In this episode, Dr. Obadan and guest Dr. Anita Lwanga delve into geriatrics, internal medicine, and the significant role of exercise. They discuss the importance of a tailored exercise routine, the power of coaching for health goals, and clear misconceptions about high-intensity interval training.
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Episode Transcript
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(00:04):
Hello, everyone.
Thank you for joining us today.
I'm Doctor Dede, Doctor.
Ndidiamaka Obadan.
I'm the CEO and founder, the younger self MDmedical clinic health and wellness.
We're located in Kennesaw, Georgia, and we helpadults at risk, prevent, and treat medical
(00:24):
conditions like diabetes, high blood pressureand chronic kidney disease in as little as a 30
minute consultation so they can go on to leavelonger, happier, and healthier lives.
I'm here with the amazing doctor Anita LowandaWho's going to introduce herself?
(00:45):
I hope I didn't butcher your name on the air.
Oh, no.
That's perfect.
Please go ahead and introduce yourself to ouraudience.
Okay.
Well, I'm Anita Lewanca.
I'm an internist.
Geriatrician.
And prior to going to medical school, mybackground was in exercise and health
physiology.
It actually even back up further.
(01:07):
As a child as a competitive gymnast.
And I used to kind of experiment on myself interms of seeing how food, and how sleep would
affect my performance.
Noticed when I didn't sleep very much, myperformance was not good.
And if I didn't eat enough, of course, myperformance was not good.
So I started to kind of change the way Itreated my Obadan, and I noticed my performance
(01:28):
changed.
So I decided to do exercise and healthphysiology.
Under the umbrella of kinesiology.
And during my studies, I learned a lot abouthow exercise impacts your body, how even
different kinds of exercise can impact say yourcardiovascular fitness or the way your muscles
grow.
And I also had a little bit of training andnutrition.
I think I ended up taking about 1 year's thenutrition courses.
(01:49):
And I realized what I was doing as an athletewas actually probably not the best for myself.
So I used a lot of that knowledge even today interms of the way I counsel my patients.
Of course, in medical school, we learn aboutthe pathology, how the body, how things can go
wrong in the Obadan we also learn aboutmedications to help fix the body, but we don't
I don't know about your trading, but in medschool, I didn't talk much about nutrition and
(02:11):
same with residency.
We didn't talk much about nutrition.
So, I kind of incorporate all my training tohelp my patients.
That is amazing.
That's the lovely introduction.
I did not know that about you.
You know, the kinesiology part of it.
And, oh, that's so you were a competitivetrainer.
(02:33):
Us, what did you say about your competitivesports?
Leave that.
Yeah.
Oh, wow.
That's great.
That's so cool.
So, we're going to tell us tell us a little bitabout your story, but, like, why did you decide
to go into the field?
So you mentioned that you're a geriatrician andfor people who do So I'm an nephrologist.
(02:57):
I'm a kidney specialist.
We're both internists.
So I always try to explain to people thatinternal medicine.
It's like the basic.
It's the general degree when you finish youryour residency.
Right?
And then you go on to subspecialize in otherthings.
So use subspecialized in geriatrics, and I dida subtraction with a little bit more number of
(03:24):
years in nephrology, which is the study of thekidney.
So tell our audience what geriatric is.
Geriatrics is the care of adults that are 65years and older if you're using the formal
death but to be honest, I think we probablyboth know people that are younger than 65, and
they seem to be a little bit older than that.
(03:46):
And I'm sure you've met people who are in theireighties, and they do not functionally look
like a typical eighty year old.
But in general, there are Yeah.
There there are a few issues that people tendto face as we become wiser.
Things such as memory loss become more common,falls.
And then even in terms of managing the medicalproblems, individuals tend to have more complex
(04:10):
medical problems.
And sometimes the medicines that we as doctorsgive them cause more problems.
Don't improve their quality of life andactually contribute to earlier mortality.
So as geriatricians, we tend to look at thepatient as a whole, not just their age, but
their functional status as well.
And we work with our other physicians to make aplan that's appropriate for that patient.
(04:30):
Our goal as geriatricians is not necessarily toprolong life, but to make people have good
quality of life and their goals of care,meaning, whether they want CPR, whether they
wanna be on life support are clear to theirfamily members, to them before they end up in a
situation where it's very difficult to makethat decision, such as when they're in the
hospital.
So it's it's it's it's Oh, I I would like in itor compare it to almost like pediatrics because
(04:56):
the children now become the parents.
You're talking to the patient, and then youhave to call their children in explain stuff
because sometimes they don't remember.
So it takes a lot of patience, but it can alsobe very rewarding.
Yes.
It is.
It's very rewarding.
I come across a lot of of the older populationas well.
And, you know, they are, I I like the analogyyou gave with the pediatrics because it it kind
(05:22):
of their own subspecial population.
And as you mentioned, there are a lot of thingsthat are frequently affecting them,
specifically like the memory issues, enforced,which is a very big one.
So, you know, but I wanted us to go back.
Tell us your story.
Like, why did you decide to become a dailynutrition?
(05:44):
Wow.
That's, it's a little bit difficult to answer.
I think to be
honest, well, it's okay.
A lot.
