Living a Long, Healthy, Meaningful Life with NYT bestselling author Dr. Ezekiel Emanuel and Journalist Meghan Rabbitt

[1:21]Zibby Owens: Hi. This is Zibby Owens, and you're listening to Totally Booked with Zibby. Formerly, moms don't have time to read books. In my daily show, I interview today's latest, best selling, buzziest, or underrated authors and story creators whose work I think is worth your time. As a bookstore owner, publisher, author, and obviously podcaster, I get a comprehensive look at everything that's coming out and spend my time curating the best books so you don't have to. Stay in the know, get insider insights, and connect with guests like I do every single day. For more information, go to zibbymedia.com, and follow me on Instagram at Zibby Owens.

[2:05]Meghan Rabbitt: I did an event at the Core Club recently with two amazing health advocates and just total gurus. The first was Ezekiel J. Emanuel, MD, who goes by Zeke Emmanuel. And the day that we did the podcast at the core club, it turned out he hit the New York Times bestseller list, so that was super exciting. His book is called Eat Your Ice Cream, Six Simple Rules for a Long and Healthy Life. If you don't know him, he goes by Zeke. Think I said that. He is a vice provost and professor at the University of Pennsylvania, bioethicist, health policy expert, and oncologist. He was one of the architects of the Affordable Care Act, and he's a regular guest on CNN and MSNBC and often contributes to the New York Times, Washington Post, Wall Street Journal, and Atlantic. He lives in Washington DC. And he is also, by the way, part of a triumvirate of incredibly accomplished Emmanuel Brothers, so you may know some of them. Megan Rabbit is the other person who was on this panel. Megan, as you'll hear, was essentially commissioned by Maria Shriver to write this women's health bible. She's an award winning journalist. You'll hear about all of her techniques. She specializes in writing about women's health and wellness, and her essays have been everywhere. Women's health, Oprah Daily, prevention, obviously, Maria Shriver's Sunday paper, which she works for. And she learns about all these health things so that we can make sense of it. A couple of the things I loved was by the time I left this event, I felt like I was equipped to live a more purposeful life armed with the facts, but focused more on finding the meaning and the joy and remembering that sometimes hyperfocus on one random health fad does not make up for living a joyless life devoid of meaning. In other words, let's put things into perspective, guys. And that is exactly what these experts did. I hope you'll join me. And by the time you finish listening, I'd love to know if you also feel the same sort of clarity and calm about how to live the rest of your lives.

[4:11]Zibby Owens: Welcome, Megan. Welcome, doctor Emanuel. It's such a pleasure to have both of you here today. Thank you so much for coming on Totally Booked and also for being here at the Cold Blood LIVE. Round of applause. Very excited to talk about everything health, wellness. Let's get everybody here to have better lives, right? It's not enough to ask for one one thing, 30. Yeah. Tell us both, tell everybody a little bit about the inspiration for both your books. I know you talk about it in your books, but just talk a little bit more about that. Maybe Doctor. Emanuel, you can pick us up. First of all, great honor and pleasure to be here. So the inspiration

[4:53]Ezekiel Emanuel: really was the best thing. I was just pissed off. Exactly two years ago, I got Peter Attia's Outlived, and there are two things which made me mad. I had just finished all my teaching. I had a lull before I had to grade papers, and in his book, at some point, says, Our only goal is to outlive, which struck me as ridiculous. Then he says nothing in the whole book about social interaction. What you're doing here, right, together, getting together, meeting people, talking to people, interacting with people, exchanging ideas, until the very last page and a half of his book, his epilogue, which says, look, you can be in great shape, but if your relationships suck, if you're not having a good relationship with your wife, what's life all about? And that is 100% true, but it's nowhere in the book, which is heavily focused, as you know, on exercise. So I said, there's much more to wellness than exercise, good diet, and sleep. Those are the cores, we all know those cores, but they're not even the most important things for living healthy, long, and a fulfilled life. Social interactions, keeping your mind mentally sharp. So literally in three weeks I sat down and wrote 35,000 words, which was the first draft of the book, trying to review all the data, and put social relations at the center of a wellness world, but also sort of rebut the idea that you have to be obsessed about wellness, you have to look for perfection, you have to do something called biohacking, which I still have no idea what it means. Are not, wellness is something you're gonna have to do for decades. You have to enjoy it. It has to be part of your life. It has to be a habit that you can easily accomplish, and you don't have to be perfect. As I say in the book, I'm a professor, right? 90% is an A. That's all you need. This isn't the Wellness Olympics where perfection is necessary, or you're not getting a gold medal. That's just nonsense. Anyway, that was the inspiration. And I wanna make wellness easy, accessible, and not something you have to really obsess about. And I hope the writing of the book makes it fun and relatively easy to do the things you can do. Well,

