Kerry 0:00

All right. Hi, everybody. Welcome back to the Get Healthy Tampa Bay podcast. I'm your host, Dr. Kerry Reller, and today we have Dr. Esra Shermadou. Welcome to the podcast.

Esra 0:11

Thank you so much. Thanks for having me

Kerry 0:13

Okay. Why don't you tell us a little bit about who you are and what you do?

Esra 0:18

Yes. So I am the founder of Sakina Health. I'm a family medicine and obesity medicine physician in Dayton, Ohio. I'm the founder of Sakina Health, which is a medical practice that I recently opened where I help adults improve their metabolic health through sustainable weight loss, hormone optimization, and helping them incorporate healthy lifestyle changes. So of course, strength training, movement, and healthy nutrition

Kerry 0:44

Awesome. And Dr. Esra can definitely be found in the gym lifting heavy weights as I have learned many a time. I think we bumped into each other in the gym. I love that we have a similar passion for sure. So for listeners meeting you for the first time, tell us a little bit about your path into family medicine and obesity medicine and founding your practice, Sakina Health.

Esra 1:05

Yes, definitely. I think my journey really started when I was diagnosed with cancer at the age of twenty-one. I went through a lot of chemo and stem cell transplant. I was hospitalized, and honestly, I never worked out before then. It was not part of my life, but during that time period, I was just in bed all the time, and I just felt like I, I missed movement. And so-- and I would get these letters from the Leukemia Lymphoma Society about their half marathons and marathons, and that really inspired me. And so I told myself that once I got healthy, I would run a marathon. And I got into running and I ran a half, not a full yet But then in med school, I... And I, and honestly, I just did a lot of home workouts. That's what I started off with is just the just, workouts on on CDs or on YouTube. And then in med school, I went to the gym one time with one of my-- with some of my friends, and then I started going to the gym. And and that was it. And then that just kinda led to my path. I've always had I really enjoyed fitness and strength training and nutrition, and I was always reading about it on my own just to better myself. And what I really liked about family medicine was just being able to kinda treat the whole body and being able to, help people live healthily. And that's ultimately what I wanna do. I want people to be able to en- live the way that they wanna live. Move and do the things that they wanna do every single day until the day they die, and I learned about the obesity medicine certification and, learned about these not only medications, but just the healthy living in general and how that can really help so many different people. And I'm really passionate about that. I think, the w-weight loss is something that a lot of people have difficulty with, and it's hard. It's definitely not an easy process. And, a lot of people end up doing things that are, not sustainable, and they're just find themselves in this constant rabbit hole of just doing the same things over and not really getting the results. And that has a big toll on your life, and it ends up being a big part of your life, and, I don't think it should be. And so I'm here to help people get healthy and just improve their life so they can live life the way that they want to. So

Kerry 3:12

Yeah, I love that. And you're right, like whole person care, family medicine, the whole spectrum from, whatever age they are to long living life at their best healthy wellness. And obviously what you preach about and what you're gonna talk about now is like very much important to get to that level, right? To continue their quality of life. Now, I did not know that about your cancer diagnosis, but I actually did Team in Training when I lived in Atlanta for a few-- a year and a half or so, and I ran the San Diego Marathon with Team in Training.

Esra 3:46

Wow, that's awesome. That's so cool.

Kerry 3:49

man, you're such an inspiration to hear that you've, started doing half marathons yourself after having such a significant diagnosis and cancer journey. That's impressive. Very impressive.

Esra 4:02

Thank you

Kerry 4:04

yeah, Team in Training and the Leukemia and Lymphoma Society were wonderful and supporters back then. And, back then I had to write letters and thank yous and things like that, and now it's like I'll just click a button and things like that. So I had to do it like the hard way back then, but I wouldn't change my experience at all. It was actually amazing. So if you ever did do that that's one of, one of the best things that I did to just use my running for a purpose, right?

Esra 4:31

Yeah,

Kerry 4:32

So amazing. Yeah.

Esra 4:34

I still need to still fullfill my marathon goal one day, but

Kerry 4:38

Yeah. They-- It's a commitment, right? I think, as a professional and having the time to do that kind of stuff is a little bit harder. Yeah. But yeah, if it's your goal, you'll-- I have a confidence that you will

Esra 4:50

Yes.

