Gladden longevity — Episode #10

Speaker 1: The Living Beyond 120 Podcast has transitioned. Welcome to the Gladden Longevity Podcast, with Jeffrey Gladden MD, FACC, founder and CEO of Gladden Longevity. Our passion is answering three questions. How good can we be? How do we make 100 the new 30? And how do we live well beyond120? Our mission is to share with you impactful and actionable information to equip you to optimize your longevity, health and human performance, as you strive to make 100 the new 30. We thoroughly enjoy our conversations and the opportunity to include you in them and trust that you find them informative, enlightening and thought provoking. As a reminder, the Gladden Longevity Podcast is provided for informational purposes only. It does not constitute medical advice. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a physician or other qualified health providers with any questions you may have regarding a medical condition. The use of any information and materials linked to this podcast is at the listener's own risk. Now, let's get to today's episode of Gladden Longevity Podcast. 

Dr. Jeffrey Gladden: Welcome everybody to this episode of the Gladden Longevity Podcast. I'm your host, Dr. Jeffrey Gladden reformed cardiologist. Today I'm going to be joined by Autumn Calabrese. I met Autumn about a year ago. She's a fascinating individual, and it turns out that she's one of the most viewed super trainers on the Beachbody On Demand platform, I believe she has over 140 million views. Despite that, she didn't start off with 140 million views, she really started off in a very humble way. And I think in addition to that, you're going to be very intrigued by her own personal journey and story around health, fitness, anxiety, depression, gut health, et cetera. And as usual, we'll be diving deep into some of the science, but I'll also be making it very actionable for you as well. So Autumn really opened up to us about her struggles with anxiety and depression, and also about weight gain, weight loss, all of these things happening while she was actually eating what she thought were healthy foods. And in addition to that, in working with Gladden Longevity for the past year, she's learned a lot about gut health to the point where she's actually bringing forward a program onto the Beachbody platform. And also she had some real insights into her thyroid genetics and her thyroid testing that really opened up new vistas for her in terms of her own fitness, body composition, et cetera. I think you're really going to enjoy this episode. If you do, feel free to download, subscribe and share it as well. I'm really excited to be here today with Autumn Calabrese from Beachbody. And she is a very intriguing person actually, she has quite a story that I think we're going to dive into here in terms of her own journey towards health and fitness. And many of you know her as being a guru around fitness and health, but we're all human at the same time. And so just like I went through my own, getting sick and then figuring it out after two and a half years and moving forward with Gladden Longevity, Autumn hasher story too. And I think you'll be intrigued by that if you haven't heard it in a more concise fashion. So Autumn, welcome to the show. 

Autumn Calabrese: Hi, Dr. Gladden. Thank you for having me. I'm excited to be here with you guys .

Dr. Jeffrey Gladden: Yeah, likewise. So tell me a little bit about how you got started on your journey here with health and fitness and what took you to Beachbody and all that sort of thing. How did that all work out? 

Autumn Calabrese: Yeah. I feel like it's just been a part of my life since I was a kid and both sides of the health coin actually have been there since I was a kid. Grew up in a big Italian family, all the meals were home cooked. Can't say they were always probably the healthiest, in fact, the only real vegetable I remember eating as a kid was salads on Sundays at my grandma's house made with iceberg lettuce. But I was a super active kid, Energy Galore, was always on the go, ended up as a competitive dancer. That's what I went to college for, so I was always very much into the fitness side of it, moving my body. I knew from a very young age, I wasn't going to have a desk job that didn't really suit my personality. I loved helping people and teaching people. I was an assistant dance teacher through high school and college and things like that. So there was always that teaching side there for me, but the nutrition was always a learning point for me. I was raised by my dad and living with my dad, like I said, we ate one way. My dad owned an Italian restaurant that was pizzas, pastas and subs. And my active lifestyle and some genetics probably worked in my favor for me not being a super overweight kid based on the way I ate. But then puberty hit and I definitely did have that puberty struggle with weight gain and things like that and feeling very uncomfortable in my skin. Went to live with my mom when I was16, my mom ate very differently than my dad. It was-

Dr. Jeffrey Gladden: How'd she eat, what was that like? 

