally deserve to have those things. And, you know, I trained in inner city Baltimore, and then I practiced most of my clinical experiences out in the suburbs. And so for me, my very interesting, very challenging patients that I experienced at the beginning of my career still affect influence the way that I practice now. I think in many instances there’s this thought process that if someone is poor, indigent, that they don’t deserve the same level of care, that someone that’s wealthy and lives in the suburbs. And I would be the first person to tell you that I treat everyone the same. People are people. They just want to be respected. They want to be cared for.

[00:08:10] Peter Bowes: And that’s one of the great issues in healthcare at the moment, and especially in this sphere. We’re at this conference in Las Vegas, the sphere of longevity and pursuing a long healthspan. It’s often seen as elitist, isn’t it, because there are so many potentially potentially useful interventions, but potentially expensive as well, that really are out of the mainstream for most people. So how do we address that issue that we make these interventions and the knowledge that you’ve gleaned and that others are gleaning at events like this available to everyone?

[00:08:45] Cynthia Thurlow: Well, I think that, yes, you’re right that that it is a privilege to be able to sit in a position where, you know, there are not just peptides and hormones and supplements and gadgets, all of which can be incredibly influential in supporting longevity. But it always goes back to basics. You can take all the the hacks and all the supplements, but if you’re still not sleeping, not managing your stress, you’re eating an ultra processed diet and you don’t move your body, it’s not going to make any difference. And so I remind people that the basics still matter. I always say, don’t major in the minors. A lot of people get caught up in the bright, flashy, you know, the newest, hottest gadget that’s out there. And I’m like, listen, I mean, yes, having an Oura Ring is fun, but it does not replace the sleep. It does not replace the nutrition. It does not replace the proper stress management. It doesn’t replace the connection to loved ones or your spiritual practice. And irrespective of where you are in time and space. I think everyone has the ability to work on some of those things. Now, I would argue there are food deserts. There are inner cities where people don’t have access to fresh fruits and vegetables. They might only have the option of ultra processed foods. And I hope that, you know, with the advent of a new administration, maybe things will shift in the right direction. That’s my hope. But I do think that I would still impress upon any patient, irrespective of their financial circumstances, to really diligently work on sleep, to try to eat less processed foods, or to find healthier versions of foods that they like. And I think that is really at the crux. I think if you have the privilege and the ability to be able to afford all the fun, new bright, shiny objects, great. But it does not replace the foundational lifestyle elements that I’m referring to.

[00:10:31] Peter Bowes: I don’t usually delve into politics in this podcast, but you mentioned the new administration. You’re referring to the new American administration under Donald Trump. Just briefly, what are your hopes? I think a lot of people I’ve spoken to, people at this at this event just waiting to see what happens. And in terms of healthcare, which has been elevated in terms of prominence, what are your hopes?

[00:10:53] Cynthia Thurlow: Well, it’s interesting, there was a Hopkins physician where I trained Dr. Marty Macari, who’s written some very influential books. He’s a physician scientist. He is the potential new FDA administrator administrator. And to me, I’m just hopeful that someone thinking outside the box might actually bring about things like, you know, including women in more trials in, you know, as an example, testosterone is not FDA approved for the use of women, although we know it’s a very important hormone for women. It’s just approved for men. So when I start thinking about how maybe one appointee may have a profound net impact on all of us, it makes me excited. And this isn’t a political statement. I’m just saying, like, I’m trying to find the reframe for a lot of crazy things that have happened in the last 4 to 6 months. And so my hope is, number one, maybe there’ll be some influence on special interest, big ag processed food industry being held accountable. Like as an example, you probably know this that in the EU and the UK there are Kellogg’s products and other types of processed foods that have different ingredients than they have here in the United States, because we are not nearly as stringent as other countries are. And so I start to think about the possibility that maybe there’ll be some more equality on removing the crap from the food, or at least eliminating most of the most toxic ingredients. And then if with a new FDA commissioner hoping that there’ll be more inclusion of women into clinical trials, which is badly needed.