Kerry 4:51

Yeah. I really loved what you wanted to talk about. So what, drew you specifically to wanna talk about jumping, sprinting, power training as a health intervention?

Esra 5:04

Yeah. So I think we hear a lot, especially nowadays, about resistance training and how important that is, and 100%, it's very important for our health and our longevity. And I don't think a lot of people know about or really hear too much about jump training or impact training and how important that, that is for aging as well. There's so many benefits to it, and you'll hear a lot of terms like plyometric training or jump training, impact training, and it all pretty much falls under the same umbrella. It's very also important for our bone density the health and elasticity of our ligaments and tendons, which is gonna, help reduce injury as we get older, and it's gonna help with our cardiometabolic fitness. It's gonna help with our just our building muscle. It's another way to build muscle as well. Helps with balance, preventing falls and ultimately fractures as we get older. So there's so many benefits to it. And a lot of people, as we get older we start... we become less of a kid. We don't do jumping. We don't do that stuff. And it's simple things that we can do every day, and it has a significant impact on our health. And, people look at maybe at others doing jump, maybe box jumps or things like that. They're like, "Oh, I can't do that." But, there's of course a, a level for everybody. Everybody can get into it,

Kerry 6:18

you already took the words out of my mouth. I'm like why are these exercises not just for kids? Why are these for adults too?"

Esra 6:25

Yeah, definitely. So even if we just start with the bone, looking at our bone and what it does for that, so it increases bone density. And when we-- a lot of people think of-- I think bone is like really cool. So a lot of people don't realize that it's, our bone is constantly remodeling, so we're constantly breaking down our bone, building it back up, and it's a process that occurs every single day and, over the course of about ten years, we essentially have new bone. And that's really cool because that means that what we do every day can influence whether we're building stronger bone or just letting it get weaker over time. And we know that as we get older, our bone density starts to decrease, and for women, we see this especially during perimenopause when our hormones start declining, specifically estrogen, and even more after menopause. And in ma-males this occurs too, and we start to see the risks of that a little bit later in their life, but they also start declining about one-- their bone density declines about one percent every year as they get older. And this is important because if we do things every day, we can prevent or minimize the loss in our bone density, which then translates to decreasing the risk of fractures which have significant morbidity and mortality with them. And so we know that jump training or plyometric training that is going to increase our bone density. And there's studies that actually look at like the f- have looked at the femoral neck and the distal radius, I believe, and the distal tibia as well, like looking at those sites specifically. And they've actually seen increased bone density with this type of training over time, which is, really important because, the, especially the femoral neck, like that's one area where we do see fractures, osteoporotic fractures occur. And that's really cool because if we do these things, like we can prevent like fractures down the line. We increase our bone density, and this allows us to live because, for those who don't know, when you have a significant fracture like a hip fracture, that increases, thirty percent of people who develop a hip fracture will die within the first year because of the significant effects it has on your health. You have increased risk of developing blood clots or for just from not being able to move infections, whether UTI because you can't make it to the bathroom, and therefore you're urinating on yourself. And so many other factors that just increases mortality from that first year. And so if we can do these little things to prevent it, like that's pretty cool, so that's one aspect of it. And then the other aspect is that it improves our our I'm blanking right

