Why Women Need to Be Paying Attention to Their Heart Health with Dr. Tara Narula

23:17That's dailylook.com, code GOP.

23:24Gwyneth Paltrow:Do you feel that the sort of pressure to, you know, like in this longevity space and wellness, And do you feel like that pressure can be counterintuitive for people? Like, do you think they have real stress responses to that? I do. I have like, I see several like young guys in finance, for example, who are very much, you know, into wanting to live to, you know, New York City, wanting to live to a hundred. And they come in with literally spreadsheets, spreadsheets on their laptop that they show me of their data. And they will tell me it is, you know, in their quest to sort of be the healthiest and live longest, the monitoring of all this is making them stressed out, right?

24:09So there is this balance between being healthy and living healthy and wanting to live long, but also enjoying your life and not driving yourself crazy.

24:21Gwyneth Paltrow:It's sort of like being focused on outcomes, like on grades. You know, like if you're taking a test, like what is the grade? What is the grade in living your life in that space rather than like I'm going to go sit outside and breathe some air and be in my body and live from that space. It's like when we get stuck in that achievement mode, which I guess can apply to any sector, it is stressful. It doesn't feel good for longevity. Yeah. And you're losing, as you said, like to use your example, I mean, you're not reading to read and, you know, enjoying what you're reading to just learn. You're so focused on the end goal.

25:00And it's that same thing. I want people to enjoy every single day. And sometimes that means that your numbers, you might drink a glass of wine or you might skip your exercise that day. You know what I mean? You have to be human. We have to allow people to be human.

25:13Gwyneth Paltrow:Just reading about, you know, the link between stress, not only on the heart, but on all the systems on inflammation, et cetera, everything, every system in the body, like stress is obviously so bad for us, but we keep so hooked into it. It's like an addiction. It is. And that, I mean, that was so much about why I wanted to write, you know, the book that I wrote was because stress is this like pervasive health issue, public health issue that affects all of us. And we talk about it being bad, but people don't really understand how bad it is that turning on of that pathway of those hormones, the epinephrine, the norepinephrine, the cortisol every single day, nonstop, 30 times a day.

25:57I mean, that's damaging long-term for every organ system, but in particular, the cardiovascular system. So yes, you know, even if in your quest to live longer and be healthier, you're getting stressed out, that stress response is damaging. You're working against your goals of longevity by creating more stress. And we have to kind of prioritize managing stress in this country. And we just don't do a good job teaching people how bad it is. And we don't do a good job teaching them how to kind of control it and turn off the stress response.

26:27Gwyneth Paltrow:I think it would be really helpful if you don't mind for me, and I'm sure anybody listening to break down exactly what happens, right? Because we just like see a text or get a notification and to us, it feels like, oh my God, like, and then you're like, oh, okay, no, it's fine. It's not a big deal. But, but there's a cascade of things that happen, right? Once you have that kind of like hit from that, you're going to, that you're, we're anticipating as bad news or a problem or et cetera. So could you break down exactly what the body does in that instance in the cascade effect? Yeah. I mean, I think the interesting thing is that our stress response evolved to protect us.

27:12So when you look in the animal kingdom and we are animals, we have the stress response to help us survive, but we're meant to turn on the stress response briefly to evade a predator, for example, and then to turn it off. And as you said, you know, we get a text notification or something happens at work or with our child, anything, and we turn that on and we're doing it over and over again every single day. And that's where it becomes damaging. And so what happens is when you sense that threat or whatever it is, you know, it starts in the brain. So everything starts in the brain, you're processing it in the brain.

27:47And from there, you're activating a pathway where you're releasing hormones that ultimately end up causing your adrenal glands to release things like epinephrine, the fight or flight hormone, norepinephrine, adrenaline, otherwise known, and cortisol, kind of the mother of all inflammatory hormones, the stress hormone. And all of that causes things like chronic inflammation. It can cause elevation in your blood pressure, elevation in your heart rate. Those things can damage the lining of the blood vessels. We talked about plaque in the blood vessels that can take a plaque that's stable and make it unstable.