Autumn Calabrese: Hers was definitely the healthier side of it. Hers was definitely the skim milk, not 2% milk, lots of veggies in the refrigerator, salads every night at dinner, but it was spinach and mixed greens with bell peppers, fruit, just a lot more of the variety things. So coming out the other side of puberty and starting to eat like that, I definitely saw a change in my weight, which is really all I ever, when I was younger, equated it to. I don't think at a younger age, you're equating it to, am I healthy or not healthy? It's just am I a size I want to be or not? 

Dr. Jeffrey Gladden: That's right. I think that carries through into adult life for a lot of people. They really focus on weight. It's all about weight, weight, weight. And I think you and I both understand that it's really more about body composition than it is about weight. Everybody needs some fat on their body, you don't want to be a bodybuilder with 2% body fat. That's not exactly healthy. But that being said, a lot of times women if they have a body fat percentage around 21%, 22%, 23%, that's considered to be quite healthy. For a man, maybe 15%, 16% would be quite healthy. And you can scooch that down a little bit if you're going that direction. But I think too many people actually obsess about weight and not enough about are they building muscle and optimizing body fat and where it's located, that sort of thing. So it sounds like you were caught up in that weight thing, but you probably have transitioned from that over time.

Autumn Calabrese: Yeah, I definitely was. When I really started to transition away from that was actually when I became a fitness competitor in my 30s. I already had been focusing way more on, I was a trainer, I started training in my 20s and I definitely had already been studying nutrition. So I was learning more and more, but I didn't really, to be totally honest, make the switch to it being about body composition and I need fat and it's okay for the number on the scale to go up because I'm building lean muscle until I became a fitness competitor. And I was blessed to have really great coaches as a competitor who didn't believe in starvation diets and things like that. And we actually probably ended up eating more. And that's where I really learned like, oh, when you eat to fuel your body and the workouts you're doing, you get to eat more and you get better results for it. And that's how my nutrition program ended up developing. That's how portion fix ended up developing and coming off of fitness competitions and creating that is how I ended up with Beachbody.

Dr. Jeffrey Gladden: So you're really a pretty competitive personality is what I'm hearing. You started-

Autumn Calabrese: Yes, I am.

Dr. Jeffrey Gladden: Dancing competitions and then fitness competitions. So what kind of dance were you doing? Was this like ballroom dancing or? 

Autumn Calabrese: I did everything. No, jazz, ballet, modern, tap, although I was never good at tap. Jazz was my strong suit, jazz and hip hop that's what I had always wanted to do. But that was never really stacked in the cards for me to do it professionally. I have a lot of misalignment issues that have been there since birth. I have a bulging disc in my lower spine, my hips are very uneven. And by the time I left college, I left college with one semester to go because my back was so bad that I sneezed and collapsed to the ground and was just laid out for two weeks because the amount of inflammation that was around that bulging disc.

Dr. Jeffrey Gladden: And was that just a function of all the competition and all the training and things like that, or was it a function of you were injured or you were exacerbating an underlying misalignment to begin with or what was going on?

Autumn Calabrese:I think it was probably a combination of many things. It's hard to say because the type of doctors I have access to now is not obviously what I had back then. The only thing I was told when I went to the doctor was I have a bulging disc. If I keep dancing as much as I'm dancing, I would be in back surgery before I was 21. I was 18 at the time. And I knew that wasn't an option. My dad had had back surgery on his bulging disc when I was a kid and it did nothing for him. I really think what it was was ballet for me probably did not help with the excessive arching backwards and the different positions we put our body in. I was dancing six hours a day, I was waiting tables. So it was probably a lot of over training. We did not have at my college, the physical therapy or access to PTs that we probably should have. And I think it was also not understanding the proper way to train my body, to counterbalance what was happening with the types of movements I was doing with dance. So it was a lot.

