Nutrition Tips for Busy Medical Professionals with Julia Zumpano, RD

I learned what a dietician did. So I was 16 and, and kind of went along that path. And as I, as you know, media has grown. I've noticed that there's a lot of conflicting nutrition information out there, misinformation. I made it a purpose to properly educate people on science backed nutrition information, and that's where the, I created a position of the nutrition media liaison and created a podcast and created an app. So just trying to really educate the public on true science back nutrition. Yeah, that's great. And you know, a lot of people seem to get into like nutrition earlier in their year, like they have find an interest in it. Is there a reason, like, you know, you decide to go down this path. Yeah, definitely. So, you know, I just struggled with personal health issues as a kid, gut issues, skin issues, and I always knew that there was a core root to the cause of it. And

I feel like the root was nutrition and kinda sought help help more in like conventional means and really, you know, we weren't as educated back then on. The impact nutrition has. So as you know, I've evolved in my career and understanding of nutrition, really understanding how it impacts the entire body. Yeah. Great. So one of the, I think the best way to start off this, you know, podcast is really dive into what is a balanced diet. You know, we all talk about, you know, there's all this diet fads out there. Like everybody's up to a new, some something new every single week. Like, can you explain, in simplest terms possible, what is a balanced diet? Sure. I would define a balanced diet is just getting a good mix of your micro and macronutrients through Whole Foods. Okay. And like how, what, could you explain what micro and macro nutrients are? Sure. You gotta start with basics with us. Yeah. Yeah. Macronutrients are the three main nutrients that we gain energy from. So they're known as

macros or carbs, protein and fat. And micronutrients are those nutrients that still provide our body with nutrition, but aren't necessarily essential for just survival or energy. So they might be things like. Vitamin D and calcium and potassium and magnesium. Things we e essentially need, but maybe aren't, we don't need as much as we need of those macros, those carbs, proteins, and fats. Okay. All right. And so, and then I guess the next step would be how do we take that balanced diet and how does that overall, you know, affect our health productivity on a daily basis? Like how do we know also like when our diet is actually causing effect to our daily lives? Well, so, you know, as we know, a healthy diet can really help improve many health markers. So, you know, things like body weight and lipids and glucose and insulin and inflammation. All of those things, you know, wreak havoc on our health, on our, on our body, and the way we feel, our health

outcome, our quality of life. So I think, you know, I, I like to gauge nutrition and, and wellness and health really, not necessarily on. Numbers, but more on the way you feel and optimizing the way you feel optimizing your ability to do the things you wanna do, whether they be physically or mentally. So it's, it's more about overall the feeling you get, in my opinion, I. So to you, you know, we see out there, we're gonna focus again, diet with wellness in there. And we understand that we're going at it from a nutritional aspect here. But you know, one of the components of that is how much we take in. Mm-hmm. And how much should we take in? And we see, you know, in the hospital a lot of times, ah, the 1800 diet, this, that, the other 2100 calories and all these things are thrown out there. The old fashioned food print pyramid that, you know, we used to see as kids growing up. So. Take me, if you will, in terms of caloric intake for dummies. How do we really kind of boil this down and kind of

how do you think about caloric intake? I know that not all calories are great. We'll get into a little bit of that later, especially when you're on call and in the middle of the night, or the only thing you have is hospital food for our residents or trainees that are out there. So walk us through that. Sure. So first of all, if, you know, I have a patient that asks me how many calories should I be consuming? And my first question to them is, well, what are you gonna do with that number? Are you actually gonna count calories? Are you gonna, you know, log them all down? So if it, if you're not going to do that, it really doesn't matter. It's more important to just understand the foods that you're eating and what they're doing to your body and how they may affect your, you know, your energy intake or energy expenditure. But you know, from a. Numbers, perspective, I, the way that I would calculate calories for a, a caloric need for someone is I would use a resting metabolic rates and activity factor, and then I would subtract calories from that equation if there's, if there's weight loss that's

needed. So it's, it's basically like your resting metabolic rate, plus how much are you actually burning to support that caloric need. So is there a difference between men and women? Absolutely. Yeah. The equations are different. We use it's called Mifflin St. Jo. It's more accurate than some of the old Harris Benedict equations, so we use that to calculate resting metabolic rate. Of course, there's more invasive ways of doing it, but this is the most simple way, and men do need more. Okay, so you, you said something very interesting, which I think is such a great point. If you're not gonna do anything about the information or you're not even gonna gather that information, it really doesn't matter. I think that's brilliant. That might be my take home message already for this podcast, but let's just say that you want to be somebody who is into a little bit of the data that you want to try to at least. Somewhat track something. What are the best options out there to, if you will, monitor your nutrition and your health? We, you know, we talk about