28:23So it can trigger a heart attack, a stroke. It can cause arrhythmias or abnormal heart rhythms. There's actually a phenomenon called a stress-induced heart attack. We see it predominantly in women, women who are older, 90 % of the time in women. And it is essentially from this massive flood of these hormones that stuns the heart muscle and causes essentially damage to the muscle, weakening of the heart muscle. And it is absolutely in the setting of stress. And it doesn't have to be negative stress. We see it sometimes from positive things that just make people excited or overwhelmed, but that really shows you.

29:01Like a World Series win or something like that? Exactly. Or you win the lottery, you know, or something amazing happens. But we think about it, you know, with this stunning phenomenon of the heart, most people will recover, but some people don't from this stress-induced heart attack, but it is one of the most classic ways for us to talk about the damage of stress. The field of stress research is relatively new. It's essentially over the last hundred years. And part of the problem is that the stress research has really been separated, the psychology research, from the practice of clinical medicine.

29:37But we are starting to use, which I think is great, imaging studies to show literally what's happening in the body at the same time. So you can see with a PET and MRI scan how the brain is lighting up, as I mentioned. You can see inflammatory cells being released from your bone marrow, and you can see inflammation in the lighting of your blood vessels. And suddenly, this phenomenon that sounds, oh yeah, stress is bad, we actually see a picture of how bad it is and what is happening in the body. And so, you know, I think over the next 10, 15 years, as we develop this more, and as we talk about this more, hopefully people will start to take stress more seriously and importantly, learn how to dial it down, right?

30:20That's the next step. Well, that's what I want to ask you about,

30:23Gwyneth Paltrow:because now listening to you talk about it, now I'm stressed out thinking about how stressed out I am all the time. So how do we mitigate that? What are your tools in your life, for example, for reducing stress? Right. Well, the stresses we can't, I tell my patients, you can't take away the stressors. You can't take away what's going to happen. But what you can do is change how you respond to the stress. That is really the key. And in writing my book, The Healing Power of Resilience, we really talk about changing a stress response to a resilient response. And so what does that mean? In my opinion, it is sort of the eight tools that I outlined in the book that start with acceptance of something that happens.

31:08So a lot of us rail against negative things that happen. We fight against them. We don't accept them. And that leaves us in that state of chronic stress. So acceptance is really one of the main keys to being able to move on to the next steps. But things like social support, so buffering stress by building your social connections, that's really important. Of course, how you treat your body physically is also going to affect your mind. So the same way that there's crosstalk from the brain to the body by exercising and eating well and sleeping, we physically have the power to kind of dial down that stress response.

31:43Things like therapy, I'm a huge advocate for therapy, I think can go a long way in terms of helping people, whether it's just have a place to unload your stress or to work through things like anxiety or fears. That can be really powerful. There are lots of different ways that we, tools that we can use, but it's very important that we start to think about that.

32:07Gwyneth Paltrow:In the book, you talk about how also traumatic events are stored in the physical body and how that manifests. And I thought that was really interesting to hear from a cardiologist. You don't hear that. I mean, that's like really the next frontier of medicine. And so I was really fascinated by that. Can you tell me how you arrived at that thought? Yeah. You know, for me, it was this kind of work in stress and resilience was so important because I've seen it obviously in my own life. I, you know, have witnessed stress and resilient responses in my family and in my friends. But I think because I straddle these two worlds as a journalist, you know, covering stories and interviewing people.

32:52Gwyneth Paltrow:Yes, on CBS News. And you've won an Emmy and everything, haven't you? I was at CBS, yes, for eight years nowadays. D.C. But in doing that, interviewing and telling stories of people who have really survived unimaginable things and looking at how they were able to move forward in their life was important for me to talk about what are those factors that help people do that. And then I would leave and come to my office and walk in the room and see patients who had just had a heart attack or a stroke or told they had heart failure. And it suddenly became apparent that we just, We need to do a better job really connecting what's happening in the mind and what's happening in the body.

33:32And I think the other main thing was I noticed when I would talk to patients about their new diagnosis, I realized that that is is a traumatic event. And we never say that out loud. We never say that being told you have breast cancer or you've had a heart attack is a form of trauma that causes a stress response in the same way that having your home burned down in a fire is a form of trauma or your business failing. Getting a medical diagnosis upends your whole life. And, you know, my patients would look at me and say, when am I going to be myself again? Over and over, I was hearing this. And it just became apparent that we need to tell people you're not going to be yourself again, but we can help you find a way to still enjoy your life and move forward from this traumatic event and become resilient.

