Beyond Physical Health: A Cardiologist’s Whole-Person Guide to Wellness

Todd: [00:00:00] By the end of this episode, you’ll discover the six domains of health based on research presented by Dr. Alan Rozanski.

Todd: Welcome to Stress Management for Highly Sensitive People, a podcast helping HSPs avoid overwhelm, eliminate stress, and find true inner freedom. I’m your host Todd Smith, a facilitator of the work of Byron Katie, a way to question and reduce stressful thoughts. And you guessed it, I’m a highly sensitive person myself.

Todd: In this episode, you’ll discover the six domains of health revealed by Dr. Alan Rozanski and how they connect to your overall well being. Surprising research findings in each domain that can transform how you approach your health. And Dr. Rozanski’s practical tips for achieving balance [00:01:00] and thriving as a highly sensitive person.

Todd: This is an edition of Strategy Fridays, where we think about specific things you can do to help manage stress as a highly sensitive person. We have a special guest today, Dr. Alan Rozanski. A cardiologist and researcher in MINDBODY medicine for over 40 years. He has co-authored over 300 peer reviewed medical articles and book chapters, and many of them are regarded as seminal contributions in the medical field.

Todd: During his long tenure at Mount Sinai Morningside in Mount Sinai West Hospitals in New York City, he has served as professor of medicine, director of nuclear cardiology, and the leader of the cardiology fellowship training program. And he also previously served as chief of cardiology. We tend to think that cardiology has to do with the effect of physical things on the heart, diet, exercise or medical treatments.

Todd: Dr. Rozanski has gone a long [00:02:00] way, uh, has gone way beyond this, um, to study the effects of emotions, thinking, purpose, social interactions, and stress management on the health of the heart and on the body as a whole. In other words, Dr. Rozanski is looking at the big picture, especially from a preventive point of view.

Todd: I’m super happy to have you with us today, Dr. Rozanski. Thank you for being here. It’s

Dr. Rozanski: a pleasure to be here. Thank you so much.

Todd: So, um, what was the first evidence you saw of the mind body connection when you started on this path 40 years ago?

Dr. Rozanski: You know, it was purely by accident in a way. I was interested in studying what were the things that are causing the heart not to have sufficient blood flow.

Dr. Rozanski: under stress. And the only way we were really evaluating that with patients was to put them on a treadmill or a bicycle. And to image the heart, for example, with people on a bike and looking at the wall motion of the heart during exercise. In a normal person, when you do that, the walls [00:03:00] contract more vigorously with exercise.

Dr. Rozanski: But if you have a significant, significant blockage of an artery, Then with, uh, stress, what happens is the wall starts to slow down and even stop moving in the area that’s not getting enough blood supply. And that’s how we determine heart disease non invasively without having to put catheters into patients.

Dr. Rozanski: So that’s what we were doing. We were doing this all with exercise. And then based on some data that had come out about what was happening when people were having their EKG recorded during daily life activity. And we were seeing, gee, these abnormalities were occurring during driving and other activities besides exercise.

Dr. Rozanski: I said, maybe we could study this in the laboratory. So I was interested in studying a scheme. I was only interested in looking at the mental stressors. that might affect the heart. But what happened is we started using a series of mental tests as a battery. And with the help of psychologists, we came up with basically three basic tests.

Dr. Rozanski: One was some [00:04:00] called the Ward Stroop test, which is, is trying to identify a ward with, but the background color is different. You have to say, yeah, it’s, it’s, it’s, it’s a, um, stimulus to the mind to work. serial sevens, subtract it as fast as possible. And the other one was just to simply ask patients to talk about the personal faults or stress that they have in their life.

Dr. Rozanski: So we’re doing a second patient. Uh, he was a 59 year old man who was about to lose his job and we’re imaging the heart and he’s talking about the stress he’s feeling. And lo and behold, about half of his heart stopped moving while he was merely talking about the stress. He stopped talking and the wall motion came back to normal.

Dr. Rozanski: It was a controlled situation. Now, let me hasten to say this was a man with significant heart disease. This would not occur in normals or even people with mild heart disease, but it happened in this man. And it happened in about 20 of the 40 patients that we studied for part of this study. When I saw this particular first case, it was one of those aha [00:05:00] moments.

Dr. Rozanski: It was like. Wow. And so I began to look at the effects of acute stress on the heart. And as I was doing this and I was publishing some papers about it, I got invited to conferences and I started to hear the work of other people working in the, let’s say psychosocial domain and psychosomatic medicine domain, um, you know, health psychology domain, if you want to call it any of those.

Dr. Rozanski: And I started to hear of the research that people were doing in terms of animal based models of stress. And what really caught my attention was work coming out at that time in the 1980s about the effects of depression and its relationship to heart disease. And this was an area today we all accept that heart, you know, depression is a risk factor for heart disease.

Dr. Rozanski: In the 1980s, that was not accepted. It was, the data hadn’t been developed yet, so it was just coming out. So this caught my attention, and one step led to the next, and I never left that field. And I’ve been working on, in this whole area ever since.

Todd: Wow. Wow. So, [00:06:00] 40 years you’ve been doing this research is what I hear.

Todd: 40

Dr. Rozanski: years. 40 years. Absolutely. Yeah.

Todd: That’s a lot of study on a lot of factors.

Dr. Rozanski: Absolutely. Yeah. Yeah. Well, it’s been a progression, you know. It’s not been one thing. It’s led to these six domains of health that isn’t something I made up. It was just, this is what the evidence tells you. These are areas that cause You know, uh, disease if you’re not functioning well.

Dr. Rozanski: And you do well if you’re functioning well in these areas. So it’s based.

Todd: I love that idea of being just open minded, you know, like when you go into research, whether it’s your own personal research in your own life or an actual scientific research, if there’s a, an openness to see what. Can I learn from the data or what can I learn from what’s, what’s there instead of coming to it with a preconceived idea of, um, well, you can test ideas, but to keep that open mind to see what’s actually being shown to me [00:07:00] here.

