#39 - What every woman needs to know about cholesterol, heart health and menopause with Dr. Alex Verge, ND

Did you know that globally, cardiovascular disease is a leading cause of death in women? Research suggests that 1 out of 2 women don't, and this conversation with Dr. Alex Verge ND about cholesterol, heart health, and menopause is full of things women need to know as they go through the menopause transition. We discuss myths about cholesterol, the role of diet vs genetics, and why dietary dogma often gets in the way of making changes that stick.

Dr. Alexandra Verge is a naturopathic doctor who loves talking about heart health. In her 20 years of clinical work, her focus has shifted from general practice to issues more commonly experienced by people as they age; arthritis, diabetes, osteoporosis, and, in particular, cardiovascular disease. In fact, in recent years, Alex would say that the subject has, well, captured her heart. She especially loves helping people better understand how high blood pressure and cholesterol can affect their current and future cardiovascular risk while developing workable yet effective management strategies.

Follow her on Instagram @alexvergend and check out her diet and blood pressure resource via https://linktr.ee/alexvergend

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Transcript

Jenn Salib Huber  0:02  
Hi and welcome to the midlife feast the podcast for women who are hungry for more in this season of life. I'm your host, Dr. Jenn Celine Huber. Come to my table. Listen and learn from me. Trusted guests, experts in women's health and interviews with women just like you. Each episode brings to the table juicy conversations designed to help you feast on midlife. Hey there, welcome to this week's episode of the midlife feast. I'm joined today by Dr. Alexandra verge who is a naturopathic doctor based in Ontario, Canada, with a special interest in cardiovascular health. And as we all know, cardiovascular health or heart health is top of mind for women in midlife, especially as we enter our postmenopausal years. And I'm really excited for you to listen to this conversation, in particular, the parts where we're talking about cholesterol and blood pressure. And some of the changes that happen in post menopause that are pre programmed into our DNA and have nothing to do really with what you're doing or not doing. But that doesn't mean that there aren't things that you can do to support your cardiovascular health and health in general and midlife. This is a really great conversation and anybody who is looking for some gentle nutrition, especially discussion around cholesterol and blood pressure and heart health in general, I think will really enjoy this. Okay, welcome Alex to the midlife feast. I am really excited to talk to you. As I said in the intro, you're a fellow naturopathic doctor, and you have a special interest in cardiovascular health and heart health, which is so relevant to midlife conversations, whether you're a man or a woman, or you know, don't identify as either of those. If you're a human being and in midlife, then chances are the topic of heart health is going to come up. So tell us a little bit about how you got interested in this area of interest.

Dr. Alex Verge  1:55  
Yeah, sure. And thank you so much for inviting me Jen. It's true, this conversation is so important for everyone. But it is particularly relevant for women in midlife it when it's, it's like when everything comes to roost, you know, and, and if you don't know what to expect, it can be really off putting, if not scary, and so it's a conversation I have a lot. But taking a step back, I mean, I think my interest developed in cardiovascular disease or cardiovascular health, heart health in a couple of different ways. Over the years, I've been in practice for 20 years now. So it's been it's been a bit of a journey. And when I first started, it wasn't people didn't focus on particular areas, we were sort of the naturopathic family practices, if you will. And so worked with lots of different people with lots of different scenarios. But over time, you do find that you you pivot to certain things, you find a, a real connection with certain things. And since I really love helping people understand more about their health, this started to become something that was really clear to me that people would come back, they hear that their cholesterol or their blood pressure was affected or something was going on and didn't understand them and weren't given the tools to understand what was going on. And so we would have these really great conversations, where even though the situation hadn't changed, their understanding of it had and there was so much even healing in that level alone, just comfort in that for so many people, that it became increasingly important for me to stitch that into my work and, and just fell in love with it. I would couple that with like a lot of health professionals of all kinds have a bit of a personal component there as well. So big family history of heart disease, even though I didn't really know about the details, it was sort of a hanging over the family, you know, so and so died of this, we're not really sure what so and so has that all this heart health stuff that was sort of hanging about which I didn't pay much attention as a younger person as we don't. But as as I got older, it started to hit home a little bit differently. And I have some pretty wicked white coat hypertension. And learning more about that and seeing where that can go. Made me just personally more invested in the subject as well. So bringing those two things together, it's just really become a passion.