Why is it difficult to answer?
Because, like, people the way life happens, youhave your own goals, your own thoughts, your
own, perhaps naive receptions of what you'regetting yourself into.
(06:05):
So even with med school, I'm like, I I don'treally think I knew what I was getting myself
into.
You go through med school and then at least forme, I was like, I don't know.
I like pediatrics.
I like everything.
I like radiology.
I like this.
I like that.
And when I was going for interviews, one of myfriends is like focus.
You know, like, you can't be all over theplace.
Pick 1.
I picked internal medicine to be honest becauseI was like, I can change my mind.
You know, you're not stuck.
You can pick any specialty.
(06:26):
Yes.
Yeah.
And the funny thing is even during med school.
Like, I did a geriatrics rotation, and I'mlike, I like the kids.
I like the older people.
Like, for some some reason, I tended to connectbetter with them.
So after I did my internal medicine, training,to go back to Canada, you have to have, like,
professional fellowship training and internalmedicine training is a little bit longer.
So I chose geriatrics as, like, an extra my 4thyear.
(06:50):
And things worked out very well.
Like, I was in a nice program at UIC.
My attendings were so kind and, socompassionate and just great role models.
Like, they really taught me the difference, of,like, you know, looking at the patient as an
individual.
I'm not just saying this is a geriatricpatient, Like, we'd have 9 gay who are
(07:12):
functionally 60s.
Like, I remember too in particular, like, whatwas playing basketball?
I'm like, what is this?
And they're like, no.
You do not, you know, treat that patient like atypical geriatric patient.
Do you wanna be more aggressive?
Because, you know, they have functionally,they're not a geriatric patient.
And then occasionally come to the clinic.
That's just 60.
They're not a geriatric patient, technically.
(07:32):
But functionally, they are.
So I I just really had great role models andgreat attendings, and that's what made it,
rewarding.
I don't practice only geriatrics because as asyou know, as a nephrologist, you have such a
wide breadth of knowledge, that you can pick upanything that's not an apology related because
you have the trading in that area as well.
Yes.
And that's why I decide to still maintain myinternal medicine knowledge.
(07:57):
You know?
So to state in health, even though I'm gonnafollow this, you know, because, yes, I wanna
put up in the whole body as a failure.
It says you're lengthened.
But that that is amazing.
You know, I feel I like what you meant from thefocusing on quality of life rather than just
belonging.
(08:17):
I want it.
I want both.
I want people to stay healthy.
I want them to be happy in the process.
I mean, And that's my definition of prolongingtheir quality of life.
And you keep, you know, so back to exercise.
Let's take a look back a little bit because Ifeel like They they're just one of the things I
told my boyfriend.
(08:38):
So I was emphasize on the exercise physiology.
I mean, everyone talks about lifestyle changes.
To talk about their adequate nutrition, butlet's let's go in detail.
You know?
There are some tips that we can share with theother on why it is important for us to
exercise.
(08:59):
I like that question.
That is a great question.
There's so many great reasons to exercise.
The classic here about why it's in exercisesthat is good for your heart.
It helps you maintain your cardiovascularfitness.
It helps you keep your lung capacityfunctioning.
It keeps helps you maintain your muscles.
So not just cardiovascular exercise, but doingsomething like lifting weights or calisthenics,
(09:24):
which is using your body weights to do thingslike push ups or lunches.
That helps you maintain your muscle mass sothat as you get wiser, you're less likely to
have falls on top of that, there's been so manystudies that have shown that exercises differ
skin for those ladies who are into, like,making sure that their skin looks great.
It's very important to exercise.
They found that people who exercise 30 minutesper day are more like, their skin actually
(09:47):
looks younger if you look at it under amicroscope.
Exercise also improves your quality of sleep.
As you exercise, I don't actually have all thethe physiology or the proper explanation.
But I'm sure you notice if you burn more energyduring the day, you sleep deeper, so you have
better quality sleep.
On top of that exercise has shown to improveyour mood.
So if you suffer with, say, like, seasonaleffect of disorder or, you know, you're just
(10:10):
not feeling as excited or happy if you exerciseyour body releases endorphins, which are like a
natural hormone that gives you a high.
So you tend to feel better.
Your mood is better.
They've also done studies on people that havepsychiatric dis disorders such as, I think
bipolar schizophrenia, depression, They tend tohave better outcomes if they exercise.
So I've told my patients, though I I can'tnecessarily prove this, but exercise is the
(10:34):
magic pill we're all looking for.
For some reason, most of
I agree.
I agree.
100%.
And, you know, exercising is the magic pill.
That we are all looking for that is gonna keepyou younger, and it is going to it's going to
do what you've been saying, make you looks likeyou're in your sixties when you're eighty years
(10:58):
old and still have everything working becauseyou went from the head to the toe and you about
all the different benefits, it affects everysingle system, most importantly, your mental
health.
Your memory, your mood, and all the othermental health disorders that can come with you
(11:18):
know, not exercising that properly.
So, yes, it is the magic pill, but people findit so difficult to get involved in a regimen.
You know, and it's difficult to this is thecomplaint I get over the phone.
Right?