Dr. Rozanski: Absolutely.

Todd: So let’s talk about, um. HSPs for a minute, highly sensitive people. Um, as highly sensitive people, my listeners and I experience, tend to experience imbalance or health imbalances, if you will, earlier. And we often feel them more acutely than, than others. Um, I like to say there’s just less of a buffer for us.

Todd: So whatever is there, it’s going to affect us. And that goes not only for emotions and mental stimulus, but, uh, also for, uh, medications and effects of things physically as well. The advantage for us is that we have, we’re kind of extra motivated to do something about our stress, and we also tend to catch it earlier.

Todd: So we are especially motivated in, um, Maintaining health, preventing, uh, issues, and we’re often very conscientious in doing some of these things. So that’s why [00:08:00] I’m excited to have you here is to kind of see what are, from the big point of view, big perspective, what are the things that we need to look at and maybe there might be some blind spots, uh, that we can become aware of.

Todd: Uh, in terms of taking care of our health. So what are the names of the six domains of health as you see them?

Dr. Rozanski: Sure. So first the the physical factors what I call the four pillars of physical health, which I say is exercise resistance training Sleep and your nutrition. So I think the one eye opener there may be is why did I you know, Separate out resistance training.

Dr. Rozanski: Um, it’s a whole different area in terms of know how In other words, it’s all, it’s all physical activity. It’s all, you know, being active, but with exercise, it’s about in part, you’re making sure you’re active and, you know, being, you know, more active than at sometimes. And, uh, some people like to [00:09:00] do things just that they enjoy and so forth.

Dr. Rozanski: And that’s fine. You know, you can find You know, be involved in sports, you can be involved in, um, uh, you know, you can like doing jump roping or jogging or taking a brisk walk and, and you’re fine with all of that. You know, you’re dealing with aerobic fitness and so forth. When it comes to resistance training, it’s important to know the know how, you know, how do I exercise my quads, my glial muscles, my shoulders and so forth and make sure that I don’t.

Dr. Rozanski: Sustained injury, which is a big, very, very big issue in this region, and you need to know, and there’s a lot of mechanical things you need to know, and also, let’s face it, it’s not necessarily fun per se, you know, resistance training follows the law, no pain, no gain, you know, exercise, that’s not necessarily true, so I separate them out for that reason, okay, and then sleep and nutrition.

Dr. Rozanski: Yeah.

Todd: Okay. So that’s the [00:10:00] physical health domain. Then what, what are the other, um, domains? So the

Dr. Rozanski: second one is mental vitality. It’s about, you know, keeping, it’s interesting. I, I look at this in two ways. On one level, Whoever you are, at any time, you know, you might have gone on vacation to Puerto Rico, Hawaii, or whatever.

Dr. Rozanski: What’s the one thing that’s going to determine your vacation more than any other thing? It’s the thoughts that you’re having at the time. You know, if you go on a vacation and you’re just so upset about what’s going on in your job, or you had a fight with somebody, or whatever, and that’s on your mind and you’re ruminating about it, good luck on your vacation.

Dr. Rozanski: You know, we carry our thoughts with us wherever we go. So part of, you know, this area, and I think, you know, very relevant to your particular community, is what I’d call mindset work, working on your mindsets. So we can come back and look at that at some length, but I think you’re looking for the overview.[00:11:00]

Dr. Rozanski: But the other part of this is, although the mind is not a muscle, It’s made up of neurons. You can think of it like a muscle in the sense that the mind benefits in terms of vitality by being able to focus and avoid distractions when you need to focus, um, by keeping your mind fresh. And so the mind likes variety.

Dr. Rozanski: So if you’re doing, you know, the one thing all the time, all day, that’s so good. And rest, rest is important. So these are ways you keep the mind. Rested fresh and so forth. And so that’s my, you know, mental vitality.

Todd: Fantastic. Then you get into the area of,

Dr. Rozanski: you know, emotional mastery. And this is about, you know, just that it’s about the ability to, you know, use your emotions for the good.

Dr. Rozanski: Positive emotions give us joy, give us energy, you know, feed what we’re doing. Negative emotions might you. you know, inhibitors. We want to be able to foster more positive emotions and then be able to, [00:12:00] you know, limit the length of negative emotions. But emotions are information and sometimes you need to work with your negative emotions.

Dr. Rozanski: And part of that is learning to bear negative emotions without charging it up and resisting it, you know, and then emotions are used for communication, enriching relationships and so forth. So that’s that whole domain of emotional mastery. How do I work with my emotions and make them better and be more in control of my emotions rather than Yeah,

Todd: yeah, very big area for sure.

Todd: Okay, so we have physical, mental, and emotional so far. Um, what are the other pillars? Next one

Dr. Rozanski: is social connectivity. It’s just about the, you know, the um, Uh, it’s got really a couple parts to it, which is, you know, the, uh, quality of your relationships with other people and then also, you know, the connections you have building up a support system that works for you, [00:13:00] building up a functional support system that works for you, you know, making sure you, you know, where you got to go for, you know, the pharmacy, who’s in your life in terms of, you know, different types of people you need.

Dr. Rozanski: Uh, and it’s, you know, holding on and building friendships, you know, today in today’s world, we’re so busy and a lot about the, our social relationships is it’s what Stephen Covey would call quadrant two, those things which are, you know, important, but not urgent. And we live in a tyranny of those things which are important and urgent, or not so important to us, but urgent to other people.

Dr. Rozanski: And relationships often are, okay, I’ll get to that manana. And what happens is we, we, we, uh, let important relationships atrophy. And then, you know, later in life, you see that it becomes such a more and more important part of life. So it’s an investment also in your future that you’re, you know, enriching your relationships and investing in them.