[00:12:24] Peter Bowes: Let’s talk and dive into food and diet a little bit more. You’ve written about intermittent fasting. I know you’re working on a new book as well, which we’ll talk about, but let’s talk about fasting and the goals of someone’s diet. We’re all different, and I think it’s widely recognized. We all respond in a in a different way to different types of different food groups and different types of of diet. What’s so fascinated you about fasting that you wanted to write a book about it? 

[00:12:51] Cynthia Thurlow: Well I think, you know, so many of us come to fasting out of a desire to lose weight. Like I mentioned, I went through that beginning of perimenopause. I’d never been weight loss resistant. It always lost weight easily after having pregnancies and breastfeeding. And so, like many people, came to intermittent fasting with a desire to lose weight. That didn’t happen initially. But what happened was I had increased mental clarity. I had more energy. I just felt better. And I stuck with it because I knew there were a lot of benefits. Intermittent fasting is one of many strategies, and I don’t necessarily advocate that fasting is the right decision for everyone at every time. But I do think when you look at the research on meal frequency here in the United States, people are eating six, ten, 15 times a day. And that is not the way our bodies are designed to thrive. And so what I generally suggest to people is fasting may not be right for you. However, every person watching listening should be eating in a 12 hour feeding window, so that gives you 12 hours of digestive rest. And that’s really the platform that I try to come from. We are all bio individuals. We may all need a very different approach, and I think that if we are eating with less frequency, we have better blood sugar regulation, we have better energy. We’re able to maintain our weight in a more proactive manner. And so I think that when we find that reframe of strategies, you know, there’s lots of strategies that are out there to help support health. Fasting is one of them. But digestive rest is right for everyone. And that’s an important distinction.

[00:14:21] Peter Bowes: Sometimes described as time restricted eating. You restrict your eating to that certain window. There is a lot of debate, though, isn’t there, over whether it should be 12 hours, 14 hours, 16 hours. At a more extreme, some people even do 23:1, which I think is very extreme. But where do you come down on that debate?

[00:14:39] Cynthia Thurlow: Well, I mean, when I think about 12 hours, that is not fasting, that is digestive rest. And that’s really to optimize digestion and give your body a break from the process of eating food. And we’re talking about intermittent fasting. And yes, you can have 14 hour fasting window 16, 18, 20, 24, 36, 72. I think you have to be deliberate. I’m not a fan of over fasting. And what does that mean? That means the individual that is maybe getting one meal in a day, because protein is so important for longevity. Protein is important for maintaining muscle mass. Muscle mass is important because muscle is this organ of longevity, but it’s also a massive glucose disposal unit. It is so very important. And I think for a lot of individuals, they get themselves whittled down to eating very little very infrequently. They lose muscle mass, they may lose weight, but they’re also losing muscle at the same time. And we know that when you lose muscle mass, which is called sarcopenia. It puts you at risk for frailty. Frailty leads to falls. Falls lead to bad things like broken hips, head bleeds, etc.. And so I think I come from the perspective of your feeding window needs to be wide enough to be able to accommodate at least 2 to 3 boluses of food. And it needs to have at least enough protein, at least 100g of protein in that in that window. So for a lot of people, they find that they’re just eating insufficient amounts of protein. And so I always say if you can eat 125g of protein in one meal, probably there are some men out there that might be able to do that, but I don’t know any women that can. And so I think it’s important to understand that as we get older, we need more protein to stimulate something called muscle protein synthesis, which is the stimulus for our body to create muscle and to maintain muscle. And there’s even a leucine threshold, which is a very important amino acid. So my teenage boys can probably eat a whiff of protein 10 or 15g, and they can stimulate muscle protein synthesis over the age of 40. We start to accelerate this muscle loss. And this is where I remind people you need a minimum of 30g of protein with each meal to stimulate that threshold.

[00:16:48] Peter Bowes: And I guess the next question is what type of protein? There’s such a debate in that area. Plant based diets. Pea protein. Are you going to eat beef every day? Chicken. Pescatarian. Fish protein. Where do you come down?

