Do you wish for someone, preferably a medical professional, to cut through all the variations and recommendations about how to stay strong and live a healthy life as we age? Join Cathleen as she chats with Dr. Vivien Brown, MDCM, CCFP, FCFP, NCMP, who is an award-winning physician, best-selling author, and international speaker. Her new book, The New Woman's Guide to Healthy Aging: 8 Proven Ways to Keep You Vibrant, Happy & Strong, is the first book written by a medical authority to tackle the key challenges women face as they grow older.
Episode 34: Dr. Brown is the president of the Federation of Medical Women of Canada and is the Assistant Professor, Faculty of Medicine, at the University of Toronto, in the Department of Family and Community Medicine.
Dr. Brown received her medical degree at McGill University and has been practicing family medicine in Toronto since 1982. In 2018, the North American Menopause Society awarded Dr. Brown the Media Award for her work in raising awareness about women’s health issues and healthy aging through her numerous speaking engagements and books.
Dr. Brown also works to help shape health policy in Canada, through numerous advisory bodies including as past President of the Federation of Medical Women of Canada, Immunize Canada, and the Women’s Brain Health Initiative, Medical Board of Directors, HealthChoicesFirst, Past Chair of the Consumer Education Committee of the North American Menopause Society, Member, Faculty Advisor, McGill Medical School. She is also the VP for North America Medical Women’s International Association.
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Cathleen: What women need to stay strong and live long. You know, there are so many theories, research and trends out there about how to stay strong and live healthy as we get older and it's even more complex for us women who statistically live longer than men. Do you wish someone, preferably a medical professional like a doctor, could cut through all of it and tell you the real deal. Don't miss our next episode, what women really need to stay strong and prosper, where we interviewed Dr. Vivian Brown, author of the book, The New Women's Guide to Healthy Aging. Stay tuned. Welcome to Seniority Authority. I'm your host, Cathleen Toomey and I track down experts to answer your questions on aging. Let's get smarter about growing older. Thanks to our show sponsor, the Riverwoods Group, Northern New England's largest family of a nonprofit retirement communities where active adults find community purpose and peace of mind visit riverwoodsgroup.org. What women need to stay strong and live long. I don't know about you, but it seems to me that each new day brings a new theory, piece of research or trend as to what you really need to do to live a long and healthy life can be confusing to sift through the many different variations and recommendations, and that's where today's guest can help. Dr. Vivian Brown is an accomplished family physician in Toronto and is a passionate advocate for women's health. She serves on the board of the Women's Brain Health Initiative and has been on the faculty of McGill Medical School, University of Toronto Department of Medical and Community Medicine and has received multiple awards for her work on women's health issues, author of the book, The New Women's Guide to Healthy Aging. Dr. Brown is also an accomplished speaker on women's health. I'm so happy to welcome you to the podcast today Dr. Brown.
Dr. Brown: Thank you so much. It's really fun to be here.
Cathleen: I am particularly interested because we all know that women are living longer than men. But let's get down to why it's so important to address women specifically when we talk about healthy aging, why would you separate women from men?
Dr. Brown: Well, from my point of view, it's all about living independently. You know, women do have a longer life. Women are more likely to have lost their partners and be widowed and live alone. And there's nothing that makes you feel more frail than when you are ill. And so I think when we look at healthy aging or long life, we need to have the caveat that that means healthy aging and being well and being independent and being able to do the things that you enjoy being socially connected. It's not just about living longer, it's about living a healthier longer life.
Cathleen: That is a really important distinction. It is not about the years necessarily, but what you are able to do in those years. And luckily we have a lot of research and facts at our disposal to start changing things. What inspired you specifically to write your book on top of all the lecturing and the speaking and the positioning that you're doing. Why did you get inspired to actually sit down and write a book?
Dr. Brown: Well, the reality is I I've been in family practice for quite some time. I have a large proportion of women as patients and a number of years ago I thought that instead of just seeing people one on one and having that impact with an individual patient, I was talking about the same things every day, I was reviewing some of the same issues with women on a daily basis. And I thought that I could really share some knowledge. The concept is called knowledge translation, but basically sharing my knowledge with a wider audience so that women can make behavioral changes and really have an impact on more people than just who I was seeing in my practice. I thought it would take me about 2-3 months to write the book. And that shows you that you can know a lot of medicine but you can know very little about writing. It took me about 18 months to write the book. And the initial book came out in 2017, it was a best seller in Canada. I got rave reviews and a lot of feedback that was very positive and fast forward. Five years later we were in the middle of the pandemic. There had been a lot of changes in medicine, a lot of new drugs, the whole concept of virtual visits and what did that mean. And I really felt that this was my time to update the book. So the book we're talking about came out in February 2021 it is the updated version of the original book. And I literally have updated every chapter and added a new chapter on sexual health for women.