Jenn Salib Huber  4:33  
Yeah, and that's so interesting. And I think that you know, you're right, we do bring our own experiences to our practice. In that just, you know, I think any healthcare practitioner, you know, we're human beings and we're, of course going to be interested in things that are going to affect us to, you know, my family early menopause is our is our trait and so I was absolutely interested in that when I started to go down that road myself, but let's back up a little bit and talk about What changes for women in midlife? That increases their risk? Because this is often, you know, a message that lots of people have heard about that after menopause risk goes up. So why don't you just tell us a little bit about kind of the connections between estrogen and cholesterol and blood pressure and heart health in general?

Dr. Alex Verge  5:25  
Yeah, and it's really the crux of the matter, isn't it? I mean, we, all the changes that occur in general occur to us. So as we get older, regardless of anything else, there are incremental changes to our heart health, which includes ticking up of cholesterol, for example. But for women, particularly due to the influence of estrogen, and to a lesser degree, progesterone and certain aspects of heart health, there's a protective mechanism for lack of a better term that we enjoy for a period of time, when that starts to change in midlife, that protection starts to dissipate. So when you look at the numbers for heart disease, or heart issues in people, and you sort of look at men versus women, men have higher rates than women earlier on for many decades, but they're sort of plateaued pretty early on with women, it's lower than men. And then you see this relatively steep rise of various diagnoses after midlife, and we think of that estrogen piece as sort of a delaying factor. So we see at least a decade or so of pushing back of cardiovascular risk for women in general, once that midlife change happens, the estrogen, of course, goes down, we start to see the risk of join men and then exceed men. Part of that is, again, because of sex differences. Part of it is because statistically, we live longer. And so, you know, we may start late, but we catch up and we exceed. And that's just the truth of it. So, circling back to your question around why and what happens, the biggest things have to do with what we call it the modifiable risk factors of blood pressure and cholesterol. So estrogen definitely has an impact on both of those things, as well as the vessel health in general. So with cholesterol, women tend to under the influence of estrogen, have lower LDL cholesterol, which is colloquially been called the bad cholesterol, although I'm not sure that's really a great accurate term in the long run, but nonetheless, so lower LDL cholesterol, and higher HDL cholesterol, and lower triglycerides, which are a related item. After midlife, the LDL cholesterol in particular starts to come up, the HDL may go down and the HDL has long been considered protective, although we're figuring out that there are limits to that as well. But HDL may not actually change that much after midlife. But all things being equal, we see an increase in cholesterol due to an increase in this LDL cholesterol as a result of estrogen, not helping us out there anymore. In addition, with blood pressure, which is actually in some ways, much more complex, you see an interplay between estrogen and progesterone on fluid balance, kidney health, blood vessel response, all of these things which work together to keep our blood pressure in a in a great, healthy place. So when the estrogen and progesterone change again, we see these changes to aspects of kidney function aspects of fluid retention and sodium excretion. I mean, I think most people with hormonal variations will have can attest to how fluid retention changes through a hormonal cycle. That's part of what we're talking about here. So when when those hormones change, the the impacts to these various factors that determine blood pressure also change so we can see this at times quite sudden increase to blood pressure in this midlife time.

Jenn Salib Huber  9:29  
Yeah. So I just want to paraphrase what you're saying. So that no just because there's a point that I want to drive home here and I think listeners will recognize the language that I'm going to use these changes that are pre programmed into your DNA happened to most people, your regardless of what they're eating, how they're moving, that these changes are happening, just because of the aging stage that that peep that women are in and has nothing to do with or it isn't called As Dubai, I should say maybe as a better kind of word, what they're eating or not eating. So it's not something that they need to feel guilty for, if they, you know, a year after they stop having their period, they have a checkup and they have some bloodwork done and their cholesterol is up in their blood pressures up, this isn't something that they've caused

Dr. Alex Verge  10:15  
that that is hitting it right on the head. And I would say that this is a conversation I have more often than then I wish I had to, which is women coming into the office and and in a bit of a panic about this exact scenario. So they've always been told their cholesterol is great, or their blood pressure is great, they haven't had any concerns. And especially, especially through this particular time, in our history, people might not have had a visit with the doctor or any bloodwork for 234 years depending on the person. And so they're they're just getting their blood work done now, and all of a sudden, there's this, quote unquote, dramatic shift to blood pressure or to cholesterol. And it starts this cascade of discussions, which often starts with well, you have to change your lifestyle and someone thinks to themselves, but what did I do wrong? I'm not sure what happened there. Maybe it was COVID. Maybe I did this, maybe I did that. Meanwhile, it was an absolutely expected change from that hormonal transition. And that doesn't mean that we can't use lifestyle tools to start to mitigate some of those changes, of course, but the fact that the change occurred, was virtually inevitable.