It's hard it's hard to start and maintain yourregimen, and they don't even know, like, how
(11:41):
intensive your exercise regimen should do.
So what suits do you have to share with themfor our audience to get them to love exercise
and I always try to counsel my patients to getaddicted to exercise than other bad habits like
alcohol and, you know, those are the negativehabits that people tend to get addicted to.
(12:07):
Absolutely.
What are the steps that it should take?
I can totally relate to that because despite mybackground, to be honest, I think during med
school and residency, I didn't exercise.
I thought I was too pissed.
I think most of us did not.
But that yeah.
I mean, but, you know, what are we talkingabout here?
We're not saying that you have to just dedicatethe whole, you know, day to go into the gym.
(12:34):
It can be as little as, right, just Been activefor 30 minutes three times a week.
Walk in Bristol going to the park.
I feel like you can incorporate exercise witheverything with your daily activities.
For example, you know, standing, having astanding desk at work.
(12:56):
You know, that's what I tell people.
Go ahead.
Those are some of the the the tips.
Yeah.
Go ahead.
I wanted to say that because I wanted to say, II I can relate to the struggle.
But once you get into the routine, it's mucheasier.
So some of the things I've used in my, life tomake exercise easier to incorporate are pairing
(13:17):
exercise with something else.
So looking back, I actually love watchingNetflix and, like, whatever's watching on, I
think Amazon TV.
I noticed two words, like, when I was doing myfellowship, if I took my iPad up and was
watching Amazon TV, within, 2 hours.
I have been walking, and I didn't realize.
So if you like watching TV, does a TV show youlike binging on?
(13:39):
Get yourself in front of the treadmill or infront of the bike and watch that show and don't
let yourself watch TV or, you know, binge onwhatever unless you're doing a physical
activity.
Another way to pair your exercise withsomething else you like, if you have a morning
routine, For example, like a morning prayer ormeditation routine, my nutrition coach, his
name is JT Tapia's actually taught me this.
(13:59):
He said, well, while you're praying in themorning.
So I really like doing that.
Like, the first hour of my day, I'm actuallydrinking coffee, like, trying to wake up and,
like, climbing the stairs to, you know, get myowing, I'm getting my cardio in, and then I'm
like, I'm listening to positive podcasts, youknow, do my affirmations.
So if you compare it something else that'salready part of your routine.
It can be very easy.
(14:21):
You can walk to work.
If you're in a place that's warm enough to dothat, you can walk to work or bike to work.
Ideally, the current guidelines recommendexercising 3 days to 6 days per week for a
minimum of 40 minutes to 1 hour.
It's very difficult to over exercise.
Most of us don't get that in that in, but asdoctor Didi was saying, if you can stand, if
(14:44):
you can take the stairs in your building, parkas far away as possible from the building that
you're in, you can add in x just steps.
But, ideally, you wanna have a block of timecloser to 1 hour.
3 days a week, that's not very difficult andjust force yourself to go.
If you have a pet, You need to walk that dog.
So add it in that way.
(15:06):
Yeah.
Grocery style, and have a point to If you needto bribe, I've used that too.
If you need to bribe yourself, bribe yourself.
I've had, like, a point system where, if I hita certain milestone, for the month, I get to,
you know, buy something.
So if you have to gamify gamify it, there areways to get it done and get it into your
schedule.
I agree.
I mean, those are all great tips.
(15:27):
Thank you for sharing.
In fact, that's way more than we wanted 3, andshe she went above and beyond.
She gave us, like, a 100.
Great.
Thank you so much, Anita.
And, you know, what I was saying is you don'tthe goal should be 1 hour.
Right?
But to start, Sometimes people are soreluctant.
So even if it is just doing a little dancewhile you're approaching your teeth in the
(15:50):
morning, Like you said, pair it with thingsthat you really enjoy.
Right?
And start small.
Start about 5 minutes.
A day and then walk your way up.
The goal is to get to where you're doing itconsistently, for 1 hour.
So, yeah, these are also so many great so muchfor sharing.
(16:11):
So let's move on to the next oh, look at thetime.
We're having so much fun, and it's almostcoming towards the end of our protest.
So bear with us something interesting thathappened to you.
Recently or something you learned that made youfeel empowered?
(16:34):
Wow.
Oh, wow.
Where do I begin?
They're so I feel like every day, I am learningso many things.
But I guess maybe the best tip I can share withpeople is that whatever goal you have, you can
achieve it.
And I think the wise way of achieving it or theshortcut way of achieving it is to get help.
(16:55):
So just going back to what doctor, Ndidiamakatalking about.
You were talking about, like, you know, how yougive your patients tips in terms of exercising.
And even this pod asked.
People who are listening, you'll find a tipthat you know you like and you want to apply to
your life.
And it'll be such a simple tip, but it can makesuch a big difference in your life.
So just my own story, after, you know,finishing residency, I actually had the
(17:20):
opposite happen to me.
I gained a lot of weight despite trying toexercise because I was exercising the wrong
way.
So I got a nutrition coach, and within a fewmonths, I lost a lot of weight.
And I was like, this was not hard.
Like, why was I stressing myself?
And just that connection with that one personreally made a big change in my life in terms of
the out come without really disrupting my lifea lot.