Dr. Jeffrey Gladden: Exactly. I think that's a critical point too, that too much of a good thing is not a good thing. Too much of a good thing is a bad thing. And I think it's also really important for people to be aligned. I think a lot of people ignore that. They go for a run, their gait isn't even, their back is misaligned, their SI joints are out of position, one leg's longer than the other. All those things can be evaluated pretty effectively by a good chiropractor or a physical therapist or somebody related to that area. And I would just encourage the audience that if you're going to take up exercise, that you don't underestimate the need to make sure that you're in alignment and that you're doing exercises that actually keep you in alignment in addition to what it is you want to do as an exercise program. So yeah, interesting.

Autumn Calabrese: Yeah. I see my physical therapist twice a week, every week. And if I don't, for whatever reason, see him, it catches up to me very quickly.

Dr. Jeffrey Gladden: Okay. There you go. So you are human after all.

Autumn Calabrese: Yeah, I am.

Dr. Jeffrey Gladden: Okay. So then you're in your thirties and now you're doing fitness competition. What does that look like? What were you lifting weights or doing gymnastics or what-

Autumn Calabrese: Oh yeah. No, the competitions I did were referenced as bikini competitions. That's what you wear onstage and you're training a lot. I was training three hours a day, five days a week, mostly weight training-

Dr. Jeffrey Gladden: Okay. So this is like the swimsuit fitness. This is like the lower level of body building if you will, but it's more like body sculpting competition.

Autumn Calabrese: Correct.

Dr. Jeffrey Gladden: Yes, okay. Understood.

Autumn Calabrese :So six months of prep, perfect nutrition, there's no [inaudible 00:12:22], I guess you could [inaudible00:12:24] of course, but the competitive side of me is I'm not taking the stage without knowing I put110% behind what I did. And I competed more multiple times over the course of about two, two and a half years, which I loved it. It was amazing. But-

Dr. Jeffrey Gladden: What did you love about it? It sounds like a lot of hard work quite honestly, so what did you love about it?

Autumn Calabrese: I think that I'm driven by that. The hard work, schedules regimens, knowing what the plan is and sticking to it, that for me is my sweet spot. I have no problem with the work as long as I know this is the plan, steps A, B, C gets me to where I want to be. When I know that, there's not a whole lot that's stopping me from doing it.

Dr. Jeffrey Gladden: No, I get that. So once you have confidence in the plan, you're able to move forward. And I think that's actually true for a lot of people too in the audience, once they have confidence in the plan. I find this is true in health, longevity and performance is that a lot of people end up questioning the plan in the sense that it could even be working with us. But certainly if they're not working with somebody that's looking at the big picture, they start to get a little bit skeptical and then they start to fall off. So I think really one of the things that we do, and I think that you do for your clients is to give them a sense of confidence, quite honestly. We actually understand what's going on with you, and this is really the way forward. So, yeah. So that's interesting. So it sounds like you've taken some of that or a lot of that, and then ran with that forward. So after you were in your 30s doing the fitness competitions, what happened after that?

Autumn Calabrese: It's crazy, everything was going great. I was competing, I had won, I ended up meeting with Beachbody being brought on board with my nutrition program, creating a fitness program to go with it. That program was 21 Day Fix, it was a monstrous success. I think we all had high hopes that it would do very well. It did beyond expectations. It's been one of their top performers for eight years. It's helped millions of people on their fitness and nutrition journey and really understanding how to take a healthier approach and mindset to food and not have this all or nothing and restrictive attitude about it. Everything was going great and from the moment I signed with Beachbody, I was working. 21 Day Fix did amazing. A year after that launched, I was developing 21 Day Fix Extreme. A year after that launched, I was developing the Master's Hammer and Chisel. And a year after that launched, I was developing Country Heat. And by the time I was developing Country Heat, it was my 35th birthday. I was on top of the world, hugely successful programs, life was going great. And then my body did a complete 180 on me out of nowhere. My physique felt great, I felt great, and the week of my 35th birthday it was like a switch flipped. I am prone to anxiety, but all of a sudden my anxiety skyrocketed off the charts, barely manageable, barely functioning anxiety daily. While everything around me was awesome and I should have been in the best mood walking on Cloud Nine, like I had been the last three and a half, four years. I was sleeping into a very deep, dark depression and I couldn't figure out why. I knew I was like, this doesn't make sense. I actually started losing weight, which was not good for me. I'm Small, I don't have weight to lose. So having 3, 4, 5 pounds fall off me when I'm eating the same and training the same was a big indication that there was an issue, which we couldn't figure out what it was. And even though I was losing weight, I was also losing my muscle mass. So I started to look pretty sick and people were commenting that I looked anorexic, I must be bulimic. How can I preach health and fitness when I look the way I do, which made everything that much worse because I knew something was wrong. And I started seeing doctor after doctor, after doctor, and they would run my blood work and they would tell me nothing's wrong. You're numbers look great, healthiest person I've seen in a long time. And I would just come home and cry because I was like, I feel like I'm dying. I feel like somebody is going to find the cancer card or the something card and they just haven't found it yet. Because there's just no way at 35, I should feel this bad out of nowhere, doing all the same things.