Cathleen: That's fantastic. I love that you took the opportunity of the pandemic to update the book. Sounds like a perfect time to focus on writing. And your inspiration to write the book is similar to my inspiration to have this podcast. I was getting asked by lots of individuals questions about aging and how to help their parents and how to think about aging themselves. And I also wanted to amplify my conversations not just with one person but with hundreds of people because the more informed people are, the more they have agency in their own life to make these changes.
Dr. Brown:Absolutely,
Cathleen: Yeah, that's what excites me about your book is that it's very practical. There's a lot of things that you can it's not reading medical tome that you are looking at the research, it's combining and distilling the research and then saying, how does this apply to you?
Dr. Brown: Making the research user friendly. You know, it's interesting some of my patients have told me they could hear my voice as they read various chapters. It's partly because I do give some examples of real life patients in real life situations because I think when we really want to affect behavioral change, it's not just listening to something or reading something and saying that's interesting, which it often is, but it's taking that interesting information and incorporating it into your life. And when you incorporate that information, whether it's about walking or dieting or blood pressure medication or whatever the information is, if you're able to incorporate it and make a behavioral change, then we really have had an impact. So we don't want to just be interesting, interesting is good, but not good enough that it's really all about behavioral change.
Cathleen: And as we know, the older we are, the harder it is to incorporate those behavioral changes. It's not impossible. But it has to be intentional.
Dr. Brown: Exactly.
Cathleen: So you've broken up your book into eight different sections addressing women's health and I would love to go through all eight, but I know that we won't have time. So it's kind of dealer's choice. What do you think are the three most critical areas for someone to make a change to make the biggest difference? So if we were saying earlier that it's harder as you get older to make changes of the major topics that you cover? What do you think are those that are you going to get the most bang for your buck if you change them.
Dr. Brown: So I actually don't talk about this very much in the book because I think it's very obvious and we've known this for a very long time. But if you could only make one change in your life, if you can only focus on one thing for the moment, the most important thing is to quit smoking. And I say it's obvious because even people who smoke heavily, know, that they shouldn't be smoking, it's not a surprise, it's not a secret, but the impact of smoking on heart disease, on blood pressure, on brain health, on lung disease, on your bladder health, on just about everything really has a significant impact. And unfortunately young women are the fastest rising group of smokers and people now have been isolated home with the pandemic, what are they doing? They're smoking, they're drinking and they're eating and those are not necessarily healthy good habits. So if you can only do one thing, the one thing that will have the greatest bang for the buck is quitting smoking because you know, Cathleen even just two cigarettes a day on a regular basis, doubles your risk of heart disease. There's no, get away with a little bit and that would be my number one. The most important area to focus on after that I think it is exercise. And I say this with a smile because we're both sitting in front of the Zoom camera and what have women been doing for the last 18 months, they're sitting in front of a computer. Most people are not standing up very much during the day then you're rushing to take care of dinner, the kids laundry, whatever you have to do in your house. And I make the point and I think it's a it's a valid point that living and being very busy or living a life that is hectic is not the same as aerobic. We need to live aerobically, We need to get out and do that exercise 30 to 45 minutes five times a week. It can be as simple as walking, but you need to be exercising on a daily basis. And I tell my patients that when you're walking you can't be walking the dog, the dog stops and starts and pees and does whatever dog does. It's not aerobic for your heart. You need to be walking at a pace that's fast enough. So you're a little bit sweaty and a little bit short of breath. This is not window shopping. This is walking for aerobic exercise.
Cathleen: Fabulous. I have heard the exercise point, but I have never heard anyone express it so eloquently that it is not walking the dog and I have a dog that I walk twice a day and I want to call her Ferdinand the bull because she stops and sniffs every flower every bush and it is not a brisk walk. So it is to get your heart rate up and get sweaty and do that. So I think that's really important for people to hear is that. And I love your point about we living hecticly is not the same as living aerobically.
