The Longevity Conversation Every Woman Needs to Have with Dr. Ginny Mansberg

The Longevity Conversation Every Woman Needs to Have with Dr. Ginny Mansberg 

What if the most important decisions you make for your future health aren't the dramatic ones—but the small choices you make every single day? 

This week I'm joined by one of Australia's most trusted GPs and health experts, Dr. Ginny Mansberg, to discuss her brilliant new book, The Women's Longevity Handbook, and the science behind living not just longer, but better. 

There is so much noise around menopause, aging and longevity that it can be difficult to know where to focus your energy. Should we be worrying about our hormones? Our brain? Our heart? The latest supplement? The newest wellness trend? 

Drawing on the latest research from The Women's Longevity Handbook, Dr. Ginny helps us cut through the confusion with practical, evidence-based advice that every woman can apply. We explore the health risks many of us underestimate, the everyday habits that have the greatest impact on our health span, and why it's never too late to make meaningful changes. 

Along the way, we talk about heart disease, brain health, the gut microbiome, cancer prevention, and the simple lifestyle choices that can help us stay healthier, stronger and more vibrant for decades to come. 

Because perhaps longevity isn't really about adding years to your life. 

Perhaps it's about adding life to your years. 

Whether you're navigating perimenopause, well into menopause, or simply thinking about the future, I know you'll come away from this conversation feeling informed, empowered and reassured. 

Alex xx 

Main Topics Covered 

• The biggest lessons from The Women's Longevity Handbook
• Why heart disease remains the number one killer of women
• The lifestyle habits that have the greatest impact on healthy aging
• What really happens to the brain during perimenopause and menopause
• Reducing your risk of stroke and dementia
• The fascinating role of the gut microbiome in overall health
• Why fibre may be one of the most powerful nutrients for longevity
• Lifestyle changes that can help reduce cancer risk

Resources & Links
 

• The Women's Longevity Handbook by Dr. Ginny Mansberg
• The M Word by Dr. Ginny Mansberg
• Save Your Brain by Dr. Ginny Mansberg
• ESK Skincare
• Website: https://www.drginni.com.au
• Instagram: @drginni

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Transcript

SPEAKER_00 0:17

I think it's fair to say that many of you will know Dr. Ginny Mansburg. And in short, it's fair to say she's completely obsessed with menopause and midlife. She's written extensively on the topic. She has a brilliant book called The M-Word, How to Thrive in Menopause, which I have to tell you is solid gold reading. But she also has a brand new book coming out, The Women's Longevity Handbook, which is coming out any day now. So check your bookshops, my friends. Now, Dr. Ginny is a GP based in Sydney, and she's one of Australia's foremost experts in women's health, particularly in midlife. She's also the founder of a cosmosceutical, gosh, that's a tricky word, skincare brand called ESC. She's a regular on Sunrise. She hosted the Australian version of Embarrassing Bodies Down Under, which I mean that could be a whole podcast episode in itself. And on top of that, she's a working mom and a working nana. And I am so thrilled that she's made time for us to be on the Grown Up Girls Report. So, Dr. Ginny, welcome to the podcast. Thanks for having me, Alex. Oh, look, I am so thrilled to have you here. Now, when I picked up your book, I just loved the introduction because it just, oh my goodness, it spoke to those memories about the Golden Girls. We all loved the Golden Girls. But I remember watching it, Dr. Ginny, thinking, those women nearly dead. Like, can they how how can they even walk?

SPEAKER_01 1:40

And they're younger than well, they're certainly younger than me. I think I'm probably quite a bit older than you. I'm 58. I'm 54, but I think they were they were they were younger than me. I think they were in the early years. They look younger than us. What the hell? And they all had grey hair.

unknown 1:53

I know.

SPEAKER_01 1:54

I know that I'm saying mine would not be grey but for the help of my favourite hairdresser. But just you know.

SPEAKER_00 1:59

Likewise, and praise Jesus for the hairdressers and the chemicals, that's all I think. 100%. But it's just such a reminder of how our perception of aging has shifted in what the space of what 30 years, 40 years? So tell me, how do you see midlife in comparison to say two generations ago? And what's driving the change in perception?

SPEAKER_01 2:22

Yeah, it's so interesting. I mean, I think quite a few things have changed. My mum did go to university, but that was like pretty out there. Like that was not many girls going to university at her age. But she got an education and then she was not interested in being a stay-at-home mum. And then on top of that, we got access to hair dye, skincare, um, divorce lawyers. Like, I think that the concept that you have to lie back and think of England because you're economically held to a marriage that makes you miserable or to a job that makes you miserable is just a bit old school. I think these days women are more empowered financially. And that's we owe a lot to our mothers and our grandmothers' generations for that. Um, and we have a lot more confidence to go out and get what we want. And so there is no way we are gonna slip quietly into the shadows at 50 and be the invisible women that our mothers became in their 50s.