Todd: I love that you’re [00:14:00] talking about this as a, one of the domains of health, you know, social connectivity because it is so easily overlooked, um, and yet we all know how important it is. And so I love the idea of putting attention on that consciously.

Dr. Rozanski: Sure, sure, sure, absolutely. So that’s the fourth. The fifth would be our sense of purpose.

Dr. Rozanski: Do we live very purposefully? Now, our sense of need for purpose is a basic psychological need. Basic psychological needs have been studied by many people, or theorized by many people, and people will argue over which needs are basic psychological needs, but on everybody’s list is a need for purpose. We were, we built body, soul, our soul, it’s food.

Dr. Rozanski: It’s need is to be living with a sense of meaning. And what happens is that when you feed this sense of meaning and purpose, you have a greater sense of vitality, a sense of being energetic and so forth. And when [00:15:00] you don’t feed it, feed it, you’d like a basic physical need, you know, we have to eat, we need to, um, sleep, you know, drink and so forth.

Dr. Rozanski: The difference between basic physical needs and basic psychological needs is that the, when a basic psychological need is not met, it doesn’t scream loudly at you. You just, it’s like a sense of frustration. I don’t have that sense of vitality. Something’s missing. So, you know, feeding that need is very important.

Dr. Rozanski: It only, not only. It gives you energy, vitality, purpose, drive, and a thirst for living. But it’s also a health domain because people who don’t have that sense of purpose, many health outcomes suffer from it. And we can go back and review all these areas I’ve mentioned to you. They’re health domains because they actually affect your physical health if you’re not functioning well in these domains.

Todd: I love it. Yeah, let’s, let’s go back and look at some of, we’ll look at all of these in detail, but I, um, I look forward to hearing more about [00:16:00] purposeful living.

Dr. Rozanski: And the sixth domain is how you handle stress. Uh, you know, stress management, why it’s its own domain. It’s very interesting. If you look at the relationship between stress and outcomes, it’s a kind of a U shaped relationship.

Dr. Rozanski: I actually have a better sense of wellbeing when I have a moderate amount of stress, as opposed to. No stress and overwhelming stress. So you, well I understand overwhelming stress, but why is that better than no stress? And that’s because of our sense of purpose. And purpose comes with challenge, a need to grow, a need to overcome.

Dr. Rozanski: That’s built into the, it’s like gravity, it’s what you have to do. So when we don’t have a life of challenge, so if I change the word stress to challenge, it’s a whole different relationship. You can say, I’m doing better if I have some challenge in my life, as opposed to none, because I want to live up, you live each day.

Dr. Rozanski: And again, there’s so much to look at here in terms of how you navigate [00:17:00] stress, but you’ve this basic relationship. You have to, to understand that you avoid stress in your life. You just want to know how to. it.

Todd: Yes, absolutely. You know, as highly sensitive people, we read, there have been many studies about, um, overwhelm, which is a common, uh, issue for, for, for us.

Todd: Um, and that comes from too much stress, but there’s also on the other side of the spectrum is too little, like under stimulation where boredom creeps in. And like you’re saying, maybe a lack of purpose and, and it, um, That also is not the optimal place for for us to be in. So we all have our own balance and I know there can be ways to increase your resiliency and ability to handle stress.

Todd: But what an important topic for Uh, for health out stress management. I love it. Sure.

Dr. Rozanski: Sure.

Todd: Okay. So there we have it. We have, um, let me just go over them again. We [00:18:00] have health, physical health, mental vitality. Uh, we have emotional mastery. purposeful living, or social connectivity, purposeful living, and stress management.

Todd: These are the six pillars of health. How did you, um, how did you come up with these, or where did this come from? Was it something that evolved slowly over time, or how did that happen? It

Dr. Rozanski: evolved slowly over time. Um, If I have a strength, it’s my ability to organize information. I always making new charts, outlines how to, you know, give things over to people.

Dr. Rozanski: This is definitely evolved slowly. And you can see this in the progression of my writings over the years. Basically I’ve been, you know, a medical researcher as opposed to a clinician. And so. The papers, I can go back and see what was my thinking in the 1990s, 2000s, 2010, and so forth. So the first classic review we wrote was an article in Circulation in 1999.

Dr. Rozanski: We were just [00:19:00] focused in those days on already about three or four of these domains, but we were looking at, at physical factors. We weren’t looking at the mindsets at all, depression and anxiety. We were looking at work stress and so forth. slowly over time, I added in these additional domains because that’s what the evidence showed.

Dr. Rozanski: So I came to this over the course of about 25 years, I’d say, you know, okay. Yeah. And I’ll say a key part of that was, and you see this reflected in the literature, if you go back historically, that we were always focused on the negative factors. which caused disease and not focused on the flip side of it, the positive factors that promote health.

Dr. Rozanski: And a big breakthrough actually was the work of Andrew Seligman, who was considered by many the father of positive psychology, who actually, you know, pointed out the need to look at the positive domains and how it promotes health. Although my early mentor, one of my early mentors was [00:20:00] Norman Cousins, who was a very prominent philanthropist and editor, and he wrote a book in 1977 called The Anatomy of an Illness, and in 1983, The Healing Heart, which was about how he cured himself from two different diseases with the force of positive emotions.

Dr. Rozanski: And he actually had donated to my first research project. I had the opportunity to meet him. And so he influenced my thinking. about that even before I was exposed to the work of Dr. Seligman. Uh, but that became a key part of my, uh, work from the early onset, looking at the, the flip side, not just the things that cause illness, but the things that promote health, positive health.

Todd: Yes. That’s uh, it’s a really nice way to look at it, um, because it’s a more balanced way to look at it. If you just look at the negative, what causes disease, then at best you’re going to have absence of disease. But if you look at what also promotes [00:21:00] health, uh, what makes you healthier, then you may be able to take it even further into a greater degree of health, I imagine.