Dr. Brown: And what do patients tell me? They say Dr. Brown, I know I understand what you've said. I just don't have the time. And that phrase I just don't have the time really says it's not my priority because we all have the same amount of hours in the day. So if you're never your priority, if exercising for you, taking care of your health is never your priority sooner or later, you're going to pay the price. And I think that when we point this out to people, when we talk to women, I then try and say, okay, so what is going to work for you? You know, you drop the kids off at whatever ice skating, do you have to sit and watch them for 45 minutes or could you go do your exercise if you're driving or carpooling everywhere? Can you walk instead of carpool? Can you walk to the grocery store? Can you walk to go visit a friend? You know, visiting a friend doesn't have to be Starbucks and coffee. It can be a really brisk walk. You need to figure out what's gonna work for you and it's not the same for everyone. I have colleagues that do their exercise at six in the morning. I start my practice at 7 30. I can't do it at six in the morning I'm busy getting up and getting to the office. So it's different for different people. You have to find what's going to work for you. But after quitting smoking, the next big impact is exercise. It affects bone health, it affects cardiac health, it affects brain health and I won't even get into mood. But mood is a big one that improves with exercise. So the third area, if I have to pick three and there's only three has to be to maintain a healthy weight. Both in the US and Canada, we see women who are overweight, we see women who are obese and we know that that is affecting lifespan as well as independent living. So there's no question eating a healthier diet, eating smaller portions, keeping your weight ideal for who you are is really important. And I don't give a number. It's not like height equals this weight. It really depends on your genetics, on your background, on your level of activity. You can be overweight and very fit and if that's your family background, that may be acceptable. And you could be very thin and very unwell and that's not acceptable. So we have to look at what is ideal weight for an individual. It's not one size fits all.
Cathleen: And that also makes a difference because that does contribute to other health risks. Do you, I just want to go back to one of your suggestions when you talk about, do you have to go to Starbucks and have coffee. I think a lot of people a silver lining in the pandemic is a lot of people walked to socialize. So I would get I have a friend who is not an exerciser and she got more exercise than ever during the pandemic because no one could go to each other's homes. So we got together and walked outside and so and you can adjust
Dr. Brown: Doing it with a friend, It's harder for you to say no, I'm too tired. I'm not going today. My friend that walks at six in the morning has a friend that she meets and she's not going to let her friend just wait on the corner at six in the morning. So the idea of being socially connected and doing it with a buddy is partly being accountable for the decisions that you make. And that also works very well.
Cathleen: I also have seen a quote somewhere that says body first business second that you it's easy to put your you know, I've got to get to this meeting. I've got to get to this appointment. But if you don't take care of your body first then that is coming and you can say body first, family second. It's important to take care of yourself and your health.
Dr. Brown: Well that's what we were just talking about at the beginning of this podcast. Women are living longer and are often living alone longer. So if you're not taking care of yourself, you may be in a situation where there's nobody there to take care of you. You want to be independent and able to take care of yourself. And so I usually suggest that people schedule their exercise time into their day ahead of time, the way they would schedule a meeting, the way they would plan to meet a friend, have it ready, you know, when you're going to do it and be accountable to yourself as well as others.
Cathleen: Exactly now, the third topic, which is being at the right weight, especially for women, is a super sensitive topic. I mean, I think all women are most women that I know are unhappy with their weight unhappy with their body. And you said it doesn't matter. You know, the you're not going to give out numbers, you know, this is how high you are, how much you should weigh. But do you have a recommendation about diets? Because there's keto and there's weight watchers and there's mediterranean and so many women are so focused on weight and weight loss. That and in some ways I think we focus and talk more about it than we should than is healthy in our culture.