Jenn Salib Huber  11:34  
Yeah, thank you for saying that. And I think that there is so much of an emphasis on personal responsibility for health, which is important. Don't get me wrong. But there is so much emphasis placed on the individual's role in being able to prevent or cure or treat any particular health condition, that when something like this happens, and it feels unexpected, I think there's an internalized shame that shows up for people. Yeah. And we know that that gets nobody nowhere. If you feel shame, you are less likely to access care, you're less likely to seek help, you are less likely to you know want to do things to improve your health because you feel like you've done something wrong. It's not that you've made a mistake, it's that you feel like you're bad. Yeah. And you know, I think calling that out any kind of shame in a healthcare situation serves no good. It's something I think everyone has felt maybe on some level, you know, you get a cavity at the dentist and you feel like, Oh, I didn't brush enough. You know, but I think that it's just so important for people to really hear what you're saying that this is an expected change for women in midlife. Absolutely. And ultimately, I think that's empowering. You know, as we kind of were mentioning, just before we hit record, I'm now you know, in menopause, I think, hopefully, pretty close. And I fully expect that my next set of blood work will look different than my last set, which was actually more than two years ago. But I'm not looking at that as Oh, you know, it's Oh, it's because of COVID. And I wasn't moving as much or, you know, it's because I'm 45 and have been on the low end of estrogen for a few years now. So, yeah, I think that it can be really empowering. But can we can we talk a little bit about cholesterol in particular, because there's so much misinformation about cholesterol. You hinted at, you know, what we call the bad cholesterol versus the good cholesterol. And, you know, I think that as a lay terminology that serves a purpose and clarifying a little bit, but what are some of the big misconceptions that you hear in your office about cholesterol?

Dr. Alex Verge  13:55  
There are so many.

Jenn Salib Huber  13:57  
Sorry, I didn't prep you for this question.

Dr. Alex Verge  13:59  
No, no, that's okay. And I just, I wanted to just turn back for two seconds about Yeah, just finishing off with what you were saying, because I was gonna say, especially when we relate cholesterol changes, or cardiovascular changes to diet, when you throw in the shame piece, when diet has such a role to play in the management, particularly of cholesterol, then people are it's like doubling down on shame. Because even what have I done to make this happen? And now you're telling me that it's food that you know, I have to make these diet changes? So what happened here, you know, what, what did I do wrong? And now it's my food that I already may struggle with, you know, it's it's just a really tough spot to be in. Anyway. Sorry. So yes, moving No,

Jenn Salib Huber  14:49  
thank you for saying that.

Dr. Alex Verge  14:51  
Moving on to Yes, the myths and misinformation about cholesterol. Maybe that's what I should call the next First thing I put in the myths and misinformation of cholesterol. There are some pretty big ones these days, the biggest of which I would start by saying is that high cholesterol doesn't matter. So there's, there's a, there's definitely a subset out there of people who are pushing the story that high cholesterol is not a risk factor for heart disease, for various reasons, and that simply isn't true. If there's anything that we've learned over the last several decades is that there is a direct what we call a causal link between high cholesterol and heart disease, this is not confusing, it's very straightforward. And if there was only one thing, one myth that I really wanted to dispel, it would be that one cholesterol is worth paying attention to. Then you know, trickling down from there, there's lots of discussion around, you know, what makes cholesterol go up or not, you know, saturated fat isn't a problem in relation to cholesterol, that is also not true. That doesn't mean you know, there's there's a way to work with all of these things. But to pretend that, that these relationships don't exist about saturated fat in particular, I think is is not helpful for people. And then there's a lot of discussion around the sugar piece. And certainly, there's a potential link between simple carbohydrates and something called triglycerides, which I alluded to before. But overall, what you sometimes see is this Whopper ru or switcharoo of it's not saturated fat, it's sugar, that's increasing cholesterol, and that just doesn't hold any water. And of course, it may not just in the saturated fat piece is not where it's all at either, as we just talked about diet has a role to play. But there are changes that happen in the absence of dietary choices. And many of them a lot of the time. So there's a huge genetic component to cholesterol and blood pressure to a lesser degree. There's these hormonal changes. So yes, the stories around diet, nutrition and cholesterol are definitely important. But they are not the be all and end all.