[00:17:02] Cynthia Thurlow: Well, I mean, the research definitely supports that that animal based protein is superior for amino acid composition. But I acknowledge that not every person enjoys eating beef or enjoys eating chicken. Maybe they just want to eat fish. Maybe they do a combination of plant based and animal based. I think that my concerns around plant based are twofold. Number one processed plant based like pea protein. I’m not a huge fan of. There’s typically if you look at the research, the degree of contaminants in pea based protein can be problematic. You want to eat peas, you want to eat legumes. You want to eat beans. I don’t have a problem with that. But my caveat is, if we know here in the United States, more than 92 to 93% of us are not metabolically healthy. Carbohydrates can be problematic because we have this loss of this very important hormone, insulin. We become less insulin sensitive, which again goes back to why protein and muscle mass are important. I don’t think most Americans can consume more than 30g of protein in a meal and be able to properly dispose of it, so if they’re eating, let’s say, two cups of quinoa, that could blow through two days worth of carbohydrate intake. And so that is always the concern. But can you marry them together? Absolutely. Can you have a little bit of, you know, you’re having a lean protein and then on your salad you might have some chia or flax seeds, or maybe you’ve got some beans or legumes. I think that’s absolutely fine. But I think that it’s with that cautionary tale of I think variety is important. I think you have to find what makes your body feel good. Some people will tell you tell you they don’t feel good when they eat beef. Some people will tell you they don’t feel good when they eat beans. So it’s finding what makes your body feel good and allows you to feel satiated.

[00:18:39] Peter Bowes: Hence, we’re all individual and there’s a large amount of self-experimentation there, isn’t there? We can we can read everything that focuses, let’s say, on pea protein or a whey protein. But if it doesn’t agree with us, and really, we’re the only people who know, no one can tell us what actually agrees with us. That’s a that’s a challenge, isn’t it? When you’re sharing information and people are surfing the internet and trying to figure out they might have certain symptoms, and they match that with what other people have done for those symptoms, and then, well, it doesn’t work for me.

[00:19:14] Cynthia Thurlow: Well, and I think that’s that’s the key is that we have conditioned our patients to believe that they have to be told what to do, as opposed to the power of the N of one. So that degree of experimentation, like, I’ll give you an example. When I spent 13 days in the hospital, I had six weeks of antibiotics and antifungals. My gut was destroyed for nine months. I was full carnivore. I missed vegetables, but if I ate a vegetable, it was a disaster. It took me about 18 months to get back to the point, to be able to eat vegetables and not have digestive issues. Having said that, do I believe that there’s value in episodic changes to what we are doing nutritionally? Absolutely. I mean, if you’re looking at a standard American diet versus a plant based diet, even for a month, you know, there’s profound benefits. Just like we know carnivore can be profoundly anti-inflammatory for the short term. But I do think we as human beings are designed to be omnivores. I think we are designed to have some plant material, some animal based protein. I think that is ideally how things should be. And beyond that, it’s what makes you feel good. What doesn’t make you feel good. I don’t eat gluten. I don’t eat dairy because those things don’t make me feel good.

[00:20:21] TIMELINE: This episode is brought to you by timeline, the Swiss longevity biotech company, which is pioneering a new category of clinically validated dietary supplements called mitoceuticals to support healthy aging. Mitopure delivers Urolithin A, which has been shown to enhance cellular energy, muscle strength, and the health of our skin. To find out more, go to the show notes for this episode.

[00:20:44] Peter Bowes: And of course, we can’t talk about protein and muscle strength without referring to mitochondria, which we hear a lot about these days. Could you just encapsulate for me why we should be interested in, why we should love our mitochondria? As the slogan goes on many t-shirts these days?  