Dr. Brown: So two points. So actually three points I want to make firstly, which is the best diet. They've done research, they've compared all the diets they've looked at people starting and one year later and the bottom line is whatever you can adhere to is going to be the best diet for you. It's not that one diet on paper is better than another. It's that different eating plans to people differently. And so I don't recommend a particular diet in that sense. I really talk to people about making good choices and whatever you can maintain it whenever you can stick to. That will be the best choice for you. If we're going to look at what has had some good research, it's the mind diet. The mind diet is a combination of the old american heart diet, the dash diet, which is low in salt and the mediterranean diet which is high in fruits and vegetables and basically out of Chicago they did some research and they discovered when you combine the dash diet and the mediterranean diet so low salt, lots of fruits and vegetables, some nuts, smaller amounts of protein, essentially it decreases your risk of dementia. Really important about the mind diet. And the reason I talk about it in the book and I promote this is the researchers were clever enough to look at people that didn't follow at 100% of the time that followed it 75 to 80% of the time. And did they still have a positive impact. And the answer is yes because nobody follows anything 100% of the time. It's impossible. You're traveling, you're going to someone's house, you're going to a wedding, whatever it is, you may not have control over the situation. So I like the mind diet because it's healthy, mediterranean eating, it's very low in salt. No added salt, not a lot of salty foods, it also gives you the option to have either a bunch of grapes or a small glass of wine every day. I'll go for the
Cathleen: I like that.
Dr. Brown: You don't have to be perfect.
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Dr. Brown: Because I think when we strive to be perfect and then something doesn't work, we want to give up. So what's good about the research with the mind diet is you don't have to be perfect.
Cathleen: That sounds great to me because I'm not perfect.
Dr. Brown: And I do follow the mind diet and I think it's something that you can stick with on an ongoing basis. But the third point that I wanted to make actually comes out of some research in Brazil. What they did is when they did their Brazilian food guide for the whole population, what you should be eating right up there in one of the most important decisions was that you need to be eating together and you need to be eating at home. So it didn't only talk about what you're eating. It talked about how you're eating. This was not fast food in the car on the way to a soccer game, this was not, you know what's convenient and I have to work late. This was focused on eating as a family, home cooked meals where you have control over the amount of fat and the amount of salt and whatever you're choosing and how important it is, not just for you as an individual but for your family as well. So older people, younger people, everybody benefits when there's that community and that family of eating together. So in summary, I like the mind diet. I like the fact that it's not, you don't have to be 100% perfect. You really want to watch portion size, pick the diet that you can stick with that you can adhere to and don't eat on the run, eat at home as a family, eat with a partner, don't have the tv on, don't be on your cell phones. You know, sometimes you go to a restaurant and everybody's on their cellphone there at a table. They're not talking to each other. They're all on their phones. Social connectedness. And that's what the research out of Brazil suggested.
Cathleen: That is that's very interesting and it's consistent with a lot of research that I hear about how to live a healthier life, which is to be more socially connected and that our social connections are more important than we may realize for keeping your mind active and for a lot of aspects of as especially as we get older
Dr. Brown: And we've seen that in the pandemic as people got socially isolated and lonely.
Cathleen: Absolutely. And we know that you know loneliness kills so just being socially isolated affects you physiologically because you don't have that connection, don't have that that joy, that interaction and it's not good.
Dr. Brown: No, it's an increase in stress and stress affects the immune system and other things in the body so that social isolation is a real issue. And unfortunately because of the pandemic, we saw older people and institutions getting isolated where they weren't allowed to leave their room, people afraid to go out of their house, afraid to go out of their apartment. We really need to make an effort to be socially connected. Whether it's on zoom, whether it's in person depending on what the situation is, but that social connectedness is really very important.
Cathleen: I think it is critical. I wanted to shift some of our conversation because you're so focused on women's health. What do you think is the biggest misconception around either menopause or intimate differences as we get older? I know that there are a lot of misconceptions out there, you have the opportunity to speak to hundreds of people through this podcast. What misconception do you want to clear up?
Dr. Brown: Well, I think those two things are somewhat linked because post menopause as women get older, they get more dry vaginally and the whole concept of still being able to be sexually active, becomes uncomfortable. They may not be able to have intercourse because they're so dry vaginally and there's two misconceptions, one that says, oh I thought it was just me, you know, I thought everybody else was okay, I thought this was just me and we know that women are ready to talk about their vaginal health, ready to talk about intimate experiences if the doctor asks them and doctors learning how to be politically correct, very rushed and overwhelmed with a lot of different demands, think that if it was important the patient would bring it up and so often in research, what we've seen is that women are ready to talk and ask questions if the doctor brings it up and the doctor is ready to answer the questions. If the patient brings it up and there's this disconnect. And what we know is that if the doctor doesn't bring it up, the woman walks out the door and says, can't be that important. The doctor didn't even ask me and it must just be me and it must just be that I'm getting too old and there's a difference between getting older and having changes in your body and feeling that you're too old to participate in intimacy. And so I think the two things are linked because we do see intimate differences in women with age and often it's very disturbing and very uncomfortable for a given patient and she feels very isolated. So I talk about this in the book because there's new medications, there's new guidelines for doctors on how to include sexual questions in the routine questions like how's your family doing and you know, are there any changes in your health and are you still intimate with your partner? We don't have to shy away from asking those routine questions and giving someone the opening to be able to talk about something that may be very personal and very difficult.