Kerry 8:59

You said VO2 max. Is that what you were talking

Esra 9:02

So we can go, yeah, we can go into that. So yes, it increases our cardiometabolic fitness, and so that means that it increases our aerobic fitness in general. And you'll notice-- this is something that I've noticed 'cause I'll say like I never really incorporated this stuff until maybe this past year, and I've noticed that, I can run a little bit farther and or, run the same amount and not get as, not breathing as heavily. And so that's something you'll notice within a few weeks, I think, and it'll also increase your VO2 max, which is one factor or predictor of mortality. And our VO2 max decreases as we age, and that's just kind of natural part of natural part of life. But if we can increase it while we can and do these things to minimize that decline, that's gonna increase our longevity as well. And that's really important. Balance is another big thing that this, that jump training helps with. We know that people who practice this practicing these types of movements. And so when we're talking about jump training, this is-- this can be anything from like jumping up and down in place box jumps. It can include just trying to, if you're standing in place and just trying to jump as high as you can, getting that vertical jump. There's so many different things that you-- jump roping, so many things that you can do. But these types of movements and even like lateral jumps or lateral hops, these types of movements will help train your balance too. And balance is something that we we tend to lose as we get older. We also lose power, and those are two things that help us prevent us from falling. And this is, for those of us who like to live independently and wanna be able to do things on our own as we get older, which I think most people do th- this is an important part of training to, to include into your daily life. And, it doesn't take very much either. There's different ways that you can incorporate it into your training. So there's one way is to do fifty jumps every day throughout the day. So the, the important thing about this is like you want a short, like short bursts of high impact activity is gonna be better than trying to do it all at one time because it does take, it does take a lot out of you. And so if you can do maybe 10, really high impactful jumps or some sort of jumping activity throughout the day or 20 in the morning, 20 in the afternoon, and, maybe 10 at night spreading it out throughout the day, that's gonna-- that's one way you can do it. The other way to do it is to do about 10 minutes three times a week of multi-directional jumping. So that's whether you're doing like jumping backward and forward or doing some jump some box jumps or jump roping, but then also doing some lateral jumps or lateral hops just, to get that all that different direction and that really has a significant impact on the bones and the joints as well. So different ways to incorporate it but-- and everybody can start at a different level. So for those people who are like, I haven't jumped in like decades, there's no way I'm gonna do it," or, "I've already-- I'm already like falling and my balance isn't so great." So one way is you can just, number one, if you're sitting down, you can just kinda stomp your like legs really hard and, doing that over time will help increase that bone density and increase the strength of your joints and the tendons as well. And then the other way is you can also just kinda stand at a desk, hold onto something, and then you can do the stomping. You can jump up and down as well as you're holding. That's another great way to do it and just slowly build yourself up and, over time you'll notice that you're feeling more comfortable doing these things. You're building yourself up to move on to the next step, and we're not talking about doing 20-inch like vertical jumps or anything. Even just a typical step, like a stair step is what? Six to eight inches and jumping up and down from that, or you can even stand at the top and just land with both feet on the ground. That's another way to do it. You're really just focusing on trying to get that impact onto your bones and onto your joints and that's really what's gonna help stimulate the response that your body needs to do what it needs to do to make it stronger.

Kerry 13:07

You said so much there. So let me, let me-- so first of all, I hate box jumps for one. It's a mental game for me. I like get scared, and I think a lot of people that haven't jumped in a while, they might be scared, right? But maybe thinking about it as if you're a kid and having fun is one way to start too, right? And I like how you said little bursts and instances. I think we think of this high-intensity interval training and that it all, has to be done at once, and I think that's not necessary for the way that you're, approaching this, right? For the ac-- for the bone health, right? I think that's important. And another thing about the bone health, I think women at least, or actually I think even men, we start-- we have that bone that we're built with, and it's done at in the twenties, right? And I think we slowly lose bone, from then. But if you continue these exercises and things like that, these impact exercises, then you're less likely to do that, and it can reform, like you're saying. And what's unfortunate is, why don't we... or why haven't we screening for poor bone health sooner, right? So basically, the guidelines say to do bone density scans at sixty-five and I think seventy in men, and men mostly aren't. They're completely forgotten. And then it's just too late to do anything, right?

Esra 14:25

Yeah, 100%. It's really unfortunate because it's, at that point you're well... most women are well into menopause at that point, and then especially with the fear of hormones that, was instilled back in the early 2000s, so at that point, you're looking at, un- unless you're doing something about your bone health, most women are gonna have osteoporosis at that time. And while, there's never too late of a time to start, why are we waiting until we've developed the disease to do something about it? Why can't we, why can't we be proactive about this, screen it earlier so that, once we start noticing some osteopenia or weakness in the bone we can really be proactive so things don't get worse. So yeah, I definitely agree with that. It's definitely

Kerry 15:09

Yeah. Intervening sooner with just simple things rather than needing a medication later in life. And I do feel bad for this generation that missed out on hormone replacement. That's clearly an issue. We know that estrogen, helps bone, and if you are having none when you're in menopause, you're gonna have osteoporosis. Certainly if you are a candidate for it or if you want to, for some other side effect reasons, do estrogen, I think it's a great recommendation. It's even FDA approved for osteoporosis, right? When some things it's not really FDA approved for. So

Esra 15:40

Exactly

Kerry 15:42

And like you mentioned earlier, the morbidity and mortality, of osteoporosis with the risk of fracture is real. I would say one thing that you did mention was the balance part of it, and that's a huge part also forgotten. And I find myself sending lots of people to physical therapy because their balance is poor, right? And so they can, get the basics down and then maybe one day start more of the jumping exercises.

