Gina:          So, we would like to welcome you to our Hydration Foundation Doctors’ talk to other doctors about recreation YouTube series and we are bringing to you today someone we have loved here at the Hydration Foundation, Dr. Sarah van Roy. She is a psychiatrist, MD, and she’s Director and Founder of the Center for Stress Management in Castle Rock, Colorado.

Dr. Sarah, let me give you the mic and ask you to talk a little bit about your history, your experience, your specialty, how you got to where you are so we have a nice strong foundation to hear what you have to say based on your foundation of education and experience.

Thank you.

Dr. Sarah:   Yeah, absolutely. Thank you for allowing me to join you in the incredible work that you’re doing with the Hydration Foundation.

So, a little bit about my background. Like you said, I am board certified in Psychiatry and I have been interested in integrative psychiatry really my whole career, which I’ve been practicing now for a little more than 25 years. And then four years ago I got received my second board certification in a relatively new physician specialty of Integrative Medicine, which I’m really excited about.

Gina:          Yes. Fantastic.

Dr. Sarah:   Yeah. And so, focusing on foundations of health before we start layering on prescriptions and expecting medications to work well is a really key part of what we do here at the Center for Stress Medicine and hydration is a big part of that, really big.

Gina:          We were so happy to find you and find your work and get to somebody whose specialty was in the mental health field recognizing the power of hydration as a first line treatment, prevention. We love your work so much. We already featured some of it at the Hydration Foundation.

Dr. Sarah:   Wonderful.

Gina:          And we’re really, really grateful that we were able to reference you as part of the strength of bringing hydration in mental health. And it’s just so important for helping … What we’re trying to do is bring this series so that we can help doctors talk to other doctors about how they use hydration in their specialties, what their protocols are, and also position the Hydration Foundation so that actually doctors can just send their clients and their colleagues to us so that we can provide these kinds of interviews and help people understand how quickly hydration should be that intervention for them because I know doctors are so busy trying to cover all that besides just saying to them “Drink eight glasses of water a day.”

Dr. Sarah:   Right.

Gina:          We need way more support around that and bringing in the ideas, some of which I want to interview you about today.

So, mental health in general is not a common theme we see in the care and prevention around hydration even though we have … Alexander did some seminal work on young healthy women and their moods and published a paper two years ago showing that even a 1.36 drop in hydration levels leads to measurable cognitive loss. This is big news. We really want to spread this around because even a minimal drop and of course what it’s impacting is executive function. The word ‘mood’ captured our attention but the real issue is that those cognitive storms that can begin [inaudible] because of dehydration.

So, what I’m looking forward to in this conversation is to ask you how hydration became so central to you in your protocols and in your office. So, share that and then you got to tell us the story about your mom.

Dr. Sarah:   About my mom, yes. The water nurse, as they called her. Yeah.

So, before I was even practicing medicine, my mom was working both as a school nurse and also later on doing some work as a camp nurse. And when teens, kids would come to her complaining of various problems, she always started out by first getting them hydrated. And 9 times out of 10 unless, it was broken bone or something, what they were complaining about got so much better. So, she earned the nickname ‘The Water Nurse.’ So, very early on I learned through my mom’s example the important foundation of having good hydration. And then, of course, even during residency training too we were taught a lot about severe dehydration and how that can even cause problems, not just brain fog but even psychotic symptoms that can show up. And so, throughout my practice, it’s been the challenge of number one, how do we efficiently just assess hydration and then how do we address it when people are so overwhelmed and stressed out? So, it’s been a bit of a journey.

Gina:          I’m curious about how you assess hydration. Help us figure out.

Dr. Sarah:   Yeah. So, one of ways that we address hydration is for all of our patients we use what’s called a body comp scale. And so, the body comp scale not only breaks down the composition of someone’s weight such as muscle mass, fat mass but it also will give us measure as far as hydration status. So, that is a nice way of telling early on and as we’re working with our clients how their hydration status is. And then one of the tools, it’s kind of basic, but one of the tools we started using is with all our new clients we give them a Hidrate Spark bottle.

Gina:          Talk about that.

Dr. Sarah:   And the benefit of that are a number of things that we’ve noticed. Even though it’s just water, as you know, it’s not the only way but it really helps our clients to start paying attention to their hydration status. And then if they’re having a day where they’re particularly low on energy, brain foggy, they can look at their history as far as how well they’ve been doing with hydrating. So, being able for them to get that feedback from the Hydration Spark app. It kind of helps our clients to believe because it’s surprising how tough it is for people to kind of believe that hydration and nutrition are such important foundations like, to me of course it is. So, when they start seeing the correlation themselves, it’s pretty innate to see how without us having to do anything they’re becoming more aware of how much their hydration status affects how well their brain’s working and how their energy level is.

Gina:          I love this because you’re really passing back to them through the medium of hydration some assessment for themselves.

Dr. Sarah:   Exactly.

Gina:          You’re handing them back their own capacity for care. This is a really extraordinary moment, that passage through water. I love that.

Dr. Sarah:   Empowering them, empowering them with the information.

Gina:          And out of the silo of coming to you as a person in poor health and looking to you for that solution, you hand them the bottle, in a beautiful symbolism of passing back to them they begin to reignite their own capacity for health just through something as simple as hydration. I believe nutrition is an extremely important part of this as well.

Dr. Sarah:   Right. So, hydration even more so. As you know, we can go a while, days without food but not without water and hydration.

Gina:          I’m really curious, do people come to you with the eight-glasses-a-day story and say “Hey, I can’t get there.” I mean, you’re up in Denver. People there have a huge issue. So, hydration is a bit of a different resonance? I mean, you’re in a culture where that’s a big part of the conversation. Can you share with us a little bit about what it’s like to be in that culture and where glasses a day prescription kind of lands in your practice in your conversation?

Dr. Sarah:   Yeah, absolutely. So, as you’re probably aware, in Colorado because of our high altitude and lack of rainfall and lately we’ve been getting more snowfall which is, I think good, but our air is so dry. So, it’s especially a big issue here in Colorado. Plus Coloradans tend to be very physically active with some fairly extreme sports that put in additional strain on their hydration status because they’re losing a lot of water too through sweat years, through some of the kind of extreme sports that we have that go on here. So, the combination the high physical activity and the extremely dry climate … Even things such as simple as if people are habitual mouth breathers rather than nose breathers has a big impact on their hydration status because the mouth breathing with our dry air really dehydrates people very rapidly. And then you combine that with altitude, you end up with altitude sickness on steroids, basically. So, it’s a very important issue and it is a challenge. So, people, I guess in Colorado probably, are especially kind of aware of the importance of hydration but getting like the eight glasses of water and drinking enough water is a big challenge, especially when they’re very stressed out and overwhelmed with their daily activities. They just forget to drink.

Gina:          I love that you identify hydration through nose breathing and through the actual biological structure that it’s meant to come in. Again, providing alternative views of how to hydrate, what that spectrum is for how to get hydration into your system not just by just drinking eight glasses of water a day, foods, movement, but now the breathing, it is really great.

Let’s return to the eight glasses a day and how often that comes up. I want to hear how people talk about that. How do they come in to you and say “What do I do about the eight glasses a day?”

Dr. Sarah:   Well, that’s been kind of the benefit because many of them, number one, they’re just not even aware. So, oftentimes the conversation doesn’t even come up because so many people aren’t even thinking about hydration but those who are, oftentimes it feels like a task, a chore to get the glasses of water and they’re like “I know I should. I know I need to” but so many of them, It’s not a priority in their world. And getting those eight glasses a day is challenging. And some of the benefit with the bottle that tracks their water intake, again, it kind of helps them to start becoming aware with their current habits – how well are they at least getting in the water.

We also do a fair amount of work with essential fatty acids which are really a key part of hydration.

Gina:          Please talk about that. When you tell people fats are part of the hydration, they’re like “What?”

Dr. Sarah:   Yes, one of my mantras throughout my career, which has often gotten me kind of puzzled like is “Fat is her friend.” We’ve grown up in a society that’s just so negative towards fats but especially the essential fatty acids, the medium chain and long-chain fatty acids. So, food intake, especially the Omega 3 is especially important. And then we oftentimes also will use things like coconut oil for helping to moisturize the oral passageways also, which tends to help improve the hydration rather than just pouring water down, especially for those clients of ours who have dry mouth either from mouth breathing or because of medications that they’re on. So, we really encourage the use of things like the coconut oil, things like that, not just good for oral hygiene but it really helps with the hydration in addition to the water.

Gina:          I love hearing that. I absolutely love hearing that. I wondered if you have like recurring issues that you hear again and again around hydration or have we kind of covered that in what we’ve said so far.

Dr. Sarah:   Part of what’s been … I guess it’s kind of like a recurring issue but it’s a fun one. And, again, kind of going back to like with the Hidrate Spark which again is just water but it’s really fun seeing our clients coming back in and it’s like they’ve developed this really neat relationship with their water bottle.