Dr. Jeffrey Gladden: Had you had a history of some anxiety and depression in the past too coming through your teenage years or in your 20s or anything like that? Was this really the first time or?

Autumn Calabrese: Not really depression. Although it runs in my family, I hadn't really experienced the depression side of it. Anxiety, yes. But my anxiety, when I would have it, I knew how to manage it. I could always manage it, I could manage it through just my breath work or exercise, things like that. The anxiety was so bad it actually put me in the hospital coming off of a work trip because I couldn't breathe. The pressure on my chest was so heavy that I was like I must, and I was on a plane. So I literally was on a plane from Florida to Los Angeles. So cross country flight, I had to wait. I landed, got in my car and drove to the hospital.

Dr. Jeffrey Gladden: Yeah. So this is an interesting point too, that it's not all about physicality. It's really about what's going on between our ears. That's really so critical in this whole journey and figuring that out. I had suffered with some anxiety as well in my story and it would lead to depression and I would just feel like I was going over a cliff and there wasn't any saving it. You couldn't talk yourself out of it, you couldn't think your way out of it. You just went over that cliff. And that was dramatic. And for me, it turned out to be awake up call, but also linked to my genetics and some predispositions that I had genetically and things like that. And once I sorted out what to do about it, that really went away from me. So here you are, you're 35, you're starting to deal with anxiety. What happened next?

Autumn Calabrese :Honestly, it was two years living like that on a daily basis. It was exhausting and it was exhausting to put on the brave face and really not let people know what was going on, because I just felt like nobody was going to understand how good my life was around me that I could have a complaint in the world.

Dr. Jeffrey Gladden: Yeah. See, this is a really big misconception is that if the life around you is good, that you have "no reason" to be anxious or whatever it is, fearful or whatever might be driving and even depression. But in actual fact, the way our psyches are built is completely different. Actually our circumstances that are around us, they do contribute somewhat, but they're really a much smaller part of the equation than what we experienced as kids growing up, genetically how we're predisposed, that's basic sense of safety and security. So I think that people really need to know that they're loved. That's really key, but I've also learned that people need to feel like they're actually really secure and those are actually two different things. They compliment each other, but they're two different things. You can feel loved, you can love yourself, but if you don't feel secure, you can still end up with a lot of anxiety. And so that's a really interesting thing for people to understand because your life circumstances, whether they're "good or bad," doesn't really have to define your sense of security. That's really internal work that you can do to get there.

Autumn Calabrese: Yeah. And that probably did play a part of it, because just the way I grew up, everything was uncertain. So I think even doing well, for me, it's taken a lot of work to not be waiting for the other sugar drop going it's doing so well, how long can you stay up here? I better work harder to stay up here.

Dr. Jeffrey Gladden: When does the bubble burst? When does the balloon get popped?

Autumn Calabrese: Yeah.

Dr. Jeffrey Gladden: Yeah. Okay. There you go.