Esra 16:09

Yeah. And I think that's a key point is like just starting where you're at and moving from there. I think there's a lot of, with the media and everything like that, everybody looks at these whether it's CrossFit or just really intense like jumping activities that people are doing, like you mentioned, like the box jumps and all, all these other crazy things that people do. And it's yeah, that looks really cool. That's not the only way to do it. And so just normalizing the regular activities that we can do and that's doable for everybody, I think that's really important. So I think physical therapy is like a really great place for many people to start because it gives them some sort of direction because it can be very overwhelming to be like, "Okay, what do I start? Where do I start? What do I do? How do I do it? How often?" And so I think that's a really great place to start just to give them some sort of a framework.

Kerry 16:55

Yeah. Another one I'll say I hate is tuck jumps.

Esra 16:59

Oh yeah

Kerry 17:00

I find very challenging and, but one that you mentioned that is good is the lateral jumps. I think I always like to say skaters are a good example of that one, and those are so good even for kids that need to be doing that because if they're playing these sports that are moving side to side, think about it, if you step off, the stair wrong or you're trying to go out and play with the kids, so many ki- so many people end up, hurting their knee or something in some

Esra 17:24

Yes, definitely

Kerry 17:26

to do these all the time are what are gonna keep you young like you

Esra 17:29

Yes, absolutely. And that is the goal, I think I worked in the ER for a few years, and you would, I would see a lot of young people, like maybe in their 40s 50s, who were like bedbound and not able to get up because, maybe they injured one, their back or their knee or something. And then from there, they never really got back into movement and ended up putting on weight and to the point where things just compile, and you end up not even being able to go to the bathroom by yourself. And, that's not, that's not, who wants to live like that, I think most people wanna be able to at least be able to change, to bathe, to go to the bathroom on their own. And so I think these little things that we can do every day is so important to prevent that

Kerry 18:09

You mentioned power and I don't know, can you speak a little bit more about how someone can work on that if, and why that's helpful?

Esra 18:17

Definitely. So power is really important for function and longevity overall. We lose power faster than we lose strength as we get older. So if we're not practicing it, we're losing it. And so these can be things like, again jump roping, but it can also be like kettlebell swings and it can be ball slams. If you take like a ball and you just kinda drop it really strong, big power, and then pick back up and do the same thing or against the wall as well. Those fast burst quick movements are important for maintaining power, and power comes from like our fast twitch muscle, type two muscle fibers, and those... we lose those quicker. And so if we're not, like I said, if we're not using it, we're losing it. And that translates really well to balance and just everyday function as we get older. And so that's reacting quickly if you trip to catch yourself and get yourself back up or, being able to pick yourself up if you fall, get up from the ground quickly, those types of things. And really important, those short bursts of sprinty type activity. So whether it doesn't necessarily have to be running, it can be anything. It can be, maybe you're on the elliptical and you just go really fast for, ten, 20, 30 seconds and then, slow it down for a couple minutes and then repeat that. The ball slams, the kettlebell swing. So so many different ways that you incorporate power, but so important for aging because like I said, we lose it quicker than we lose strength. And and that's really key to function as we get older.

Kerry 19:44

I'm glad you mentioned, kettlebell swings. They are one of my favorite. Unfortunately, I'm not allowed to do them right now 'cause I have an elbow injury, so

Esra 19:50

Oh no!

Kerry 19:51

sad. But th- that's one of the great moves too. And I think some of those, get your heart rate up too, so you are working that extra zone cardio and mentioning maybe not getting to VO2 max except for the sprints, but I think that's another, doing at the same time, right?

Esra 20:06

Absolutely. Absolutely. Yeah, for sure. Even battle ropes, and I think that would, if you're doing it for 10, 20 seconds, I think that, that would help improve your VO2 max over time. I think that would touch base- touch it a little bit. And definitely benefits to it. And, our heart is a muscle, and so that needs strengthening. And so if we can strengthen it by getting into those higher heart rates, that's a great way to do so as well.

Kerry 20:29

So you mentioned heart, muscle, bones. How do you think this impacts neurological function?