Dr. Rozanski: Well, this is one of the most profound things people have to understand. When I go around, and I’ve done this because of my interest, asking new trainees, you know, fellows, other people, you know, I engage in health, what is health? I ask him the question, you know, I’ll get a smile, I’ll get a thoughtful response, but people will pause and they’ll give me answers which are kind of general, you know, it’s more than just the absence of disease.

Dr. Rozanski: We all understand that intellectually, but we approach health often as it is as if it was the absence of disease. You go to see the doctor because you’ve got symptoms and so forth. The doctor sees you and then does a review of systems. Great detective work and so forth. And so, and that’s what they’re trained in.

Dr. Rozanski: That’s [00:22:00] what they’re paid for, which is fine. You want your doctors to do that, but what is health and health is not just the absence of disease. It’s of course, physical and psychological wellbeing, but it’s also this. sense of vitality. It’s this sense of having a pleasurable sense of energy. And when you have it, you feel you want to do things with it because we have this soul drive to do meaningful things.

Dr. Rozanski: So what happens is health is about vitality. It’s about feeling energetic. And then that becomes a vital sign. Just like you go to the doctor and they measure your heart rate and blood pressure. If you want a subjective vital sign of your health is how energetic do I feel? And if your energy is off, Something’s off about your health in one of these six domains.

Todd: I love it. That is so, so valuable. Yeah, you know, it makes me think about the levels of imbalance. You know, when we get to an actual disease that is treated [00:23:00] by the medical profession, it’s often very far down the line of imbalance. But some of those imbalances started out as just little whispers that we could have easily corrected if we knew how.

Todd: Um, probably early on and either lessened that disease or avoided it, um, in, in completely. So what you’re talking about really is on the level of prevention and not just getting rid of disease or trying to prevent disease, but how to live a vital life. I mean, that’s for me, that’s what I get excited about.

Todd: So thank you. Okay, so let’s look at each of these six domains, and we’re going to take two episodes to do this. So we’ll do, we’ll start with a few of these domains, and for, and then we’ll continue in another episode with the other domains. And for each domain, I would love to hear two things, two main things.

Todd: Obviously there’s a lot of complexity in each of these [00:24:00] domains. Uh, it’s taken you 40 years to, to, um, to do the work. So we’re still looking at an overview. However, what I’d love to see is, um, some of the research because, you know, you’re evidence based kind of. person. So I love to hear some of that evidence.

Todd: Um, and then secondly, what are the practical tips, um, as, as a doctor and as a person living this yourself that you can, um, encourage us to, to start adopting some of these principles? Sure.

Dr. Rozanski: Sure.

Todd: So let’s look at, let’s look at physical health first. That’s where we started. So you said there were four main areas, diet, exercise, resistance, training, and sleep.

Todd: Let’s look at some of the evidence there. And if you want to go one by one, we can do that. Um, but let’s, let’s see, what is it? that you know from research is important for physical health.

Dr. Rozanski: Okay. Well, when you get into physical health [00:25:00] domain, that gets, these four subdomains are huge.

Todd: They’re huge. Yeah.

Dr. Rozanski: But since we’re going to, so I’m going to shorten my conversation.

Dr. Rozanski: That’s fine. Then to cover some of the other domains, which I think will be of interest, but I will always start with exercise. If there’s one thing you want to do, you want to be moving, you know, movement is life. And the data that exercise is important is profound. Uh, we first learned this back in 1953 classic study that was done in a British, um, you don’t have these two layered, uh, double decker buses.

Dr. Rozanski: So the investigators looked at the conductors who were, uh, and the drivers. The driver was just sitting in the, driving the bus the whole time, and the conductors were going up and down all day to collect the tickets. And they found that, lo and behold, the conductors had less heart disease and less heart attacks as they followed them over time.

Dr. Rozanski: And this created a whole [00:26:00] range, you know, range. So the, it was the beginning of, epidemiological research in terms of exercise. And by the early 1960s, you already had the presidential council on physical fitness, uh, Dwight Eisenhower, John F. Kennedy, they’re already promoting this before scientists were promoting it practically.

Dr. Rozanski: Um, and then we’ve had an enormous amount of epidemiological data that shows. A relationship, a proportional relationship between the amount of physical activity and health. And we have data where we put people on a treadmill that the greater your exercise capacity, you live longer. We have randomized studies where we took people who had heart attacks or bypass surgery.

Dr. Rozanski: And randomized them to either receiving cardiac rehabilitation, which is mostly about physical exercise. Now it’s much broader than that, or not being randomized to it. And lo and behold, they did better. And then we have all of these experimental studies, which show that practically every important [00:27:00] physiological system in the body is benefited by exercise.

Dr. Rozanski: So that’s, that’s the data. that’s profound. Now, the important thing there is that there’s actually an inverse relationship in terms of, you know, promoting outcomes that when you get go from no activity to even mob physical activity, let’s say even a brisk walk 10 minutes a day, you’re decreasing your risk of having a heart attack or clinical events over a defined follow up period by 20%.

Dr. Rozanski: That’s a profound drop. That’s equivalent to using a statin, for example, to control cholesterol. And then that’s the, so the biggest benefit goes from doing nothing at all to saying, I’m going to do this small amount of physical activity. And then from there, there’s added benefit. when you increase the amount of physical activity and until you get to a good sweet spot.

Dr. Rozanski: Now, the [00:28:00] American Heart Association, the American College of Sports Medicine, and so forth, for many years now, they have promulgated that people should get about 30 minutes of physical exercise per week. This could be moderate exercise, like a brisk walk, five days a week, or 150 minutes of exercise. And that has been the recommendation for many years.