[7:25]Zibby Owens: now he's A minus, so I don't know.

[7:34]Meghan Rabbitt: Yeah, so I have a fun story in that the book, Marie Shriver asked me to write this book for her imprint at Penguin Random House. So I had been working for Marie Shriver on her weekly digital news magazine, The Sunday Paper, for about a year and I was out in LA. We were brainstorming story ideas and she said, you know, we haven't had a really great comprehensive women's health book since Our Bodies Ourselves. And even Our Bodies Ourselves, as we started thinking about it, is really focused on what we now call bikini medicine. It's our gynecologic health, our sexual health, our breast health, and these are all important aspects of our health. But we need to talk about women's brain health and heart health and what we now know, thankfully, because we are starting to research the female body and due to that sex specific studies, yeah, we need a book that talks about all of it. And so she said, I want a manifesto and I want you to write it. And so I got to work thinking about all the different aspects of our health from what bikini medicine. So my book starts with anatomy, goes into puberty, sexual health, all of the gynecologic, you know, important topics, but then into some of the specialties like heart health, brain health, the immune system, and really highlighting what we as women need to know to optimally take care of ourselves, to have really informed and great conversations with our doctors and chart a path forward that feels empowered because we are informed.

[9:00]Zibby Owens: Both of you took very different tags in terms of the presentation of the material, which you will all find when you see your books. But yours, Megan, is almost like a textbook sounds bad in the best, most sexy version of textbook. But it's chock full of information and a reference guide. Doctor. Manuel, your book is actually also imbued with a lot of found stories. I feel like I really got to know your dad. He's a funny buddy and know a lot of people who would get along with him and a very personal take on menaces. So from your different outlooks, tell us a little bit more about cognition and how to improve brain health. My kids are convinced I have dementia because I can't remember their name. Was calling them by the wrong names. I forgot to bring in a second book. I can't remember sec, and I'm like, No, you'll have dementia. Anyway, was earmuff, by the way, reassuring them last night by saying, Okay, well, here in this book are the precursors and the risk factors for dementia. Let's see them fine.

[10:01]Meghan Rabbitt: We go. Yeah. I mean, I think from a female perspective, what we are thankfully starting to talk about is that the menopause transition is a really important point in a woman's life for brain health because as we now know, our brain is we have loads of estrogen receptors in our brain. And as estrogen goes down in the menopause transition, that impacts our brain. I think there our conversation about women and Alzheimer's, women are two thirds the cases of Alzheimer's. So we, as women, really need to be focused on our brain health. I think sometimes it can sound a little doom and gloom. We can get really afraid. We can be all like, oh my gosh. Like, I have you know, I forgot where I put my keys. Is this the beginning of the end? You know? And I think what I learned after reporting this chapter of the book is there are a lot of really, you know, simple in in the end at the end of the day, things that we can be doing to protect our brain health. Exercise being one of the best. You know? It really does move the needle. Some of these lifestyle habits that we talk about a lot and maybe like, you know, roll our eyes and say, okay, I know I have to exercise and eat well and and sleep, but they really do help when it comes to brain health.