Jenn Salib Huber  17:25  
Thank you for saying all of that. And I do think it's really important to, to talk about the dietary dogma, you know, when it comes to something, whether it's cholesterol, whether it's cancer, whether it's IBS, you know, there are some very extreme camps, even within our world, and within our kind of naturopathic world here, you know, that, really, I think, we need to be cautious in, in if whether we're a consumer, whether we're a family member, or whether we're a health care practitioner, we need to be really cautious when we have those all or nothing views. You know, I remember when cholesterol first started becoming less popular as a, you know, as a risk factor, I should say, not not in the data, but in, you know, the conversations probably about 15 years ago, and I remember that I was at a particular conference, and there was a speaker there who had written a book about, you know, the, what's the word I'm looking for, you know, just the I'm, like struggling for this word. This is definitely a menopause moment here. But anyway, he written this book about because I'm trying to be politically correct. So he'd written a book saying that cholesterol doesn't matter, basically, is what I'm trying to say. And that it was this conspiracy theory with Big Pharma. And it was, it generated a lot of momentum. And you know, and people were just coming off of their statins and they were eating all the butter and bacon fat, and you know, all those things. And it was like, well, it doesn't matter. It's just a big scam. But that's not the case. And I think anytime that something sounds too good to be true, it's probably too good to be true. You know, that holds true for health medical research, too. Yep. Yeah. So what percentage of cholesterol in particular is influenced by diet and exercise? Because I think sometimes talking about that is helpful in terms of setting the stage too.

Dr. Alex Verge  19:40  
Mm hmm. Yeah. And that that's a trickier question to answer and, and I'm, I'm gonna ballpark it and say, maybe 5050. But but the reason it's tricky is there are multiple reasons why that's a tricky question to answer. The first is the genetic input. So the The genetic influence on cholesterol is quite varied. So there are like very specific genetic conditions where people can have profoundly elevated cholesterol, those are going to be virtually unchanged by diet in any way, shape or form. Yep, in other circumstances, there can be a mild or genetic influence. So you know, sometimes you'll see this run in families that we're not talking about dangerously high cholesterol. But people are seeing these elevations at younger ages, that are maybe qualified or quantified as sort of borderline and that we're going to need to watch this. And there's a definite genetic piece there. But those are going to respond more to dietary pieces. And then there's the third category where even if you don't have any genetic influence to your cholesterol situation, or very little, you, you can affect your levels by making certain dietary choices. So in those cases, I would say we're looking at lifestyle may have a very significant impact 7585 90% on the cholesterol levels, so it really runs the gamut. So when you when you wish them all together, you know, you could say that that lifestyle is going to have a significant impact. But it's going to depend on the person and their scenario

Jenn Salib Huber  21:26  
that I've heard. Oh, sorry, you go ahead.

Dr. Alex Verge  21:30  
Well, I was just gonna say that. And the additional trick these days is as we continue to learn more about cholesterol, and that getting numbers down, reduces risk overall, the the lifestyle changes may not be, quote unquote, enough, depending on the situation, to get us to where we need to go. But But that's, that's a different conversation. And, and, but worth keeping in mind. Because sometimes people say, Okay, well, I've I've made some changes, you know, I've made some changes, and my cholesterol levels have come down. But I'm still being told that I need to consider medication. And, and sometimes that's because the strategies and the brainstorming, and the tools that they've been given to help work through the lifestyle changes were insufficient. And that just needs a little bit more attention to see greater results. Or sometimes the situation really, is that yes, the lifestyle did help. But it didn't get us to the point where we were looking to get to in order to reduce someone's risk sufficiently.

Jenn Salib Huber  22:46  
Yeah, absolutely. And I've heard various numbers as well, which is why I wanted to ask you, you know, I think something that I had read recently was that, theoretically, meaning under perfect circumstances, where you know, all factors are controlled for your food is cooked for you, you're getting the same amount of fiber every day, all of these things. Theoretically, it should probably be upwards of 50%. But practically speaking, over 1020 30 years, what can a person do consistently that fits into their life that's accessible, all of those things, it's probably more like 20 to 30. And I actually think that that's helpful for people to think about, because if you are starting to try and manage cholesterol at 45, you really do have to think about, okay, whatever I do, if it you know, air, quote, works, I'm gonna have to continue to do for the rest of my life. And so it's not a, I'm gonna eat oatmeal every day for a month before my blood work. It's a can I find ways to include oats most days that I enjoy and works for my family? And if the answer is no, then and all of the tools have been applied, then that's not a part of your solution. Yeah, right. Yeah. And so absolutely agree.