Dr. Rozanski: But in 2018, there was a profound change in the guidelines, physical activity guidelines, for Americans, which are updated every 10 years. And based on newer data using accelerometers, they found wait a second, any amount of physical activity provides benefit. And even if it’s a small bow, this is very profound because it meant, hey, wait a second, I can be strategic.

Dr. Rozanski: Maybe I don’t have time to exercise, but if I park further away from the supermarket, if I decide to take stairs instead of the escalator or the elevator, I’m [00:29:00] promoting my health. And you can make a game out of it and say, wait a second, how can I get enough physical activity that way? So that’s been a big change.

Dr. Rozanski: Of course, you’d like to add more on to that, but I like to start with people because I’m a doctor, because I see so many people who are sedentary just getting them on the playing field, you know, getting them physically active. And then we can talk about getting more active. So. Basically, if you’re active, keep it up.

Dr. Rozanski: If you’re not active, please, please get going.

Todd: Yeah. And the best thing about that is the first step into exercise, even if it’s just 10 minutes a day or even who knows, five minutes a day there, you’re already seeing the greatest gain in that first, uh, beginning. Compared to someone

Dr. Rozanski: who’s sedentary. Yes, absolutely.

Dr. Rozanski: That’s right.

Todd: So that’s

Dr. Rozanski: physical exercise, exercise, and then resistance training. So resistance training, in part, think about it, you know, protecting your muscles, you know, as we age, we’re losing muscle, [00:30:00] mass, strength, and power. And we start to lose that at around age 30 and around age 60, you have an acceleration of that.

Dr. Rozanski: Many people are going to live today because of the wonders of modern medicine, where actually they’re in danger of actually outliving their muscles. And one of the big things we want to protect as people get older is against frailty, and perhaps more than any other single indice, it’s the, it’s the, it’s your muscle strength, it’s like, uh, how can you grab things, you know, how fast can you get out of a chair, or can you get out of a chair, and so forth.

Dr. Rozanski: So here we have to do resistance training. And, you know, people often ask, you know, what’s more important, exercise or resistance training? And I say, it’s like, you know, enzyme, coenzyme. They’re both important. They, they, they feed different things, but they’re complimentary as well. So, you know, you have to get in and start to do physical, you know, resistance training.

Dr. Rozanski: And this you can, don’t necessarily have to go to gym. You can do [00:31:00] bands, you can do planks, you can do, you know, different types of, you know, um, stretches and so forth. Stretching is important as you get older. Balance exercises, um, that you can do simple. balance exercises. And the point is, is that you can break this up just like you do with, uh, uh, physical exercise.

Dr. Rozanski: So I talk about activity snacks, exercise snacks, and resistance snacks, things you can break up into five, 10 minutes. And maybe you can say, wait a second, you know, if I’m watching, let’s say television at night during commercials. May, or maybe a couple of the commercials. I will do some of my resistance training, you know, training and you can break that up and so forth.

Dr. Rozanski: The only thing I’ll say there, you know, very important is that here people do need instruction. You know, you have to figure out, you know, how you’re going to get it, you know, maybe go to a trainer, you know, a therapist or physical therapy, physical therapist, or, you know, a friend who’s very knowledgeable.

Dr. Rozanski: And there’s a lot of stuff online, [00:32:00] but you want to, you know, be guided. on how to do this well, you know, because it’s very easy. You can injure these things not well. So it’s a, it’s a certain know how to develop. Just as like, you’d want to know, Hey, I want to take care of my car alone. You’re going to build up that knowledge base.

Dr. Rozanski: Your body’s your car. You have, you have to build up that understanding. Okay, so that’s,

Todd: yeah. No, that is super important. I remember one point, I was doing a ton of yoga in one particular posture. It caused me to get a golf elbow, you know? Absolutely. I just strained the, the, the tendon or whatever it is there.

Todd: And, uh, so you know, you have to, and if you’re training with weights, um, how much weight and how you’re using it, the range of motion, how you’re, how you’re actually holding that and moving it is super important. So that’s a, I’m glad that you’re emphasizing that. Just before we go on from the resistance training, is there any, uh, is there any studies or, or evidence that comes to mind when you think about that, [00:33:00] uh, uh, that particular domain or that subdomain?

Dr. Rozanski: Sure. First of all, there’s outcome studies that people who have, for example, a stronger hand grip It’s a very profound, profound predictor of outcomes. Your gait, your gait, you know, watching your gait and your speed of your gait is, is important. That’s a complex action. Uh, if you look at outcomes data where people look at exercise.

Dr. Rozanski: and resistance training synergistically, you have, you know, greater longevity, less risk of heart disease when you do that. And interestingly, in the psychological domain, both with exercise and resistance training, good data showing that these act like antidepressants, that there is a decreased risk of depression.

Dr. Rozanski: And when you, when you do that, the data isn’t as easily followed in terms of stress reduction, but empirically, and from my observations over many years, with many patients. Um, this is a great way to release tension, stress, and, uh, and increase a sense of self [00:34:00] esteem, vitality, um, and so forth. So, yeah, I think the data is very strong, extremely strong there.

Todd: Excellent. Excellent. Okay, so we focused on exercise, resistance, training. We now know the difference between those two and the value of each of those. Let’s talk about, uh, diet. Okay. That’s another aspect.

Dr. Rozanski: So diet’s a very interesting area. You know, we have Here, a lot of interesting confusion in terms of even researchers, the public, and so forth.

Dr. Rozanski: It’s a very complex area to study. In truth, modern nutritional epidemiology and science is a field that’s maybe 25 years old. If you look at the studies. from earlier times that wasn’t, wasn’t so good compared to where we’re going. But even now, you say, well, how do we study this stuff? So we’ll give people like these food frequency questionnaires.