34:22And my hope with the book is really that hospitals and medical centers everywhere build resilience training programs for patients to really buffer them and protect them and scaffold them in those moments where we hand them a diagnosis, we hand them a prescription to learn resilience. How awesome would that be to really help shuttle patients forward and protect them mentally? Because we can't really help them heal. We can't get them to go to their appointments and take their medicine and do all these things if they're frozen with fear or stuck.

34:59Gwyneth Paltrow:Right. And I suppose, you know, if you can leave feeling like you're a participant, like a true participant in your healing and that you have the power and capacity to do that, I imagine it, yeah. I mean, that would be great to have that kind of – I don't feel yet that in Western culture we're good at that yet. You know, like arming a patient sort of with a bigger picture. but I mean I think your book goes a long way to that end you know I think it's a very like the synthesis between a patient and their experience and the idea that they can bring on a set of tools to help them and yeah maybe they're not going to be the same as they were before and maybe that's the wrong question.

35:52Gwyneth Paltrow:It's like, what is the blessing of this? And how can you kind of fold it in going forward and become who you want, like this next incarnation at this point? Right. Yeah. I use the quote in the book of Michelangelo, carving the marble and setting the angel free. And it's this idea that we are constantly being shaped and evolving based on things that happen to us in our life that we can't control, but it doesn't mean our life has to stop and that we can't have joy in our life and meaning and thrive. We have to learn how to do that because the insults and the challenges are going to come at us forever at all different angles.

36:31But at the end of the day, people want to enjoy their life. They want to derive meaning from every single day. And so my hope is that we help people do that by teaching them that they can be, they have resilience inside them. That is an innate gift that most of us have, but we can actually strengthen it and build it just like we build a muscle.

36:51Gwyneth Paltrow:Yeah. You mentioned as well, uh, the importance of heart rate variability. What is heart rate variability and why does mine suck and how can I get it better? So what do you measure your heart rate variability with? A couple devices. I have an Oura Ring and a mattress and an eight sleep. So heart rate variability is sort of the range of your heart rate that we assess over time. And generally, it's a marker of our underlying kind of nervous system. We call it the autonomic nervous system that controls the kind of excited tone and the quiet tone. And you want to see a more varied sort of higher heart rate that generally indicates kind of a better fitness level, at least cardiovascularly, better ability to have recovery from stress.

37:54Whereas that low heart rate variability, we don't see much change in the heart rate over time during the day or night would imply that you're less cardiovascularly fit or able to kind of manage the challenges or stresses of your daily life.

38:11Gwyneth Paltrow:So it is a helpful tool for some people. And so how do we improve it? Is it more cardiovascular activity? Is it, you know, in some cases it is. In some cases, yes. For some people it is improving their cardiovascular fitness can help with the heart rate variability. And in some cases, things like meditation and breathing and some of these other exercises that work our kind of parasympathetic nervous system can also help us as well. So what is this VO2 max thing? And do I need to go put that alien thing on my face and run on a treadmill? Yeah, it's another measure, another exercise, another test that we do to kind of get a sense of your cardiac fitness.

38:54I don't tend to send patients for their VO2 maxes. That's not something I do in my practice, but some of the cardiac pulmonologists or heart failure doctors will use VO2 max or exercise physiologists as well. So it's, again, another tool in the toolbox. But, you know, these are not things, I think generally for most people, the advice is pretty straightforward. We talk about getting, you know, cardio exercise, a moderate amount, about 150 minutes a week, or a vigorous amount, about 75 minutes a week. And that's kind of an easy number for most people to think about targeting and starting with.

39:31Gwyneth Paltrow:I mean, that seems pretty doable. Yeah. I feel like I used to do a lot of cardio. Yeah. And now I'm just so old. You can't be older than me. So you're not old. I'm like, do I really need to bounce all over? Like, I'm just like, oh my God. But I guess it's important to do. I mean, resistance and strength training is important too. And we are talking about that a lot more now. Generally in the cardiology world, we talk about two days of resistance training or strength training being built into your overall cardio. And they're important for different reasons. You know, especially as women, we tend to lose muscle.