[11:08]Ezekiel Emanuel: Yeah, I have a whole chapter, the third chapter in the book about staying mentally engaged. I don't know about you, but I know what hell looks like, and for me, hell is, my heart's working great, my lungs are working great, kidneys, liver, everything's doing great, but the brain. And I have cognitive, I have dementia, that would be hell. That's not the way I want to live. I've told my kids since they were knee high, that's not the way dad's going to live. And so what can we do? Well, it's really important to understand the process of mental decline and why certain things are not about dementia. The first and most important thing you can do is get a lot of education. Higher education is sort of on the outs. Everyone's poo pooing it, not important. They're only looking at it from the financial standpoint, not from the brain health standpoint. From the brain health standpoint, the more education you get, the more connections you make neurons make by reading, by studying complicated things, the richer the brain is. And when that decline happens, you push out very far when it's gonna be a problem. Now, we have what's called fluid intelligence. Fluid intelligence is how do you solve a new puzzle? How do you approach a new situation? How do you keep two ideas in your head as you're reasoning about it? It's really what we think about as creativity and all the other aspects of really personality. And that's involved in, that's the frontal brain. And the key thing there, as Megan said, is there's a whole set of activities you can do to preserve that and to keep your brain as active and as engaged as possible. Exercise is one of them, but also eating well. Let me just distill down. We have very good data from a very large study in Brazil that the more ultra processed foods you eat, the worse, the more rapid your cognitive impairment happens. So not eating ultra processed foods, those packaged items, sticking to fruits and vegetables, fresh meats, fresh fish, and things like that, really, really important for brain health. Similarly, sleep. Really important because what does sleep do? It cleans out the brain of toxic materials, but it also allows the short term memory, which is here, the hippocampus, to actually go here, which is where your long term memory is. And if you have short sleep or you don't sleep well, that becomes a problem, and that's one of the things we see as we age, that the sort of longer term memory is declining. In addition, challenging your mind is really, really important. So one of the arguments I make in the book is don't retire. Retirement is associated with substantial cognitive decline. Your schedule, you don't have to get up, so you might, ten in the morning, eleven whatever. You don't have peers, people you're socially engaged with. You don't actually have challenges in your job. So if and when you retire, you have to think about how you're gonna do all that stuff. Keep to a schedule. Have people you talk to have challenges to your mind, whether it's volunteering, whether it's taking on new activities. Churchill is famous for taking up painting. People can take up pottery. You can volunteer at food shelter, or at a school, or at a library. Those are very important. They're not just important because you're giving back to your community, they're important for your own mental health. I think this is something we miss. The single most important thing for your mental health, again, is exactly what you're doing here, social interaction. There is nothing that will make you healthy, live long, and more fulfilled than interacting with people, both your close friends and family, as well as casually people you don't necessarily know deeply, but actually can learn something from.

[15:24]Zibby Owens: And interestingly, you get to have a tiny note that even if you do the Wordle every day, your brain gets yeasted doing the Wordle every day, so that's not

[15:33]Meghan Rabbitt: a salt

[15:34]Ezekiel Emanuel: for this problem. That is one of many. Right, because you have to remember, one of the key things as your brain ages is all those complex connections. First of all, if you don't do new things, you're not making new connections. And if you do the same ones, yes, that pathway gets really heavily emphasized. It's sort of your brain neural connections are kind of like Darwinian survival of the fittest. Those that you ping often, the same wordle, they're really strong. But all the other stuff around them weaken because they're not exercising that. And your brain is just like a muscle, right? Use it or lose it. And so one of the great things you can do as we all age is use it a lot.

[16:18]Zibby Owens: I wanted to talk about exercise a little bit, and one of the things in your book, Doctor. Emmanuel, is don't be a schmuck. Like, these are the schmuck things. They're just like, some are obvious, like don't smoke, all But in terms of exercise, and I know it's important for so many parts of somebody, even hormonal, even menopause, just for so many reasons exercise is important. But it's not just exercise, all exercise is not created equal. What is the most important for busy people thing for us to do? Is it spending thirty minutes weightlifting?