Dr. Rozanski: And you know, it’s complex in terms of people recalling what they ate or [00:35:00] recording it and so forth. And then the effects of individual studies, if you look at the effect size of the studies, is not as profound as, let’s say, data with exercise or with smoking. And then what happens, I think, is we lose the forest from the trees, because you’ll see a lot of controversy.

Dr. Rozanski: eating red meat okay? Is it unhealthy? Is it? Um, can I have eggs? Can I not have eggs? You know, what’s the role with cheese and all of that stuff? I mean, what’s very clear is there’s a general consensus that if you look at enough Epidemiological studies, you know, experimental studies, observational studies, that we can come up with general principles.

Dr. Rozanski: Um, interestingly, you know, we know that eating fruits and vegetables are healthy. You have bioflavonoids, you have all these bio nutritious. compounds that exist within them. Everyone agrees that eating vegetables, put a lot of them [00:36:00] on your plate. Fruit, generally good. Some people might limit that in specific circumstances when they’re worried about blood sugar and so forth.

Dr. Rozanski: Fish, good. Nuts, beans, all of that is good. In terms of red meat. chicken. You know, it’s kind of more neutral. It’s kind of important to get enough protein intake, you know, so you know, you would say from that end beneficial. There is a concern when you get to highly processed meats here. You have to be very concerned here because you have nitrates, a high salt line, and the data is more strong that these are not healthy things.

Dr. Rozanski: So avoiding, you know, I’m not saying completely eliminate, but deli meats You know, sausage, hot dogs, things like that should be quite limited. But then you get into the ultra processed foods. And when you look at this, it’s interesting that, um, the whole system called the NOVA system was [00:37:00] developed about, I don’t know, 10, 12 years ago to classify foods in terms of how much ultra processing there is.

Dr. Rozanski: Now, most of the foods we eat today are processed to some degree. But ultra processed foods, I mean, certainly diet drinks, You know, sodas, all the candy sweets, all the muffins, all of that material, all of that stuff. Well, first of all, it was surprisingly that constitutes about 60 percent of our calorie intake, both adults and children.

Dr. Rozanski: I mean, that’s a shocking statistic, but that’s true. And then there seems to be a proportional relationship between the amount of ultra processed foods we eat and adverse health outcomes. So instead of getting so complicated, You know, the, the, the trees might be, I’ll argue about, you know, how much red meat I might eat in my diet.

Dr. Rozanski: The forest is, what’s, what’s, how much ultra processed foods that you have in your diet. And then you get into things like, well, [00:38:00] looking at your diet in terms of a macro picture, in terms of, well, you know, how is your overall health? And, you know, are you exercising? And how are you feeling in general? And so forth.

Dr. Rozanski: And then putting your diet in proportion to that, you know, so, you know, the diet area is very interesting. Of course, it’s important what you eat and it’s important to avoid weight gain. So, you know, have a scale in your bathroom and then, you know, watch that you’re not overeating. I know there’s a lot of emotional based eating, we eat under stress and so forth.

Dr. Rozanski: And there’s part of the, this might be, you know, dealing with the stress in our lives. That’s why, you know, uh, over the years when I’ve had patients come to me very often, I start the conversations with diet when they bring it up that they wanna change the diet in terms of getting them exercising first, because general principle is that when we strengthen ourselves in one area of our physicality, if you will, it allows us, it makes it easier to do so in other areas.

Dr. Rozanski: So [00:39:00] often you get people exercising and naturally we start eating better. You know, uh, or yes, and empirically, I’ll tell you this. It’s very interesting. If you look at all the domains of health, I just mentioned all of them. And you say, let’s look at the negative parts of that. Let’s say people are pessimistic or people are depressed in the emotional domain or people who are lonely or people don’t have a sense of purpose, or people highly stressed, they all have poor diets.

Dr. Rozanski: There’s strong empiric data to show that, showing you the strong interrelationship between our emotional and psychic well being and how we eat. So you can’t completely separate these things out. On the other hand, here’s a good tip that, you know, we all react to food differently. You know, different people like different foods and affects us differently.

Dr. Rozanski: Monitor how you feel after you eat and see how things are going. I’ll tell you by point of self confession, even though I knew a lot about diet, you know, [00:40:00] for years when I was coming to work in my early years, I was coming in so early, I’d have breakfast at work and I’d have this cereal on the side. I’d have milk in this little refrigerator and I’d have one and then a second bowl of cereal.

Dr. Rozanski: And then I’d be like crashing about two hours later. literally crashing. I mean, where’s the coffee? It took me a while to realize, Hey, wait a second, this isn’t good. And I eliminated that from my diet, you know, anyways, I can, I’ll have a piece of food and some nuts and that all went away. So that was self observation.

Dr. Rozanski: So self awareness, self monitoring, how food affects you and it’ll bring you a long way to understanding, you know, what you need to eat.

Todd: I love that. I think we tend to think about the taste of food or the experience of eating, and sometimes don’t pay attention to the effect that it has half hour later, an hour or two later, like noticing that and connecting that can give a lot more information about what [00:41:00] I’m going to do, what I actually want to eat.

Todd: Um, you know, because it may taste good at first, but It may not make me feel good, and we’ll, we’ll

Dr. Rozanski: Well, this is a related point that, as you mentioned that, in terms of how much do we really enjoy what we’re eating? We’re living today in a multitasking world where so often we have something in front of us, but, you know, okay, while I’m doing this, I’m gonna look at the news, social media, and so forth.

Dr. Rozanski: So, um, there used to be a time where I used to have one diet soda per day. And I didn’t want to have it too early. So I had this kind of rule at 1130. Or beyond, I could have the diet soda. And I developed this routine. My office was in one building, in the hospital, and the soda machines were elsewhere. So that would be a walk I would take at 11.

Dr. Rozanski: 30, I’d go get my diet soda, I’d come back, and, aha, okay. [00:42:00] So often, I would have, this is what would happen, I would be sitting there and he’d say, Did I have that diet soda? And I’d look in the garbage pail, and it was gone! It was gone! I felt so gypped, you know? But isn’t that us? Isn’t that us? I mean, isn’t that what happens to us?