Esra 20:34

Yeah. So once, when we're using these when we're tapping into that extra, whether it's the extra like speed, like higher heart rates doing the sprinting exercises, or if we're working on our balance through different movements, this is all going to require more, it's gonna tap into the muscle and that's gonna pull in the extra neurons as well to oh, what's the word? It's gonna bring in those neurons to reinforce that movement. And even though we may not feel it or realize it at the time, as we get older and once we really need to, for example, if we need to like work on, if we're falling and we're losing our balance, that's where like kind of that neural drive is gonna come back in and remind you like, "Oh, wait, we can stabilize ourselves." So it's, it's almost like it works in the background and we don't realize it at the time, but once we really need it it'll kick in.

Kerry 21:32

It's like that muscle memory thought, right? Like the your proprioception, your balance centers, they kick in when you need it to, support yourself from falling. And if you are, working at these things on an every day or whatever, every week, whatever basis, then you're not going to... You're gonna have that essentially muscle memory to not get injured, right?

Esra 21:53

Absolutely, and that is the goal.

Kerry 21:56

What do we know about these forms of movement and, frailty and sarcopenia and preventing or treating those conditions?

Esra 22:04

Yeah. So I think with all of these movements, we know that-- So sarcopenia, for those who don't know, that's an age-related muscle loss that occurs over time, and there's so many things that go into this. Whether it's nutrition, making sure we're eating enough hormone replacement, if, that's something that w-we are, comfortable with the strength training component. But even with this type of jump training plyometric training, that also is going to incorporate, muscles and that's gonna help improve that. And if we are working on these things, in general, we're gonna develop the strength and the ability to really just care for ourselves as we get older. We're not gonna be as frail because we're gonna be able to catch ourself if we fall. We're gonna be able to do things in our everyday life, whether even if it's just like walking, these activities are all gonna help strengthen our normal day activities, and so we're not gonna be dependent on others. And so there's so many, so many different components of movement and strength training and different things that all come together to help support us as we get older. And so it's important just to incorporate all, little bits of here, little bits of there to, about that whole... It's kinda like the whole picture coming together to support us as we get older.

Kerry 23:25

absolutely. What would you say to the person who says, "Oh, I thought jumping was bad for my joints," or something like that?

Esra 23:34

Yeah, definitely. And if you have not done anything like this in a long time, I would say let's start slow. But it's this ty-- th-this is what's going to allow us... one of the, one of the factors or one of the good things that comes with this type of training is that it actually makes your tendons more elastic and less stiff, which is gonna decrease your injury risk over time. And so this is where you kinda start from the lower side, whether it's just stomping really hard over time and, progressing. But this is actually going to help improve and decrease your risk of joint pain over time. And obviously, if you have some sort of orthopedic, background or if you had surgeries, take that into consideration. But I think there's something that anybody can incorporate that will improve them, improve their health overall.

Kerry 24:26

Who should be cautious other than the osteo- orthopedic or osteoarthrosis or arthritis people? What about other patients with, injury or maybe even pelvic floor issues? Should they have concern?

Esra 24:37

So it's going to be-- everybody's gonna, start from your baseline. Don't push yourself. Don't go from zero to 100 overnight. This is something that's gonna take time, and you wanna make sure you're doing it in a controlled manner, yes, it's cool to see somebody do some crazy, box jump or some crazy activity know your capabilities and your limits. And that's gonna-- that's one of the most important things is start slow and progress slowly over time. You will get impact no matter where you start from. And then with pelvic floor issues, that's a very big concern for females even males too. They also deal with pelvic floor issues. And this is something where you might need to see a pelvic floor therapist to strengthen your pelvic floor to help you do these activities. I think one of the main complaints is that, some females don't like to jump or do these exercises because, they ha-- it'll make them urinate on themselves. And yes, that's not comfortable, and it can be a little embarrassing. But then, you also do see like high level, CrossFit level athletes, who do unfortunately urinate on the floor, and that's, they just kinda move on and do it. So while most people don't wanna necessarily do that, and it can be embarrassing I think you can find a level where you can incorporate this stuff that's not gonna, take you to that degree of urinating on yourself. But you might need to incorporate some pelvic floor physical therapy. I think that's something that is so underutilized but so important. And so we shouldn't let that issue completely limit our ability to do these things. Let's work on both things and strengthen both so that we can do them to a certain degree, so that we can reap the benefits of plyometric training.