(17:43):
Like, he actually enhanced my life even tellingme, you know, you need to sleep more.
So if there's something you're trying toachieve, try and get a coach, try and get
somebody to help you, and you'll expedite yourprocess and you won't have to work as hard.
So to me, that's been, I think, the biggestlesson in the last probably 8 months.
Find the right connections, get the right help,and you can really expedite your process.
(18:07):
That's amazing.
That is so good.
Thank you so much.
And and so it's so, I mean, it it resonateswith me as well.
Because, you know, we all need accountabilitypartners.
I always say, so I I created this campaign getmad about saving the kidneys.
(18:27):
And, MAT stands for movement and mindset fixingthose, which is pretty much getting the
exercise regimen in place.
And the a in my MAT is accountability.
And I tell my patients that, just as you said,Biproneta, it could be as small as getting your
(18:49):
spouse or your kids on board or your familymembers or your friends on board to keep you
accountable for the goals that you set.
Or getting a coach, you know, getting a coachto help you get back on track.
We all need some formal accountability.
The d in my MD campaign is diet.
(19:13):
So, you know, that's, we'll talk about that inthe next.
When I have you back on the podcast the nexttime, so we can go delve deeper into the
nutrition aspect.
But this has been so good.
There's one question I wanted to ask you.
You mentioned that you, were exercising wronglywhen you started adding weight.
(19:33):
And I was like, I need to hear more about thatbecause I didn't know that's what do you mean
by that?
Can you do you wanna share with us?
I'm glad you asked that question becausethere's still so much more I wanna say about
exercise, but I'll keep it to that, and we cantalk next time.
So was exercising in a way that spiked mycortisol level and made me more hungry.
(19:58):
So I ended up eating more, and that wasprobably choosing the wrong foods.
So I was doing a lot of what we call highinterval intensity training.
So when you look at the way we we do exerciseor brain.
There's what we call low intensity, which iswalking, and you'd have to do that for a longer
period of time to burn calories.
You'll eventually burn calories But becauseyou're going at the slower, lower caliber, you
(20:20):
burn more fat as your fuel source rather thanglucose, and you're not putting your body under
stress.
So you're not spiking cortisol, which is astress hormone, and you're not spike you're
not, increasing your, I think, growth hormones.
And there there's different hormones that areinvolved when you do those interval intensity
workouts.
So I was working night shift, and that'sanother thing.
(20:40):
My sleep was not as good as it should be.
So my cortisol level is up I was doing thishigh interval intensity training for, like, 30
minutes to 1 hour before my night shift, wenton the night shift, and then I was very hungry
and eating the wrong foods.
So I switch now when I do primarily walking,like, or sometimes I don't even work out very
much, and I'm hungry.
(21:02):
I'm working out, but working out in a waythat's not spiking my hunger hormones.
So that's what I meant, but I was I was doingthe wrong workouts.
If you're gonna do hit, it's It'll help youmaintain and build muscle, but you do not need
to do it more than two times per week.
Otherwise, it's like you're kind of makingyourself go backwards because your body can't
recover fast enough and you're gonna be hungryall the time.
So that was my big mistake.
(21:24):
Yes.
And, you know, as a nephrologist, I really, youknow, a kidney doctor when you exercise
intensely and get dehydrated.
Or develop a breakdown of your muscles, wrapyour myelitis.
Those are the consequences for doing theexcessive hits.
(21:46):
Training, and it can definitely affect yourkidneys as well.
So I I I mean, this is something we we wantpeople about, like, You have to before you
start those, intense regimens, make sure thatyou are evaluated by your positions.
So that they can clear you and make sure youdon't have any cardiology.
If you're hard issue and your kidney lineintact, then, you know, they'll they'll cancel.
(22:10):
You don't have to stay hydrated.
That was good.
That was good.
Thank you for sharing that with us.
We also have to be mindful about, theconsequences of exercising wrongly.
You know?
Yeah.
So so well, Doctor Anita, this was so good.
How can people find you if they wanna work withyou.
(22:32):
I'll learn more from you about your exercisetips and your nutrition tips.
Well, on LinkedIn, I'm Anita Lowanga.
The last name is l w a n g a.
On Instagram, I stent to spend more of my timeon Instagram, at doctor Lwanda.
Doctors just d r l sorry.
(22:53):
Lwanda m d l w a n g a.
MD.
That's all caps.
On YouTube, you can just search Doctor La Wancaon I think it's TikTok.
It's Doctor La Wanca lower case.
I haven't been as active there lately.
And on Twitter, I think it's at Doctor Lowanga.
I might have all these handles wrong.
It's, like, hard to keep track of all of it.
(23:15):
So Yes.
We'll we'll put them in the in the calm send anote so that everybody can find you easily.
Well, thank you for being our guest, and it wasout You can find us at younger selfmd.com, and
we're accepting patients.
We're also on instagram at younger selfmd.
(23:35):
And, YouTube channel is the younger self MD.
So we're currently accepting patients, and wewould love to take take care of you.
And until next time, stay tuned for our nextamazing guest who's going to be who who's it
gonna be next?
Or or you have to join us to find out.
Thank you so much, Doctor.