[16:50]Meghan Rabbitt: Is it making sure you go on walks? What is it? What's the answer? I mean, I can speak to what I learned for women specifically when I was interviewing experts. They said, it is amazing that we are having the conversation right now as women and and how important it is for us to strength train. So I know personally after every all the research I saw, all the interviews I did, I prioritize strength training. But in our focus on strength training and lifting weights, I fear that we as women are losing sight that cardio is still really important. And so I think there's not one from my view, there's not one magic ten minutes of strength training plus ten minutes of cardio equals, like, you know, optimal exercise regimen. Right? But I think, you know, that's what I'm noticing now that we are talking about strength training, and it is amazing because I grew up in the generation where, you know, at the gym, at college, I was on the elliptical machine while all of the guys were in the weight room lifting heavy weights. And, man, if I could go back in time, I would tell myself and all my girlfriends, we gotta push our way into that weight room. And now that we finally are there, we have to still focus on cardio because that cardio exercise works our heart muscles and the vasculature in our heart in such a way that is really key as we get older as estrogen impacts that vasculature and makes it stiffer, and cardio really keeps it pliable, keeps our hearts healthy. So that's what comes out to me. Yeah, so look, there are three kinds of exercise.

[18:16]Ezekiel Emanuel: There is the aerobic exercise, for the heart, the lungs, the vasculature, making sure that's really hip top. There's strength training, which is for your muscles and your bones, and then there's balance and flexibility that is very important so you don't fall over, especially as you age. Probably the most damaging thing that can happen as you age from a physical standpoint is you fall, you break your hip, and then it's really hard to get out of that downward loop. You gotta do each one of them. The important thing is not to overdo them. And one of the things I worry about from all the wellness influencers is more and more and more. That turns out to be false. The recommendation on aerobic exercise is seventy minutes a week. Ten minutes a day, or twenty minutes three times a week of vigorous exercise. You can go up to one hundred and fifty minutes, and you get some added benefit from a mortality standpoint. Going over that, you reach a plateau, and you know what? You risk repetitive motion injuries, tennis elbow, a problem with your knees, or your hips. I actually like to look for what I call wellness trifectas. What are the things you're doing that can get all three of them? Strength training, aerobic, and balance. The number one in my book is cross country skiing. And if you look at the best athletes in the world, in terms of VO2 max, that's how well your body uses oxygen, it's always Norwegian cross country skiers. I don't know what they got, but they're the best. They're just under 100. The top 10 people, I think six of them are Norwegian skiers. So look for something which does everything. Swimming, aerobic, but also strength training. I'm a big bicyclist. What does bicycle do? Definitely aerobic, rate goes up, you're breathing hard, but it's also good for the muscles, whether your quads, or your hamstrings, or your hips, right? So look for those kinds of exercise that'll get you multiple benefits, that'll get you strength training, as well as balance, as well as aerobic exercise. And the important thing, just you gotta make it a habit. Do it two, three times a week, and that is probably the most important thing you can do, is be consistent about it so that you don't lose it. Let me just say one of the really important things about strength training, and I think Megan's 100% right to emphasize it, is once we get to the 50s and 60s, our muscle mass really drops. You fall off a cliff sounds a little too dramatic, but we decline between 68% in muscle mass per decade after the '50s and '60s. Muscle strength training is really important to keep that muscle mass up, And what you want to do is strain the muscle, and strain the bones where the muscles go into the bones a little bit. Those micro tears, micro fractures, really important because the body comes back and repairs them, and makes them stronger. So women where you're worried about your osteoporosis effect on your bones, that exercise is really gonna help prevent the osteoporosis,

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[24:38]Zibby Owens: Just started working with the trainer. He's like, Oh yeah, mom, you trying to lose weight? And I was like, Actually, I'm trying to just get up off the floor. And he said, That is so sad. What do you think about that? There are all these videos there, this, me, that, me. Do we ignore best of all? First of all, don't chase a fad. If it's really important, it will be established,

[24:57]Ezekiel Emanuel: and everyone will hear about it. The fads come and go. Now we're also in a fad on the eating side about protein, protein, protein. That's gonna disappear, and it's gonna be fiber next. I yes. Standing up off the ground is good. Is it the be all and end all?