Dr. Alex Verge  24:01  
And I would also add that that's true with other aspects of cardio, cardiovascular health as well, particularly, blood pressure. So we know that there's these relationships between sodium intake and I would add to that potassium intake as well. So I'll often describe how sodium potassium are buddies, one going one way, one going the other way. So it's not the potassium can buffer sodium. It's just that you will see better results if you can reduce sodium and increase potassium. Although a quick note there increasing potassium isn't always the right choice depending on the person if they've got kidney disease or concerns in that way, or if they're on certain types of medication, actively increasing potassium can be not the right choice. So that's always worth something worth checking about. But nonetheless, you know, having a low sodium diet can make a huge difference to blood. of pressure. But if you can only achieve it for two months, it's, that's not going to be, that's not going to work for you. It just, it just isn't. Now, sometimes that's because the tools, you can't find the right tools. And that can be super frustrating, you know that the number of times, someone will say, Okay, I've got three months to get my cholesterol down or three months to get my blood pressure down before we have a conversation about medication. And I don't know where to start, because no one gives me any information, just to do better with my diet. And that's what does that mean? It's so grating,

Jenn Salib Huber  25:40  
it isn't. And again, I think a lot of it comes back to that one. I think a lot of the people giving that advice aren't actually trained in nutrition. You know, I've heard everything from one hour to one day of nutrition training and conventional medical school. And I've talked to many, many family doctors who really don't get anything unless they seek it out themselves with continuing education and things like that. So I think that a lot of the people giving the information, actually just have limited tools in their toolbox. Absolutely. And I think that people underestimate how practically difficult it can be to change something that you do regularly, habitually, or that involves other people, which if you happen to have other people in your house that you live with, whether that's children or older parents or roommates, your decisions about food aren't always your own. And so I think recognizing that that limitation, is again, it can actually be empowering, when it's like, okay, well, I may want to have oatmeal every morning. But if everyone else in my family hates us, then that's going to be something that you know, you just need to work with someone who can actually try and help it make work for you. Yeah, yeah, so I love talking. So in general nutrition and intuitive eating, we talk about the add in approach, which is whatever we're trying to do. And because of course, Food Matters, I'm the last person to say it doesn't. But it doesn't matter in the way that I think people think it does, or that doesn't matter in the way that we've been taught. It doesn't have to be perfect. It doesn't have to be rule based. And you don't have to take things away. It's much more empowering to add things in. So if you could share a couple of things that people can add in in midlife, that may help to improve their cholesterol or help to lower their blood pressure, or just help them feel better. What would those be?

Dr. Alex Verge  27:36  
Yeah, I love this question. Because not only will those types of additions help with cardiovascular risk, but they often make us feel better in other ways, too. And that's some of the joy that I get from doing this work, that the things that will improve cardiovascular health will improve our health in general, and you will just be feeling better overall, which is awesome. Yeah. So and I love that add, add in add on approach, and that that's inadvertently how I'm often working with people. Because there are a lot of options with cardiovascular health these knots, not necessarily specific foods, which I try and and not I try to avoid specific food recommendations. It's about themes. And there can be a number of items that will fit for a particular person under a theme. So we talk about these are the different options, what's going to work for you under these categories and your family and your circumstances. And the studies or the the information that's out there in terms of overall dietary approaches for cardiovascular health, and I use approaches, quite specifically, because there are patterns of eating that seems to be seem to be beneficial. So most people will have heard of, say, the Mediterranean diet style of eating, that there's also the DASH diet. So the Dietary Approaches to Stop stopping hypertension approach to eating. There's a lot of overlap there. These are the sorts of places that I start. And so we'll talk about why why do those types of diets or food eating patterns show benefit, they show benefit because they're higher fiber they show benefit because they they're pretty plant forward. So they bring a lot of plant phytochemicals to the table that may be anti inflammatory or antioxidant. They bring lots of Mono Unsaturated and unsaturated fats through things like nuts and seeds and avocado and olive oil and fish for example. They have just inherently a lower sodium content. They have a higher potassium content. They have a lower saturated fat content By virtue of focusing on proteins that have more mono poly unsaturated fats such as fish again, or legumes, for example, so, so when we talk about the add ons, we'll we'll say, can, you know do like nuts and seeds? Doesn't matter which ones, you know, can you add? You know, a small handful a day? Do you like olive oil? Where do you? Where do you add olive oil? Do you what what kind of high fiber foods can we go through here that you might enjoy? Well, you know, let's say oatmeal, which brings other things to the midst of the mix as well. But it doesn't have to be oatmeal. If you hate oatmeal, we're gonna move on to something else, right? Whether that's ground flax, or just trying to get whole grains in a different way that bring the right fibers or the right fibers fibers to the table. So I There aren't a lot of specific add ons, although nuts are often at the top of the list. And I try and suggest that a habitual as we talked about before, you know, the habit forming component is so powerful. And so I have a jar of mixed nuts on my counter. So that when I'm making dinner, I will have a pre dinner snack of about it small handful of nuts. A lot of times we'll have it in the morning making breakfast if depending on how my day is going. But having it out there, it's just become a habit that I don't, I just don't have to think about anymore.