Gina:          I love hearing that.

Dr. Sarah:   It’s pretty funny. Part of it helps because the bottle will give them kind of funny notifications but also they again are really becoming so aware in ways that we can’t … We can talk until we’re blue in the face about the importance of hydration, the researches, but when they actually experience how much better they feel, they’re so surprised. It’s like with a lot of our other kind of foundational interventions. It’s so fun to just see people coming back currently and like “Wow! It was that simple.” Even some of our clients who I’ve worked with pretty severe mental health problems and they’ve been on every medication in the book and then when we finally are able to, with some of these tools, get them properly hydrated, they’re just pretty much shocked and amazed at how much more effective that is than some of the most intense prescription psychotropic anti-psychotics and antidepressants that something as simple as hydration could make them feel that good and they come in so excited and pretty shocked, which is kind of surprising from my end because it seems like “Well, of course, hydration and nutrition is important” but that recurrent kind of like excitement they come in and it’s like “Wow! It made such a difference.” If they are on medications, the medications can start working once they’re properly hydrated. So, we can make so much more progress. So, that’s kind of a recurring thing that has been really fun to see

Gina:          Dr. Sarah, you have just said the most important thing. This is an extraordinary thing you just laid before us because to understand the that we are 99% water by molecular count, we can’t say it enough, bringing that water, if we go back to the young women in mood study where we know that 2% drop in hydration, that’s a very small body drop, has that much impact. And what you just laid out for us is what happens when we get above that 2% deficit and what happens with the metabolites that we’re dealing with, which then allows them to be more effective. And it’s such important information and I’m just so excited to actually have you on record saying what hydration can accomplish.

Dr. Sarah:   Yeah. Well, I’m so excited to find out about your Hydration Foundation and really looking forward to learning more myself, just some of the incredible research you’ve coordinated. It’s exciting.

Gina:          So, I’m thinking about your spark bottle. There’s a study that came out last summer from Sports Medicine which we can get so much information on hydration and they simply put some sea salt, pink salt, rock salt in the water bottle.

Dr. Sarah:   Lovely.

Gina:          Very simple intervention, right? A pinch of salt in your water bottle. I notice that at the end of the marathon that the dehydration levels had been cut by almost a third. This is extraordinary information. [Inaudible] accessible in terms of what are the dollar signs in mental health care today? Extraordinary.

Dr. Sarah:   And how do we even begin to measure as far as the impact of poor mental health. And the point you bring up, as far as the quality of the water and the content in the water, is just so important because with so many of our bottled waters, we’re taking everything out of the water. And then we run into a whole different problem with water toxicity which also can make people psychotic and can eventually kill us. And so, making sure that we haven’t over sterilized our water … Our health and wellness coach Kylie Myers, she’s doing some additional training with autoimmune conditions and one of the things that’s come up in her studies is the use of dirty water. Are you familiar with the dirty water?

Gina:          I would love to hear you talk about your and Kylie’s research.

Dr. Sarah:   Yeah. So, it really kind of replaced with adding the sea salt, so really putting kind of minerals back into and making sure our water isn’t too sterile.

Gina:          Have you come to any sort of standard protocols yet, are you still exploring it, do you recommend that your clients take trace minerals or that they get their water through foods which carry natural minerals? I mean, there’s so many [inaudible].

Dr. Sarah:   Yeah and that’s still very much a work in progress and that’s part of what I’m looking forward to the more I can learn about some of your interventions and studies as far as how we can introduce protocols and making them individualized as well because what works for one person may or may not work for another person. So, part of what we emphasize here in Castle Rock where we’re at in Colorado, water sources are variable. So, some of our residents in Castle Rock will get water from the municipalities but many of us here have wells. And the wells are incredible like in our own home, I think, it’s 700 feet deep or something. So, we’re getting into some really wonderful aquifers. So, part of what I emphasize with our clients is don’t go out and spend so much money on bottled water, especially if you have good well water from some of these deep aquifers that are enriched with the minerals and the things that we need. So, I really try to emphasize drinking our natural well water as long as there’s not contaminants and stuff in that.

Gina:          Well, as long as we’re talking about minerals in water and how they are necessary part of the hydration chain, it’s so important because these minerals are actually, sometimes they’re called electrolytes. Then it makes sense to us “Oh my god, we have to have those in our [inaudible].” I think that’s really what creates the electrical charge in water and then water’s able to conduct what it does, electricity, far more efficiently in our system. And that’s a part of the hydration story, I think, that I don’t hear often. I’d love to hear you address the electrical function of water in our bodies or how water isn’t just there to keep us wet. I mean, our first instinct we’re so dry, we need wet and then hydration is taken care of, right? Hydration has this perhaps hidden but much more, ‘invisible’ is a better word, but as deeply important delivery and that’s kind of electrical function.

Dr. Sarah:   Right.

Gina:          When you come to mental health issues, this is right up in front.

Dr. Sarah:   Very much. Yeah. So, absolutely, the whole electrical function of the electrolytes is huge. Many people are aware of the importance of electrolytes for cardiovascular health to avoid arrhythmias, heart missteps but the brain primarily runs on electricity. And so much of it is based on proper electrolytes, electrolyte balance. Brain signaling is so strongly influenced, it is an electrical, a little bit of a chemical part to it but it’s mostly an electrical activity.

Gina:          Wait, let me [inaudible] I just heard what I heard. So, you’re really saying me activity in the brain is more electrical than chemical.

Dr. Sarah:   Yeah, yeah. So, it’s both. I think we’re focusing on and oftentimes overly focusing on the chemical part like we just need to get the right amount of serotonin, dopamine, but majority of brain signaling is electrical. Then there’s a little chemical kind of conversion gap and then it’s electrical again. So, electrical stability of our brain cell membrane is so important for all brain health but especially for those clients of ours with bipolar conditions where the electrical threshold tends to fluctuate quite a bit for mostly genetic reason. So, making sure that we’ve got the brain in balance for proper electrical activity is very, very important. And then oftentimes the brain can maintain his own serotonin balance, dopamine but if we’re not making sure especially … We talk a lot about marinating brains in the Omega 3, in fish oil, because so much of that brain cell membrane is composed of the Omega 3. So, with all of our clients we do initial measures of Omega 3 levels and then monitor that. And huge majority, no surprise here in our country, come in with essential fatty acid deficiency which is really … Part of hydration is making sure we are getting those essential fatty acids. And then the brain cell membranes getting depleted and then that disrupts the electrical stability of the brain cell membrane, making us way more susceptible to getting over-stimulated by our really over-stimulating environment.

Gina:          Yes. So, I just want to nail this for our listeners, our viewers so that we really help people understand hydration isn’t only water.

Dr. Sarah:   Right, exactly.

Gina:          [Inaudible] oils. So, essential to know that those two work together because most people think water and oil don’t mix but actually that’s not … The precise formula for hydration for the cell function is that that Omega barrier around the water which lets the proper [inaudible] in and conduct electrical charge. So, I just absolutely love that we have now … We have been saying this in [inaudible] we can really share with people that that electrical function in the brain is hydration and oil driven.

Dr. Sarah:   Yeah, exactly. And let’s not emphasize so much I’m manipulating serotonin. That has its value but it’s been so over.

Gina:          Yes, beautiful. Thank you so very much.

I know that you have founded the Center for Stress Medicine.

Dr. Sarah:   Yes.

Gina:          I would like to return to that idea of the role of stress and hydration. What’s your favorite thing to say about that?

Dr. Sarah:   Yeah. Well, it’s very much an interaction between stress and hydration, meaning that the more stressed out we get including us as providers – I talk with a lot of other physicians and sometimes we kind of joke about how we almost subconsciously intentionally dehydrate ourselves because we’re back to back with patients, we’re in the surgical suites, we don’t have time to go to the bathroom every two or three hours and then we expect to function while, it’s kind of scary, to be honest – but when we get so stressed out, oftentimes we either forget about hydration or it becomes a low priority. And then, as we’ve been discussing, when hydration status is so poor, we get brain foggy, our brains don’t work as efficiently, we get more stressed out because we’re just not focusing as well and we’re not as productive as we could be. And then our energy drops low. So, we then turn to caffeine and coffee, which unfortunately then ends up often further dehydrating us or carbonated sodas. That’s a big issue we see at the center here is helping people understand kind of the addictive relationship that can happen. I just spoke with a woman this morning about her relationship with coke and how habit forming it can become and then dehydrating, which increases thirst. So, that’s part of that whole interaction between stress and hydration that we try to address. And educating people on How things like too much caffeine and too much carbonated drinks will actually work backwards in their mental health.

Gina:          I can’t help it, bo back to the picture you’ve already drawn of the water bottle you get people attached to it and that [inaudible] for the bottle of Coke or the cup of coffee. So, I tend to over hydrate with coffee. There isn’t any expert out there that’s practicing it perfectly.