40:14It's important for our bones and aging to kind of retain that as we get older.

40:26Gwyneth Paltrow:I've been thinking about this lately. What could your home actually be doing for you while you're not even in it? For anyone with upcoming travel, your place could just be sitting there empty when you could be listing it on Airbnb. And that's kind of the shift, right? Whether you're away for a long weekend, a work trip or a proper vacation, your space doesn't have to just sit unused. It can work for you in a really low lift way. And that extra income can help offset the cost of your trip. If you live in a city that draws people in, concerts, tournaments, festivals, you already know there's a steady flow of visitors looking for somewhere that feels a bit more personal than a hotel.

41:06Listing your space on Airbnb lets you meet that demand in a really natural way, giving people a place that actually feels like home and a more grounded way to experience your city.

41:16Gwyneth Paltrow:So it starts to feel like a smarter, more intentional way to travel, knowing your home is working for you while you're away. Your home might be worth more than you think. Find out how much at airbnb.com slash host. And now, the next chapter of the CERTA Counting Sheep. Hey, Uncle Number One, why aren't we counted anymore? Let me tell you a story. Long ago, CERTA invented the Perfect Sleeper mattress. Oh, no. Oh, yes. It says the all-new CERTA Perfect Sleeper with the Q4 support system has four-in-one perfectly interlinked coils that help relieve aches and back pain for perfect sleep night after night.

41:55Gwyneth Paltrow:We'll never get counted again. Uh, nope. Serta, we make the world's best mattress.

42:05Gwyneth Paltrow:And is there some trick like, okay, you know, be out of breath for 20 minutes? Like, is there some? There's no trick. The trick is to do something you like. So I usually tell people, find something you enjoy doing. So if that's swimming or running or biking or dancing or the rowing machine, whatever you're going to be consistent with and doing it to the degree that you are a little bit out of breath, that's the kind of pace you want to think about. Okay. So it's not like gasping for air. No, you do not. Well, I think that's important because I think in the culture we think, you know, for those of us, it's like, okay, you have to be gasping for air in order for it to be like true heart healthy cardio.

42:46Gwyneth Paltrow:but it's good to hear that's about the case. What happens to the cardiovascular system during perimenopause? Are there changes? Yes, sadly. We do see, for example, risk of cardiovascular disease go up in women post-menopause. So when we take a history of someone and we ask about the risk factors by virtue of being post-menopausal or being over the age of 55 as a woman, you know, is generally considered an increased risk factor. We see things like cholesterol levels go up, post-menopause, blood pressure sometimes goes up. So a lot of these things change around that time. And that's why that's another great time point for women, if they haven't been plugged in with a cardiologist to get plugged in, to make sure that their risk factors are really well managed.

43:39Gwyneth Paltrow:And does, does estrogen, you know, you hear about estrogen has a protective role in brain health, dementia, stuff like that. Does it have a protective role as it pertains to the heart? It's such a complicated, you know, question. I think there's so much interest right now in hormone replacement therapy. And, you know, I think the best guidance we have now is that first of all, it's individualized. And so you really have to look at a woman's risk. Does she have a history of breast cancer or blood clots or you know anything that would preclude hormones but in general you know part of the reason why women women's risk start to go up post-menopause is because we do lose estrogen and estrogen does in some respect have protective effects on the blood vessels but what we think happens is that this is why we call it sort of the timing hypothesis that once you're 10 years out of menopause or over the age of 60 the blood vessels change and at that point if you're add estrogen there may be increased risk.

44:35So that's why we sort of say if you're doing it more around the time of menopause in someone who's low risk, you know, then it's probably fine. Maybe there's some protective effects on things like cholesterol and blood vessel health. But as you get older, it definitely can shift and change. And certainly if you're a higher risk woman, so we know that women, for example, who have cardiovascular disease, so let's say they have plaque in their arteries or they've had stents, they are not really candidates for hormone replacement therapy because that can actually be associated with increased risk.

45:10So I see a lot of women in my practice who come and say, can I take hormones? My GYN is sending me to you to make sure from a cardiovascular standpoint, it's safe.