Autumn Calabrese: But it was about two years of feeling that way. Seeing a lot of doctors, getting no real answers. And actually probably by the time I was 37ish, because I had been doing so much research on my own, I had actually taken this year long course through the Integrative Institute of Nutrition, trying to learn more about nutrition. And like I said, it's year long and it's doctor after doctor, after doctor leading doctors in their fields, different fields, but all in their fields. And as I was taking that course, little things kept coming up that sounded like what I was experiencing, which sounded like gut health issues. And I was struggling to even find a doctor, which is crazy in LA that I could reach out to about it. I actually tried to go to a doctor in New York, but that doctor was booked for months in advance. I finally ended up finding a natural path here in Los Angeles. She had gone all the way through school, but then went on to study the more natural side of it. And I met with her for two hours and it was the first doctor that actually sat with me for a long time and listened to everything that was going on. Then she took a lot of blood and ran a lot of tests and turns out she had run food sensitivity tests. And when those results came back, she called me and she said, wow, this is really bad. Your gut health is really bad. In fact, it's so bad you are malnourished. Your adrenals are completely tapped and exhausted, your B vitamins are gone. You're eating healthy, but you're not absorbing anything. The crazy part is my sensitivities happen to be towards really healthy food that should be okay for people to eat, but just for me they're not. Eggs, nuts, flax seed are my three big ones. And those were things I ate everyday. So-

Dr. Jeffrey Gladden: This is a really important point that you make. This is a very important point because people get hung up on it's a healthy food, but in actual fact, you never really know what's healthy for you unless you go through some testing. To look at food sensitivities, gut health, your digestive system, how well are you able to digest things, et cetera, you have leaky gut and all that. And then when you have those problems, it becomes a positive feedback loop, but in a negative direction, in the sense that inflammation's leading to more problems, to anxiety then you eat glutamate, that all of a sudden your brain gets activated. It really becomes a pretty complex circle of things that can trigger this for people. So just in the audience, you should understand that this is a knot that needs to be unraveled. It's not just, well, I'll try staying away from dairy and gluten and see if that fixes it. It's usually more complex than that, although that's helpful. So anyway, that's interesting. So you figured out that your gut was really not only suffering probably from all the stress and strain that you put on it, but also then contributing to all the anxiety and stress that you were feeling.

Autumn Calabrese: Yeah. And that was the first time that I really started to put that connection together. That because my gut health was out of balance, this cascade of other things, not physical, meaning not my physical appearance, were also happening, the anxiety, the depression, the panic attacks. And so I worked with her for a long time to just start to get that under control, take out the foods that were causing the huge problems for me at the time to give my body a chance to rest. Started supplementing with the vitamins and things that I was incredibly deficient in to try to bring those levels back up. And what's interesting is within about a week or two, it took me a minute to even realize it, but within about a week or two of doing that, of getting rid of those foods that were obviously hurting me and starting to put the vitamins back in, the anxiety dropped significantly and the depression. It was again like the light switch flipped where one day it was flipped on, I woke up one day and it was just not the there. And I thought, well, that's weird. I wonder if am I out of the woods, am I over this kind of thing? And obviously slowly but surely, I realized okay, I am heading in a much better direction. I do feel better, the happy me is coming back. And it has not been a short journey.

Dr. Jeffrey Gladden: No, exactly. The other thing about that too, and there are a number of papers in the psychiatric literature that have been written about the fact that depression is actually a disease of brain inflammation. And certainly when you have gut inflammation and a leaky gut, it's almost synonymous, what's called a leaky blood brain barrier. So the brain is walled off from the rest of the body, by this single cell layer barrier that protects it from toxins and bacteria and other things like that. But when the gut gets leaky, the blood brain barrier gets leaky, and the inflammation that normally the brain can be protected from now infiltrates into the brain. And now the brain becomes inflamed. And that can trigger, to your point, a lot of anxiety and is even a root cause of depression. So it's not just about taking an antidepressant, it's important for people to understand that there really is a link between the brain and the gut through this whole inflammatory pathway. And if you want to fix your brain, yes, focus on the brain, focus on your own psychology, even if you will, security and all that. But actually you need to go back into the gut, which is what you were experiencing. So it's fascinating to hear you say that.