SPEAKER_00 3:26

Absolutely not. Like at 54, I've just set up a new business towards the end of last year. And I I feel like I'm, you know, I've I feel like I'm the most energized and in the best headspace of my life, if I'm completely honest with you. And I couldn't think of slowing down or winding down or getting ready for the, or even thinking about where I'm going to go with the nursing home or retirement village. It's just so not on my radar. I can't say that strongly enough.

SPEAKER_01 3:49

Yeah, and I I think also we've been a bit like freaked out by the Royal Commission into the aged care sector. And I think that came around the same time as COVID, and we were watching people die alone in nursing homes, like just how dreadful that was. And that's something that, you know, we have an aging population now, so our mums are more likely to be in an aged care facility versus our grandmas who probably died before they got to the stage when they needed to be in aged care necessarily. So we've got this new fear of getting old and being unproductive. And so we're really interested in doing maybe the hard yards, because it is all hard, Alex. It's not there, isn't it? I'm not gonna be telling you take this simple supplement, and your old age is just gonna be, you're just gonna be Barbie forever, and that doesn't exist. So I think we are prepared to put in the hard yards, I think, um, to actually have a really good second half, because like at 50, you're at the halfway mark now, right?

SPEAKER_00 4:53

100%. 100%, absolutely. I think I think you make a really good point. I think that the Royal Commission was a really big moment in time. I'm going back there now as you were saying that, and it was horrific, the stories. I think it gave us a real kick in the ass, if I if if I can simplify it like that. So there's that going on, obviously, advances in technology, say skincare, divorce lawyers, etc. But do you think there is also something psychological about obviously around the 50 mark, the kids are sort of somewhat independent, although I've still got a bunch of them at home. But there is something that I feel like I now have got space, I'm not doing Saturday morning sport, to say, actually it's time to invest in me. There's something that happens at this age as well. Coming back to ourselves?

SPEAKER_01 5:31

I think there are some women who are quite empowered, and yes, I definitely see them who have got their life back. We have a Gen Z, like if you're a mum who had your kids in your late 30s and you're now in your early 50s, you've got a child who's very likely to have some sort of mental health disorder. Um, like I was really young, mum, so my kids are all in their 30s now, and I missed that whole thing. There was no social media, there weren't mobile phones. I mean, we had a flip phone that they, God helped them if they used it and went on it because like the charges were extraordinary, you know. And then you got that in high school. I I think I really dodged the worst of it, and I see a lot of my patients who are Gen Xers who do not feel that sense of liberation now, they actually feel very sandwiched between kids who are not doing well and parents who are aging. And then they're mummaging at work. You know, they've got the gent-bed, you know, kids who are less worldly in so many ways than we were in our 20s. They're staying at home, they haven't done the same kind of life experiences as dangerous and as stupid as we were when we did them in Gen X. They haven't done that. And they haven't really sort of grown up. They're much younger and need to be, we feel like we need to baby them. And I also, you know, for those of us with millennial kids, how the hell are they ever going to buy a house? Like just that, you know, we were so lucky just by dint of the fact that we were Gen X. We got into the housing market because you could get a house for 250,000. I mean, got to that those days are so gone for our kids. I wish that that most of my patients felt completely liberated at this stage of their life. I think there will be a group, a cohort that are, but there's going to be another group, another cohort that might have shed the dickhead husband that they really didn't need, but have not managed to shed the other encumbrances that are sitting on their shoulder like a weight. And if that's anyone who's listening to that, to us now, I see you daily in my surgery. I see you. It's hard.

SPEAKER_00 7:47

Yeah, absolutely. No, you make you make a really good point. So, so when I was reading your book, there were a couple of startling moments. The first one for me was when I read the chapter about heart disease. And it was a real catch your breath moment because as you rightly say and reminded me, heart disease is actually the number one killer of women in Australia. But it's not really on our radar. We talk about breast cancer, we talk about cancer, but it's just, it's not maybe it's not as sexy. I mean, it's a silly thing to say. I don't mean to make it sound twity, but it's maybe not as palatable. But but what struck me, because you go into some amazing detail about prevention strategies, is there's a lot of things we can do to mitigate that risk.