Dr. Sarah:   No, exactly.

Gina:          We’re all [inaudible] exactly environments but building a relationship with your water bottle, I just think that is the best new relationship I want to be in. I think it’s super cool.

Dr. Sarah:   It’s fun. Here’s my water bottle.

Gina:          Is that your spark water bottle?

Dr. Sarah:   It is. Yes.

Gina:          So you actually get a readout, your patient gets a readout.

Dr. Sarah:   Yeah, it does.  So, they download an app and then the app tracks. And it’s pretty cool too because it will help adjust for physical activity so the actual goal for how much we need to hydrate. It will take into account altitude physical activities. And then you can look back at your history and see how well you did. You can also join and compete with other people, which is kind of fun. So, again, making it one of our big focuses, simple fun and effective solutions. And so, being able to help people find fun in effective ways to better hydrate.

Gina:          I just love this and I love that you’re using technology in a way that’s really smart that has this bridge quality. I mean, it doesn’t mean people have to be linked up to their app for their hydration bottle for the rest of their life. It actually just gets them in that flow. I also really noticed the trend in beautiful water bottles. There’s a lot of really beautiful water bottles and people are very … there’s a lot of appeal there being drawn to something of beauty that they’re getting close to. And I think these are really helpful in a very stressed out environment. In Hydration Foundation and through my work as an anthropologist, looking at desert communities and how they hydrated, I really became very alert to the importance of helping people understand that we actually live now, all of us, in desert communities. That’s really what we’re see now. The biology doesn’t match. We’re not living outdoors. We don’t have access to the kind of waters and foods. We don’t have access to proper lighting and sunlight which is also … I think you’ve had a chance to be exposed to some of the issues around structured water. I’d love to hear about that and the role of [inaudible].

Dr. Sarah:   Yeah, great.

Gina:          Wonderful. I know you also care a lot about vitamin D [inaudible] hydration. You’re just so right on.

Dr. Sarah:   It works, it works. Yeah, the other intervention that’s been fascinating both in what we see clinically but also the research is things like infrared wavelengths and how that can change things as far as circulation of the body, hydration which is pretty fascinating. There’s still, and that’s really one of the areas like in reading your book that I’m so excited about to learn more about structured water because there’s a lot of talk about that and so many of us are aware too that all water is definitely not created the same. There’s such a difference in texture with water and being drawn more to the water that is kind of silkier in consistency instead of that kind of harsh. You can tell it hydrates better, the structure.

Gina:          I think actually it’s why people have such difficult time with eight glasses of water a day. They’re [inaudible] resistant because actually there are many waters, people are not aware of this, that actually dehydrate.

Dr. Sarah:   Right, exactly.

Gina:          You’re drinking but you’re actually flushing out the very electrolytes because the water that’s going in there isn’t coming in. The water that is not structured is a deficit water that starts taking down your structured water inside of you.

Dr. Sarah:   Like a battle.

Gina:          Like a battle. They’re like “Oh, put us in your body. We’re going to go get ourselves structured. We’ll just ignore you and have it for ourselves.” That’s why, I think, people have a lot of issues around trying to hydrate because the what they’re being given to hydrate with is actually dehydrating and their body feels it.

Dr. Sarah:   Absolutely, yeah. And one of the things that you support, the concept of getting so much more of our fluid from plants and fruits and produce is very exciting, as well as, good moist salmon. It’s so much better than just water. You can start with water as far as awareness but absolutely being able to get more hydrated through food is very exciting.

Gina:          Well, nature just packaged it that way, right? I mean, all those cattle out there grazing on grass, grass is 90% water. This is coming out of the research I did around desert communities and seeing they were using cactuses instead of searching for open water. So, I love the fact that hydration, what’s really nice about this project of bringing different ideas around hydration out into the medical community is that you’re putting nutrition back in the picture of hydration.

Dr. Sarah:   Right.

Gina:          People think about their food sources as their water sources as well. How that got so separated, I don’t really know

Dr. Sarah:   Yeah, not sure where it happened. And I love your background with the anthropology and noticing other cultures. I just saw an interview a couple of weeks ago by a gentleman from India and he was just laughing about our attachment to our water bottles and the eight glasses and he’s like “What?” That’s not the best way to hydrate. I mean, it’s a good start and it’s important you have to start somewhere but absolutely taking it to the next level of food for hydration.

Gina:          And also recognizing again that we live in the extremely compromised environments. You and I are both sitting in our offices, right? We’re probably not going to see the light of day for a while. And we’re surrounded by drywall. And I think that the conversation on electronic devices is huge. The relationship between the use of electronic devices and hydration is an extremely important conversation versus [inaudible] reasons not just their drying capacity but for the electrical function …

Dr. Sarah:   The whole EMF.

Gina:          This is very important issue. And the second part of that also is the stress that these machines [inaudible].

Dr. Sarah:   Right. Our environment begins to buzz quite regularly, yeah.

Gina:          Yeah. So, the stress issues and their impact on how we metabolize and what our hydration is one of the key hits on our hydration and why we’re all walking around with water bottles. So we know something’s amiss but no one’s helping us say “Yeah, honey, you live in the most abnormal culture that has ever existed.

Dr. Sarah:   Exactly.

Gina:          “You’re going to feel dad. Let’s help you.”

Dr. Sarah:   Yes and there are so many exciting trends in that. Some of my colleagues I work with here in Colorado, one of the companies, Agriburbia, I think there in New York you have Square Roots, like really bringing plants and growth of plants into our environment to get us more connected with just the natural humanification too. That’s a really big issue here in Colorado is the struggle just to get the humanity of our internal air, where it needs to be, eat source’s EMF. There’s so many of those factors that really work against especially in the wintertime here.

Gina:          Right. We try to offer some really fun tips every day at 3 o’clock which is often where people who hit their low point right, they’re just about to go into really feeling, with I hate, dehydration, normally called afternoon fatigue, but we have our Instagram account Hydration Daily where we just send reminders to everybody “Hey, do something about your hydration but here’s a tip to do it.” And one of the things here is simply having a bottle or a glass of open water on your desk.

Dr. Sarah:   Right, right.

Gina:          So simple. Just put a couple drops of essential oil in that. For busy physicians…

So, how do you help busy physicians hydrate, dear?

Dr. Sarah:   Well, part of what we challenge like with busy physicians as well as just busy people is to kind of steer people away from the idea of sipping water all day long. It’s also very important when we’re working with clients who struggle with issues of constipation, it’s something I learned from one of my mentors in internal medicine Dr. Phil Mailer who has just done incredible work in the eating disorder area as well as with some of our big hospital systems and part of what he taught me is one of the best interventions for constipation, which also I find works great for hydration, is you know the room temperature water and guzzle it, sip it all day long but being able to just chug it down, makes it a lot easier to reach our water intake goals rather than trying to sip all day long but it also stimulates our digestive tract in a way that keeps everything working a whole lot better than just trying to sip all day long.

Another technique is the car. So many of us are spending a fair amount of time commuting. So, having a tall glass of water, again, at room temperature in the car where you can really hydrate during your commute, kind of a captive audience anyway. So, that can be a really helpful time. And getting away from, again, that whole misunderstanding that you have to sip water all day long. We can hydrate kind of in bunches like starting the day out with a tall glass room temperature water and just chugging it down. It just wakes up our metabolism, our digestive tract and it’s so much more efficient hydrating than trying to sip water all day long.

Gina:          We recommend using straw but we have to be careful now not to say plastic straws.

Dr. Sarah:   Right, right, very important too.

Gina:          My mom was in the nursing home and, of course, we were trying to drink. I would literally take two or three straws together.

Dr. Sarah:   There you go.

Gina:          So, that sip function at a much higher level. It’s just such a straightforward …

Dr. Sarah:   The big straw, yeah.

Gina:          Yeah. So, there’s a million clever ways to get around that. Soaking is important too and that’s also something we’ve seen come out of desert research where I was looking at how Bedouins work, looking at text back in the ‘30s, and they always have a big soak before they ever go out to face that desert. And, I think, in helping physicians and all of us who are really busy know that you don’t have to haul water bottle around with you every minute. You can strategically park it at the beginning of the day, in the middle of your day, and somewhere right where you’re ready to go into your evening when you have really … and then you don’t have to water bottle with you all the time.

Dr. Sarah:   Exactly, yeah. And pairing it up with another thing we do every morning like before we have morning coffee, I try to be really purposeful to get that good tall glass of room temperature water, chug that down before my coffer. Easier said than done.

Gina:          So, we are [inaudible] because I have my coffee first and no one is ever going to interfere [inaudible] way to my coffee but then my second drink is always …

Dr. Sarah:   There you go. See, there you go. [Inaudible] pairing it up with habits that we do anyway.

Gina:          Yeah, exactly.

I’d love to hear you talk a little bit more about mentors. I just love hearing how [inaudible].