Kerry 26:16

My one tip was gonna be definitely go to the bathroom immediately before starting it. I remember going to a trampoline park with my kids and I was like, "Oh boy, I'm going to the bathroom. This is terrible." I couldn't handle it anymore.

Esra 26:30

Yes, definitely. That's a good, that is a good one. Absolutely

Kerry 26:34

honestly, you're right. Pelvic floor physical therapy is highly underutilized and, honestly I ha- was having a little bit harder time in our area of finding someone to refer to. I would, search that out and make sure if that's something that you need that I would look for, Ohio, Florida, wherever you are, right? Yeah. So I know you're also obesity medicine physician in direct primary care. How do you incorporate this in for your patients who are, trying to lose weight or maybe using the GLP-1 or something like

Esra 27:00

Yes, definitely for sure. And for me it's, meeting my patients where they're at. So a lot of times they're coming to me, they're not really consistent with a workout routine. And so it's working with them slowly over time, meeting them where they're at. There's some people who you don't necessarily wanna s- scare them away from you because they, are like-- you don't wanna push them too far. So first we start with let's just work on some walking. Let's work on some maybe incorporating some strength training, but while we're doing that, let's also maybe work on some stomping exercises or can we do little jumps here and there just to slowly build it in. And then over time, absolutely working on incorporating these things because there's so many benefits, not only with, everything that we talked about, but also insulin, it improves the s- insulin sensitivity as well. And that's something that as we get older, and we know that our risk of insulin resistance increases over time, especially with that visceral fat, that belly fat that many people complain about as we get older. And this is something that, we know that like little high intensity interval training really targets that visceral fat really well. And so definitely something that I incorporate in various ways with my patients.

Kerry 28:16

Yeah, obviously if it's building more muscle and using that muscle, it's going to be like a glucose sink and just suck it all in and use it up, so it can be very helpful too. So since we were talking about osteoporosis and menopause and bone health and, weighted impact and things like that, I just want your opinion on weighted vests

Esra 28:39

Yes. So I think they are a great way to boost your heart rate when you're doing normal training. It'll, so maybe instead of walking for 20 minutes before your heart rate kicks up, you can get that a little bit sooner. I don't know how well-- I don't think it does very much to improve bone density. I do weighted vests every morning because that's just an easy way for me to get my cardio in the morning, and I don't have to warm up, before work 'cause I don't have much time. And so I just throw a weighted vest and I go on my treadmill, I do an incline walking, and it just increases my heart rate faster than if I didn't have it, and I don't have to run to get that same, equivalent. And so I don't wanna run in the morning 'cause it's 4:30 AM, and I'm-- have not warmed up because I don't have time to really warm up, and so I use that for that. So I think they're great in that aspect, increasing your aerobic fitness a little bit more, but I don't know that they do very much to improve bone density.

Kerry 29:32

I wonder though, I don't-- I can't remember. I haven't looked at the evidence in a while. But since you're adding weight and some patients who have more weight have, actually pretty good bone density,

Esra 29:43

That is true. That is true

Kerry 29:44

a long period of time, right? So somebody did a study, I think, that they wore like the weighted vest as they were losing weight on a GLP-1, and that they didn't have as much muscle mass loss or lean loss. I don't know. I can't remember. I'm gonna have to go back

Esra 30:00

I'll have to look into that.

Kerry 30:01

And I only bring it up again because once again, like I said, my elbow's injured, so I actually bought my first weighted vest that's way too big on me. But I have been using it because I can't do like straight arm lifts to do like step-ups or any deadlifts or anything. So I just am now modifying everything in every way possible and, I'm fortunate enough to be able to just go buy one and try to figure it out.

Esra 30:26

I have seen that people who do incorporate it with weight training, that there is benefit to that. So I think maybe depending on the exercise, it's gonna affect maybe how much benefit, additional benefit you'll get. But I have seen that with incorporating it into resistance training, you do get that it does help improve some bone density. So with walking it probably... i'm not gonna say there's zero benefit to it. I think it's better than nothing for sure. But yeah I don't know that there's a lot of... I think it's, it might be something that's like a little bit over

Kerry 30:56

yeah, it's

Esra 30:57

are using it maybe, I think that people are using it to replace maybe resistance training.