SPEAKER_01 8:27

Can you simplify this for us? Yeah, it is really interesting because the number one killer of women in Australia is actually dementia. But then if you put the number two and three um killers, which is heart attack and stroke, together, they then eclipse dementia. And either way, you could almost say that dementia is a chronic disease of the brain, which is kind of a very similar process to what's happening to heart um for heart disease or even the process that leads to stroke. And we know what's good for the heart is good for the brain. And so we're gonna wrap up all of these unsexy things together. And it's really interesting, every woman that thinks she's gonna die of breast cancer, which is why the fear that is sort of really consistent around hormone therapy for for menopause symptoms is just it's hard to shift because every woman thinks that that's what's gonna get her, which I'm not saying that it's not, but it's not even in your in your top two killers, cancer killers of women, which is number one lung cancer and number two bowel cancer. Again, not sexy. Not sexy. And most of the things that end up being in the women's longevity handbook just come down to really unsexy stuff, Alex. As much as I would love to give you the magic pill and the magic supplement and just take this and you're fine. We don't have that. We don't have any of the evidence for the unsexy stuff. In fact, the further we go along, the less evidence there is for massage therapy and acupuncture and things like that. And it all comes down to diet, exercise, getting enough sleep, actually moving your body, getting vaccinated. I know these are really unsexy, like people just don't want to talk about them, but the evidence is so strong for these really boring, unsexy things that will extend your life and will actually give you a good quality of life. It's not just going to be about extending your lifespan, it's actually gonna extend your health span as well. And the more we research, the more we come back to basics. So that is a good or a bad solution, depending on we how you see it, because this that stuff is really hard. Eating vegetables and not eating a packaging is hard. Um not spooling up the Netflix and going to bed at a decent hour is hard. Um you know, actually socializing and going out when your perimenopausal brain is just going, just stay home this weekend, really. Just stay home, it's fine. Why do you want to go out? You know, don't spend the money. No, you've got to go out and stay on the city. Stay on the couch. Yep. And and I feel like that it's uh woman to woman, I want to give you the easy wins. But doctor to woman, there are no wins.

SPEAKER_00 11:10

There aren't it's hard, yakka, unfortunately. Absolutely. But that's another thing I liked about the book, though. To be honest, there are a lot of good solid basics in there, but it's evidence-based because I think a lot of us, you know, we scroll Instagram, we scroll on TikTok, and we are, oh my god, overwhelmed is even an understatement with all the influencer style advice. Now, I'm not saying it's all wrong and it's all crazy, but there is an element that is not evidence-based and it can whiff you into a frenzy. So I love this because it cuts through all the crap, excuse me, speaking so bluntly, and it just gives it to us. You know, it's just like a Bible. It's a toolkit as well, this book that you can dip in and dip out of. I I felt as well. Like I probably wouldn't, and I I did read it from start to beginning, start to end rather, because I was preparing for this. But if I had it in my bookshelf, I think I'd be dipping in and finding the things that were pertinent to me.

SPEAKER_01 11:57

Yeah, that's what it's designed to do. Like if you come home and your GP's just told you you've got high cholesterol, which by the way is like a biomarker for for menopause, like that's the first thing that happens. Uh, don't don't tell me to uh to measure your hormone levels, that's a bust, but I can really tell what's happening with your estrogen level because your your cholesterol just goes ka-ching, up it goes. Um, but if you have high cholesterol or you've been told for the first time you've got a high sugar level or you've got high blood pressure or your bone density isn't great, you can just go to that section and read up about it. And if you're more interested in then delving into the entire musculoskeletal system and do I really need to retire from my day job and go full-time into eating cottage cheese, I've got you covered. We've actually got ways we could do this that do not involve like you having to give up your job. But there is actually a whole lot of information in there. If you want to just check a few things and make sure that you're on the right track, because while I am as big a fan of AI as anybody else, oh my goodness, I've tried all of them. They all are sometimes really good and sometimes just have completely bogus garbage in there that they've picked up from some commercial website that is trying to sell you something.

SPEAKER_00 13:10

Okay, so let's let's let's talk about some of the key things in the book. So we talked about heart disease. Can you just quickly just give me a couple of things that we could do or we could focus on when it comes to prevention?