weight BMI, you know, body fat percentage, lots of others. Tell us a little bit about this. Well, it really depends on what you're tracking for, right? So if you're trying to lose weight, obviously you wanna manage your weight. If you're trying to build more lean muscle mass, then body fat percentage would be a great thing to track. If you're just trying to track calories and really getting an understanding of how much you're consuming versus what you actually need, then tracking calories would be ideal, or macronutrients would be ideal. So it's really depending on what your goal is. What about how often you should monitor these types of things? You know, you see people get up every morning, they get on a scale you know, maybe they have it in conjunction with some sort of weightlifting program or exercise program, and they're saying if they can lose weight, those pounds you lose or gain every single day here and there that matter. I'm not a fan of weighing every day, I just think it's, it just gets into a cyclical thought of like just being obsessed with a number. And I think, I think

people should gauge more on how they feel. Now, I do think weight is a very, you know, useful tool. So I usually recommend if you're gonna weigh once a week, same day, same time of day, same amount of clothes, same scale. So keep it extremely consistent. But once a week is what I recommend it most. 'cause I mean, you've gotta think about your fluctuations of weight vary so greatly on fluid retention, fluid intake, sleep stress. I mean all those things play a re big role. And then females with hormones, like it drives half of my female patients crazy. 'cause they're weighing themselves every day and I'm like, just don't do that. Bad idea. Yeah. I, I, I think that's a common theme for people who are, you know, especially trying to lose weight, right. You know, is weighing yourselves every day. And you mentioned, just to reiterate, is about, you know, once a week is a good time in the same situation, close, you know, time of day, all those other things. So scale close. Yep. All of it. Yeah. And I guess it's starting kind of turning into like a bit of a MythBusters, you know, a

little bit of a, a podcast too. But, you know, we always talk about is it more about eating healthy is like the stuff that you're intaking versus in your diet or just like the number of calories you're taking in. So people target calories a lot, like I need. You know, so and so calories a, a day, and then we'll eat whatever they want. What do you think about that? I mean, I'm more along the lines of eating healthy because I think the health outcome is what you're looking for versus just looking at weight. 'cause I think when you think about calories, you're thinking about weight, weight alone, because that's what your goal is. I'm reducing calories to lose weight. I'm burning calories to lose weight. Whatever your, you know, way you're handling it, but. When you think about eating healthy, you're really, you know, improving your overall health. You're reducing inflammation, you're keeping, you know, all those health markers in at bay. So I'm really a huge component of just educating on eating healthy, how to do it quickly, easy, conveniently on a budget, and just trying

to really focus on Whole Foods versus calorie intake. Okay. Well, I guess diving into, you know, one of the main reasons that we asked you to come on today is, you know, we, as you know, Scott and I are surgeons. You know, we've went through a long period of training and then even further training and then heavy workloads afterwards. Right. And I think a lot of people in medicine in general, not just surgery. Have trouble balancing a diet, especially in his work heavy op occupations. Why is this difficult and you, we had talked about this prior and you're like, oh, why don't you tell me why it's difficult? Well, you know, it is difficult because, you know, you're, you have different sleep, wake, wake cycles. You have 24 hour calls. You're eating between cases versus established times every day. You're often, you know, stressed out, especially during the training years. You may have, you may have the sleep deprivation from multiple weeks adding on top of 'em. Those are the big things I think that we're trying to balance. And I guess, you know, in general, the question going back to you is that, maybe not specifically in this occupation, but where

and why do people fail in their diets? Like what are the biggest, you know, risk factors for failure? Well, I think you know, to give people credit, there's a lot of. You know, a lot of influencing factors to where what you eat and when you eat. We've built a society around convenience. So most of our convenience foods are loaded with junk and chemicals. They're readily available, low cost can be grabbed at, at any point, at any location in a vending machine, wherever you go. You know, our work ethic is, you know, work and no play, no fun. I mean, it's, it's just, it's a really hard. Life and balance. It's just, it's very, very challenging and let alone in the medical field. So I think that what I think is the biggest reason for failure or is not setting aside time and focus on your nutrition. So it's not difficult, it's just maybe needs to take a little bit of time and focus so. Planning ahead when you have a ti