Cathleen: That's so important because I think that's a chilling effect that's gonna have a chilling effect on women if they feel that they are the only one experiencing this. And I could absolutely see people saying it must just be be I'm too old for intimacy. That's that I'm shutting up, shutting up shop and closing down and that is just wrong.
Dr. Brown: And I think that's why I included this in the updated version because there's a new mayo clinic guide for doctors on how to perceive on what are appropriate questions to ask. I'm honored that I was part of the writing group of that guide. But it's really important because with all the need to be politically correct and with all the concerns that people have, sometimes it's easier for a doctor to say, well I'm going to stay away from this one. I don't want to open this can of worms or maybe seeing someone that she's also friends with and then, you know that you know, in a smaller town where you know socially socially she sees the doctor and the doctor golfs with her husband and she may not be comfortable. So I think we have to get past that. I think we have to be open to talk about the issues so that as an individual patient you can see what is appropriate and what is out there and what can be done to help your situation because there's lots of new things
Cathleen: It's normal.
Dr. Brown:Absolutely.
Cathleen: If you don't understand that, then you would be shy to ask your physician. So they, the answer to that is don't be hesitant about talking openly with your doctor. If you feel like you could benefit from some help or guidance that there are tools out there.
Dr. Brown: You know, women often have trouble with continents. They have leaks, bladder leaks, they cough, they leak, they can't get to the bathroom on time. They often will have that for years and they will only come to the doctor when they had to go to the pharmacy and buy depends and you know when you actually have to go and buy those adult diapers, then they may decide. I better tell the doctor about this. It's not normal. And we know that there's lots of things to do and there's lots of different options. So I would encourage individual people not to be shy to ask your doctor intimate questions. You know from the doctor's point of view. Whatever you bring up, I'm ready to answer and ready to talk about and what we're hoping as we teach doctors to give the opening question, give someone an opportunity to talk about those difficult things
Cathleen: because it's much easier if the door is open versus you, the patient who's already embarrassed and feeling less than when you're talking about an issue. It's hard to bring that up. And I think that's important. It's just another part of the physical body that the doctor is focused on. That's great. That's a really important change to make. And I also like in your book, the connection that you make between exercise and sleep because they are very symbiotic. And I think that's also another thing that people struggle with as we get older yet. I know a lot of people who have never gone into a gym are intimidated walking into a gym where you see people who are super fit and they feel that they don't belong. Again, there's the issue that people give up because of their age and they really shouldn't, they should lean in because you're not dead yet. And so do you have recommendations for this group on how to start an exercise program, that would help their sleep or vice versa?
Dr. Brown: Well, first thing I would say is that no matter how you've lived your life up to this point, it's never too late and you will get a benefit by starting exercise. There's a study that they did with women over 80 who were wheelchair bound and they started to do upper body exercises with this group. And what they found is that women were able to transfer better from the wheelchair to the bed. They were able to get on and off the commode a little bit easier. They were less likely to fall, it improved their balance. And so if you've always been fit, that's great. Keep it up. But if you've never been fit, don't think it's too late now, you can still start. And what I suggest is that you start slowly but consistently. We don't want weekend warriors and weekend warriors or people who have said I was too busy monday to friday. I'll make it up by doing three times the amount on saturday and sunday. And what that does actually is it puts great stress on your heart and you have a higher risk of heart event. So you want to start an exercise program that you can keep up with, whether it's a walking program or a stretching program or yoga or whatever it is that you're going to do, start at the beginner level but be consistent do it again and again and again. You can't just do it once or twice and say, okay now I'm now I'm okay, you have to be consistent about it. And that's what makes a big difference.
Cathleen: I think that's critical and it doesn't have to be a gym. There's a lot of shows on tv on the computer that you can pull up and you can do it from the comfort of your home. It doesn't you don't have to go into a space that's intimidating.