SPEAKER_01 13:22

Yeah, I I mean one of the big ones is get your blood pressure checked. And if your doctor goes, oh, that's a bit high, we'll need to keep an eye on it. Can you take that to the next level and keep an eye on it yourself? One of your best investments might actually go be to go and buy a sphigmominometer, which is the one that your doctor will use. These days, battery operated, very few of us use a stethoscope to measure your blood pressure anymore. It's really easy. It's the sort of thing you can get from a pharmacy from for 60 bucks. If you have private health insurance, your GP can write a letter, you'll get a rebate back on that. Um, and one of the reasons we want to do that is because having high blood pressure that is not addressed is linked so strongly to so many parts of heart disease, stroke, dementia, kidney disease, heart failure down the track. It's one of the easiest things that we can do. Pretty much everybody needs the same diet for high blood pressure. We put you on the DASH diet, um, which you can look up. I got a little bit about it in the book. Um, but everybody needs to be on a DASH diet. Hint, that's just eating less crap and eating more good stuff. And then we'll we'll talk about medications, where I know nobody wants to do medications, and I'm certainly no shill for the pharma industry, but I am a shill for keeping you alive for longer in a really good state. You do not want to have a stroke. It is a really tough, tough recovery. And some people come back close to 100%, but you could lose your speech. You could lose the the use of one half of your body. You can now end up in a in a wheelchair and you're now going to be in a nursing home. That thing that you wanted to avoid, like the plague, you're there now. So if we can give you a medication once a day that keeps you out of a stroke unit and out of a nursing home, I'm calling that a massive bargain. And so the reality is for blood pressure, it's not all lifestyle. Yes, if you can lose some weight, get into a healthy weight range, yeah, if you can sort of drop some salt out of your diet, eat less processed food, if you drink a little bit less alcohol, give up the cigarettes, it'll all bring it down incrementally. But sometimes it's just your genes. Sometimes it's just shit that happens. And I find that patients in my surgery look at me like, you know, they're 58 my age, and they'll go, but my blood pressure's always been low. And I'm like, correct. Because we don't really see blood pressure in your 30s and 40s and early 50s. It's your late 50s when it starts and your early 60s. Here we are. I wish you didn't have it. You don't have to have medication forever. If you dropped like 30, 40 kilos and you're overweight, no worries. We can we can get you off it. We might even have to get you off it. These days with so much Azempic around taking people off blood pressure medications are all over the place. I see women who've been grumbling along with a blood pressure of 145 over 95 for three years and no one's dealt with it. Hello? Not we're dealing with that. We're getting on top of that. We're not leaving you with your plumbing under ridiculous amounts of pressure that is doing damage to your arteries and potentially giving you a heart attack and a stroke down the track. Okay, that is fantastic advice.

SPEAKER_00 16:23

We've actually got a little blood pressure machine downstairs and in the in the study. It's we use it, it's fantastic. I think ours was 50 bucks, you know, the best money we ever spent. So look, I I love that. Now, the other thing I have noticed about you, Dr. Ginny, is that you have a real passion for brain health. I know we we talk a lot about the nervous system and and how it's affected in midlife, but I thought perhaps we might take a step backwards and actually explain, if you don't mind, explaining to people, what actually is our nervous system?

SPEAKER_01 16:50

So your nervous system is your brain, which is kind of the mothership, the spinal column, which is now sending ropes, big thick cords of cells, of nerve cells down to the various body parts, your arms, your legs to help you move your guts, your chest to help your diaphragm move up and down. And I just want you to think a little bit about now going into a party and scanning the room for people you know and then going and having a conversation with them. So you need to walk in, and at the same time as you're walking, you need to be scanning the room with your eyes. You're listening for different bits of conversation, you're looking for people you know, you recognize them, then your body says, I'm gonna now move in that direction. So you pivot and you now move your legs, they're now gonna move in a different way. You're gonna put a smile on your face, so you've got to communicate that to all the muscles around your eyes and your face to smile, and you're gonna be listening, and now the act of having a conversation, the parts of your brain that listen, think about what the person has said to you. Maybe link that to a memory, something. Do you know something about this conversation? You've got to go through the filing cabinet. Meanwhile, someone's offering you a drink. You might put your hand up to, you know, have your drink, your glass filled. This is such a complicated whole body system that is using insane amounts of energy and insane amounts of brain power. It's so complicated. And what I realized when I was working on Save Your Brain, which was my two books ago book, yeah, was that your brain is wired for efficiency and not accuracy. Because your brain needs to very quickly sum up is this person good or bad? Am I safe? Am I not safe? Do I need to cross the road? Do I need to run? So your brain is constantly wired to make snap judgments. That can make us really, really vulnerable, as women in particular. That pretty influencer who looks 25, hint she is 25, who's telling you to buy this menopause supplement, but she doesn't declare to you that she's getting $5,000 a post for every post because she doesn't say it say that allows us to be exploited because we like that. That makes us feel good. I see that young woman, she looks, she clearly has a good-looking brain, or I can really tell her vagina's going places, it's taking her great places. I'm gonna buy what she's peddling, because that's great. And and so the brain that serves us so well to keep us safe also makes us very vulnerable to exploitation and to reading stuff on social media that makes us believe things that are not true.

SPEAKER_00 19:29

Let's throw in the chaos that other hormonal imbalance delivers up in midlife. How does that affect brain health? I've got some personal experience, but I'd love you to answer.