Dr. Sarah:   Yeah. Well, mentor for me, around really what I would call yeah Integrated Medicine which is incorporating things like lifestyle, hydration, foundations. Definitely the strongest mentors in my life was my grandma, a really incredible exceptional woman. She was born and raised here in America but went to India in her early ‘20s after obtaining … she was a surgeon. So, she went to Rush Medical, did a fellowship in surgery and then went to India as Chief of Surgery for [Inaudible] Medical School. And then my grandfather who also was a huge mentor for me, he also went to India as Agricultural Missionary. And so, he was bringing the technology and nutritional information we had here in the States at that time, from Iowa he was, to India, brought the first egg incubator. So, really addressing a lot of the protein malnutrition there in India through teaching agricultural techniques on how to be more efficient. And then they retired from their work in India after being there for 40 years. They retired back to the states here where I was born. So, I had the privilege of really growing up closely to them and my grandma in particular was just such exceptional, not just as a woman but also as a physician and surgeon because she really incorporated some of the Ayurveda practices of medicine there in India with her practice of what she learned in allopathic or Western medicine. So, grew up really seeing her having her vitamin tinctures that she made grandpa take every day. They had just an amazing garden, just an amazing garden. So, a lot of fresh produce. She also made her own yogurt before Dannon was around. So, we learned how to make yogurt, they called it curds, and the importance of the probiotics with that and really integrating lifestyle nutrition as well spirituality. Being a medical missionary, she also incorporate a great deal of prayer in her surgical procedures, which has been shown to improve outcome too. Pretty amazing. So, my grandma was just an amazing mentor for me and so humble but really in demonstrating as a physician and a surgeon as well as a grandma the importance of our relationship with the earth, with plants, with nutrition, with spirituality as a foundation that we don’t always just jump to a surgical knife or to prescriptions. She taught me a lot about the use of like vinegar inhalation for sinus infections, so effective because she was practicing in India before they had antibiotics there. So, as far as mentor, she and my grandpa are huge ones for me in so many ways.

Gina:          Well, Dr. Sarah, I am really fortunate to have your voice and to have your approaches. I hope we can spread it widely. Thank you for this interview.

Dr. Sarah:   Thank you. And I really look forward to further developing our relationship and learning more.

Gina:          Yeah, I really. Very grateful. We’re looking forward to supporting physician now and make it easy to hydrate because it is such a foundation.

Dr. Sarah:   It’s a challenge, yes.

Gina:          Thank you.

Dr. Sarah:   Yes, thank you very much.

Gina:          Bless you.

Bye, bye.

Dr. Sarah:   Bye, bye.

Gina:          Hello, everyone. Today we are here with Dr. Lisa Mosconi, a PhD and INHC. She is the Associate Director of the Alzheimer Prevention Clinic at Weill Cornell Medical College, New York Presbyterian Hospital, where she was recruited as an associate professor of Neuroscience and Neurology. Dr. Mosconi founded and was formerly the director of the Nutrition and Brain Fitness Lab at New York University School of Medicine and an assistant professor in the New York University Department of Psychiatry where she served as the director of the Family History of Alzheimer’s Disease Research Program. She also holds a dual PhD degree, I want you to hear that, in Neuroscience and in Nuclear Medicine from the University of Florence – Oh my god, Dr. Lisa – in Italy. She is a board certified integrative nutritionist and a holistic health care practitioner. She comes to us at the Hydration Foundation at the recommendation of Dr. David Perlmutter of Grain Brain. He said she’s the one to go talk to. So, we’re really fortunate to have her here today.

Dr. Lisa, we are very excited to be talking to you about hydration. And the purpose of these interviews are, again, to help physicians speaking to each other about the urgency of hydration, how important it is, how we use it in our protocols and our practices and, of course, anybody who wants to listen into physicians talking to other physicians about what they find important and what they use in their own life. We are really happy to hear.

So, welcome. Dr. Lisa Mosconi, we are very excited.

So, I know from your work and from your book, which is called The Brain Food – yes, could you just hold it up for us so we can find that – the surprising science of eating for cognitive power. So there’s a whole chapter in your book. Yes, you devote chapter three to hydration.

Dr. Lisa:      Yes, I do.

Gina:          I was so excited to get this book and to see your commitment to hydration.

Dr. Lisa:      Yeah, and it’s interesting because I’m a scientist. So I don’t really follow the internet that much. I don’t know what’s trending and what’s not. So, I don’t really read diet books.

Gina:          Good for you.

Dr. Lisa:      Yes and no. I had no idea that it would be so strange, so radical, and it’s not.

Gina:          Yes, you actually call water or hydration a nutrition.

Dr. Lisa:      I always talk about it every time I give a talk or I do an interview or a podcast. Very often I’m asked “What are your top five green foods?” and I always say “No, it’s not considered a food but I’m going to start with water because it’s so important for the health of your brain.

Gina:          So tell us why water is important for the health of our brain in particular? So why are we separating out the brain as a specific need for hydration as opposed to just “Hey, get that water in there. It’s great for everything.”

Dr. Lisa:      It is great for everything. We do not associate drinking water we keeping our brains healthy. We do have a sense that we don’t drink enough water, we’re going to be tiring, we’re going to get cramps, we’re not going to be able to [inaudible]. Nobody really thinks of water as good for the brain and that’s just because weather is fluid rather than solid but it has a lot of nutritional value. And especially for the brain, the brain is 80% water. So, 80% of the chemical composition of the brain is actually water.

Gina:          That’s remarkable.

Dr. Lisa:      It is remarkable, right? So, the body contains a lot of water in and cells are really made of water in big part but that’s even more so in the brain, [inaudible], really brain cells [inaudible], astrocytes. They’re all very rich in water. And water is needed for every single chemical reaction to take place inside the brain, the action potential that triggers [inaudible] the neurons. It’s really based on water. Energy production is based on water, the mitochondria, just to process glucose into energy. So, everything is based on water and that means that even my dehydration can really cause neurological symptoms in the brain, fatigue, brain fog, dizziness. And some studies have shown that a dehydrated brain is actually shrinking brain. So, using brain imaging and brain scans like MRI or functional MRI techniques, studies have shown that if you’re dehydrated, even mildly dehydrated, your brain will show shrinkage.

Gina:          On the screen, you can actually see it.

Dr. Lisa:      Yeah. I mean, you can look at the difference between before and after. So, if you’re dehydrated and you could get a brain scan, it looks like this. And then you can drink water and just reverse that your brain is going to look like it’s coming back to life. And it’s not a big difference, very subtle difference, of course but the reason, in fact, I think is quite remarkable.

Gina:          You talk about the need for hydration for cognitive power. That’s not a conversation we hear. We hear about function but when we hear about dehydration all the time, what we don’t hear about is what happens when you’re actually hydrated. Can you say a little bit more about that? That’s a very sexy question. What happens when we actually get hydrated?

Dr. Lisa:      So, it looks like it really has a beneficial effect on cognitive performance. There are some studies that looked into that and show our reaction times, for example, improve when people are allowed to drink before taking a test. So, there was this study done in England, where they had participants randomized into a group of participants, all of them were going to do some testing, cognitive testing for perceptual speed and just cognitive performance. And one group was given an energy bar right before the test but no water and they were mildly dehydrated and the other group was getting water to drink and the energy bar. And then I think there was another group with just water. And it turns out that drinking water was really the factor that made the difference with better reaction times by up to 14% to 15%, in some cases more than that, obviously. So, it was an average. And there are other studies showing that if you drink enough water, that’s correlated with better memory performance by up to 30%.

Gina:          30%.

Dr. Lisa:      Up to turn 30%.

Gina:          Wait, we can’t get pharmaceuticals to produce those kind of numbers. That’s extraordinary.

Dr. Lisa:      It is. And pharmaceuticals are usually tested in people with memory deficits. So these are studies in cognitively intact people showing that it does boost your memory performance but it doesn’t take a scientist.

Gina:          It takes an Italian. I love it.

I think that you also talk about water playing a structural role and filling in the spaces between the brain cells. Can you say a little bit more that. I love that idea that water is way that ourselves space each other approximately from each other and appropriately?

Dr. Lisa:      I can show you some [inaudible].

Gina:          Sure, I would love to see that. That’s why I’m here at your opposite [inaudible] office.

Dr. Lisa:      So this is a really nice brain scan. This is an MRI scan of the brain. It’s been stripped of the white matter. So, this is basically gray matter which is really the part of your brain that thinks, it’s where all the action is.

Gina:          How awesome that we’re seeing this? Totally cool.

Dr. Lisa:      And do you see how this part is black everywhere in size?

Gina:          Yes.

Dr. Lisa:      That’s water.

Gina:          That’s water.

Dr. Lisa:      If you notice that this would be the skull. The bone would be all around it. And everything [inaudible] no brain is actually fluid. It is called the cerebrospinal fluid and there’s water with a number of molecules which is flowing in and out of your brain at any given time. It’s actual water plus. So, it’s like enriched water which is really the opposite of what people are trying to drink when they drink purified water.