(23:56):
And I thought you said it's so good.
Thank you so much for having me.
I appreciate you taking time out.
Bye.
Where's the stop button?
Oh, there again.
Hello, everyone.
Thank you for joining us today.
I'm Doctor Dede, Doctor.
Ndidiamaka Obadan.
I'm the CEO and founder, the younger self MDmedical clinic health and wellness.
We're located in Kennesaw, Georgia, and we helpadults at risk, prevent, and treat medical
(00:24):
conditions like diabetes, high blood pressureand chronic kidney disease in as little as a 30
minute consultation so they can go on to leavelonger, happier, and healthier lives.
I'm here with the amazing doctor Anita LowandaWho's going to introduce herself?
(00:45):
I hope I didn't butcher your name on the air.
Oh, no.
That's perfect.
Please go ahead and introduce yourself to ouraudience.
Okay.
Well, I'm Anita Lewanca.
I'm an internist.
Geriatrician.
And prior to going to medical school, mybackground was in exercise and health
physiology.
It actually even back up further.
(01:07):
As a child as a competitive gymnast.
And I used to kind of experiment on myself interms of seeing how food, and how sleep would
affect my performance.
Noticed when I didn't sleep very much, myperformance was not good.
And if I didn't eat enough, of course, myperformance was not good.
So I started to kind of change the way Itreated my Obadan, and I noticed my performance
(01:28):
changed.
So I decided to do exercise and healthphysiology.
Under the umbrella of kinesiology.
And during my studies, I learned a lot abouthow exercise impacts your body, how even
different kinds of exercise can impact say yourcardiovascular fitness or the way your muscles
grow.
And I also had a little bit of training andnutrition.
I think I ended up taking about 1 year's thenutrition courses.
(01:49):
And I realized what I was doing as an athletewas actually probably not the best for myself.
So I used a lot of that knowledge even today interms of the way I counsel my patients.
Of course, in medical school, we learn aboutthe pathology, how the body, how things can go
wrong in the Obadan we also learn aboutmedications to help fix the body, but we don't
I don't know about your trading, but in medschool, I didn't talk much about nutrition and
(02:11):
same with residency.
We didn't talk much about nutrition.
So, I kind of incorporate all my training tohelp my patients.
That is amazing.
That's the lovely introduction.
I did not know that about you.
You know, the kinesiology part of it.
And, oh, that's so you were a competitivetrainer.
(02:33):
Us, what did you say about your competitivesports?
Leave that.
Yeah.
Oh, wow.
That's great.
That's so cool.
So, we're going to tell us tell us a little bitabout your story, but, like, why did you decide
to go into the field?
So you mentioned that you're a geriatrician andfor people who do So I'm an nephrologist.
(02:57):
I'm a kidney specialist.
We're both internists.
So I always try to explain to people thatinternal medicine.
It's like the basic.
It's the general degree when you finish youryour residency.
Right?
And then you go on to subspecialize in otherthings.
So use subspecialized in geriatrics, and I dida subtraction with a little bit more number of
(03:24):
years in nephrology, which is the study of thekidney.
So tell our audience what geriatric is.
Geriatrics is the care of adults that are 65years and older if you're using the formal
death but to be honest, I think we probablyboth know people that are younger than 65, and
they seem to be a little bit older than that.
(03:46):
And I'm sure you've met people who are in theireighties, and they do not functionally look
like a typical eighty year old.
But in general, there are Yeah.
There there are a few issues that people tendto face as we become wiser.
Things such as memory loss become more common,falls.
And then even in terms of managing the medicalproblems, individuals tend to have more complex
(04:10):
medical problems.
And sometimes the medicines that we as doctorsgive them cause more problems.
Don't improve their quality of life andactually contribute to earlier mortality.
So as geriatricians, we tend to look at thepatient as a whole, not just their age, but
their functional status as well.
And we work with our other physicians to make aplan that's appropriate for that patient.
(04:30):
Our goal as geriatricians is not necessarily toprolong life, but to make people have good
quality of life and their goals of care,meaning, whether they want CPR, whether they
wanna be on life support are clear to theirfamily members, to them before they end up in a
situation where it's very difficult to makethat decision, such as when they're in the
hospital.
So it's it's it's it's Oh, I I would like in itor compare it to almost like pediatrics because
(04:56):
the children now become the parents.
You're talking to the patient, and then youhave to call their children in explain stuff
because sometimes they don't remember.
So it takes a lot of patience, but it can alsobe very rewarding.
Yes.
It is.
It's very rewarding.
I come across a lot of of the older populationas well.
And, you know, they are, I I like the analogyyou gave with the pediatrics because it it kind
(05:22):
of their own subspecial population.
And as you mentioned, there are a lot of thingsthat are frequently affecting them,
specifically like the memory issues, enforced,which is a very big one.
So, you know, but I wanted us to go back.
Tell us your story.
Like, why did you decide to become a dailynutrition?
(05:44):
Wow.
That's, it's a little bit difficult to answer.
I think to be
honest, well, it's okay.
A lot.
Why is it difficult to answer?
Because, like, people the way life happens, youhave your own goals, your own thoughts, your
own, perhaps naive receptions of what you'regetting yourself into.