[25:15]Meghan Rabbitt: No. And

[25:17]Ezekiel Emanuel: so I would you know, doing squats is good. It exercises, you know, your quads and your hamstrings. You do 10 of them, you will be a little breathless too. So good. No. No. I don't have anything against it. Would I be obsessed by it? That's what's a mistake. You know, there are plenty of other ways of getting that strength training and that aerobic activity.

[25:41]Meghan Rabbitt: When I talk to doctors about this, and I would love to hear your take on this as well, it's like really a big theme is start small. If that's your goal, if your goal is to go from sitting crisscross on the floor to standing up, like, great. But even just starting with a brisk walk after a meal, it really does move the needle. And I think it's important, especially when it comes to older women who, let's say, have already had a diagnosis of osteopenia or osteoporosis. It's like all is not lost. We talk a lot about prevention these days, which is amazing. And even if you have the diagnosis, it can still move the needle if you start where you are. Start lifting weights.

[26:21]Zibby Owens: I'm asking like prescriptive questions, but that's not really the heart of either of your books. Yours is information. Yours is like, Lindsay's common sense and live more full, healthy, soul gratifying lives as well. And I really like the outlook on what makes life worth living. Are you going to spend your limited time here chasing this idea of super healthy, long lasting life and what you can do for that? How do you both see, I know you touched on this a little bit, but how can we, from a wellness mental health standpoint, really improve our lives and our health therefore?

[26:59]Ezekiel Emanuel: So one of my big heroes is Ben Franklin, partially because I'm at the University of Pennsylvania. He founded the University of Pennsylvania, but he's also the most brilliant person ever in The United States and all of The Americas. The only person I can really think of who rivals him is Leonardo da Vinci. He did everything, and I mean everything, in a world class status. And he had three guiding principles for his life. Principle number one, be curious. Just try to learn about the world. Try to figure out what's going on. That's how he made breakthroughs in electricity and figured out lightning was electricity. He actually did a lot of advances. He got the equivalent of the Nobel Prize for Science in his era. He is still, still to this day, one of the top five inventors of all time. Know him for inventing bifocals probably. That's probably the thing that comes to mind when I mention Ben Franklin. Turns out he invented them at 79 years old, and after that he still had two more inventions that he made. He was always curious, how do I do something? How do I understand something? Second thing he did in his life that guided it was to always try to improve his life. He recognized he had deficiencies. He was disorderly all his life. He had prejudices, and he recognized it. I'll just give you one example that surprised a lot of people. As a young man, he owned slaves, and then when he was in his 50s, he went to a school for African American children, and he looked, he says, they're just as smart as white kids, they're just as attentive as white kids, and they're just as curious as white kids. They're not inherently inferior, which was the reigning thought. And then he became anti slavery. He actually was the first person to petition Congress to end the slave trade and end slavery in The United States. He was always trying to grow, recognizing his deficiencies, and trying to improve. And the last thing, and I think this is the most important thing, he had a thing of being useful. The important thing in life is to be useful. And what did he mean by be useful? How do you improve the world? One of the things he is most famous for is all his civic improvements. He founded the first hospital in The United States, a Pennsylvania hospital. He founded the first lending library. He founded insurance company. He founded a fire brigade. He founded the University of Pennsylvania. He founded the first learning society in The United States. And I could go on and on and on. Why did he do those things? And by the way, many of his inventions, like the lightning rod, like bifocals, he could have patent them, he never patented them. Never. He did not make any money from his invention. And he said, look, I'm giving to the world, someone's gonna take it up and improve it, and make the world even better, just like I've taken a variety of things and tried to make them better. And that was his guiding principle. I think for us as human beings, if we can embody that principle, how do we make the world better? How do we make our family better, our communities better, our cities better, the country better? I think that's really what motivates it. It's gonna keep you young, keep you mentally engaged. It involves all the wellness activities. So when I think about how do we do all of this, I always think about Ben Franklin, because I think he is a fantastic role model. And by the way, if you haven't read his autobiography, it's one of the 50 greatest books in American literature throughout all of history, and it's very short. It's under 100 pages, definitely worth reading.