Gina:          Okay. So you spoke about purified water in your book. Is there anything else you can tell us about those brain scans? What do you [inaudible] when you see something like that?

Dr. Lisa:      Well, this is a beautiful scan actually. So, I don’t have much to complain about it but I think anatomy perhaps is interesting. So, the brain is divided into lobes or major partition. This is the frontal cortex which is in charge of thinking and reasoning and language. This is the temporal cortex and that kind of decodes sound. This is the central cortex in charge of movement, planning. And this is the visual cortex in charge of vision. And this is the cerebellum. It’s mostly associated with motor function. And then if you look deep inside the brain …

Gina:          I love being able to twirl it around like this, it’s amazing and beautiful. It’s beautiful.

Dr. Lisa:      It is absolutely beautiful. Deep inside temporal cortex we find the limbic cortex which is more like the memory and emotional centers of the brain. This we’re looking at is the hippocampus and the hippocampus is kind of the seat of memory where you have consolidation. So, memory formation really kind of takes place there, not just there but it’s renowned for its role in memory function. And the amygdala sits right on top of it. Here they’re a bit more from frontal and it’s really important for emotional function, functionality for emotions. And it’s one of the first regions, amygdala, that really starts shrinking more in women than men as we reach middle age.

Gina:          Shrinking as in dehydrating?

Dr. Lisa:      No, shrinking as in losing brain cells. And every structure of the brain is sensitive to dehydration. So it’s really important to replenish fluids. So fluids have a structural role literally. The brain doesn’t have bones, obviously. So it’s basically sitting on top of this fluid. So, fluid has a structural supporting role for the brain and also serves as a cushion. When people have a traumatic brain injury or just hit on head, it’s the waters, the fluids that make sure that your brain doesn’t bang against your skull because that would cause a hematoma and it could be an enormous issue.

Gina:          So we could say therefore that hydration would be concussion and tissue protective to be well hydrated, for example, before you play afternoon sports or you want to make sure that hydration …

Dr. Lisa:      Yeah. I mean, it’s not that you can’t lose that much fluid in your brain. [Inaudible] go straight to the hospital before you actually have a problem in sports but, hydration is essential. I think of hydration as being more important for every day functionality at the microscopy level because if you lose so much fluid that the cushioning is not there, you’re at the hospital. There’s no way you’re playing at the park. So, it’s really important to get hydrated it at all times.

Gina:          Could you tell us a little bit about would there be a difference between hydration in the brain, are brain structures different for men and women, would there be a difference in need for hydration?

Dr. Lisa:      It’s a good question. I don’t think there are any studies that looked at the brain versus hydration by gender, as far as I know, but being very well hydrated is important for women’s health.

Gina:          Could you speak about that? We would love to hear more about that.

Dr. Lisa:      I didn’t look into women’s brains for a really long time, actually, since college, my first year in college and I do have a dual PhD. So, it’s been a long time. And the reason being that my grandmother developed Alzheimer’s around that time and then her two sisters also developed the same form of dementia but their brother did. In my family there’s just a female prevalence of Alzheimer’s that I was surprised to find out actually reflects the general population in some way.

Gina:          Isn’t that interesting?

Dr. Lisa:      It’s frightening.

Gina:          Dr. Mosconi, I know this sounds strange but could you just say your grandmother’s name and her two sisters. I think naming people is important.

Dr. Lisa:      My nona’s name was Anna and her sisters were Ethela and Angela.

Gina:          And part of their struggles have led you to where you are today.

Dr. Lisa:      Yes.

Gina:          These are beautiful lineages that we should mention in our scientific work, don’t you think?

Dr. Lisa:      Yes.

Gina:          So I would love to hear you speak a little more about female brain and Alzheimer prevalence.

Dr. Lisa:      So there’s this strong gender disparity in Alzheimer’s that most people are not aware of. Alzheimer’s disease is the most common form of dementia all over the world. There are almost 6 million patients with Alzheimer’s in the United States alone and these numbers are expected to triple by the year 2050 with close to 15 million patients.

Gina:          Amazing.

Dr. Lisa:      And it’s really a public health crisis. There are estimates that if we don’t find a way to slow down progression of the disease or find a cure to stop it, they’re going to be 120 million Alzheimer’s patients worldwide in the next 30 years. That’s really a huge problem but what most people don’t realize is that of every three Alzheimer’s patients, two are women. And whenever I say that, the standard answer is that’s because women live longer than men. And at first, honestly, I didn’t look into that because everybody knows that women live longer than men but in truth women don’t leave that much longer than men. In the United States, women on average live four and a half years longer men but in many other countries like in England the gender longevity gap is only two years. And still in England and Australia as well Alzheimer’s dementia is actually the number one cause of death for women whereas heart disease is the major cause of death for men.  And there’s still this two to one ratio, so two women with Alzheimer’s with every man with Alzheimer’s in this country. So, it’s not always just aging. There must be something more. And we’ve been looking into that for a long time. And we broadly showed that it’s not that women live longer. It’s that we tend to develop Alzheimer’s earlier and specifically as women goes through menopause.

So, when I started working in this field which again was 20 years ago, basically, most people’s thought of Alzheimer’s and understood Alzheimer’s as the consequence of bad genes in your DNA for aging or a combination of the two. And it turns out that neither of these alternatives universally indicates. There are genetic mutations that cause Alzheimer’s but they’re not nearly as prevalent as we thought. So genetic mutations in [inaudible] known so far. They’re very aggressive and they’re in less than 1% of the population. So less than 1% of the population develops Alzheimer’s because of genetic mutations in their DNA. And also, if you just look at people with a family history of Alzheimer’s disease, genetic mutations are found in no more than 7% of families. So they’re not nearly as prevalent as we thought, which is not to say genes are not important. So there are genetic risks factors for Alzheimer’s that are a little bit more common than mutations. Some of them are quite common in the population but they do not cause disease. What they seem to do is to either reduce clearance of these Alzheimer’s plaques that form or increase inflammation. Most genetic risk factors increase inflammation. So it’s important to know whether we’re at risk or not but more in a preventative way.

Gina:          Exactly.

Dr. Lisa:      So, if I have the genetic risk factors, so [inaudible] clearance but we’re [inaudible] things reducing inflammation.

Gina:          Please help us understand how to do clearance.

Dr. Lisa:      Well, drinking water.

Gina:          Yes, that’s what I wanted to go to.

Dr. Lisa:      Make sure that you have a healthy digestion and elimination. And the way clearance works in the brain is a little bit different from the rest of the body and this really depends on a number of factors that some are under our control and some are not. And so it’s really important to focus on those that we have some control over. And keeping our brains healthy overall is really key to reducing inflammation and improves intravenous circulation which is really the key, so healthier brain.

Gina:          And, of course, the role of hydration in cleansing, circulation, release of toxins, sanitation, we call it brain sanitation, the whole finding the … We’re here as young authors together. It’s really fun to share and talk about how we’re getting this information out into the world. And that is our mission, our goals as healers, as physicians as healthcare people and my training as an anthropologist. So surprised… Well, looking at health strategies around the world but particularly why and how people hydrate and I got very excited because in your book you mentioned a strategy which we have found around the world and that is using Aloe Vera or cactus waters or coconut waters. So, I want to hear why you are in love with Aloe Vera and why it’s in your chapter on hydration.

Dr. Lisa:      And before I do that can I finish what I was saying about it?

Gina:          Yes, yes, I want to hear it.

Dr. Lisa:      Alzheimer’s is not necessarily genetically determined and it does not start in old age. It starts in midlife with negative changes to the brain that eventually lead to the symptoms at age 70 or later. And it looks like the process starts earlier in women around their transition to menopause, which is really anytime between the age 40 or 60. So that’s an extra good reason, I think, to really take care of our brains, which does include hydration. And, as you were saying, Aloe Vera, I drink it every morning. I’ve been drinking it steadily for 20 years and I personally feel like a huge difference when I drink Aloe Vera.

Gina:          Well, you are radiating and your skin is gorgeous and I love the fact that I’m sitting here with a double PhD and she obviously could be a fashion model. So beauty and radiance and cognitive power, what a great package. I really love that. So how do you drink it, when do you drink it? We always ask what are your hydrating tips.

Dr. Lisa:      Yeah, I try to keep really hydrated all day. I feel a big difference for me mentally when drink Aloe jam. Actually I like the jam more than the juice. I don’t know, for me it has a better effect and I mix it with [inaudible].

Gina:          Green cells are really important for our brain cells, right?

Dr. Lisa:      I always say there are no scientific trial that I can quote to justify this. It is something that I found personally which was trial and error. And this works great for me to the point that I now have a three-year-old little girl at home and she drinks it too with me and she loves it and she has great digestion.