(06:05):
So even with med school, I'm like, I I don'treally think I knew what I was getting myself
into.
You go through med school and then at least forme, I was like, I don't know.
I like pediatrics.
I like everything.
I like radiology.
I like this.
I like that.
And when I was going for interviews, one of myfriends is like focus.
You know, like, you can't be all over theplace.
Pick 1.
I picked internal medicine to be honest becauseI was like, I can change my mind.
You know, you're not stuck.
You can pick any specialty.
(06:26):
Yes.
Yeah.
And the funny thing is even during med school.
Like, I did a geriatrics rotation, and I'mlike, I like the kids.
I like the older people.
Like, for some some reason, I tended to connectbetter with them.
So after I did my internal medicine, training,to go back to Canada, you have to have, like,
professional fellowship training and internalmedicine training is a little bit longer.
So I chose geriatrics as, like, an extra my 4thyear.
(06:50):
And things worked out very well.
Like, I was in a nice program at UIC.
My attendings were so kind and, socompassionate and just great role models.
Like, they really taught me the difference, of,like, you know, looking at the patient as an
individual.
I'm not just saying this is a geriatricpatient, Like, we'd have 9 gay who are
(07:12):
functionally 60s.
Like, I remember too in particular, like, whatwas playing basketball?
I'm like, what is this?
And they're like, no.
You do not, you know, treat that patient like atypical geriatric patient.
Do you wanna be more aggressive?
Because, you know, they have functionally,they're not a geriatric patient.
And then occasionally come to the clinic.
That's just 60.
They're not a geriatric patient, technically.
(07:32):
But functionally, they are.
So I I just really had great role models andgreat attendings, and that's what made it,
rewarding.
I don't practice only geriatrics because as asyou know, as a nephrologist, you have such a
wide breadth of knowledge, that you can pick upanything that's not an apology related because
you have the trading in that area as well.
Yes.
And that's why I decide to still maintain myinternal medicine knowledge.
(07:57):
You know?
So to state in health, even though I'm gonnafollow this, you know, because, yes, I wanna
put up in the whole body as a failure.
It says you're lengthened.
But that that is amazing.
You know, I feel I like what you meant from thefocusing on quality of life rather than just
belonging.
(08:17):
I want it.
I want both.
I want people to stay healthy.
I want them to be happy in the process.
I mean, And that's my definition of prolongingtheir quality of life.
And you keep, you know, so back to exercise.
Let's take a look back a little bit because Ifeel like They they're just one of the things I
told my boyfriend.
(08:38):
So I was emphasize on the exercise physiology.
I mean, everyone talks about lifestyle changes.
To talk about their adequate nutrition, butlet's let's go in detail.
You know?
There are some tips that we can share with theother on why it is important for us to
exercise.
(08:59):
I like that question.
That is a great question.
There's so many great reasons to exercise.
The classic here about why it's in exercisesthat is good for your heart.
It helps you maintain your cardiovascularfitness.
It helps you keep your lung capacityfunctioning.
It keeps helps you maintain your muscles.
So not just cardiovascular exercise, but doingsomething like lifting weights or calisthenics,
(09:24):
which is using your body weights to do thingslike push ups or lunches.
That helps you maintain your muscle mass sothat as you get wiser, you're less likely to
have falls on top of that, there's been so manystudies that have shown that exercises differ
skin for those ladies who are into, like,making sure that their skin looks great.
It's very important to exercise.
They found that people who exercise 30 minutesper day are more like, their skin actually
(09:47):
looks younger if you look at it under amicroscope.
Exercise also improves your quality of sleep.
As you exercise, I don't actually have all thethe physiology or the proper explanation.
But I'm sure you notice if you burn more energyduring the day, you sleep deeper, so you have
better quality sleep.
On top of that exercise has shown to improveyour mood.
So if you suffer with, say, like, seasonaleffect of disorder or, you know, you're just
(10:10):
not feeling as excited or happy if you exerciseyour body releases endorphins, which are like a
natural hormone that gives you a high.
So you tend to feel better.
Your mood is better.
They've also done studies on people that havepsychiatric dis disorders such as, I think
bipolar schizophrenia, depression, They tend tohave better outcomes if they exercise.
So I've told my patients, though I I can'tnecessarily prove this, but exercise is the
(10:34):
magic pill we're all looking for.
For some reason, most of
I agree.
I agree.
100%.
And, you know, exercising is the magic pill.
That we are all looking for that is gonna keepyou younger, and it is going to it's going to
do what you've been saying, make you looks likeyou're in your sixties when you're eighty years
(10:58):
old and still have everything working becauseyou went from the head to the toe and you about
all the different benefits, it affects everysingle system, most importantly, your mental
health.
Your memory, your mood, and all the othermental health disorders that can come with you
(11:18):
know, not exercising that properly.
So, yes, it is the magic pill, but people findit so difficult to get involved in a regimen.
You know, and it's difficult to this is thecomplaint I get over the phone.
Right?
It's hard it's hard to start and maintain yourregimen, and they don't even know, like, how
(11:41):
intensive your exercise regimen should do.