time off to have snacks available that you can grab, or meals or just, you know, being able to give yourself five extra minutes to go to maybe the cafeteria versus a vending machine. So just, just a little bit of a mindset and a little bit of extra planning I think will really help improve. Your decisions on what you choose to eat and, and how you set up your timing of, of meals you know, with what, whatever's within reason of your lifestyle. But I do think it's all about mindset and a little more focus on nutrition and diet and just setting a little bit of time aside. Okay. And I guess the one follow up question is if you're in that schedule where you're having difficulty planning your meals, like we, there's obviously benefit is scheduled, scheduled interval eating. Where do you, how would you plan your day out if you, you know, woke up at six? I. Maybe you're in the OR from like, you know, seven 30 to, you know, 2:00 PM and then you had like, you know, potentially into 8:00 PM a case

back there. Like, where would you put your calories? Like, you know, I'm not talking about specific foods, but you know Sure. Where would you put everything? Sure. So I would try to first of all, I would start off with if you know you're gonna have a long stretch of time without eating. Anything. I would try to have a really good, well balanced meal before that long stretch, whether it's in the beginning of the day, the middle of the day, night shift, whatever it might be, so heavily focusing on protein and fiber rich foods, and those will carry you on through a long extended period of time. Then when you do have little windows of chances to grab something quick, I would avoid things like sugary foods. Those are going to give you immediate energy. Yes, but they're also gonna crash you pretty quick. So focusing on, you know, fiber, again, like something like a handful of almonds or fiber and fat, something very portable, very easy. So it's just a matter of really having a good balanced meal prior to. That long stretch of time

that you're going to be needing to be very on point, very alert, and won't have much opportunity to consume anything for a while. So Julia, we hear a lot, whether it's in a comedy show or just people that we know that talk about stress eating. And do you have thoughts about stress eating? Is there any data out there about either eating quickly? My wife gets mad because I'm done with dinner in about three and a half minutes, and she would rather just take a, a lot longer time or just eating in general while stressed. What are your thoughts around that? Yeah, I have a lot of thoughts on that. I'm gonna address the eating quick first, so, you know, I'm, I'm also. Very guilty of eating quick, but like my husband says, I do everything fast, so of course I'm gonna eat fast. Everything's done quickly. 'cause of course your, you know, your, your Rolodex keeps going of things to do, but I think it is very important to slow down and eat for, for multiple reasons. One's digestion.

Obviously you eat fast, you're gonna have more gas, bloating, you know, you're not gonna digest your food as well. Also you're not giving your. Brain enough time to your stomach might not be, might be full, but your brain doesn't know that yet. So your brain needs enough time to get that signal that says, I'm full. So it takes about 20 minutes for your stomach to send a signal to your brain so you, you know, if you eat too quickly, it may, may make it difficult to catch these signals. And studies have shown that eating slower helps you make healthier choices. And. Really slowing down, preparing a meal instead of grabbing something quick and consuming it has also been linked to less, significantly less weight loss year after year. So then on the topic of stress definitely I think stress can certainly impact. The how, how much

you eat. So stress is, is, you know, a huge issue. Obviously in our society, our kids are stressed, you know, everyone's stressed. But what happens when your stress is your body pumps out cortisol, and that's a hormone that kicks off your flight or fight or flight instincts. So back in the paleo lith lithic age when stress was life threatening their bodies needed more food to keep 'em alive. Although stressors these days are not life threatening, these stressors still in still stimulate our appetite. So they still cause us to want to eat. And then we typically, we're grabbing things that are very soothing. So we might be grabbing chocolate or sugar or salt, and that's an immediate. Stress relief immediately feel better. But studies have shown that that actually reaction only lasts about three minutes. So you only get three minutes of stress relief, and then the stress come back, comes back, but then you, you know, the guilt and, you know, not feeling good after that eating and then that

cyclical issue over time can come become a problem. So obviously we need to manage the stress, try to slow down our eating habits. Those are a lot easier said than done, but I think it's also coming back to the awareness. You know, I'll. Some little tools I'll have my patients do is like, eat with their non-dominant hand. So it's a lot EAs it's a lot harder to eat fast when you're eating with your non-dominant hand. So I do that when I notice I'm eating too fast or I'll put my fork down. Little things like that. Eating from a very small plate. So then when you're done with that, you have to get up and go back and get more if you want more. So, trying to pace yourself if you have like children or a slow eater, trying to pace yourself with them. And then when it comes to stress, you really have to come up with a soothe. Something that's going to soothe you at the time of stress and try to disassociate the food as a, you know, reliever of your stress. And maybe you close your eyes and take a