Dr. Brown: You can do it in the park, you can do it with a friend when you visit China and I had the opportunity to visit China a number of years ago when you drove by the parks at seven or eight in the morning, there were thousands of people out doing tai chi and most of them were retired older people that would meet in the park. So we need to be creative during covid and you know a gym may not be the best place in a given situation but that doesn't mean you shouldn't be exercising and it doesn't mean you should be exercising regularly consistently but at a pace that you're comfortable with picking up your pace as time goes on.
Cathleen: Because once you have that habit and cultivate and hold onto that habit um it will also improve your sleep which is can be very elusive.
Dr. Brown:Absolutely. It improves posture. It's good for bone health. It improves sleep. It improves mood. You know, we there's studies that look at exercise and brain health. It decreases your risk of dementia. I mean exercise is one of those things that is really an important area of life and for those of us that spend their life in an office as I do. You really need to make it mandatory to schedule when you're going to do your exercise and not let that slip away.
Cathleen: You've heard the expression that if exercise were a drug, every physician would write a prescription for it.
Dr. Brown: Exactly. So yeah, it's very true and I think it's been harder during the pandemic because people have felt reluctant to either go out or go to a gym or be in in a different situation. And I have seen some people that have been extremely isolated, put on a lot of weight haven't exercised in a year or year and a half and it really is backtracking when you allow that to happen because you will get a year older, no matter what happens out there. You know, we continue to age and we want to age in a very healthy, healthy dynamic way because we want to be independent. I want to do this podcast with you in 20 years.
Cathleen: Absolutely.
Dr. Brown: We want to be able to be thinking about our health and the choices we make in an independent way. It's very hard to give up that independence end up in some kind of a seniors facility or nursing home and have all your decisions made for you because you're unable to function anymore. That's not healthy living, that's not healthy aging.
Cathleen: How did the COVID-19 pandemic change your perspective on this advice. You said you reframed or rewrote every chapter. Tell me a little bit about that.
Dr. Brown: I had to take into account the fact that isolation and social disconnect were really parts of what was happening. And what I feel is that even if I phone an individual patient, that phone call has meaning, you know, that connection is important at some point in the pandemic, I had a number of my quiet elderly patients. I'm talking about people over age 90 living in the community, phoning me 23 times a week to ask a very basic question. And I realized after a couple of months that it wasn't the question, it was the contact. And so, you know, I've been looking at the whole situation of how to manage your health when the stress level in the community in the country is so high. And so I wanted people to really focus on decreasing stress, understanding what a virtual visit is, understanding what the term social connectedness means and how important that is on every level. And so for me, it just seemed a really good time to package this and share with my patients who were struggling in various ways.
Cathleen: Yeah, I think the pandemic underscore the importance of social connection with everyone. And I see within our community at Riverwoods, it's been positive because people are able to walk out they walk out of their hallway and see each other and do it in a safe venue and it can be harder if you are alone. And as you mentioned so many people are living alone more than ever before because of divorce, because of outliving a spouse and it has never been more lonely then during this pandemic.
Dr. Brown: And we know there's a great difference between being alone which is sometimes wonderful and everybody leaves you alone and you can read your book and that's great and being lonely and you can be very lonely even if there's, you know, three other people in your household. And it's that loneliness and sense of isolation that we really want to guard against. So it's not just being alone because being alone for lots of people is fine. But being lonely perhaps in a, in a, in an abusive relationship or in a situation where you're very uncomfortable. You know, women have had a real struggle in the last 18 months and lonely and alone are not the same things.
Cathleen: Amen to that. One of the questions I wanted to ask you is what do you wish women would talk more about? We we talked earlier that everyone talks about their weight, their hair, their body. They don't like this. They don't like that. How would you reframe conversations that you hear every day as you walk through Starbucks or in the grocery store or at the hair salon. What do you wish women would be talking about?
Dr. Brown: I try and encourage women to talk about being athletic to talk about what they're doing, that's different. Have they joined a dance class? You know, are they, did they get an opportunity to have a peloton? What are they doing? That's really helping them keep up with their Children, with their grandchildren, with their great grandchildren. I think our conversations have to be less about food and weight and how we look and more about what we’re doing and so the what we're doing can be really interesting. And I think that if we start to have an impact on our friends and our family and that makes a really big difference.