[30:39]Zibby Owens: Megan, in your book you advocate for us advocating for ourselves, to our doctors, ignoring health problems, not putting things up.

[30:47]Meghan Rabbitt: Talk a little bit about that because I feel like we all need to hear it even though we know it's what we hear. Yeah. I mean, I I really think we are living in a time where we have to own our health. Know? When Maria Shriver asked me to write this book, we were talking about it and she said, I think it is crucial that we as women become the CEO of our health care. And when you think about that, it's like, what do CEOs do? They educate themselves. Right? They find out the information they don't have. And I think for women, that means understanding the sex specific research that is finally being done. We need to know how our hearts are different than the male heart, how our brains are different. Then I think it comes to hiring the right team, right? Which for us means working with the right doctors. We, if we're lucky, have some choice and I think we really do have to go to our doctor's appointments like interviews almost. Like, are you the person to take care of me? When I bring up the sex specific research I read about, say, in a book, you know, is the doctor engaging with with me? Is is this clinician really excited when, you know, he or she sees that I'm coming engaged? And then I think also too, we have to be prepared when we go to those doctor visits. If I am seeing a doctor, I need to come with my personal health history, with my family health history. I need to understand what kind of cancer screenings I might be up for, what cancer screenings I've had. I need to come with a list of symptoms. What a doctor beautifully told me is once you write down that list of symptoms, organize it in order of priority, what feels like most important to you. Like, as we say in journalism, don't bury the lead. Like, come with the most important thing right off the bat. Doctors, nurses, all the people who take care of us have heard everything. They've seen everything. You know? We don't have to have shame when we talk about our bodies, which I think a lot of women can relate to. But if we do those things, I think that really is when we become advocates for our health, and it's really important to do that. I couldn't agree more, and I think my

[32:47]Ezekiel Emanuel: experience in the healthcare community is wellness has not been the top of the agenda. Say this over and over, we have a sick care system, not a healthcare or wellness system to keep people healthy. And I think we have this growing recognition of the importance of of keeping people healthy to prevent chronic illness as people age, or if you can't prevent it all, at least push out further those things that happen. And the best thing, think as Megan says, is this doctor engaged in keeping you healthy? Maybe you're coming with no symptoms at all. You don't have any symptoms. You don't have any illness. You don't have hypertension. You don't have diabetes. Then their job is to make you hypertension free, diabetes free for as long as possible. And are they advising you on the right diet, the right exercises? And if you come with a problem, like you have some repetitive motion injury or stuff, can they advise you how to change your exercises, how to mix it up so that you're still getting good aerobic exercise, and maybe not straining that particular part? Do they ask about your sleep? Do they ask about your social activities? I'm just gonna tell you one sort of interesting story, which is I think really heartening. I have a very dear friend who got diagnosed with pancreatic cancer, unfortunately, in LA, and he got chemotherapy, then went to a major, major surgery, He went to his surgeon, and his surgeon says, All right, you have to see this psychologist. He says, I don't see a psychologist, that's not for me. He says, No, you're seeing the psychologist. He goes to see the psychologist, and the psychologist says to him, What makes you happy? And he said, He's being a curmudgeon. He just threw the ringer with his cancer therapy. He says, What do you like to do? He says, I like to have conversations with people. And the guy looks at him and says, All right, that's your therapy. I am prescribing to you that you have to talk to people, have dinner parties, go out with people, and engage them. Now that's the kind of interaction you wanna have with the healthcare system, figuring out what drives you, and prescribing and keeping you to doing that. Unfortunately it doesn't happen that often, but it can happen, and you've got to find, as Megan says, you've to find that doctor or that person in the healthcare system who's gonna help you. Maybe it's hard for you to keep a diet, I don't know. It all depends what to do. All right, figure out a doctor who's gonna recommend a very good dietitian who can help you with where you're at and how to improve.