deep breath, or you know, you have some lavender oil that you, you know, take a deep breath of, or you take a little, like just a two minute walk just to get away from the situation. So you just have to have. Something to replace that stressful eating with, like something that soothe is soothes you or comforts you. Yeah. You know, I think that's what you said about the trying to take that or need to eat. You know, I think I do that even personally where I, I'm, I'm bored even, I mean, I'm just sitting at my desk doing notes, like after a long day I just find myself eating whatever is, you know, close by and, and large amounts because it's just like been a long day. I'm trying to consume as many calories as possible. I think the next I want to kind of transition into. How to eat in a hospital, because that's where we find most of our, you know, time as a, as a surgeon obviously. So I guess the first question is like, what are your favorite snacks inside of a hospital? Maybe not snacks, but meals, and not every hospital is the same. Not everybody

has the same cafeteria, not has the same vending machines, but like what are your favorite things to eat throughout the day if, maybe, if you can't sit down and take a meal? Sure. So I have to have a disclaimer because I pack all my snacks and bring everything. Okay. I've been at the clinic for 20 years. I've probably eaten here about. 10 to 20 times. So, only because, again, it's, it's a lot easier for me to control when I pack it myself, but I, I'm very versed in what's available. So, you know, of course if you're, if you're having a meal, my favorite would be a salad bar. 'cause you have fresh ingredients and you have a variety of ingredients. So that would be, again, if you have the ability to have a meal, quick, easy snacks would be like a piece of fruit, a sleeve, like a sleeve of nuts. Boiled eggs if they have anything like hummus and veggies cut up, or cheese and crackers, even like whole grain crackers and a lighter cheese protein bars or protein shakes can also make their way in there. So those are some of my

favorites. You know, depending on where you work, obviously some of these are less or more available. But I would try to even like, if you know that none of these options are available to you where you work, it's just a matter of like trying to pack snacks that you can have like in your locker at your desk, or you know, in a backpack that you can grab. And it also will save you time, obviously, from having to go to the cafeteria and get it. So just planning ahead I think is a big one. Okay. Yeah, I mean, I think that's a good call, especially on those, you know, long 24 hour shifts. And, but if you were kind of, if you were maybe, maybe you're not usually up working nights, right? And you find yourself working a 24 hour call every three days or so and you're find yourself up working on doing, you know, consults or traumas or whatever else coming in the door. Like how would you eat on, on call, especially if after you've been awake for the, you know, the day prior. So I would try to space out like little shift little snacks throughout your shift. 'cause you're, you need the the

food, you need the energy, you need to be alert. So I would even try to space them depending on how hungry you get. Like some people are good in four hour increments, some people are good in two one hour increments. But focusing on like protein-based snacks that may include a healthy fat, like I mentioned, like nuts or nut butters, fruit protein bars, protein shakes. Obviously I even have suggested people like buying a veggie tray, putting 'em in like their refrigerator at their office or you know, the unit or whatever, and just like grabbing a few here and there. Same with like a big fruit salad. So just having those things ahead of time, if you have a refrigerator or place to put them is, is very helpful. But like almost just packing a whole bag of multiple whole food based snacks and snacking on those throughout the day, throughout the shift. Sorry. So switching. Is there a way though? I mean we all kind of are go-to you mix and sleep and you're hungry and you don't have much time. And let's face it, there's a lot of us out there

that even with the best wishes we just don't meal prep, we don't do a lot of these things. So. How do you self-correct when you realize that your diet's poor? And is there anything that seltzer, you know, I've heard people say, well, I'm gonna do this intermittent fasting. Mm-hmm. And and I wanna kind of see what that's about and, you know, I'll just fast during the day and then I'll go and crush it at night or do whatever. Any thoughts around those? Well, I'm a huge fan of intermittent fasting. If done properly, I think that as long as you're fasting within the right hours, so like if you're fasting throughout. The time that you really need to be alert and aware that may not work the best for you. I mean, everyone reacts to fasting differently. Some people get more mental clarity. Some people just get more lethargic, kind of angry, irritable, hungry. So you have to kind of gauge how you react to fasting and then how many hours you're fasting. So that also can look different. When I have patients that do shift work, I.