SPEAKER_01 19:41

I mean, when I think about perimenopause, that's women in their 40s mostly, right? Because the average age of menopause proper when it's been 12 months since you've had a period, is 51. In other words, most women in Australia, average, will have a period in their at age 50. And the women that we are talking to, the mid-50s women, this is all in the past, and actually your brain gets quite a bit better. It's when you're writing that hormonal trampoline, like in perimenopause, 80% of women report brain fog. One in three will have uh either an anxiety or a depressive episode. Like it's your brain hates the hormonal trampoline, hates it, like with a passion. And so many women in their 40s and 50s or early 50s are starting to feel I can't do this anymore. I like I used to be great at work. Um, I could look at a spreadsheet, it spoke to me. I knew what it was telling me. I don't even understand what it's telling me anymore. I'm having to put it into Chat JPT to tell me what's going on here. I I don't know how to do the job that I used to do. I am feeling overwhelmed. You forget everything. Uh you are absolutely convinced that this is stage one of dementia. And particularly if you've got a mum who has, you know, maybe been diagnosed with dementia or a mother-in-law who's been diagnosed with dementia. I think the thing to remember, Alex, is that dementia before the age of 65 is very, very rare. It's more likely to be exhaustion. You know, so many women don't sleep well around menopause. And that is torture for your brain. I mean, just mate, you might just need a few good sleeps. Um we know that once the hormones stabilize and you pass through into menopause proper, your brain fog does tend to go away. A lot of women still refer to themselves as having brain fog, but you might just be tired.

SPEAKER_00 21:29

Okay, because I have to say, in all the group chats that I'm in, and it's a term I don't know who who I can um give the credit to, menobrain is something that we we talk about very regularly. And I suppose the greatest concern is, as you tapped into before, the fact is it brain fog, is it menobrain? Have we got early dementia? But I loved that statistic you shared. It's very rare to be diagnosed with dementia before. Is it 65?

SPEAKER_01 21:50

65. It's very rare. It's certainly, you know, the Chris Hemsworth gene, the APOE, little E4. Um, that's The one for dementia. And if you have two of those genes, if you're what we call homozygous, so both of your Apo E4, um little E4 uh genes have got this mutation, um, we know that you're six times more likely to get dementia than the average person, and that's already quite a lot, like you know, so it's a it is very concerning, and they are the people who will tend to get those homozygous people will tend to get it earlier, or people who have been very heavy drinkers or who've had some sort of brain disease. But for for vast majority of women, it's an after 65 issue. But I think that that doesn't mean that you walk away and don't worry about it. If you are forgetting to do important things um and you're going, oh my god, I told that person I'd send them an email and I never did it, and it's three days later and I look terrible. You're gonna need to go with um some really low-tech, what I call cognitive aids. I love me a good sticky label. Very, very nice on a on a dashboard of a car, on the uh frame of your laptop. Um reminders in your phone are excellent. Having said all of which, if you are easily distracted and you feel like you've got now a new onset of ADHD in your 50s, um, as so many of us do, uh, you might just be really, really better off uh turning off all of your interruptions on your laptop and turning off your phone altogether, like putting it into flight mode and then switching it on when you take a break and have a cup of tea.

SPEAKER_00 23:33

Okay, some good advice there. I love that. I love that absolutely. Now, let's talk about the gut, the second brain that I know it's often referred to as. Um, we hear about mitochondria, um, we hear about the microbiome, it all feels a little bit abstract. So could you break it down and explain exactly why the gut is, I suppose, even more important in midlife?

SPEAKER_01 23:55

So it's the time where you are most likely to have gut symptoms. So um irritable bowel syndrome peaks for women in their 40s and 50s. Um, so that's a functional disease, but it's the time at which we start to really consider other colon conditions and colon cancer, which is the second biggest cancer killer of women, um, just after lung cancer. It's still not breast cancer, it's bowel cancer, again, an unsexy cancer. And the symptoms are really, really vague, which which is like your bloating, your gas, your change in your stools. When I see a new midlife woman for a menopause consult, who doesn't have changes in their bowels, like at our age, everybody does. And but we have to take it seriously. Like, I need to examine you, I need to see what's going on. You may well need a colonoscopy to see what's going on. So that's why it's important. And I love that you mentioned the microbiome, the 1.1 kilos of bacteria, viruses, but also yeasts and fungi, that's all part of your microbiome in your gut. There are trillions of them down there. 1.1 kilos.

SPEAKER_00 25:02

I have to interrupt. Sorry, did you sorry? Sorry, I have to interrupt. Did you say sorry? Sorry, 1.1 kilos of microbiome.

unknown 25:09

Yeah.

SPEAKER_00 25:09

Good.