[35:21]Zibby Owens: I was sent to this doctor. I was having a medical issue that I thought might be related to my ups and downs weight over the years. And so for my first appointment, grabbed up like this four page, very detailed thing, loss and gains. And this is when I tried Atkins with Weight Watchers and all this stuff, my side got to Seth. And he was like, thank you, very detailed.

[35:43]Meghan Rabbitt: Embarrassing. I'm not going to do that.

[35:46]Zibby Owens: Better to be over prepared. The last thing I wanted to touch on in both of your books really talk about being informed consumers and where the data is about health conditions and where you're extrapolating from. So, a lot of the women's health studies are done on men and women obviously are just small men. In your case, you talk about mice that had a lot of researches done on mice, and you're like, I don't know. Do you want whiskers? I don't know, whiskers. So talk a little bit about that and what we should be aware of when we're making conclusions, reading things in in the media.

[36:22]Meghan Rabbitt: Yeah. I mean, there's a whole chapter in my book that's basically aimed at helping us understand how to tell the difference between hype and facts. Right? It's like in this day and age, we are bombarded with information. We are on Instagram and it's just like health information, wellness information, and it can be really hard. Even as a health journalist, I I sometimes have to really do a deep dive to understand, like, can I trust this advice? And I think what I really wanted to do with that chapter is to help readers walk away and feel like they can be a health journalist in their own life. So I feel like all of you have the skills that I have or can pick them up. And really, it is some common sense stuff. It looking at the source of the Is this a doctor like doctor Emanuel who we can trust? Is it a health influencer who is selling supplements? And you're like, oh, that's interesting. They're selling a ton of supplements and they're telling me to take these same supplements. Noted. I think we also have to look at medical consensus. That is when multiple different medical associations, doctors all agree that this is good sound advice. There is a skill called lateral reading, which I do a lot, which is you find out a piece of information, you wanna know if it's accurate, you open up a new tab on your computer, and then you open up multiple tabs, like 20 different tabs. And you just search that information, not from a biased perspective, but from as objective as possible. And then you see what happens. You see what the search results are. And I think these are all is it unfortunate that we have to do this in this day and age? Absolutely, and it's crucial. It only is another little step that can really help us chart the best course based on evidence. Yeah,