Give them shifts of fasting. So I give them a longer period of fast on their days off actually, and shorter fasting periods when they're working a shift because I'm trying to support their energy level during the shift. So it's just a matter of. Kind of, you know, really kind of playing around with what works best for you. I mean, the best way to intermittent fast is to follow your circadian rhythm. So like, you know, obviously eating with the, when the sun comes up, stop eating when the sun goes down. That's ideal. Obviously, someone who's working 24 hour shifts, that's, that's not necessarily possible. So I would say just trying to. I mean, this is where a dietician can really be helpful is sitting with a dietician and like how walking through some of this they can give you specific times to fast specific snack ideas, meal ideas, et cetera. But I do think fasting works very well for a lot of people

to kind of manage their appetite and, you know, manage insulin levels, blood sugar, of course weight too. So just a little thought there though, for those of us who feel like I have a tapeworm and I'm constantly hungry, can you get used to fast? Is there ever a point where you're like. Hey, I'm not starving all the time. It just, it's, that's the very difficult concept for me. Yeah, I, I do think that you can, but I, I can't say enough that I think there are some people who just don't do well with fasting and someone who's always hungry. I wouldn't have them fast, but I normally see the natural rhythm of how people eat their meals, and if they're the type of person who naturally just consumes one to two meals a day. They just feel more comfortable in that setting and having like a lack of food for a while. Then those are the types of people who are gonna be more successful with fasting. That's just their natural rhythm. That's the natural way that their body has reacted to, to things. Like I even think about myself, like I've never ate breakfast, never

wanted to eat breakfast. Even as a child, I do better not eating breakfast. I just feel more alert. I feel better. I feel lighter. So, I mean, I usually, my first meal's between 11 and one, and I'm fine with that, but some people can't manage that and, and there's a lot of truth to that. You have to listen to your body, you have to listen to what it's telling you. It's your, you know, it's your number one coach on how to survive. So you have to listen to it. And then we back up just a little bit here and talk about, you know, a couple of the challenges, right? We've, I think we can summarize it as a, a time issue in the hospital and outta the hospital, and also like a preparation issue. So, and then it might be a financial issue, people especially so in training, so. Like, the two things I wanna ask you about is that how do you eat on a budget? You know, maybe you're, you have you are working through some stuff and you gotta try to figure out how to make a meal plan on a budget. And also what about meal prepping? You know, that's a big thing currently. I think a lot of people in medicine already do that, but what are your thoughts on

it? Love both of those ideas. You know, on a budget is super tough these days. I mean. It's just the price of groceries is insane. But I would shop bulk if you can, especially for dry goods. That's easy. Like, quick, easy snacks, shopping, bulk. You know, obviously pre-packaged things are gonna be more expensive. So if you're buying, like I mentioned, packing snacks from home, like getting a big. Container of, you know, almonds and separate them, separating them in bags, although time consuming is gonna save you a lot more money if you're, you know, instead of going to the hospital and buying them from there. So that's gonna save a lot of money. Meal prepping. You know, I like. I've had a couple patients and who's have had a lot of success is they may have a group together and they meal meal prep in a group. So maybe you take, you know, a bunch of residents that might be off on the same day and you guys all get together and you make a bunch of meals and

distribute all those meals amongst each other, and then you have 'em for the week. I love that idea, whether it's within a family or within a neighborhood or within a work environment. I think that's a great way to go. So everyone kind of brings one meal to the table and then makes enough for all the, all the people involved in the meal prep. And then everyone gets, let's say four different meals or five different meals and they've only paid for one. Love that idea. Obviously going to the grocery store is gonna be a lot less expensive versus takeout. Or you know, people always think like, oh, health food is so expensive. Well, I always tell people, like, calculate all the, the money you've spent on things like soda or sports drinks or coffee or snack foods that do nothing to your body, like chips and pretzels and crackers and bars and granola bars, and see how much money you spend on those. 'cause those foods are expensive. And if you eliminate all that, you'll have. A couple hundred dollars to spend towards healthier food