45:19Gwyneth Paltrow:And you have to assess, there's no kind of panacea. We want to make sure there's no underlying cardiovascular disease. Do they have high blood pressure, cholesterol? What are their risk factors before we kind of make that decision? I get like heart palpitations at night. They say it's perimenopausal. Like what is, what are they? Why are they happening? So palpitations are really common phenomena. They're scary when they're strong. They are. They hurt. They feel very weird. It feels like almost like you're on a roller coaster and suddenly your heart kind of just jumps. Most often when someone says they have palpitations, it's extra beats that the heart is giving off.

45:58So the heart gives off what we call a premature beat. those are not generally considered dangerous at all. We worry when people have a lot of them. So for example, when we give people a heart monitor to wear, we can count how many extra beats they're having. If they're having, you know, a thousand in a day or even 15 ,000, not as worrisome as someone who's having 20 ,000. So first of all, identifying what the palpitations are is key. And that's really with a Holter monitor that we would give someone to wear. And that kind of records their heart rhythm and it lets us see a tracing of what's happening.

46:31The reason it becomes the concerning part is if they end up having irregular heart rhythms. So there are some times where people will say I have palpitations and we do a heart monitor and we find they have irregular rhythms like atrial fibrillation or atrial flutter and those carry with them a stroke risk. So usually if you're feeling palpitations, getting a heart monitor to kind of identify exactly what they are is really one of the first steps. Again, most often it's not anything concerning, but there are times where it could be. We hear a lot about palpitations around menopause, around periods with caffeine, lack of sleep, thyroid problems, alcohol, viruses.

47:11A lot of these things can trigger them. So people may not have them for a while and then suddenly they have them and then they kind of go away and they come back. Very, very common to have palpitations.

47:21Gwyneth Paltrow:Speaking of viruses, you just reminded me about a question that I wanted to ask you, which was this kind of post-COVID. You know, we heard a lot about people who had contracted COVID having more heart disease. Is that correct? Did that end up being right? So we think the COVID virus did affect, does affect, can affect the blood vessels. No question. but the big finding was really with the vaccine and the concern for myocarditis, which is like inflammation of the heart muscle, which we saw in younger boys more often. Any virus can damage the heart muscle or cause myocarditis and COVID itself can do that, can cause inflammation of the heart muscle.

48:07But that is one of the things that we did see with COVID. And now we have long COVID. So I have, we see a lot of patients sometimes who have that autonomic dysfunction, We call it long COVID where their blood pressure might be low, their heart rate might be up, they feel tired, they feel dizzy. And it's all sequelae or phenomenon resulting from COVID. So COVID did a lot of things. It taught us a lot as well about virus.

48:32Gwyneth Paltrow:And how are you able to pinpoint the cause to COVID as opposed to other? You can't, you can't really. I mean, obviously the timing, if they got COVID and then something happened right away. But if it's something where you're sort of putting the pieces together and saying, well, you had COVID and now you have this, maybe it's linked, but there's no way to definitively link sometimes these things together. You know, you talked about the sort of finance bro that you have in your office, this whole fascinating cadre of men, this new breed of, what is the kind of female equivalent of that? Are you seeing sort of a hyper-achieving woman come in?

49:22Gwyneth Paltrow:What do you think culturally the equivalent of that is on our side? Well, if you're in New York City, I think it's different than if you're in some other parts of the country. But yes, I see a lot of women too who, what's interesting is they come in and they're thin and they're fit and they exercise and they eat healthy. and they feel good. And then I'll send them for a calcium score, which is a screening test for heart plaque. And it comes back showing they have heart disease and they're shocked because they say I was doing everything right and I feel fine. And how can I have heart disease? And that's where, a lot of these screening tools can be really powerful.

50:03But yes, I see a lot of women, New York city women who think they have their everything together. And they're really surprised when they find out that they might have heart disease.

50:14Gwyneth Paltrow:So is it, I mean, I know partially it can be genetic, but what's the common denominator? Is it stress? Why are they all having it? I don't think we know. A lot of it can be family history or genetics. And that's why I said it's important to know your family history because you can be doing everything right. But if you have a very strong family history of early heart disease, that can be enough to sort of tip you over. But certainly things like sleep. I mean, I ask everybody about sleep And I would say 90 % of my patients tell me they're not getting seven, eight, nine hours. They're getting much less.