So what suits do you have to share with themfor our audience to get them to love exercise
and I always try to counsel my patients to getaddicted to exercise than other bad habits like
alcohol and, you know, those are the negativehabits that people tend to get addicted to.
(12:07):
Absolutely.
What are the steps that it should take?
I can totally relate to that because despite mybackground, to be honest, I think during med
school and residency, I didn't exercise.
I thought I was too pissed.
I think most of us did not.
But that yeah.
I mean, but, you know, what are we talkingabout here?
We're not saying that you have to just dedicatethe whole, you know, day to go into the gym.
(12:34):
It can be as little as, right, just Been activefor 30 minutes three times a week.
Walk in Bristol going to the park.
I feel like you can incorporate exercise witheverything with your daily activities.
For example, you know, standing, having astanding desk at work.
(12:56):
You know, that's what I tell people.
Go ahead.
Those are some of the the the tips.
Yeah.
Go ahead.
I wanted to say that because I wanted to say, II I can relate to the struggle.
But once you get into the routine, it's mucheasier.
So some of the things I've used in my, life tomake exercise easier to incorporate are pairing
(13:17):
exercise with something else.
So looking back, I actually love watchingNetflix and, like, whatever's watching on, I
think Amazon TV.
I noticed two words, like, when I was doing myfellowship, if I took my iPad up and was
watching Amazon TV, within, 2 hours.
I have been walking, and I didn't realize.
So if you like watching TV, does a TV show youlike binging on?
(13:39):
Get yourself in front of the treadmill or infront of the bike and watch that show and don't
let yourself watch TV or, you know, binge onwhatever unless you're doing a physical
activity.
Another way to pair your exercise withsomething else you like, if you have a morning
routine, For example, like a morning prayer ormeditation routine, my nutrition coach, his
name is JT Tapia's actually taught me this.
(13:59):
He said, well, while you're praying in themorning.
So I really like doing that.
Like, the first hour of my day, I'm actuallydrinking coffee, like, trying to wake up and,
like, climbing the stairs to, you know, get myowing, I'm getting my cardio in, and then I'm
like, I'm listening to positive podcasts, youknow, do my affirmations.
So if you compare it something else that'salready part of your routine.
It can be very easy.
(14:21):
You can walk to work.
If you're in a place that's warm enough to dothat, you can walk to work or bike to work.
Ideally, the current guidelines recommendexercising 3 days to 6 days per week for a
minimum of 40 minutes to 1 hour.
It's very difficult to over exercise.
Most of us don't get that in that in, but asdoctor Didi was saying, if you can stand, if
(14:44):
you can take the stairs in your building, parkas far away as possible from the building that
you're in, you can add in x just steps.
But, ideally, you wanna have a block of timecloser to 1 hour.
3 days a week, that's not very difficult andjust force yourself to go.
If you have a pet, You need to walk that dog.
So add it in that way.
(15:06):
Yeah.
Grocery style, and have a point to If you needto bribe, I've used that too.
If you need to bribe yourself, bribe yourself.
I've had, like, a point system where, if I hita certain milestone, for the month, I get to,
you know, buy something.
So if you have to gamify gamify it, there areways to get it done and get it into your
schedule.
I agree.
I mean, those are all great tips.
(15:27):
Thank you for sharing.
In fact, that's way more than we wanted 3, andshe she went above and beyond.
She gave us, like, a 100.
Great.
Thank you so much, Anita.
And, you know, what I was saying is you don'tthe goal should be 1 hour.
Right?
But to start, Sometimes people are soreluctant.
So even if it is just doing a little dancewhile you're approaching your teeth in the
(15:50):
morning, Like you said, pair it with thingsthat you really enjoy.
Right?
And start small.
Start about 5 minutes.
A day and then walk your way up.
The goal is to get to where you're doing itconsistently, for 1 hour.
So, yeah, these are also so many great so muchfor sharing.
(16:11):
So let's move on to the next oh, look at thetime.
We're having so much fun, and it's almostcoming towards the end of our protest.
So bear with us something interesting thathappened to you.
Recently or something you learned that made youfeel empowered?
(16:34):
Wow.
Oh, wow.
Where do I begin?
They're so I feel like every day, I am learningso many things.
But I guess maybe the best tip I can share withpeople is that whatever goal you have, you can
achieve it.
And I think the wise way of achieving it or theshortcut way of achieving it is to get help.
(16:55):
So just going back to what doctor, Ndidiamakatalking about.
You were talking about, like, you know, how yougive your patients tips in terms of exercising.
And even this pod asked.
People who are listening, you'll find a tipthat you know you like and you want to apply to
your life.
And it'll be such a simple tip, but it can makesuch a big difference in your life.
So just my own story, after, you know,finishing residency, I actually had the
(17:20):
opposite happen to me.
I gained a lot of weight despite trying toexercise because I was exercising the wrong
way.
So I got a nutrition coach, and within a fewmonths, I lost a lot of weight.
And I was like, this was not hard.
Like, why was I stressing myself?
And just that connection with that one personreally made a big change in my life in terms of
the out come without really disrupting my lifea lot.
(17:43):
Like, he actually enhanced my life even tellingme, you know, you need to sleep more.