[00:21:00] Cynthia Thurlow: Yeah, so it’s interesting that mitochondria are considered to be the powerhouses of our cells. And that’s an important distinction. But over the age of 40, most if not all of us have some degree of mitochondrial dysfunction. And that is part of immunosenescence or cellular senescence. Like over time, our mitochondria will not be as vibrant, will not be as, you know, as adaptable, will make less energy, which makes us slow down, makes us maybe feel like we’re not. We don’t have as much cognition. We’re not as clear cognitively. And so this is where strategies like anything that is going to upregulate autophagy, which is this waste and recycling process in the body, like time restricted eating, intermittent fasting, strength training, high intensity interval training, cold exposure, heat exposure, all these things can upregulate getting rid of the disease disordered mitochondria that could have the potential to go on and create disease. So I’m all about finding those strategies. It doesn’t all you know, unfortunately, the intermittent fasting space has just gotten so focused on autophagy, autophagy, autophagy. And I’m like, wait a minute, time out. You don’t have to time restricted eat. You could do all these other things in conjunction with perhaps 1 or 2 days of fasting a week, and you can garner the same benefits. So when we talk about autophagy, we can talk about mitophagy, which is specific to the mitochondria. We can also talk about mitogenesis and how that can be stimulated. But I think the more that people understand that most of the chronic disease states that we see here in the United States are a byproduct of disease disordered organelles, including or mitochondria just makes you understand like this explains a lot of the symptoms that people think are just part of old age. Really doesn’t have to be the case.

[00:22:35] Peter Bowes: Are enough doctors, and I suspect the answer is no. But our doctors and health practitioners explaining what you’ve just said?

[00:22:43] Cynthia Thurlow: No. Most are not. I think if they have functional, integrative training, probably. But I think we are so siloed in medicine that when I worked in cardiology, if I if a patient came in and reported as an example, reported a GI symptom or a urologic problem, my doctors would say to me, oh, that’s not yours to deal with. You have to refer them back to this person. You’re referring back to that person. So we we get very myopic and we just try to stay in our lane. And so I think that ultimately comes at the detriment of the patient. The other piece of modern day medicine that’s challenging for providers. They don’t get a lot of time with patients. They get 5 or 10 minutes. I had a provider who used to say to me all the time, if your patient has a list, you need to take away the list. And he said he holds the holds the list is in control. And so I think we have gotten to a point where patients are desperate for answers. They want providers that care. It’s not the providers don’t care. They are stuck. They are a wheel and a cog of a system that is destructive and is outdated and is no longer working. And so I think for many, many people, they’re starting to look outside that traditional allopathic model because they’re looking for more answers.

[00:23:49] Peter Bowes: Interesting. I know some patients in some practices are told the number of questions they’re allowed to ask during the ten minute consultation, probably one. Well, I heard it was well, I’m sure everyone’s different, but I heard 3.

[00:24:03] Cynthia Thurlow: Oh. I mean, that’s I mean, I guess a lot of my, a lot of my patients, when they ask a question, it’s like one plus subcategory A, B, C, D and E. But it also speaks to the fact I don’t think any provider wants to function like that.

[00:24:16] Peter Bowes: No, no.

[00:24:17] Cynthia Thurlow: You go into medicine not to make money. You go into medicine because you have a love for taking care of patients. It’s a service industry. It really is a calling. And I think for any of us that have worked in medicine have had the honor of working in medicine. We want to do what’s best for the patient. We truly do. I think a lot of people are trapped in a system that doesn’t allow them to function the way that they want to.

[00:24:39] Peter Bowes: I mentioned you’re working on a new book at the moment. What are you thinking about?

[00:24:43] Cynthia Thurlow: Yeah. So the book right now is really so menopause is having a moment. And because I have my own podcast and I get to interview all the experts and researchers, I realize that there was an area around perimenopause and menopause that not a lot of people were talking about, or at least amplifying. So this book is going to be focused on the microbiome and how the gut microbiome impacts bone health, immune function, aging, metabolism, etc. And so putting all those pieces together with the research that’s been done thus far and creating actionable items for women to be able to evolve out of. And here’s the big takeaway. The gut microbiome impacts everything. And that is what I think a lot of people don’t realize. They don’t realize the oral microbiome, the skin microbiome, the vaginal microbiome, the gut microbiome, they’re all impacting one another. And so people assume if I take an antibiotic that doesn’t impact my oral microbiome. Yes it does. Things you put on your skin impact and disrupt the skin microbiome. A round of antibiotics, even if appropriately dosed, impacts the gut microbiome quite significantly. And so putting all those pieces together will dovetail nicely into the existing literature that’s out there.

[00:25:51] Peter Bowes: I think that you just hit the nail on the head there in terms of the number of microbiomes within our body and how independent they are and how independently they’re affected by our lifestyles. It could be just your teeth cleaning regime that has a huge impact on your mouth and the microbiome. Well, you explained to me how significant that could be during an action that most people take for granted and don’t think about it.