Gina:          That’s great

Dr. Lisa:      It really helps me. I also juice [inaudible] and I know [inaudible] books and they talk about food and vegetable as good sources of water and fluids, some more than others. Of course banana won’t help you at all in dehydration whereas cucumbers and watermelon is so good.

Gina:          So delicious.

Dr. Lisa:      Many vegetables are very hydrating, it’s great. And it’s not just the water content. It’s really because they contain all the minerals and electrolytes that really keep you hydrated along with just the fluid. Just the fluid doesn’t help you. You need the fluid and the electrolytes, which is why I always say purified water is not water. It has to be natural water, spring water, mineral water, tap water if you like but you have to avoid filtering out the nutrients that actually make you hydrate.

Gina:          Okay, so reverse osmosis. Reverse Osmosis does take out the minerals.

Dr. Lisa:      Oh, it does.

Gina:          And so it’s a form of purified water. And so you’re not recommending that because you’re missing the nutrients. It’s a fancy name for a style of decontaminating water or purifying water. It’s very widespread. It’s considered the ultimate way that we can purify water and that’s why people want to drink it. What I loved about your book was saying that purified water is actually problematic because without the electrolytes or the nutrients in the water, the minerals in water …

Dr. Lisa:      That is not the same as water as far as hydration in concerned. If we’re thinking volume, then sure. I always say that your brain doesn’t just need something wet. It needs the actual electrolytes that are going to power all these chemical reactions that need to take place. It’s not just oxygen and hydrogen. You need to have sodium. You need to have potassium. You need to have magnesium. You need to have all these other minerals and substances that just keep you hydrated.

Gina:          Well, I’m not going to let you go away without giving us your recipe for Aloe Vera and you put chlorophyll in it. Tell me the actual recipe.

Dr. Lisa:      I’ll do that. [inaudible].

Gina:          I know that company. They’re great.

Dr. Lisa:      I do not know them. I just love their product. It’s an Aloe Vera gel from the United States. It’s an excellent product. It’s very, very well done. Family owned. I’ve already checked this all out.

Dr. Lisa:      Good, good.

Gina:          They’re great.

Dr. Lisa:      Then I buy minty chlorophyll.

Gina:          Minty chlorophyll. It’s called minty corporate but it’s liquid chlorophyll. And those brands are widespread in natural health. So we know you like minty brand but just go get yourself some liquid chlorophyll. Then what do we do with it?

Dr. Lisa:      So I do it in a glass like this much Aloe gel, maybe two tablespoons and maybe one tablespoon of chlorophyll and then water and just mix it.

Gina:          Okay. So you’re not drinking the gel straight. You’re not making like a mint drink that you would dilute with regular water to be consistent that you found pleasurable. So you start with maybe two tablespoons of the Aloe Vera gel, quarter cup?

Dr. Lisa:      Yeah, two, like big ones.

Gina:          Big tablespoons.

Dr. Lisa:      Yeah. And I think starting with Aloe gel.

Gina:          Well, I have friends who actually add lemon water to it or lemons to it to give it a different flavor. So the thing is flavor it so that … the gel has a much more neutral flavor and it actually, I can tell you from my research on cactus, that it is actually more hydrating than the liquid. So, great to know. Great to share this information. And you say in your chapter that the thing you found that has the most impact on you and your cognitive power is hydrating and you’d want to recognize it.

Dr. Lisa:      All the time I have my mineral water. I noticed that when my daughter was born, because my husband used to work in Boston, it was just me and the little one and she’s not a good sleeper. She’s amazing but she’s not a good sleeper and neither am I. So great combination. And I was literally on two hours of sleep for two years. And my brain was fine. The rest of me was ready to retire but my brain, I never missed a meeting, I never missed an appointment, I wrote the book, I wrote it like the first year my daughter was born. This is my third language. My second language is French. And my brain never skipped a beat. And it’s really like I didn’t have time for exercise back then, stressed, [inaudible], and all other things that I should have done but I didn’t have time or any way possible to do it. So, it was really my diet and …

Gina:          And your diet is a high fruits and vegetables diet. So those also carry that hydration and electrolytes. Excellent, excellent.

Dr. Lisa:      It’s very hydrating. I find it’s really needed. Never drink cold water in an empty stomach. It’s the worst thing you can do. And then we do a lot of brain scans. We do complicated procedures sometimes that involve blood draws or having a [inaudible] catheter [inaudible] for the brain scans and every time to all my patients I say 30 minutes prior drink a big glass of warm water, not hot, not cold, warm. And they all laugh – why would they do that. Because number one, it makes your veins pop and number two, it gets absorbed much faster. So cold water is a vasoconstrictor. It makes your veins shrink whereas hot weather is a vasodilator and that’s why your veins pop and so [inaudible] put the line in, it’s also why the weather gets absorbed a lot faster. For pregnant women, it’s really important to drink warm water because it hydrates you so much faster.

Gina:          Thank you so much for that information. It’s key, it’s important, and we have to share it with women.

Dr. Lisa:      Those are people over 16. So it’s something that happens when they get older is that the natural response to thirst is depressed just because of changes in the brain. And so many people over 16, they’re actually chronically dehydrated. It’s just that they don’t realize it. They can’t tell. So in that case it’s really important to drink warm water to rehydrate.

Gina:          That’s great. Would tea count like, for example, a tea with … We’d like to think about this and I’d love you to check in and I want to make sure I’m saying the right thing but often the teas are carrying plant materials, it’s a tea, and those plant materials have a set of minerals that they carry as plants. So you’re getting a kind of mineralized water by virtue of having tea. I know my mom, in her nursing home they were giving her ice water and I don’t know any older person who wants to even drink ice water. So, of course she was dehydrated.

I would love to return to your observation that women begin the journey to Alzheimer’s around menopause and I’m very curious. I know we’re probably not going to be able to unpack. First, just having that knowledge is really important and sharing it with women. And then introducing the power of hydration into that moment in their life and helping them see it’s important that you care for your brain as an organ that needs a special attention to the hydration and water issue during your menopausal years.

Dr. Lisa:      Also the rest of your body. There are so many changes that take place around menopause. Bones become frail. Many women develop osteoporosis. And bones have 31% water. It’s really important to keep that in mind. You need water also for your bones to be strong. Your heart, the heart is over 70% water or close to 70% water. And women start having an increased risk for heart disease around the age of menopause. So water is good for your heart as well. There is a natural way to lubricate every organ in the body. So many women of menopausal age really suffer dryness, not just vagina dryness. Their skin gets dry. Their hair gets dry. So, your body’s kind of drying up because estrogen is not just a hormone that helps with fertility but it’s a hormone that has a lot of different effects in the body as in the brain. In the brain it’s in the mode of protector. It’s a hormone that stimulates growth. So, in the brain it really stimulates neuronal plasticity in your dendrites. It keeps your neuronal terminals very plastic and very active. And it has a sort of rejuvenating effect in the brain and in the body. And so losing that really makes you as an organism age faster, right? So I think anything we can do to help with the symptoms is very much necessary. And for women in particular that involves cutting down on alcohol, being careful around caffeine because both have a dehydrating effect, [inaudible] number of other patients related to [inaudible] in some cases and mood swings for some women. And soda has to go. There’s studies from Harvard showing that frequent consumption of soda increases the risk of ovulatory infertility in women which means that kind of negatively affects the health of your ovaries and your ovaries are aging faster or not functioning well. That’s when you go into menopause. So, it’s one more reason to just ditch the soda can and drink more water. And if you create a taste [inaudible] it’s better to drink carbonated water from a natural source [inaudible] or other natural medium of no carbonated waters and then maybe add some fresh fruit juice. That could be a nice way.

Gina:          It’s a soda substitute.

Dr. Lisa:      Fruits, veggies anything.

Gina:          I think helping people move away from sodas is a very important hydrating question I get asked a lot too about – “Does my soda count?” – and I’m like “No, it does not because even though it’s wet, it creates an issue.” So, it’s something you should not do.

Take us into your conference room or your opportunity speaking with your … Are you clinical? Do you see people regularly? What do you say to them about hydration.

Dr. Lisa:      One f the recommendations that we give all the time is to drink at least two liters of water a day. And I personally add real water. So, it’s something to think about. And it is surprising how many people have a hard time doing that.

Gina:          Yes, I think it is a difficult issue to accommodate so much water and that’s why we really try to help them.

Dr. Lisa:      [Inaudible] so much.

Gina:          Well, because a lot of people are not drinking water that they can absorb. They’re drinking purified water. So you can say two liters of water to someone and they’ll go right out and buy a kind of bottled water that’s reverse osmosis or is purified in some way or even, god forbid, distilled without any …

Dr. Lisa:      We use it for [inaudible]. I was so [inaudible] when I moved to the States because I was looking for a bottle of water and I just couldn’t find it. Number one, it was in the fridge. Why would you put your water in the fridge? And then when I found it, it was all like distilled water and no, I don’t drink it

Gina:          I’m not an iron.