Cathleen: I love that because it is talking about appreciating what our bodies do. And I think as women, we are so supercritical and we feel we're never enough and we're never thin enough for skinny and are good looking enough for this or that. And we focus on being done enough as opposed to saying this middle aged body helped me. I could walk to the car and could carry groceries, could carry a grandchild. You know, I kept up with my younger daughter, we have to really appreciate what we can do as you said, not what we look like, but what we are capable of doing and focus less on comparing ourselves to everybody else that's on Instagram and say, hey, you know, my body did a pretty good job of getting me through the day today.
Dr. Brown: When I talked to women who are, who are obese, who are looking to lose weight, I try not to talk about what number they want to get too, it's not like you're 220 you want to get to 180. I talk to them about what do you want to be able to do that you can't do now because you're so heavy and you know, sometimes someone will say, I want to be able to sit on the floor with my granddaughter, you know, it's looking at what your body can do and then working to get there and I'll share with you. A couple of years ago, my husband and I had the opportunity to go to Australia. I was actually speaking at a conference and I spent about three months deciding whether I was going to walk the Sydney bridge and do up the Sydney bridge climb to the top of the bridge, and I don’t like heights, and at the same time I felt this is one of the 10 best things to do in the world when you're traveling, is to do the Sydney bridge climb and ultimately we decided to do it and you get tethered on and they really do take care of you and they, you know, it was totally wonderful, it was so empowering for me to be able to say that I did that bridge climb that when I came back, I was more excited about physical activity for me because I thought I did that bridge climb, I can do this or I can do that. So I think when you have something that you sort of set out to do and then you're able to do it, tell all your friends are not going to be shy about. This is something to celebrate. And we celebrate looks and we celebrate events, but we don't necessarily celebrate achievements. And you know, for somebody else, walking to the mailbox, maybe an achievement. If she's recovering from some illness, let's celebrate the physical achievements of doing more with our bodies and the more we do, the more we'll be able to do.
Cathleen: That's a fantastic sentiment. A few years ago I did my first half marathon and then I was so excited about that. I did a sprint triathlon, and so I think getting those goals and again, you're going to have different goals at different stages. But saying this is what I want to do, not what I want to look like, makes you feel better about yourself because there's always going to be somebody better looking thinner, you know, all that, but it's really what you are able to achieve. And I think
Dr. Brown: It’s confidence. You know, you stand straighter, you're more confident walking into a room, you don't feel fragile, you know that feeling frail and fragile and isolated. This is what healthy aging is all trying to move away from, We want to get you feeling strong and confident and standing straight and feeling like you can do whatever it is you want to do.
Cathleen: And that's why I love weightlifting for women who are 70, plus I think that's a really strong empowering thing, especially for a generation of women who would never consider lifting up lifting a weight. I think that and you can change your bone density when you do that. So
Dr. Brown: Absolutely right.
Cathleen: I like that change of of conversations. How would you recommend that people change the conversation with their doctor or their PCP? One thing you mentioned is that women should talk about intimacy issues and not assume it's just them to not be embarrassed about talking about that, which you are embarrassed to be experiencing. To open up the conversation. Is there anything else you would do differently or recommend people frame the conversation differently with their physician when they meet them for a yearly checkup or?
Dr. Brown: Yeah, to me it's all about preventions, you know, it's all about your immunization, the appropriate screening at the appropriate ages and I due for a pap test a mammogram, colon cancer screening. You know, let's look at preventions and as we're talking about prevention's which the doctor is set to do and that's part of what they do. Let's then talk about lifestyle, let's talk about relationship with your partner or lack of partner? Let's talk about healthy choices in terms of eating, exercise, smoking, drinking those lifestyle issues are very, very important. And I think if you put it under the umbrella of preventions, that's really what we're talking about. We're talking about preventing that heart attack, preventing that hip fracture, preventing dementia. So, I think when people go into the physician and you're talking about the very practical things, you know, blood pressure cholesterol, you want to expand that to talk about your lifestyle, what you're doing and what you could be improving upon.
Cathleen: Great, and maybe asking your physician, how do I get better at preventing the things that are threatening me in the next five years?
Dr. Brown: Exactly
Cathleen: Think forward, as opposed to in this particular moment.