[00:26:17] Cynthia Thurlow: Yeah, well, thinking about just mouth wash destroys nitric oxide. Nitric oxide is this potent vasodilator in the body. How impactful mouthwash is people. You know, my husband was like a Listerine guy when I met him, and I now have got him weaned off that. But my dad used Listerine his entire life. And what it does when you just realize this incredible domino effect of nitric oxide, which is a signaling molecule, much like other signaling molecules that I’m sure we’ll probably touch on. I think for me, it’s it’s interesting that we’re starting to put these pieces together to help people understand some of the practices that we were taught we needed to do are probably totally unnecessary. We want to do as little to disrupt the microbiome as possible.

[00:27:02] Peter Bowes: How important is the mind body connection? I know this is something that you’ve considered in the past, but first of all, what does it mean? Mind body connection and how can we nurture it?

[00:27:13] Cynthia Thurlow: Yeah, I think it really speaks to an awareness. I think a lot of people are disconnected from their bodies. They will tell me I have no symptoms. And then I’ll look at labs and I’m like, how could you not have symptoms? Whether it’s a trauma response, whether it’s a lack of awareness, whether it is an inability to feel connected to their body. You know, some people have been either through abuse, shame, blame, trauma. I think there can be a lot of reasons why that happens, but I find that sometimes the easiest patients to work with are the ones that will say, you know, I you know, correlation is not causation. But when I started doing X, I had this reaction. And then, you know, trying to kind of work through that. But when I think about a mind body connection, it’s are you aware of how your body feels? Are you able to distinguish when something makes your body feel good versus something makes your body feel bad? The more I understand about trauma work, the more I fervently believe that a lot of people who are very disconnected from their bodies. It is a trauma response, whether they’re aware of it or not. And trauma is big T trauma all the way, all the way down to little t trauma and everything that occurs in between. But I think bodily awareness and empowering patients really starts with saying, how does this make you feel? That’s why food diaries are so helpful. How did this make you feel? I want you to do this for a week. Initially, they think it’s silly and then all of a sudden they’re like, oh, every time I eat gluten, I get bloated. Or every time I eat dairy, I get a rash or, you know, XYZ causes loose stools. I mean, those kinds of things can be really, really powerful. But the mind body connection is one that I think people have to be open to the possibility of that they have to be open minded enough to understand that, you know, the mind sometimes is not as tangible as other body parts. And so they have to first and foremost, they have to be open minded enough to consider it and then kind of walking them through, you know, checking in with yourself. How do you feel? And some people aren’t, are just aren’t capable to get to that connection. They’re perhaps not ready not willing.

[00:29:10] Peter Bowes: And also the importance of being aware of balance in your life, the different aspects of your life, whether it’s your work life, your home life, your social life, your your physical life, your your dietary regimes, everything is balanced with each other. And you need to understand that and understand how one thing affects the other, and especially in the area of stress and mental health.

[00:29:33] Cynthia Thurlow: Yes. Well, and I think I always say balance is elusive. I think that was a word that I picked a few years ago. Like I always have a word of the year. And I finally realized balance is futile because it is always it’s a constant adjustment. You know, some days you’re going to not be well balanced and other days you will be balanced. And so it’s learning how to say no. Creating healthy boundaries, I think, is the key to finding more balance in your life. But the concept of finding balance, I think is elusive.

[00:30:01] Peter Bowes: Learning how to say no, it’s very difficult, isn’t it?

[00:30:04] Cynthia Thurlow: It’s very powerful. And I think for me that has been one of my guiding principles I’ve been working on the last five years. It’s very, very powerful because I used to feel bad, you know, being a people pleaser, reformed people pleaser. I would feel a sense of guilt. And then I start to realize that’s not serving me well, because I would get that gnawing, annoyed pit in my stomach like, you did it again. You did something you didn’t want to do. You said yes to something you don’t want to do. And so I think for anyone, male or female, you have to get to a point where you can comfortably, emphatically say no.

[00:30:36] Peter Bowes: And it’s about prioritizing your life.