So if there's something you're trying toachieve, try and get a coach, try and get
somebody to help you, and you'll expedite yourprocess and you won't have to work as hard.
So to me, that's been, I think, the biggestlesson in the last probably 8 months.
Find the right connections, get the right help,and you can really expedite your process.
(18:07):
That's amazing.
That is so good.
Thank you so much.
And and so it's so, I mean, it it resonateswith me as well.
Because, you know, we all need accountabilitypartners.
I always say, so I I created this campaign getmad about saving the kidneys.
(18:27):
And, MAT stands for movement and mindset fixingthose, which is pretty much getting the
exercise regimen in place.
And the a in my MAT is accountability.
And I tell my patients that, just as you said,Biproneta, it could be as small as getting your
(18:49):
spouse or your kids on board or your familymembers or your friends on board to keep you
accountable for the goals that you set.
Or getting a coach, you know, getting a coachto help you get back on track.
We all need some formal accountability.
The d in my MD campaign is diet.
(19:13):
So, you know, that's, we'll talk about that inthe next.
When I have you back on the podcast the nexttime, so we can go delve deeper into the
nutrition aspect.
But this has been so good.
There's one question I wanted to ask you.
You mentioned that you, were exercising wronglywhen you started adding weight.
(19:33):
And I was like, I need to hear more about thatbecause I didn't know that's what do you mean
by that?
Can you do you wanna share with us?
I'm glad you asked that question becausethere's still so much more I wanna say about
exercise, but I'll keep it to that, and we cantalk next time.
So was exercising in a way that spiked mycortisol level and made me more hungry.
(19:58):
So I ended up eating more, and that wasprobably choosing the wrong foods.
So I was doing a lot of what we call highinterval intensity training.
So when you look at the way we we do exerciseor brain.
There's what we call low intensity, which iswalking, and you'd have to do that for a longer
period of time to burn calories.
You'll eventually burn calories But becauseyou're going at the slower, lower caliber, you
(20:20):
burn more fat as your fuel source rather thanglucose, and you're not putting your body under
stress.
So you're not spiking cortisol, which is astress hormone, and you're not spike you're
not, increasing your, I think, growth hormones.
And there there's different hormones that areinvolved when you do those interval intensity
workouts.
So I was working night shift, and that'sanother thing.
(20:40):
My sleep was not as good as it should be.
So my cortisol level is up I was doing thishigh interval intensity training for, like, 30
minutes to 1 hour before my night shift, wenton the night shift, and then I was very hungry
and eating the wrong foods.
So I switch now when I do primarily walking,like, or sometimes I don't even work out very
much, and I'm hungry.
(21:02):
I'm working out, but working out in a waythat's not spiking my hunger hormones.
So that's what I meant, but I was I was doingthe wrong workouts.
If you're gonna do hit, it's It'll help youmaintain and build muscle, but you do not need
to do it more than two times per week.
Otherwise, it's like you're kind of makingyourself go backwards because your body can't
recover fast enough and you're gonna be hungryall the time.
So that was my big mistake.
(21:24):
Yes.
And, you know, as a nephrologist, I really, youknow, a kidney doctor when you exercise
intensely and get dehydrated.
Or develop a breakdown of your muscles, wrapyour myelitis.
Those are the consequences for doing theexcessive hits.
(21:46):
Training, and it can definitely affect yourkidneys as well.
So I I I mean, this is something we we wantpeople about, like, You have to before you
start those, intense regimens, make sure thatyou are evaluated by your positions.
So that they can clear you and make sure youdon't have any cardiology.
If you're hard issue and your kidney lineintact, then, you know, they'll they'll cancel.
(22:10):
You don't have to stay hydrated.
That was good.
That was good.
Thank you for sharing that with us.
We also have to be mindful about, theconsequences of exercising wrongly.
You know?
Yeah.
So so well, Doctor Anita, this was so good.
How can people find you if they wanna work withyou.
(22:32):
I'll learn more from you about your exercisetips and your nutrition tips.
Well, on LinkedIn, I'm Anita Lowanga.
The last name is l w a n g a.
On Instagram, I stent to spend more of my timeon Instagram, at doctor Lwanda.
Doctors just d r l sorry.
(22:53):
Lwanda m d l w a n g a.
MD.
That's all caps.
On YouTube, you can just search Doctor La Wancaon I think it's TikTok.
It's Doctor La Wanca lower case.
I haven't been as active there lately.
And on Twitter, I think it's at Doctor Lowanga.
I might have all these handles wrong.
It's, like, hard to keep track of all of it.
(23:15):
So Yes.
We'll we'll put them in the in the calm send anote so that everybody can find you easily.
Well, thank you for being our guest, and it wasout You can find us at younger selfmd.com, and
we're accepting patients.
We're also on instagram at younger selfmd.
(23:35):
And, YouTube channel is the younger self MD.
So we're currently accepting patients, and wewould love to take take care of you.
And until next time, stay tuned for our nextamazing guest who's going to be who who's it
gonna be next?
Or or you have to join us to find out.
Thank you so much, Doctor.
(23:56):
And I thought you said it's so good.
Thank you so much for having me.
I appreciate you taking time out.
Bye.
Where's the stop button?
Oh, there again.
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