Dr. Rozanski: Totally, totally

Todd: not even present for your own, your own experience. We’re so used to

Dr. Rozanski: eating while we’re doing other things today, that has become almost impossible. Yeah. Just to eat and not do something, you know? Absolutely. But you know what, if you would, and if you would actually enjoy chewing and so forth, you know, we’d cure a lot of overeating just by that, you know, mental habit,

Todd: Absolutely. What I noticed is. When I really pay attention, I notice that whole foods, non processed foods are actually more satisfying to me. I actually enjoy them more when I really slow down. And I actually pay attention, I can tell when I’ve had enough, like, okay, that’s a good point to stop. Instead of [00:43:00] where I’m sort of, if I’m not paying attention, dividing my mind or, or just rushing through it, I can go way past the satiation point and then, you know, I’ve overeaten and, and now I have to deal with that.

Dr. Rozanski: Yeah, so, you know, it comes out of what you’re just saying is that another thing to self monitor is what are the kind of foods that make me want to eat more? You know, like if I’m having certain, let’s say, Just take, for example, rice cakes. Maybe you’ll find that if you had one and two, you want three and four.

Dr. Rozanski: Whereas if you had, you know, uh, an apple, that won’t occur, you know? And again, I believe there’s a lot of individuality in all of this. But I think if you would monitor that, that would also be a clue as to, gee, you know, maybe this is where I should be going in terms of my eating habits, you know? Yeah. And in terms of, perhaps, perhaps there’s a high sensitivity.

Dr. Rozanski: people in terms of their diet, you know, because maybe in different domains, people are [00:44:00] highly sensitive. So, uh, just a thought about that.

Todd: This is an advantage, you know, for people that are highly sensitive is pay attention, use that. It’s a, it’s a gift, use that and pay attention as you’re eating and, and notice what makes you feel good.

Todd: Notice what, what you like, what tastes good, what satisfies you versus what makes you just want to start. eating a bowl of chips and never finish, you know, never stop because it just, yeah,

Dr. Rozanski: yeah. I think that could be advantage, you know, and you know, when you were giving your introduction about highly sensitive people, I couldn’t help but think it’s just a turn on the dial, which comes both with some areas, which might be more challenging, but with gifts in terms of, gee, you know, things may be richer in terms of certain life experiences.

Dr. Rozanski: And this might be another area, you know, in terms of physical. Yeah, yeah, yeah, yeah.

Todd: We call them the superpowers of being a highly sensitive person. And there are a lot of them. Everything comes with its pluses and minuses, [00:45:00] but everything,

Dr. Rozanski: everything. Yeah. We all have to realize that. Absolutely.

Todd: Exactly.

Todd: Okay. So, uh, we talked to quite a bit about diet, any. Any empirical data just to point us in that direction before we move on? The, the

Dr. Rozanski: most interesting area I have my eye on right now is all of this data coming out using this NOVA classification, indicating that people who have a high concentration of ultra processed foods in their diet have a greater risk of premature mortality, heart disease, diabetes.

Dr. Rozanski: And other other, you know, chronic illnesses. So I think that is very important information for people

Todd: Yeah, just that one takeaway about highly processed foods uh, I think is is a huge thing if I got nothing else out of that, I think that would be major because you know, we’re talking about balance, uh, we can move the the big balance, you [00:46:00] know, when you’re, when you’re on the weight scale, you move the big weight over like, and that kind of balances some things, but then you can get lost in all the little weights.

Todd: Sometimes when the big weight hasn’t been moved, we need to move that one.

Dr. Rozanski: Yeah. Well, if I may add just two points to that, you know, Sometimes it’s a lot easier to concentrate on something positive to add than something negative to subtract. So it could be where I’m going to go is, you know, can I, you know, have a, a, um, an extra salad per day that I hadn’t put into my diet?

Dr. Rozanski: And then maybe strategically say, wait a second, maybe I’ll make a big salad and put it into, you know, Tupperwares and whatever. And so that I can have this for the next three days. And then when it comes to the ultra processed foods, if you’re, you know, because let’s face it, you know, all of this feeds a certain need in terms of the pace of life or multitasking.

Dr. Rozanski: Don’t have time to create salads, things like that. Can I decrease this? by 1%, [00:47:00] another 1 percent and so forth. So you, you know, you’re,

Todd: there’s, and you’re not leaving yourself hanging. You’re saying, let’s, let’s do something that I also really enjoy. That is a nutritious whole food and then have that available too.

Todd: And the chances are, it may drop off. Yeah, getting

Dr. Rozanski: more into like lifestyle change rather than denial mode, you know.

Todd: Yeah, yeah,

Dr. Rozanski: exactly.

Todd: We can’t starve ourselves. That’s not, that’s not it either. It’s balance.

Dr. Rozanski: Right, right.

Todd: Okay, so let’s talk about sleep, the fourth area under physical health. Um, what is the research about sleep and health?

Todd: So this seems to be a

Dr. Rozanski: sweet spot, you know, it seems for most people to be around seven to eight hours of sleep per night, because if you look at epidemiological data there as well. It seems that people who are very short sleepers and people who are very long sleepers have a higher risk of, you know, heart disease and all cause mortality and so forth.

Dr. Rozanski: I say [00:48:00] this, that’s a general statistic, uh, individuals that might be, you know, considerable variation in that. Uh, here I’m sticking myself out a little bit because, you know, I, I noticed so many people who I know who even go on five or six hours of sleep. And what I notice about those people is they have a very high sense of purpose.

Dr. Rozanski: They’re like, you know, and I’ve often wondered about how much does that compensate in terms of the amount of sleep you need? Interestingly, in terms of the literature, there’s no real data on that. You know, it’s just, it hasn’t like been measured in enough people in an epidemiological sense that you could say that.