[38:02]Ezekiel Emanuel: as I have already said, I would stay away from fads. Ninety percent of women report getting information from the internet, whether it's TikTok or Instagram or acts, on health unsolicited, and that's a huge amount. And it turns out, a recent study was done looking at the TikTok videos, 2% are supported by human data. Two percent. So I wouldn't chase all of that stuff, and I would leave it to the side. If there's gonna be a big breakthrough, you're gonna hear about it. As Megan says, a variety of sources will say, yes, this is valid, this isn't valid. I'm a cancer doctor, and one of the things I know is in cancer research we have cured millions of mice with drugs that don't work in people. There are differences between us and mice. There are many similarities. So something that works in a mouse, you test out in people before it works. This area is full of some good research, and also lots of unanswered questions. Why are they unanswered? Because a lot of wellness is about doing things for years, and a lot of research is testing people after a few months, and it won't necessarily give you the full results. I'll give you one that I think is sort of unresolved. Intermittent fasting, right? You got different studies. First of all, have lots of different things that people mean by intermittent fasting. Are you going fifteen, sixteen hours on a fast? Are you going 24 once or twice a week? You've gotta get a uniform protocol. That's the first thing. The second thing is, it's unlikely to have a big effect in two months. What you wanna know is if I do this once a week for several years, is that really gonna make a big difference? We don't have those kind of studies going forward, and that's often a big challenge. Well, my advice always to people in those kind of situations is, is this thing potentially harmful to me? And if it's harmful to me, or potentially harmful to me, not worth trying, okay? If it's neutral, what's my biggest risk? Losing some money. And sometimes it'll be big money. All right, not gonna do it. Sometimes it'll be small money. I can try it, and I can see if it makes any difference to me or not. And I think that's a reasonable place to go. I will finally say, Megan, really important suggestion. The amount of conflict of interest in this space, just humongous, whether they're selling you supplements, a specialized test that'll cost you an arm and a leg, specialized treatments that have no evidence, whether they're selling you some special gym membership unneeded, or a consultation. Be very, very skeptical of those kinds of things. I have no conflicts of interest, I have no investments in anything related to this, because I just want the data to talk for itself, and where there's no data to be upfront, don't know. I just can't tell you. That's a really important conclusion. The last thing I would say, and I think this is kind of really important, the sort of wellness industrial conflict often tries to go to extremes. Oh, this looks good, let's do a lot of it. The human body is not like that. The human body is a very finely balanced machine between too much of this versus too much of that. Just think about the immune system, right? Too much immune system function, right? You get autoimmunity, you get a lot of inflammation. Too little, susceptible to infections, cancers, and other things. It doesn't mean you wanna pump up the immune system. No, that can be bad too. You need to get a middle ground. And I find too much of all those influencers go to extremes, like the extreme we're seeing today about protein. No, it's about one gram per kilogram, seventy, eighty grams. And by the way, you don't have to measure it day to day. Every American, I can tell you, every American almost gets enough protein, unless you tend to be an older person who's not eating too much, or might have some deficiency in their gut. The thing we're really deficient on, right? Fiber. Over ninety percent of Americans don't get enough fiber. They don't eat enough fruits and vegetables a day. That's actually bad. Fiber is basically the prebiotics. You don't buy them, just eat your fruits and vegetables, right? They allow the microbiome to grow and to flourish, and they're not just one kind of fiber, lots of different kinds of fibers for the different gut microbiome bacteria.

[42:49]Zibby Owens: A quick last question, and thank you both, by the way, for taking what I'm imagining. It's whole rooms filled with other books and just clear

[42:59]Meghan Rabbitt: the path that these two in their place.

[43:04]Zibby Owens: Favorite brand of ice cream, favorite flavor.

[43:08]Meghan Rabbitt: Such a great question. Well, in Boulder, Colorado where I live, there is a great little homemade ice cream shop. And my husband and I, our favorite flavor is chocolate peanut butter. It's called Larry's

[43:21]Ezekiel Emanuel: Chocolate Peanut Butter, and it was named after the owner's son. It was also his favorite. So good. I had a book party on Saturday in Washington, DC, and we had it at an ice cream factory called Dolceza Ice Cream Factory, and they made two special flavors for me, which are outstanding. One is chocolate hazelnuts with the hazelnuts from Piedmont, Italy, which is the heart of great hazelnuts. That's where Nutella was created, and Nutella's sort of junky. They make a much better chocolate hazelnut combination. And then Levena honey pistachio ice cream, which was to die for, frankly. Then they mixed it with pomegranate sorbet. As the owner said, we did this because it's all the flavors of The Levant, lebna and pomegranates from Greece and Turkey and The Middle East, great, great flavors. I would say when you're trying to eat your ice cream, be very careful that you're eating really wholesome ice cream that has very limited number of ingredients, doesn't have any of those additives like emulsifiers, etcetera. Someone said, Well, would you endorse this ice cream? First of all, no, I will not endorse your ice cream. And then I was looking at the ingredients, polysorbate 80. Well that's an emulsifier that's really not good for you, and they're putting it in your ice cream. You don't want that. So the important thing is, whatever flavor you like, enjoy it. Really important.

[44:50]Meghan Rabbitt: What about you, Zibby? What's your favorite favorite

[44:52]Zibby Owens: favorite flavor? I'm on a mini chocolate chip. Ah. Okay. Cool. Thank you all so much. Thank you for coming on, and see you soon. Thank you for listening to Totally Booked with Zibby, formerly moms don't have time to read books. If you loved the show, tell a friend, leave a review, follow me on Instagram at Zibby Owens, and spread the word. Thanks so much. Oh, and buy the books.