Dr. Lisa:      Yes, it’s been purified and all these strange things or flavors. Just give me plain water. How hard can it be?

Gina:          It’s hard. It’s hard and there’s a lot of reasons why it’s hard. And there’s also a lot of reasons why people cannot get those two liters of water down every day and why we really love to share how important food is, for example, Aloe Vera juice. And that has such a different impact and you are so much more vitally rehydrated with a different kind of absorption level when you use some of your foods to cover that amount and that’s an important switch for people.

In your book you say something like 20% of our water can come from food.

Dr. Lisa:      Yes. And it does not necessarily mean saying [inaudible] to government [inaudible] at least 20% of your fluid or water is from, mostly vegetables. I would say milk doesn’t really count. In some ways it counts but in other ways it depends on the kind of milk that you’re drinking. Milk’s more like food than water because it comes with fat and protein and unfortunately sugar because a lot of manufacturers just put a lot of sugar in it just to make it taste differently. And then so many people will go for skimmed milk and skimmed milk is basically a hormonal concoction. Actually it’s not very good for women because it favors testosterone and androgens as opposed to estrogen. So there’s that too.

Gina:          And I know so many women who swear by skimmed milk in terms of trying to control their weight. So it’s sort of a trade off of weight versus cognitive power.

Dr. Lisa:      I mean, how much milk can one drink if that’s really what makes a difference? I don’t know. I think that a good quality organic whole milk is better for you overall.

Gina:          Certainly than a soda, absolutely.

Dr. Lisa:      Definitely. Nature doesn’t make bad food, people do. And it’s all our manipulations and all the way that we adulterate our foods or change our foods that really increases [inaudible] eating healthy natural foods.

Gina:          Yes, this is great because it leads to my last question that I wanted to talk to you about and see where you land on this, which is the environmental insults, the amount of pesticides, the amount of incoming contaminants and its effect on the brain and the relationship. Really what I was hoping you would want to speak about is the relationship of hydration to detoxification of the brain and what’s that relationship

Dr. Lisa:      Right. So environmental pollutants are a natural problem. There’s a lot of debate around that. There’s a lot of conflicting opinions. And the problem is that there isn’t a lot of data and for good reasons … not really good but for political reasons. There’s a reason that we don’t have the data. It’s not because we don’t believe it. It is so hard to test to find the data, to find the information, to then disclose it but there is evidence, emerging evidence, strong evidence that some environmental pollutants act like toxins to the point that the American Society of Endocrinology called these xenoestrogens, it’s neuroendochrine disruptors, which means that they really mess up your hormones and your body at the same time. And this is an issue especially for children, pregnant women because the pollutants can cross the placenta and go to the fetus, and women in general but they have also been linked to a number of issues from very precocious puberty in girls to men boobs in men and there’s also even an increased risk of breast cancer. So more work is needed to really understand which of these toxins are really bad for you and what we can live with but I think it’s really important if you’re a woman with children, it’s really important to be careful and be aware. And I personally … I go [inaudible] as much as I can, especially for myself and my daughter, I really believe in that, I talk to my mom about it. My parents live in Italy and pretty much everything is we say geological or kind of [inaudible] as contaminated. That is definitely important. We are exposed to so many toxin through our foods, through our cookware, the things that we use for cooking, through household products, even our makeup items, I have organic makeup and I only use certified skincare and skin products for my skin, even shampoo. I recently switched to organic and some really works. I know the Clean Beauty Movement is there for a reason. Some is marketing, it all is, but there’s actually a good reason to really go back to the roots [inaudible]. Once you have all these toxins inside your body images, even just smoking, for former smokers and current smokers, some of the recommendations that are always given or should be always given include load up in antioxidants like vitamin C and vitamin D to detoxify and to really counteract the effects of free radicals and oxidative stress, drink a ton of water because it really is the only way your body has to really flush out toxins and that in the brain happens during sleep.

Gina:          Yes. Fascinating, yeah. Speak to us a little bit about that.

Dr. Lisa:      So, the way the brain can clean itself up is basically when the rest of the body is asleep because otherwise the brain has to take care of everything else by itself. So, when we are in a specific stage of sleep called deep sleep or slow-wave sleep, that’s when the washing system of the brain comes out. So, basically the brain gives itself a shower literally, which is a lymphatic system that gets activated and that’s the system that the brain uses to flush out all the toxins and waste products including Alzheimer’s plaques. So it’s really important to have a good night’s sleep.

Gina:          With hydration.

Dr. Lisa:      Drink a glass of water before you go to sleep, have a good night’s sleep, and as soon as you wake up in the morning, drink water to replenish your fluids because there’s water loss at night as you sleep. It’s less than during the day.

Gina:          Do you have any recommendations for people who don’t want to drink before they go to sleep because they don’t want to have to get up and pee, which is a big issue for a lot of people?

Dr. Lisa:      It is a big issue. Stop drinking two hours before going to sleep.

Gina:          But be thoughtful about getting that hydration before you settle in.

Dr. Lisa:      Yeah, ice chips. Remember to go to the bathroom before you go to sleep and drink more in the morning if you can’t sleep at night.

Gina:          I think that’s a great alternative to really remind people, look, there’s a lot to flush out when you are getting up from that vertical position after a night. You really have to flush out and flush a lot of water and waste out of your system. So if you have issues around putting water in your body before you go to sleep at night, even though it’s worth waking up to pee, it really is because you’re going to save your cognition, if you can’t do that, then when you get up first thing, you have really a beautiful slug of warm water, maybe with lemon.

Well, Dr. Lisa Moscone, we are really grateful for you work. We are here to share our research and we’re here to help physicians find resources for their own work. So both of these books can be easily shared with patients, helping physicians understand the role of hydration and getting their patients to quick health, a potent health. At the Hydration Foundation we have a curriculum for patients. It takes eight minutes to bring your patients up to speed. So you can always write this as a prescription. If you don’t have time to discuss hydration with your patients, send them to us. We have all the tips, we have recipes, we have techniques, we have fun discussions, and we also have a Hydration Daily Instagram where anybody can come and find us on Instagram and they get a nudge at 3 o’clock every day to hydrate and then a little tip on how to do that. So, we exist to support physicians to bring this really important message into their protocols and provide the science. We’re thankful for your science. We’re thankful for your work and may you always be well hydrated.

Thanks so much.

Dr. Lisa:      Thank you.

Gina:          The Hydration Foundation welcomes Dr. Stephen Sinatra, M.D., a renowned cardiologist and heart advisor to many, including Dr. Joseph McCollough and the McCollough website and that is one of the most widely read health sites. So you now you have a chance to hear a voice that’s widely heard. We’re very, very pleased to have Dr. Sinatra here to share his insights with us about the role of hydration and the heart, heart health. He’s also been a leading voice in the grounding movement and a supporter of our work here at the Hydration Foundation. In this interview, we provide information for doctors to hear other physicians speaking about the primary role of hydration to achieve vital health.

And, Dr. Sinatra, I know your dynamic book Metabolic Cardiology is already in its third edition and that has helped change the conversation on cardiac treatment. Tell us what you most wanted to communicate in that book.

Dr. Sinatra: Well, Metabolic Cardiology has been my main interest over the last, oh gosh, almost 40 years. I’ve been using CoQ10 for like 35 plus years. And when I stumbled upon ribose about 15 years ago at a [inaudible][06:27] conference, I realized that there was something magical about combining coenzyme Q10, ribose, certainly carnitine team and magnesium together. And I read an article in 2009 about stem cell regeneration. It always perplexed me that medical school, even though our professors said that heart failure had about a five-year existence, in other words, if you had breast cancer, you were better off than having heart failure because people would die of heart failure quickly and it was a major cause of death in cardiovascular disease but when I stumbled upon metabolic cardiology, especially with the advent of ribose back in around 2004, something magical happened. And when I read the stem cell literature, I think what’s going on here is that metabolic cardiology, by using these nutrients, you are stimulating what we call cardiac renewal. And I’ve known for years in heart disease that if you have a major heart attack, for example, and you cannot regenerate the heart cells, if that cannot be accomplished, then you would go on a steadily downhill course, maybe heart transplantation, maybe devices but it wasn’t good, but what I realized was that metabolic cardiology did something to stimulate stem cell renewal, intrinsic stem cell renewal in our body. In other words, we replace our epithelium in our mouth every couple of days, in our nasal passages. In our gut, for example, the epithelium is replaced. Our red blood cells are replaced every 120 days, so to speak, but we never thought we could replace tissues in the heart. And with the stem cell revolution, now we’re realizing that the heart can regenerate itself. So I think metabolic cardiology is a link in stem cell regeneration. In other words, there’s a step that I’m not privy to or I haven’t really understood fully but there’s a step that when you drive ATP in a preferential direction with metabolic cardiology, that ATP is doing something in our body to elevate our own intrinsic stem cell repair with what you can regenerate the heart. So that’s the most exciting thing that I’ve come across in my 40 plus years as a doctor.