or maybe even to hire a meal delivery service where you have a fresh meal at your doorstep or a meal that you can prepare within 20 minutes or less. So it's also a lot about budgeting. So I'll sit down and, you know, calculate like how much a case of soda costs and how much this bag of chips costs. And people don't realize 'cause it's just kind of what they fill their cart with. But, I'm not denying the fact that healthy foods, it is expensive. It is true, but there are a lot of healthy foods that are not expensive. Yeah, I think that, you know, if I could take away a lot of things, anything from this so far is that, you know, we, we tend to scope in on the things that we don't necessarily want to buy. 'cause nobody, you know, inherently wants to eat healthy unless that's like, been something your entire life. If you're trying to change your diet Yeah, definitely. And you, you forget about all the other stuff you're already paying for. I guess that kind of moves into our, our last part of this is like. Why should we care about our diet, especially people in medicine, you know? What's the

data showing about physicians that are overweight that have the comorbidities, diabetes, cardiovascular disease, and stroke? Yeah, so I mean, the data's there, right? That, you know, we're looking at like, the 2007 Physicians health studies show that 40% of the 19,000 doctors were overweight, 23% were overweight. Obese. A more recent study of male physicians revealed that 44% of them were overweight, 6% were obese. So research has shown that doctors are, you know, susceptible to the same kind of triggers, if not more stress at home. Skipping meals, grabbing junk food from the office. I mean, overeating, sedentary, 10, sedentary behavior. I mean, there's. Definitely, you know, a, a lot of challenges there. And, you know, well good news is that physicians are a little less likely than an average American to be overweight or obese, but they're definitely not

immune to that risk factor. And another thing that I thought was really interesting is that it turns out that a physician's body mass index may be strongly associated with. He, how he or she counsels patients about obesity. So while normal weight doctors and obese doctors are equally as effective in diagnosing obesity. Normal weight doctors are significantly more likely to counsel their obese patients about weight loss. So it's also a service that we need to do to our, for our, you know, patients to be healthy ourselves. So we can continue to help promote that. 'cause anything you do yourself and you are successful with, you're more likely to promote. It's just the way we're designed. And you know, I think also like making a movement and a change. I mean, at the Cleveland Clinic we have. A lot of good, healthy options. I mean, we'd have, we definitely have some unhealthy options, but they've made a huge movement since I've been here. And we used to have McDonald's at the Cleveland

Clinic. You know, we've eliminated a lot of the junk food, snack foods, unhealthy food products, and really replaced them with reasonable healthy food choices. Of course, there's. Some improvement we could still make, but it's consistently being improved. So every time I go to the cafeteria or the little convenience store that's open all night, I, I do, I am impressed by the, the improved health options. And I think that making a movement to try to have more healthy, available food items, you know, in, in the hospital. So Julia, information is key. And knowledge is critical to making some of these changes. So what resources, books, guides, apps, anything that is out there, obviously I would be amiss not to not. And again, full disclaimer, I worked at the Cleveland Clinic but really congratulate you on a, a lot of the great work that you've done in this space, really coming up with again, the Cleveland Clinic Diet and, and the app and stuff. Can you talk a little bit about resources? So we did just

launch a Cleveland Clinic diet app. There's two plans that are available, a bodyguard, which is just general health decreasing overall risk factors for chronic diseases and decreasing inflammation. And then there's a bo heart smartt. Plan that's more geared towards cardiovascular health. So that's a great resource and just being able to log your nutrition. If calories are something you really wanna know about, that's a great way to write down what, have a log system of what you're eating, and then be able to have a, a numerical value of your caloric intake. And then there's health Essentials, which started as a blog in the Cleveland Clinic, but it's, they, they, we do podcasts outta there. Just launched a Nutrition Essentials podcast as well as a ton of great information. So, I mean, millions of recipes. Pretty much searching any topic on health essentials. You'll find an article on it and all written by health professionals data research based. So, those are two great resources that, and the podcasts

are great because again, who has time to read a book? So those are nice to be able to listen to and they're short, which helps. Well, Julia, I really appreciate you coming onto podcast today. Honestly we talk about diets so much when, you know, especially when people feel like they're falling off the wagon. So I think. The things we talked about today were, will be really helpful for people that can quickly listen to this on their drive to work one day. Hopefully make some changes in their life. Yeah. And I wanna want add one note. Definitely use your registered dieticians. Hmm. I mean, every hospital has 'em. So they are a world of knowledge in the form of nutrition. They can help you personally, they can help your patients great with resources. So, you know, utilize them a, a for a personal and from a patient care perspective. I just echo what John said and truly appreciate you coming on here and going through just this first part of this overall wellness and with the focus on nutrition. So from all of us to you, I hope you dominate the day. Thank you so

much for having me.