50:46Sleep is a risk factor for cardiovascular disease. Stress, as we talked about. Diet. I mean, a lot of what we eat that we think is healthy may not be healthy. So all of these factors may play into why we see coronary artery disease or plaque in people who we otherwise would have assumed would not have it.

51:02Gwyneth Paltrow:Right, right. Probably a lot of it's environmental, yeah. Yeah. So if somebody comes in and they have early heart disease and it's a surprise, right? Like they thought, wow, I thought I was healthy and I run and I eat well, et cetera, like the sort of the profile that you just mentioned, is it reversible when it's early? And no, it's not. That's the hard part of cardiovascular disease, you know, is that once the plaque is there in the vessels to your heart arteries, you can't take it away. It's there with you forever. And that's why it's so important to start this process early of prevention, because once the disease is there, you can't really get rid of it.

51:47You can maybe have a little regression or pulling back of some of the plaque with medications and lifestyle, but essentially once the disease process is there, you can't change it. And at that point, it's about managing the disease going forward. But you can keep it from getting worse. Yes, you can keep it from getting worse and you can keep it stable. So I have a lot of patients who have heart disease and they're worried, you know, what if tomorrow I have a heart attack or am I going to live to 100? And the answer is it depends. I think there are a lot of people who have heart disease and live to 100 and continue to run marathons and, you know, live a wonderful life.

52:24A lot of those people are doing everything right at that point. It's really a turning point where you have to look at, am I taking the right medication Am I living the right way in terms of my lifestyle so that I can prevent my heart disease from progressing and getting worse?

52:38Gwyneth Paltrow:Tell me a bit about why you decided to write the book. What happened? What was the culmination that you thought, you know what, I need to really sit down and do this? As I said, I think it was just an accumulation of interest in this concept of what allows us to move forward when bad things or difficult things happen to us in life. You know, my father is an immigrant from India. I grew up really seeing his stories and hearing his stories of resilience. I had my own episode in medical school where I lost vision and part of my eye and nobody knew why. And that became a period of time for me where I had to really find my way through something that was the most challenging thing I've ever faced.

53:22And then, as I said, being a journalist and being a doctor and seeing it all around me, I just became fascinated with this. And so when I was at CBS, I said I want to do stories, a couple stories on resilience. And I ended up interviewing psychologists who their whole world is about studying resilience. And they said to me, you know, number one, most of us are really innately resilient. And I thought that's such an amazing fact that we don't tell people. Wouldn't it be great if we told people how strong they are? because so many of us think we're not that strong and we would really fall apart if something happened.

53:55And then in the same breath, they said, and we have all these ways we can build it. And we know this because we studied it in Navy SEALs and we studied it in POWs. And I thought, if you have all these tools, why are we not getting this out there for everybody to use in their everyday life and for our patients to use? And so it was so important for me to then say, let's just put this information out there in a relatable way as a roadmap for people to easily use step-by-step to think through what can I do to build my resilience and explain to them why stress is bad. So it was really a passion of mine.

54:33You know, initially I got approached to write a book about COVID and diets. That was the initial call. And I said, well, I can do that, but I really want to write about resilience. and thankfully that Simon & Schuster let me do that. So it was a labor of love getting this book out there.

54:50Gwyneth Paltrow:It's a beautiful topic and it's a very universal topic. And I think it's great. I just, it makes sense about your dad. I wondered if there was some thread that ran through. He always told my brother and I, no matter what happens, you'll be fine, you'll survive. It's like I hear him in my head. And I thought that just those words are so powerful, just being told you can get through it. Sometimes it's just those words, the shift in our perspective that helps us through challenges. Is there like a particular one or a few wellness practices that really bug you? Like when your patients come in and they're like, I'm doing this and I'm trying that, whether it be, I don't know, IVs, hyperbaric chambers, whatever, I don't know.

55:40Gwyneth Paltrow:Probably all of those. Um, yeah, I mean, I think, listen, everybody's entitled to want to improve their health and to try things. And I think as long as it's not anything dangerous, I don't have a problem with people trying to do better for themselves. I think I get concerned if it's something that might cross the line that might actually harm them. And that's, you know, what would that be? Well, like I said, some of the supplements certainly that can cause liver injury or damage that's, you know, might be concerning. But a lot of the other things that people do, the cold plunges and, you know, the saunas and the probably not harmful for most people.