[00:30:39] Cynthia Thurlow: Ruthlessly.

[00:30:39] Peter Bowes: And those people in your life. And I’m thinking of families and children and the needs of children, and the questions and the demands that children make on a parent. And the parent with a blossoming career has to make those balancing decisions.

[00:30:54] Cynthia Thurlow: Yes. Well, and I think you have to understand what are your key priorities and then prioritize from there. Like, to me, I have teenagers and if they want to talk, everything stops. It doesn’t matter where I am and what I’m doing. They more often than not don’t want to talk. So when they do want to talk, I’m always there. Same thing with my with my husband? I think that, you know, you have to prioritize what is most important to you, and then everything falls into line accordingly. And I think for a lot of people, they don’t they don’t learn that. They end up learning that the hard way. You know, when they feel like they didn’t, they weren’t able to invest as much time, effort into their loved ones. And then, you know, maybe their child is no longer living at home. I know the statistics say that the most time your children will spend with you is up until the age of 18, and then it’s incrementally downward the rest of their lives. And so I tell people that have younger children, I’m like, you will never regret that time you’ve invested in them.

[00:31:47] Peter Bowes: And that is at the heart of many people’s aspirations for their own longevity. Why they want to live long and stay healthy, pursue a long healthspan it almost always comes down to the children and the grandchildren in their lives. And I find this with so many people that I talk to. It’s the same answer that I want to be here not only to be with, but to help and to and to nurture and to share the wisdom of my life. And it’s when you think about it, it’s a very simple message, but it’s a strong motivation.  

[00:32:19] Cynthia Thurlow: Yes. Well, even now, I mean, my my husband and I are both in our 50s, and I tell my husband all the time, I want to be the grandparent that crawls around on the floor. I want to be able to be that grandparent who can pick the kids up from soccer practice and help my my kids and and their spouses out. I want to be that person. And so, you know, on many, many levels, wanting to be physically active and capable throughout my lifetime is a large prevailing. I call it the old lady. We’re trying to avoid the old lady syndrome. So I want to be able to get on and off the floor. I want to be able to lift heavy things. I want to be able to, you know, not have to take medications that are lifestyle mediated. And by that I don’t mean hormones. But I think for a lot of people, it’s like having a powerful motivator for many people can make a huge difference. You know, what is your why?

[00:33:05] Peter Bowes: Exactly. Yeah. So we’re both at this event in Las Vegas, this annual event. Anti-aging medicine. I personally don’t particularly like the phrase anti-aging. Yeah, I don’t like it. Pro aging I like to look forward and be positive. But as you look forward, what excites you about the kinds of things that you and I are privileged to to see, hear, and to learn about. From longevity medicine, the new innovations, whether it be medicine, gadgets, artificial intelligence, there’s so much going on at the moment.

[00:33:33] Cynthia Thurlow: Yeah, I mean, I feel like there’s so much that it’s sometimes it’s very it’s like you’re a kid in a candy store. There’s so much that’s prevailing. I think peptides are really interesting. I mean, obviously that’s not a new concept, but I think in conjunction with hormone replacement therapy, I certainly think a lot of these devices, you know, whether it’s, you know, something that tracks your sleep, something that tracks your HRV, something that tracks that’s always interesting. You know, personally, I like supplements that are very targeted and are multi purposeful. So things like Urolithin. A you know, obviously it’s a signaling molecule is exciting to me. And and, you know, for me, the one thing that I have taught my patients is that there’s only a couple of things that I recommend that women take every day. And Mitopure is one of them. The other is creatine monohydrate because they’re so multifunctional, multi purposeful. But I tend to be a little cautious with new gadgets and devices until I’ve tried them out and felt like it’s worth it. I sit in again in a place of privilege that I get a lot of these things that are given to me. And every once in a while I’ll have something. I’m like, I really like X, Y, or Z, so I like my Oura ring as an example. But that’s not new.

[00:34:40] Peter Bowes: Don’t we all?

[00:34:41] Cynthia Thurlow: Yes, yes. And now now that is that is one thing that I will say I enjoy. 

[00:34:47] Peter Bowes: That’s part of the data collection.