Dr. Rozanski: Now, perhaps you need less sleep, you know, on an individual basis, but here’s a good clue. How are you waking up in the morning? And how refreshed do you feel? Do you need the alarm clock to wake you up and so forth? Generally, you know, I find, I know for myself, I do best on seven hours sleep, but for [00:49:00] decades went on five hours sleep, but I was.

Dr. Rozanski: I was, you know, I was driven by what I was doing and so forth, you know, and so forth. But I’ve, um, had the luxury of not being able to have to come in as early and not using the alarm clock. And then I say, Hey, there you go. It’s, it seems to be about seven hours for me, you know, um, once a week I need a good nap.

Dr. Rozanski: Uh, but you know, it’s not just about sleep. It’s about being rested. It’s about, you know, taking times off during the day to You know, sometimes a good nap and a short sleep can compensate somewhat. Um, but you know, generally speaking, I think that the data looks pretty good, about seven, eight hours of sleep per night.

Dr. Rozanski: Okay. Okay.

Todd: Great. And so if you’re, if you’re talking to patients or people interested in their health, what do you suggest, um, to support moving towards getting a better sleep or a better quantity of sleep? Um, what suggestions do you have? Sure.

Dr. Rozanski: [00:50:00] Well, there’s a whole area called sleep hygiene, which has been very well worked out, even in terms of a cognitive behavioral approach and so forth.

Dr. Rozanski: Um, one of the key things is the regularity in your sleep, you know, trying to go to sleep the same time each night, get up at the same time when you have a lot of variability, that itself seems to be, uh, both an inhibitor to sleeping well and also associated with Some worse health outcomes. So that’s key.

Dr. Rozanski: Then, you know, having a room that’s a little bit cool, having a room that’s dark, having a room that is quiet. These are all helpful things as well. Not having a large meal right before you go to sleep. Some people say don’t exercise soon before bed. Although I’ve found variability with that, so you can test that out.

Dr. Rozanski: Uh, these are key things to do, uh, as far as that’s concerned. Not looking at your cell phone in a blue light before. bedtime and having perhaps a unwinding period before you, you go to sleep. And, and, uh, and these are things that [00:51:00] people can use, you know, uh, to sleep well.

Todd: I love that. Yeah. I, I recently in the last many, many months or so, I started a little unwinding program.

Todd: It takes me about a half hour and I lie down, I have my foot up on a particular, I’m doing kind of a stretch, but I sit there and I just listened to either a. Audio book or some music or something. And lo and behold, I would say 99 percent of the time I fall asleep in five minutes when I finally go to bed because it’s just this slowing down.

Todd: And it feels like time off. You know, I can sometimes in my past or even now sometimes think, Okay, now I have to go to sleep. My job is to go to sleep. I’ll be on my bed like trying to go to sleep. And this kind of takes that out of that. It’s like, I’m just gonna I Relax. I’m not even trying to go to sleep.

Todd: Then when I get up, go to bed, it’s just okay. I’m ready to go.

Dr. Rozanski: Right, right, right. Very good. I like that.

Todd: Cool. Okay. So this covers the [00:52:00] kind of one, one of the main domains, physical health. Obviously, this has probably been studied more than anything over the years. I don’t know, but it’s where attention has been focused for, for many decades.

Todd: Yes. Um, So let’s take a break and, uh, we will, uh, we’ll then plan another episode where we can go through the other five, uh, pillars and look at more of the data and look at more of the, uh, tips that you have for all of us. Sure.

Dr. Rozanski: My pleasure.

Todd: Thanks for having me. Okay. Yeah. Thanks for being here. It’s been very educational and a lot of fun as well.

Todd: Okay. In this episode, we looked at the six domains of health revealed by Dr. Alan Rozanski, and we saw how they connect to your overall well being. These six domains are physical health, mental vitality, emotional mastery, social [00:53:00] connectivity, purposeful living, and stress management. This is a wide range of places to look to manage stress, and it gives a lot of options.

Todd: It’s not like just get on a treadmill, change your diet, kind of the basics of what you expect from a doctor. And in this particular episode, we did focus mainly on the physical. We looked at sleep, We looked at exercise, we looked at resistance training, and, uh, we looked at diet as well. So all these are the main components of, uh, the discussion today, and they all affect us as highly sensitive people.

Todd: We looked specifically at some of Dr. Rozansky’s practical tips for achieving balance and thriving as a highly sensitive person. And even though they can be applied to every human being, they apply even more to us. Because we are, uh, more sensitive to imbalance in our physiologies and we actually respond [00:54:00] quicker and we’re more interested in making those responses.

Todd: So, a little bit of exercise can go a long way or a little bit of more balance in the sleep routine can go a long way. Just not eating, uh, processed food or eating a little less processed food can go a huge long way. So, thank you for listening, and I look forward to continuing this discussion with Dr.

Todd: Rozanski. We actually have three more episodes planned, uh, for this ongoing interview. This one, we looked at the overall picture, and then we dove into physical health. Next time, we will look at, uh, mental vitality and emotional mastery. Then we’ll do another episode on social connectivity and purposeful living, and then we’ll finally do an episode on stress management.

Todd: So if you’re following, every Friday is Strategy Friday here at, uh, this, [00:55:00] uh, stress management, um, podcast for highly sensitive people. And we will just continue every Friday with a new episode with Dr. Rozansky. In the meantime, if you want to check out Dr. Rozansky, go to alanrozansky. com.

Todd: Dreaming of a stress free, balanced life? Visit trueinnerfreedom. com and complete the HSP Stress Survey. Gain clarity on your stress triggers. And enjoy a free 15 minute inner freedom call designed to guide you towards lasting inner peace and fulfillment.