56:21Right.

56:22Gwyneth Paltrow:So, and when you see like, cause did you see that big Finnish study that came out on saunas that said like reduces all cause mortality by like 30 %? Is that true? Is, can that be true? I mean, maybe. Probably has to be replicated. It's very hard to control for all the other variables that people who use saunas might actually be living healthier in other ways and to be sure it's the sauna that's doing that. But certainly, you know, there may be something to the heat and how your blood vessels respond. And maybe they end up responding in a healthier way because they're exposed to heat. So who knows?

56:59Gwyneth Paltrow:Tell me what your day looks like. You have two little girls. I have two little girls and a golden retriever that's six months. And two careers. And two careers. So I'm up at five and I walk the dog while everyone's sleeping because, you know, they're sleeping and I want to let my husband. With a coffee or a green tea or. That's very kind of you. Yeah, I know. Wow. I walk the dog and then I exercise. So my time for exercise for me is like my wellness practice and stress relief. So I'm up in the gym from like 5.30 usually to, well, if I don't have TV till like 6.30, at which point I go back downstairs and get my kids up and start to get them ready for school.

57:42If I have TV, then I'm usually out the door by 7.10 in the morning.

57:49Gwyneth Paltrow:Oh, you mean, yeah, because you're going, I thought I was picturing you like watching TV on a treadmill, but you mean, no, going on TV. Right. Right. So, yeah. So for the last so I was at CBS for eight years and then briefly NBC and CNN. And then I've been the chief medical correspondent at ABC for the last year. And so I never know from day to day if they're going to want me on the next day. I usually find out the day before. And so, yeah. So it's a lot of preparation the night before to kind of prepare for the segment the next day. But typically, so I'll be up at five trying to get lunch boxes packed, breakfast for the girls, flat ironing my daughter's hair, which she requires me to do in the morning, eating my oatmeal and coffee, and then heading to Hudson Square for Good Morning America.

58:34usually do my segment around 8.05 and then I'm heading uptown to my midtown practice. And I see patients here Monday, Tuesday, Wednesdays from 9.30 to 5 usually. Oh, wow. About 18 patients. It's a big day. Yeah, it's a long day. And then Thursdays I do telehealth for half a day in the morning. Do you do that from home? I do that from the office here. Oh, wow. Okay. And then I do some administrative roles. So I help run the, do direct communications for the Katz Institute for Women's Health, which is Northwell's big women's health program.

59:09Gwyneth Paltrow:Right. So that we have meetings for that. So the days are really busy. And then my husband works across the street from me. He's a plastic surgeon. And so we leave together. Six, yes. And we take the subway home and we all try to have dinner as a family. That's really important to us. So we sit down, have dinner. And then, you know, what's dinner? Sure. So I have a nanny who does it. Yeah. But I order HelloFresh. So she has all the ingredients she needs and all the recipes. And so she prepares the food for us while we're at work. And then we have a, we have Goop Kitchen opening in New York city very soon.

59:48Gwyneth Paltrow:So this is our food delivery service. That's healthy and delicious. So that, that will help you out. I will love to try that. Yeah. I mean, I wish I have number one, I don't know how to cook, but I have no time. but the kits are really awesome. So yeah. And then basically we're hanging out, relaxing together, you know, for the next hour and a half, usually television and then trying to usher my kids into bed, which is like a process. So, and then my husband and I are usually in bed by like 1030. Okay. So yeah, it's a long day, but a full day. Well, thank you so much for joining me on the podcast today.

1:00:27Gwyneth Paltrow:It's been so interesting to talk to you and the book is fantastic and I'm so glad you wrote it. And I highly encourage everybody listening to read the book and don't forget to go to the cardiologist. That's right. Thank you. Thank you so much for having me. Oh my gosh, such a pleasure.

1:00:50Gwyneth Paltrow:Thanks for tuning in. This has been a presentation of Cadence 13 Studios. I hope you'll listen, follow, rate, and review all of our episodes, which are available for free on Apple Podcasts, Spotify, Odyssey, or wherever you get your podcasts.

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