Dr. Brown: Right. You're thinking about the big picture, you're trying to make good choices. You know, I'll often have a patient say to me, okay, so what should I do differently? And I'll say, you know, the one thing I need you to do is I need you to do whatever that one thing is, you know, you don't want to give people too much of a burden. It's hard to make lifestyle changes. Um but when you're with the doctor and getting that one on one visit, that's your time to get the best advice.
Cathleen: So, I would recommend preparing for that meeting because in our hectic non aerobic lives we could be rushing from one thing to the other, pulling on two wheels to dr Wyman and waiting for the doctor tell you what's wrong? Don't be reactive, like the plan ahead. What are you really worried about? What do you not want to have happen in the next five years, then have that conversation, because that's the time to do it.
Dr. Brown:Absolutely. And I think that especially if you know your doctor, if you've been together already for a number of years, just come out and talk about it. You know, you don't have to talk about your son at college and your mother here, and this is what you're worried about it. Oh, by the way, the end of that 20 minutes or 30 minutes, whatever it is. Oh, by the way, because that by the way, conversation is usually the most important thing.
Cathleen: Sure, that is so true. Especially if you know the doctor, if you're in the same small town, you're going to be sharing this recipe and talking about kids going off to school and you're like, embarrassed to bring something up. So, I think that's important. We've had such a fabulous conversation and I feel like you've given us a lot of good suggestions as to how to think differently. Not overwhelming, but how to think differently about living a healthier life. Is there anything that I didn't ask you that you would want to share with our listeners today?
Dr. Brown: I think I'm just going to share one more point. Um, and that is that women need to learn how to say no. And what I mean by that is that women often are trying to please everybody trying to take care of everything. Trying to take care of the family you get or at work, you're trying to sort of do well at what you're doing and you get asked to do one more thing that you really feel you don't have the bandwidth to do. And what happens is either you take it on and you feel you've taken on too much and you can't do everything or you feel imposed upon. And I think if we just learn how to say no, open three steps, open your mouth, you know, that just doesn't work for me, thank you for thinking of me, but no and close your mouth. Don't say I'll try don't say, I think about it, don't say I'll get back to you,
Cathleen: Don't say not today, but next week on Tuesday at three.
Dr. Brown: thank you. But no, because when you say no to something, whatever that whatever that task was, you said no to that, you're really saying yes to something else. You're saying yes to more time with your family or yes to time to work out or yes, some time to meditate or whatever it is that you want to do for yourself. So I think if we learn how to say no, will recognize that we really are saying yes to some other things and then we can enjoy that saying yes.
Cathleen: I think that is brilliant, I love that. And I think we could do an entire podcast on saying no and what that will bring it to your life. How saying no can enrich your life because I think you are nailed it that women are conditioned to say yes, they say yes and they resent it, they say yes and they feel guilty, they say yes and they don't feel like they're doing enough of I didn't do a good enough job, I didn't and we need to learn to say no.
Dr. Brown: So if someone wants to remember two things, hectic is not the same as aerobic and learn how and when to say no, because it really means you're saying yes.
Cathleen: I for one am glad you said yes to this podcast because you have really helped all of our listeners today and me personally, it was a personal delight to finally get a chance to talk with you after reading your book. I highly recommend everyone going out and getting their copy of The New Women's Guide to Healthy Aging by Dr. Vivian Brown. Eight proven ways to keep you vibrant, happy and strong. And it's been a pleasure. Thank you so much.
Dr. Brown: It’s a pleasure to talk to you.
Cathleen:You're so easy to talk to. Thank you. So that's our show for today. If you enjoyed it, please say yes um to us, tell your friends about us so we can grow our tribe. Take a look at our website seniorityauthority.org to submit questions. If there's something on your mind, send me a question and I will track down someone to answer it for you. Give us a rating on your podcast platform. It helps other people to find us and until next time, enjoy the chance to get smarter about growing older. Thank you. Thanks to our show sponsor the Riverwoods Group, Northern New England's largest family of nonprofit retirement communities where active adults find community purpose and peace of mind visit riverwoodsgroup.org. That's our show for today. Did it spark a question? If so, send us your questions at seniorityauthority.org and I will track down the answer. Meanwhile, don't forget to subscribe, like us on Facebook, follow us on YouTube and rate us on your favorite podcast platform. Until next time, let's get smarter about growing older.