Jenn Salib Huber  31:36  
And I love I love telling people to that, you know, there are certain meals I think that are easier to build habit into. For me, I find that breakfast is really easy to build habit into. So I have my overnight oat recipes that are you know, my soy milk and my oats and my flax and my fruit. And in the morning, I have a very similar thing. I have a salad topper that has like all different kinds of nuts and seeds. And I just add a couple tablespoons of that into it. So kind of having that and still having variety. So I can lead with satisfaction, I can choose what fruit I'm going to put in, I can choose what toppings but just having something that is part of your routine, that you don't have to think about making the decision all the time because that is hands down the hardest part about any dietary change. It is the thought process and actually executing it. So that decision fatigue that we get around like, what do we want to eat? What's for supper? What do I have, if you like plan to have these things at certain times? And that doesn't mean like, as a rule into the exclusion of other things, but just to have them accessible and make them make sense. And actually, you know, is easier, like having those nuts on the counter while you're cooking supper? It's just easier. Yeah.

Dr. Alex Verge  32:45  
And given that, that heart health benefits from building over time, it perfectly suited to finding these habits that that you enjoy. So yeah, if the goal is to incorporate these things that that you will be having over a very long time. We want to a enjoy them and be make it something that you don't have to think that much about. Yes. Oh, my

Jenn Salib Huber  33:12  
goodness. Yes. Thank you so much. I've loved this discussion. And I'm pretty sure that we'll have to have another one. Because I think that I think we're very much on the same page when it comes to this stuff. But I always ask my guests, what do you think is the missing ingredient in midlife?

Dr. Alex Verge  33:31  
Oh, I have so many answers. I think I'll say information which is sort of a boring one and in a way but it was circling back to one of my my opening statements around a lot of people want to know more about how their health works. And they're they're willing to meet people halfway or more and and when they don't have the information to better understand what's going on. It's harder to make decisions. And it's harder to to find your path through to what and how you want to do things. And it also can be scary. You know that information is so powerful in so many ways and being given the opportunity to better understand what's going on with your cholesterol in your blood pressure and what changes you can make to reduce risk. And maybe that includes making a choice to start medication. Maybe it doesn't, but you're the one who now understands how all those pieces fit together. I think and that's true for not just cardiovascular disease, the work that you're doing and and helping people understand what the midlife journey is all about. It's such a huge conversation that is helping people feel so much more at ease with themselves, their changes and taking control of their health and that information piece is helping them get there

Jenn Salib Huber  35:00  
I love that information. It's so it can be really powerful. I think that we have I think we've information overload too. And so I always come back to just make sure that you're getting the right information and that not everyone qualified to give advice or not everyone who gives advice is qualified to give advice. And that's especially true when it comes to health advice. So just making sure that you know, you've got the right people on your team. Thank you so much. So if people want to find out about you learn more about you, what's the best place for them to to look for you?

Dr. Alex Verge  35:35  
Probably Instagram and Facebook. They're both Alex verge nd I, my social media is very information based. As as a focus on getting that that valuable heart health information out there, so that that's probably the best way to connect.

Jenn Salib Huber  35:54  
Awesome, and I'll have those links in the show notes too. Thank you so much for sharing all of this. I know that it will be really, really welcome. A welcome discussion for lots of listeners. Thanks a great day and

Dr. Alex Verge  36:08  
it's been a pleasure. Take care.

Jenn Salib Huber  36:11  
Hey there. Thanks for tuning in to this week's episode of the midlife feast. Season Three is just getting started and there is so much in store this season. Be sure to check the show notes and get on the waiting list for the midlife feast community, which is brand spanking new and registration opens in October for founding members only and then we'll be open again until the new year. And as always, if you find this episode helpful, please consider leaving a review and liking wherever you listen to podcasts so others can help find us