SPEAKER_01 25:10

In your gut alone. A lot. And they sit there. And you know, when I first started in medicine, how we knew you had a bacteria, let's say you had a urine infection, we'd get a bit of your wee, you'd go and give it to the doctor, and we'd drop a little bit onto a petri dish of like agar, this kind of bloody jelly stuff that like bacteria absolutely thrived in, and then we just leave it in a warm environment and see what grew. But some of these things were notoriously camera shy, but as far as we knew, there was either nothing on the agar plate, or there was your E. coli, which was the, you know, agent responsible for your urine retract infection. We now know that often even the E. coli is quite camera shy. So if a woman really is convinced that she's got a urine infection and the urine test is negative, we'd probably believe her. Um, that's one thing that we we also I used to believe that the bladder was a sterile environment with no bugs in there whatsoever. And that if there was ever a bug in your urine, that's a problem. Well, we now know the microbiome of your bladder keeps your bladder functioning healthily. And a disruption to the microbiome in your bladder where an evil bug is allowed to dominate all the others and cause a urine infection is a problem. But we're only just starting to work out how do you nurture a healthy microbiome in your bladder? What does that even look like? Your lungs are full of viruses and fungi and bacteria that keep your lungs healthy. We never knew that. We used to think if you had like a bug in there, that's you know, we now know you know your lungs are full of these bacteria keeping you healthy. And the gut is how we learnt about it because they're the easiest to access, right? It's easy. Pooh in a jar and we go and find it. And the other thing that made it easy is the technology that allowed us effectively to map the DNA of different viruses, bacteria, fungi, and effectively bar scan, barcode, um, and read different um bits of poo and see what was in there. And that's how we've started to learn that in fact there are hundreds of thousands of different bugs that we never knew about. And now we know that some of them help us digest our food. If we don't have them, we will have digestive issues. We will not be able to extract certain vitamins and we'll become vitamin deficient. We we know that they're doing so much heavy lifting in terms of the immune system because often your immune system is concentrated around your gut because you eat stuff and that stuff is all contaminated, even though you've kept it in the fridge and been really good with your glad rap and everything. It's introducing new bugs into your gut, and your immune system is ready and waiting there, happy to sort of go, okay, who are you? You know, they're like border force in your gut, actually protecting you. And so we now know that we that there are trillions of different bugs in there, that they weigh 1.1 kilo, that they help us digest, they help us with a healthy functioning immune system. What we don't know yet is what is a perfect microbiome? Like what should it look like? How do I give you a score out of a hundred for your microbiome? We don't know yet, because we don't have enough data yet. We've only just worked out that there are these trillions of things. We have now got some data from, let's say, China or Korea, that people in China or Korea who have certain bugs are more likely to suffer from obesity or diabetes. Does that apply to people in India, Australia, America? We don't know. We don't know if we give you a particular type of prebiotic or probiotic or postbiotic, that we're doing, we don't know whether those things are going to help or not. We've got some very early data on very small data sets. But I love big, thumping thousands of people, hundreds of thousands of people data, if I can get it, to be absolutely sure that the advice that I'm giving you is not just a placebo. And at this point, we don't have much evidence, even for probiotics. Even though people think that they've been around for so long, they must be good. They don't really have the evidence there yet.

unknown 29:20

Okay.

SPEAKER_00 29:21

So so so with your heavy evidence-backed approach, what do you suggest we do? As midlife women who are wanting to really, you know, do the best we can for our gut, what should we do? What's my action plan?

SPEAKER_01 29:35

So, what you need on a daily basis, everybody go and grab a pen. Okay, this is sheer gold what I'm about to do. Actually, notes on my phone. Okay. Amazing. Get on your phone is good. Okay, so what you need per day is a minimum of 25 grams a day of fibre. Chuck that into ChatGPT, it's not as easy as it sounds. That is really hard to get to 25 grams a day of fibre. Like a metamucil teaspoon is about three grams. Can't rely on that. That's not gonna get you. We pretty much need salad for every meal, so yeah. Um, and then we're gonna have about one gram per kilogram of body weight uh protein. Plant-based proteins are better for you than animal-based protein. So hello, get to be friends with your chickpeas and your beans. Yeah. Then for the sake of your bones, I'm gonna chuck in there that if you have not hit menopause yet, it's a thousand milligrams a day of calcium. But for the rest of us, past menopause, 1300 milligrams a day of calcium, it's about four serves of dairy per day. Um, heavy on dairy sauces. That's a lot of dairy. That's a that's a lot of, you know, if you're gonna have three lattes, that's a lot of milk. That's a lot of weight. It's not easy. So I want you to go and take all of that information and go to Claude, ChatGBT, Gemini, whoever's your favorite um AI, and tell it about your busy lifestyle. Feed into it all of your stupid weird foibles, like if you don't like Brussels sprouts, you don't like tin tuna, you don't like chilies, whatever it is, you hate garlic, you re-react to onions, whatever it is, chuck it all in there and get it to devise a plan for you, an eating plan. Dieticians hate it when I say this, and I'm so sorry, because I think dietitians are really fantastic. There are just some who will just pull out a recipe for tuna salad without bothering to say, Do you like tuna salad? It's like, yeah, maybe give it to me, and I'm not arguing with you. But like it, you I see so many people who've gone to a dietitian and it didn't work. Um, and I think what we really need to do is go to ChatGPT and then if you want to, run it by your doctor, your dietitian, and go, what do you think of this, roughly, for a diet? Um, and just you know, put it by them. But I think if you've only got 10 minutes to make dinner for you and five fussy kids, put that in there as well. Like there's no point in it giving you a complicated curry recipe that requires you to make a curry paste from spats from scratch. That's not gonna happen. So so this is how I think we can make it work for you with no excuses that, but I don't like chickpeas. No worries. Tell tell tell chatters that you don't want chickpeas in your diet.