Kerry 31:02

I see what you're saying.

Esra 31:03

yeah, and so I think that's where if, I think resistance training is gonna trump walking with a weighted vest, but if you're not gonna do anything, I think it's better than nothing

Kerry 31:13

I remember another part of the study was when they were using it to lose weight was that the resting mol- metabolic rate didn't drop when they wore that

Esra 31:24

Okay. Okay. Wow, that's awesome. Okay, yeah.

Kerry 31:28

This wasn't part of them, if that makes

Esra 31:31

yeah,

Kerry 31:31

yeah, but that's a very big commitment. I mean-- I guess maybe you don't have to be carrying around 30 pounds the whole time, but something. I don't find it very comfortable, so there... You're not getting me to wear that on a long walk at this point. But like I said, I don't think mine fits very well. But it is a new fad, of course. It's maybe actually a little bit older from a couple years ago, but it's now back in my world.

Esra 31:51

Yeah.

Kerry 31:52

Yeah. Any misconceptions that you wanna expel from, patients about aging and exercise or anything like that?

Esra 32:00

Yeah, I think for a lot of people it's, "Oh, like it's too late to start. I'm 70 years old. I haven't done this all my life, and what's the point now?" We know that starting at any age you're gonna gain some improvement from it. And so there's definitely no age limit to starting. You can start whenever. And everything can be modifiable to you, whether it's an injury that you've had or your fitness level whatever limitation everything can be modified, so

Kerry 32:25

Absolutely. Yeah, I think it's important to know that. You can follow some video and make up some alternative thing that you could do instead, yeah. What does being stronger than you think mean to you?

Esra 32:37

Stronger Than You Think. I

Kerry 32:39

I think that was one of your quotes.

Esra 32:41

I think it's- it means, you're- it empowers you, to... I think being stronger just is so empowering a- and it translates to different areas of your life, even if you don't notice it. I think it adds small amounts of confidence just knowing that you did something challenging, and I think that's what strength is about, is you're overcoming challenge after challenge, picking that weight up again, running that extra step. All of these things that you think you can't do and then you do them and you're like, "Oh my gosh," "I can't believe I just did that. That was kinda cool." And so then that translates to the rest of your life and, you may not notice it, but I think everybody around you does notice it, so it's so empowering, and so I definitely encourage everybody to give it a try.

Kerry 33:23

Awesome. Yeah. It's like me and that box jump thing. We're heads together.

Esra 33:27

It's very mental

Kerry 33:28

yeah. Do you have anything else you wanna share that you didn't cover today?

Esra 33:34

Yeah, I just encourage everybody to go out and move. I'm a big proponent for strength training and I absolutely love it and I think everybody should do it. But I understand that for some people it, they're not ready for it yet. But, movement in general is so good. We spend unfortunately a lot of our times these days just sitting in front of the computer, whether it's due to work or whatnot. There's a lot of sitting and so just getting out there and moving whether it's just a few minutes around your house, getting a mental break from your computer, going outside, that's, the extra benefit of being outside and getting some sunlight if it's sunny where you're at. But just breathing that fresh air, walking, any- wherever you're at, just, do it. And, motivation is not always gonna be there, but just knowing the benefits that you're gonna reap from it is, so important. And so I encourage you to just challenge yourself a little bit and do something outside of your comfort zone.

Kerry 34:25

I love that. It's a long-term game, but you can start now, right? I have a... Are you standing? Yay.

Esra 34:31

I am.

Kerry 34:32

I'm not, but good job. High five. Awesome. Where can people find you if they wanna follow you, work with you or

Esra 34:40

Yes, definitely. So if you're in Ohio, I do offer telehealth throughout Ohio and soon to be Indiana and Pennsylvania. And I'm on all the social media as Dr. Esra Shermadou Instagram, Facebook, TikTok. I do have a YouTube channel as well. And so yeah, you can find me there. And message me if you have any questions or, anything at all. So

Kerry 35:01

Awesome. Thank you so much for coming on the podcast today. We'll put all that in the show notes

Esra 35:05

Thanks for having me.

Kerry 35:06

Yes. You're welcome back anytime. And everybody, stay tuned next week for next week's episode. Get Healthy Tampa Bay. Bye