[00:34:50] Cynthia Thurlow: I’m very quantitative focused. And so for me, I like to get up in the morning. What’s my. You know, what’s my HRV. What’s this? You know, did I get enough sleep? Did I did it did it track my nap I had on the plane? You know all those things,

[00:35:00] Peter Bowes: Right? Yeah.

[00:35:01] Cynthia Thurlow: But I think for a lot of people, data for me is comforting. For some people, data is not. And so I think you have to know yourself to figure out. But I’m looking forward to walking around and getting to know some of the new vendors that are here.

[00:35:13] Peter Bowes: Just to be a little geeky about the Oura ring, the stress calculations that it’s making, and the graph that you can see across the day of your your stress high points and your stress, your more relaxed points. For me, they’re incredibly accurate and reflect what you’ve been doing in the previous 12 hours.And that information is so useful. And that’s the whole point, of course, isn’t it, that if we absorb this information every day and see what triggers us, we can determine our lifestyle accordingly and perhaps hopefully stay more in that relaxed zone? I think a little bit of stress is good occasionally, but stay in the relaxed zone for maybe a little longer.

[00:35:50] Cynthia Thurlow: Yeah, well, and it’s interesting to me because sometimes stress isn’t all per se, a bad thing. You know, we’re talking about hormesis hormetic stress, beneficial stress. You know, when I get on a podcast interview, I get excited. And so my stress goes up. But it’s not bad stress. It’s not. Oh, I had a brutal workout. Or, you know, something’s going on that’s stressful with a family member. It’s different types of stress. So that differentiator. But I do agree with you when I watch that stress trend, you know, trying to make sure that there is some elusive balance over the course of the day that I have some restorative time. And restorative time is important. Unfortunately, I think we’re a nation of people that like being busy. And I remind people like, you need to be able to rest when your body needs it and not just be busy for the sake of being busy, because that in and of itself is a whole separate conversation that in and of itself can be a whole trauma response.

[00:36:38] Peter Bowes: Yeah, exactly. You mentioned Urolithin A just a couple of minutes on what your own personal experience has been with the supplementation of Urolithin. A.

[00:36:49] Cynthia Thurlow: Yeah, for me, it started off with more energy. And so I, you know, being doubtful, you know, I was like, okay, I’ve taken it for six weeks. I definitely felt like I had more energy, particularly the more I don’t drink caffeine. So,and I’m actually a fast metabolizer of caffeine. I just don’t love the taste of coffee. And I will occasionally suffer through a drinking green tea and put a straw in it and some ice and chug it down. Having said that, for me, initially it started with energy. And then the other thing that I noticed was as unpleasant as VO2 Max is, you know, getting that tested. Mine improved. And then the other thing that I noticed was that, you know, gains in the gym, because I’m very transparent about how I’ve been trying to put on 5 pounds of muscle. That’s been a goal of this this year and trying to see like, how do I recover when I lift heavy? How do I recover after exercise? And so even talking to my trainer about it, who just trains women at this stage of life, try to identify to her this may be something you may want to think about talking about with your other clients about. I rarely have soreness and I do lift heavy and, you know, progressive overload and all the right ways to do it. And I do think those are the three things that I personally have noted when I’m talking about my patients that I’ve recommended it to. It’s always energy, but some of them see improvements in sleep metrics. Some of them see improvement in cognition, which I think is really exciting. The brain health piece, I think, is one of those things that will evolve with time, more research around that area. But I think every woman north of probably 50 is fearful of Alzheimer’s. They don’t want that to be part of the trajectory of their futures. And so anything that’s brain health mediated, where people feel an improvement in brain health and cognition is exciting.

[00:38:27] Peter Bowes: Let’s talk about your aspirations for the future. Clearly, you’re focusing on your book at the moment and you’ve explained some of your ideas there. But as you look ahead through the decades of your life to come, do you have specific goals? Do you have a vision of the future?