SPEAKER_00 32:24

I've actually become quite the fan of Chat GPT of recipes, opening my fridge and saying, Hey chat, I've got chicken fresh, zucchini, pumpkin, chickpeas in the cupboard, and saw the sauces. Honestly, and some of them are real hits, to be honest. I have to say, there is a role for AI. I love it.

SPEAKER_01 32:39

Oh, yeah. It's it's fantastic. It's really helped so many people. Like, you know, I don't want to harp too much about chickpeas. Everybody thinks I'm like a shell for big chickpea, um, which I'm not. But like a chickpea is like the most amazing, it's the most amazing food. It's so efficient. It gives you like 150 milligrams of calcium. If you have like a half a tin of chickpeas, you're gonna get like six grams of protein, which is really good. Six or sometimes nine, depending on the different chickpeas, you're gonna get a good five to ten grams of pro of fiber, like it's so good. And so for me, like that's one of the most efficient foods you get. If you are somebody who can't eat a lot, I don't love the squish of a chickpea. I'm not a big squishy kind of food person, but I love a roasted chickpea.

SPEAKER_00 33:32

Roasted chickpea, I was about to say ground coriatic human salt and pepper. Yes, girlfriend, that's mine. That's my recipe.

SPEAKER_01 33:39

You're reading my mind. Totally. But how good is that? You chuck it on your salad, you've just turbocharged the fiber content and the protein content of your salad. Like that is just happy days. And then if you want to, take a little pack of them and snack on them because that's like a really good snack. And you can build up your calcium from there too. So, yeah, happy days.

SPEAKER_00 33:58

The other chapter in your book, which I I really just took a breath about, was the chapter about cancer. Because, you know, it's something I think we all quietly worry about. And um, you mentioned another surprising stat that Australia actually has one of the highest cancer risks in the world. Can I ask, why is that? The sun?

SPEAKER_01 34:17

We don't know. I mean, look, the sun, we are the melanoma capital of the world, so definitely, you know, a big part of that is melanoma, but we've got ridiculously high um bowel cancer rates as well, particularly increasing amongst young people. And that, you know, 50% of that at least is from lifestyle. So, you know, going back to the very first conversation we were having about it's just gonna be hard. I can't make this easy for you. I can't, I can't make a way for you to live on pasta and chips and be fine as you get into old age. I can't do that for you. If you've never liked salad, you've never liked veggies, we're gonna have to find a veggie, a salad that you can live with. We're gonna have to work this out. Um if you have spent your whole life going, well, I just need my three shards or or three vodka and cokes at night because I'm just so stressed at work, we're gonna need to find another way for you to relax at night. Because those things are putting you like a ball in front of the post, in front of the cancer posts. And I can't I can want for you all sorts of things, but I can't get you into a healthy weight range, and I can't eat your fiber for you, and I can't eat your protein for you, and I can't go for that walk for you. And midlife is tough because you might have gone through your 20s and your 30s, and maybe even a lot of your 40s, thinking, oh yeah, we'll I'll get around to it. I'm I must stop drinking one day. All of a sudden, at your 50s, that horizon is looming at you like there is no tomorrow. And when you see it in your mom and your dad and your auntie, and you go, holy hell, this is coming for me. You have to get serious about this. And and look, I've gone through my own journey with this as well. I know that, like so many people in COVID, I whacked on the COVID kilos. I had got to drinking every single night. I don't even know how that happened. Um, we looked forward to the bottle of wine and initially we'd have one glass, but you know, really after three or four days, the bottle's not good anymore, so you might as well have it a bit quicker. And, you know, for me, alcohol is just like good year blimp. And there was a point at which I just went, you know what, I've got to make some changes. I was in the most beautiful practice in Sydney, but it was a 45-minute drive each way. And I just went, I'm not doing it. So I moved to a practice that I could walk to. I sold my car, that makes me walk everywhere. I'm very lucky I'm reasonably close to public transport. It's not because I don't like driving, it's just because I want to be healthy. That was a health move for the for me. You know, food prepping, I food prep on a Monday. It's something I take really, really seriously. I get my delivery of my groceries on a Monday, and I'm just gonna make that healthy food because it's important to me now. I've left it late, right? I'm I'm you know, late 50s, but it feels really good. I feel younger now than I did 10 years ago.