Autumn Calabrese: Yeah. It was fascinating to experience it. And for me, it was one of those things I think that was back there in my mind knowing, but until I experienced it, not really fully understanding the impact that our food could truly have on us. And I will say this, because obviously you and I are we work together now because I came to you almost a year ago, it's crazy. Even over all these years of working on my gut health and improving my gut health, it has not been a straight line. It has definitely been many steps forward, but when I came to you last year, I was getting really frustrated again because I was starting to suffer, not quite the depression side of it, but the anxiety was back. And I was starting to have a little bit of hair loss, which is weird for me. I have very thick head of hair that runs in my family. So all of a sudden I was having this little spot of hair that was thinning that didn't make sense to me. My stomach started to feel off again. And my thought was, well, how am I back here? I've been doing all the things and still always learning and researching, I actually heard about you, Dr. Gladden, from Suzanne Summer's book. I was listening to her book where she had interviewed several different doctors. And when I heard her interview with you speaking about longevity, health, performance, the fact that it was all three is what really was like, okay, I need to reach out to that doctor. That's my doctor specifically because yes I want longevity, yes I want health, but I also want performance. Let's find out what's going on.

Dr. Jeffrey Gladden: Yeah, exactly. And they're actually interlinked as you can surmise that they would be, but they're actually interlinked in ways that people don't fully comprehend either, which we can go into, but I want to stay with your story here for a little bit. So you did come to us and you were starting to struggle again. I remember meeting you, talking with you on the Zoom call initially, and then meeting you in the office, et cetera. And how's it gone since you've worked with us in this past almost a year?

Autumn Calabrese: Oh my gosh, it's been a complete 180 and I've learned so much about my body and my genetics and things that I'm predisposed to and things that I would've never thought. In fact, I remember one of the tests that we did was to check the strength of my heart and my VO2 max and I was on the bike. And I remember you telling me I underperformed, which for somebody who was very competitive was a very hard pill to swallow still is. But it was one of those things that was really interesting, because it was like, okay, well, you're training this way and while that's working in a lot of areas, your heart isn't as strong as it should be for your age and for how well you train. I was expecting to come in and get the gold star when you ran all my numbers and I think I got the gold star in maybe one or two areas, but not all the areas.

Dr. Jeffrey Gladden: Exactly. Well, that's part of the comprehensive view. So when we do work with people now, we really create a mosaic of ages for them. There's not just a single age, but there is a hard age, a blood vessel age, a brain age, on and on and on. And I think it is interesting and it was interesting to us when we saw your test results to think, okay, here's really a fitness guru who really does a lot of things and I think we're actually going to be able to really help her, which is great because then she'll be able to help more people too, because you have a large audience. But it was interesting to us that your cardiovascular system wasn't as strong when you came into us as you would've wanted it to be. And just so people know, we measure something called VO2 max, which essentially is answering the question, how much blood can your heart pump. And it turns out that the more blood your heart is able to pump, the longer you live, the less cancer you have, the less heart disease, the less dementia. And you carry that forward for more years than you would otherwise. So it becomes a really important metric of overall health, if you will, is to know what you or VO2 is. And that's measured with a test, it can either be on a bike or a treadmill, we use a bike because nobody falls off a bike like they fly off the back of a treadmill. But you wear a mask and we measure how much oxygen you're consuming, how much carbon oxide you're producing. And from that, we get an incredibly accurate look at the status of the heart, how it performs with exercise, whether or not there's any very early heart disease, whether there's any left ventricular dysfunction, it's called. It's an extremely good test. And I've been board certified in cardiology, interventional cardiology, nuclear cardiology, all those things. And this is really the best test I've ever seen to look at somebody's heart status. So we love that test. And then really one of our goals is to have your VO2 max improve. So I think we set you up with an exercise routine to push you in that direction if you will.

Autumn Calabrese: Yeah. We'll be testing it again in April when I come back to see you guys. But one of the things that was really interesting when we got all my blood work back, I remember you saying you suspected that my thyroid was off. Based on okay you trained this way, but this is how you performed, it's definitely underperforming. And sure enough, we got that back and my thyroid genetically, I'm not making enough thyroid in my brain-