[00:38:42] Cynthia Thurlow: Yeah, I mean, I think I would like to be at a point where, when I reflect back on my career, I feel like and I’m a very proud nurse and nurse practitioner, that I was able to serve as an example to my colleagues. because one thing I’ve heard over and over again is people say, I want to be where you are. How do I get from where I am now in traditional allopathic medicine to where you are? So serve as an example to my colleagues and my peers. I think, number one, but leave a legacy where, you know, I’m one of those founding experts that has been able to help change the trajectory, change the narrative about the aging process, because, as you stated, it is a privilege to get older. I don’t love the anti-aging concept. I do think it should be proactively aging. I mean, you know, beneficial aging. There’s a way to find a reframe that doesn’t, you know, this anti-aging, you know, what’s the alternative? You know, something that I don’t think any of us want to think about, but my big audacious goals are things like, you know, I have a very successful podcast. I’d like to there aren’t a lot of female centric podcasts that are at the level of, you know, Peter Attia, Huberman Lab, and I would love to be one of those. And I, you know, we’re heading in the right the right direction. You know, in terms of downloads and impact, you know, the other thing that I talk about is eventually getting to a point where I’ve created a scholarship at the university that I attended in honor of my grandmothers, who both were nurses. And, you know, just leaving a legacy that my grandchildren and great grandchildren will be able to build from.

[00:40:17] Peter Bowes: What’s your biggest logistical challenge with the podcast?

[00:40:21] Cynthia Thurlow: Well, that I can’t be more of me. Because I record typically two a week. But, you know, my team would love it if I was doing double that. It’s just it’s bandwidth. Especially while writing a book.

[00:40:32] Peter Bowes: Time

[00:40:32] Cynthia Thurlow: Right? And, you know, no one can be me. So if I’m the person that’s driving the podcast and the podcast is, you know, downloads are going up exponentially every year, it’s the realization if we want to scale, you know, how do we go about doing that? So I would say podcast. Next book will be even more successful than the first. I have a supplement line that’s coming out. I mean, all these things are the things that are going to get me closer to some of some of those not just financial goals, but also aspirational goals and making impact, because ultimately that’s what it comes down to. Like I always tell people that I was meant to be my boy’s mom and be married to my husband, but the next thing that I was meant to do is the work that I’m doing now. Like being a disruptor and not just going with the flow and not being. I hate to use this term sheep because if I had stayed in sheep mode, I would have still been in clinical cardiology. And I respect my colleagues. It just wasn’t the right path for me. But being able to be on a platform where I can reach more people and have more influence is what I was meant to be doing.

[00:41:33] Peter Bowes: And just in closing, we’ve looked to the future. If you were in a position to give some advice to your younger self, or perhaps you’re advising young women starting out on their lifetime health journey, what would that, in a nutshell, what would that advice be?

[00:41:49] Cynthia Thurlow: Well, I think the first thing, and I actually talked about this on the panel today was number one, I don’t think any of any of us knew the impact of oral contraceptives on our health. You know, number one is a gut microbiome disruptor, an endocrine disruptor impacting negatively bone and muscle health for, you know, for martine’s into our early 30s. So number one, I would say consider a short term solution and find something else to work on that has less detriment on your health. I think the other thing is, you know, not fearing the aging process, I think that my generation is perhaps turning, turning that process around. But I know my mother’s generation, they never wanted to talk about their age. They still have tremendous age shame. My mother told me she was 30 until I was probably 30 years old, and I was like, come on, this is, you know, this isn’t even funny anymore. There’s no way you could be 30 if I’m 30. Having said that, I think that destigmatizing the aging process, helping women understand that aging is a privilege, that aging is something that so many people don’t have the ability to do. And, you know, if you get focused on the esthetics, you’re going to miss out on tremendous opportunities of growth. And, you know, I think sometimes the the anti-aging movement gets too preoccupied on the esthetics piece instead of thinking about what’s going on internally. And so that that would be the other hope that would be alongside that. If I were talking to myself, I would say worry less about silly things and worry more about substantive things.

[00:43:18] Peter Bowes: That’s a good way to end this. Cynthia thoroughly enjoyed this conversation. Thank you so much.

[00:43:22] Cynthia Thurlow: Thank you for having me.

[00:43:24] Peter Bowes: The Live Long Podcast is a Healthspan media production. I’m Peter Bowes. You can contact me through our website, Live Long and Master Aging, where you’ll also find the show notes for this episode.