SPEAKER_00 37:27

Yeah. Do you know I think I would agree with that actually? I I actually would agree with that. Really? Def definitely, definitely. So, so can we just talk about alcohol? Because I know for a lot of women, it is I I my tolerance has completely decreased as well, which is probably a good thing because, as you say, it's not very healthy for us. But I know a lot of people who are still nightly drinkers, and I'm not judging, for goodness sake, I'm not judging because I've been there and I remember just some of the thick, those very heavy years of intense parenting, even with how I got through, if I'm being really honest, I look back now, so I'm not judging. But have you got any advice for women who are really struggling with trying to trying to, I suppose, ease it out of their life? Because it is so toxic, isn't it, in terms of inflammation and cancer risk?

SPEAKER_01 38:08

It is. So I'm not going to double down and tell you how bad it is because everybody who drinks too much knows how bad it is, and I don't need to be part of the bad. The thing that I find doesn't work is taking somebody else's advice, as well-meaning as it may be, and trying to slam that square peg into the round hole of your life. Everybody is different. I have patients for whom AA is amazing. And these days, a lot of the meetings happen online. You don't have to do all of them in person. Yes, they want you to go to different meetings and find different people, but there's a certain sense of a higher being that might not work for some people philosophically. And for some people, if you're antisocial, that is your actual worst nightmare. Like you could not think of anything. And for those women, it might be a matter of going, I'm gonna try then the alcohol-free drinks, of which there are so many right now. And some of them have adaptogens in them. Like, do they have any evidence? Not really, but like if that works for you, great. Some of them are just like they taste like alcohol. For some people, that makes them want alcohol more. But for some people, that's really helpful. For some people, we just go, okay, you're currently having four drinks. Let's just see what happens when we go to three drinks. And then let's try in a few weeks going to two drinks. And now, if we can do two drinks five days a week, you're you're at the healthy guidelines, because that's the NH and MRC guidelines. I wrote in the book that the evidence is that for any given alcohol intake, women are more likely to get cellular damage than men. And as a result of that, we're probably going to need to follow suit like a lot of the other countries around the world and actually reduce drinking guidelines for women further. But right now, the way they sit from the National Health and Medical Research Council, which in this country is amazing. I spend so much time in the UK and the US. The Australian health authorities are just leaps and bounds ahead of everyone in so many areas. I can't, I'm so proud of the Australian academics in health healthcare. They're amazing. Ten drinks a week is still okay. Never more than um three in a single setting. And no, and mostly what we're saying is two drinks five days a week is okay. There is no safe drinking guidelines if you want to completely avoid cancer. And you know, I mean, I used to spend a lot of time with Professor Ian Olva from the Cancer Council, and he certainly was a zero drinker. And a lot of people who work in the cancer space or cardiology space just don't drink at all. I get that. I like a drink, so that's probably not gonna work for me, but like everybody is different, and I think you've got to be really careful who you talk to about your journey because some people will go, I know exactly how you feel, I've been there, this is what you've got to do. And their advice is ass up for you. The person who you can trust is your GP because they have 18 different methods that they can pull out of their pocket and they know you because they've known you for years, hopefully. They know your medical history, they know what's gonna work, what's not gonna work, what are the local, you know, systems in your area, where the best AI meetings are. That's your GP. And while I know a lot of people are turning more and more and more to AI and trying to avoid their GP right now, um, which is a whole nother story, I think, I think GPs are feeling feeling it as well. I think your GP really does want to help you. And I think that they have the tools to do it, and maybe this could be the new start for you if you have lost the love for your GP.

SPEAKER_00 41:46

So, Dr. Janine, thank you so much for your time today. I love the fact that your approach is all about taking small, deliberate decisions to set us up for an amazing second chapter. It's what I'm all about, making the second chapter the best, the best yet. So thank you for your time. But before we go, tell me where can people find you? Obviously, your book will be out, you know, in the next few days, but if they want to find you online, how can people find you?

SPEAKER_01 42:09

How modern am I? Great. And it is www.drginny, so d-r-g-i-n-i.com.au. Or you can check out ESK Skincare. So it's www.esk-ar-e.com, and um, I'm all over that as well. Look at this, not bad skin. 50A.

SPEAKER_00 42:29

That is actually the first thing I noticed when we actually tuned in. You were rating it looking. Love it.

SPEAKER_01 42:35

Love it looking bad. You can you can tell by my neck that I don't get anything done. I've got to get something sorted from an ac there.

SPEAKER_00 42:41

I have the same issue.

SPEAKER_01 42:43

That's my new area of focus, the neck.

SPEAKER_00 42:44

Anyway, that's another one cuts conversation. Thank you so much. Lots of love. See you soon.