Gina:          No kidding! I mean, to talk about igniting our own capacity to regenerate …

Dr. Sinatra: Exactly.

Gina:          It’s extraordinary. So I’m interested in the hydration aspect of cardiac, and we know that hydration keeps the heart moist that helps the blood circulate, but what other kinds of roles would you say hydration would have in this metabolic function?

Dr. Sinatra: Well, hydration is very important because when you’re dehydrated, this puts an enormous strain on a cardiovascular system. And why is that? Well, we know that if you have sticky blood, for example, where the blood is clumped and it’s not fluid, it’s almost like being … You live in New York City and you know what it’s like in a traffic jam. The cars aren’t moving, they’re sort of stuck. Now, think about Germany on their highways where the cars are going. They’re going 80-90 miles an hour. Well, the velocity between those cars, we call Zeta Potential. So in New York City when you’re stuck in a traffic jam, the energy between the cars is minimal, it has minimal Zeta Potential, so to speak. In other words, Zeta Potential is the way red blood cells repel one another. So when you have hydration in the body and your cells are more hydrated, then the repelling of the red blood cells is better. And it’s the repulsion of the red blood cells which increases Zeta Potential. And whenever you do that, you’re supporting the cardiovascular system. Now I know that’s a complex term but I learned about Zeta Potential when I did my work on earthing and grounding. And when we published it in the literature, we realized when you put your bare feet on the ground, this sort of not only supports what we call blood viscosity, the thickness of the blood, like hydration does, hydration supports blood viscosity, but basically you’re supporting Zeta Potential as well. And this is complex cardiology but basically the better hydrated you are, the better you are from a cardiovascular point of view. That’s what it means.

Gina:          Could you speak a little bit more about this electrical function that’s going on, the Zeta Potential, because it’s simple when we remember that water conducts electricity?

Dr. Sinatra: Yeah, that’s the key. See, water is vital to life. We all know that. I mean, we can go without food for 40, 50, 60 days but water, four or five days that you’re done. No, water is vital because water lubricates our cellular membranes. And our cellular membranes will let nutrients in, get toxins out, it’s sort of an ebb and flow. And a lot of us can be dehydrated even though we’re drinking lots of water because it’s really the cellular membrane that’s key right here. And, in your book Quench what you guys really focused on is the cellular membrane. And if you can hydrate the body or your cellular membranes whether it’s water or vegetables or fruits, all the things you mentioned in your book, whenever you make that cellular membrane more alive, more viable, more penetrating, whenever you have intracellular hydration, then the energy of the cell increases and you have better adaptability of the cell in the body. So it’s no accident that grounding and hydration go together. And I’ll just tell you a little anecdote.

When I wrote the book Earthing, I used to be friends with a contractor from Long Island who was a building contractor for years and we used to walk the beach together on the sands of Montauk Point. And walking in the ocean on the beach is a phenomenal way of grounding but he told me when he was a young contractor, he was working with a bunch of Norwegian carpenters and the foreman, and this is what this 40, 50 years ago, this is amazing stuff, and the foreman of these Norwegian carpenters told everybody to take off their shoes and to walk on the wet due, the grass barefoot because this would ease their aches and pains of working. And he was absolutely right. So, Gina, there’s a connection between the ground and hydration. In other words, it’s hard to ground in the desert because you need hydration to conduct the electrical, what we call, potential or the humming of the earth. It’s the mother earth energy, it’s 7.83 Hz. And whenever you bring moisture to the earth’s surface like if you’re walking on barefoot, walking in the ocean where the waves surfs and meets the sand, that wet area, whenever you bring hydration to the table, then the grounding is so much better achieved. So there is a connection between these and it’s all very simple. I mean, it’s simple cures, it’s not rocket science, but the better hydrated you are, the better electrically connected you are. And remember, the heart is an electrical organ and the body is electrical. I mean, we’re all electricity. So hydration of cells is vital for health. And that’s why your book is so good because it’s a very easy read. And it’s captivating because there are certain catchy phrases and sentences in there that really get the reader to say an aha and once you get that, you get the essence of your book.

Gina:          I think it’s so funny to help people understand what walking barefoot and hydration would possibly have to do with each other?

Dr. Sinatra: Oh, yeah, but they’re very, very connected.

Gina:          They’re very connected because the prescription for everyone for hydration is eight glasses a day and that’s the only prescription we give. The idea of moving up, moving into grounding and allowing people to use the water within their bodies to absorb the electricity of the earth and conduct that more profoundly, they’re a partnership, the hydration and the electrical function, it’s really exciting. And if you were going to advise, and I know you love to advise young doctors, how would you help them talk about this to a patient like what would be the script that you would give them to say “This is the three points you need to make about hydration while you’re with your patient.”

Dr. Sinatra: Well, it’s almost like a cardiovascular trifecta. I mean, certainly there’s various ways you can hydrate and ground, for example. Putting your bare feet on the ground makes the blood thinner, it supports heart rate variability, it does all these good things for the body but it’s not enough. Hydration is really key, as you mentioned. And the way to hydrate … I really love the charts you gave in your book – hydrating fruits, hydrating vegetables, for example. These are little pearls that people need to understand. For example, if you’re a meat eater and a bread eater and you’re not getting fresh fruits and vegetables, well, then you’re basically throwing out a whole entity where you can improve your intracellular hydration. So, eating lettuce or romaine lettuce, you talked about in your book. One of my favorites is cucumbers and cucumbers was at the top of the line, I was delighted to see that. And then one of the breakfast that I like to do is a berry-berry breakfast, like raspberries, strawberries, blackberries, and they are exceedingly good hydrating foods. So I think the essence of your book is sure, you can drink a lot of water, that’s good, but you can also get your water from vegetables and fruits. So I would say the trifecta of cardiovascular health would be drinking water is good, taking in fruits and vegetables with good hydration indices … I mean, even watermelon. I mean, it may have a high glycemic response but it’s 100% water. And certainly grounding at the same time. In other words, if you can hydrate and then ground at the same time and taking that mother earth humming, 7.83 Hz, this energy, this is amazing stuff because we’ve showed that grounding thins the blood. And if you could thin the blood with hydration… Look, the essence of strokes and heart attacks … We used to think you get blockages of vessels, which is true, but a lot of people have coronary thrombosis or clot in the brain, a cerebral vascular accident. And a lot of this can be due to sludgy blood. Sure, it can be superimposed on plaque formation but when your blood is more like red ketchup and not like red wine, the incidence of cardiovascular events are on the increase.

Gina:          Well, I think part of that increase has to do with the fact that we’re really not acknowledging what a dehydrating world we now occupy.

Dr. Sinatra: Oh, yes.

Gina:          Whether you’re in an air-conditioned room, schools, offices, airplanes, wherever we turn, we’re really in dehydrating environments and we haven’t done any compensatory adjustment. We just move on through is if we haven’t actually reshaped the entire environment that our biology lives in. So returning to our more natural biology, it seems so simple but really when you take a fish out of the fish tank, there’s going to be a rise in chronic illness? It just does.

Dr. Sinatra: That’s right. And I’m glad you mentioned fish because it just triggered something in me, right? One of the essences of Quench, and you wrote it in there and it was footnoted nicely, it was a 2017 reference, when you commented on Omega 3 essential fatty acids, allowing the cellular membrane to breathe or to conduct in and out flow, I mean, that to me was a real pearl because, again, it shows that you can do certain things in your diet, for example, that can help intracellular hydration because you’re right, a lot of us are intracellularly dehydrated. And in your book you talked about brain fog and fatigue, the two most common symptoms. I mean, I’ve seen this in my son who got very sick when he worked on Wall Street from electromagnetics and brain fog and fatigue are a part of that and it’s vitally important to really focus on intracellular hydration. And that’s why your book is so good because it gives a lot of information on that.

Gina:          Thank you. I’m just glowing from your praise. I know that one part you really cared about and drew attention to was the role of fats. And so few people put the fats with hydration as part of the hydration chain, just like walking barefoot is not where they’re thinking of going when they talk about hydration. So can you say a little bit more about the role of fats in hydration?

Dr. Sinatra: Well, I mean, fats are part of the cellular membrane and fats can sort of hold moisture in, so to speak, or actually breathe more moisture out. And if you look at the populations of the world, I mean, look at the Mediterranean basin, for example, it was just written up only recently. In fact, it’s on my website DrSinatra.com, I put a notation up there that Italy and Spain were the two top countries in the world for longevity now. It used to be Okinawa but the Mediterranean basin was second in longevity. By the way, the United States is horrible. I mean, the average lifespan for an Okinawan was 86. Now they say it’s a little higher in Spanish and Italians, a couple of months higher, but the average American is 79 and we’re going to look at that but if you look at the Mediterranean basin, I mean, what do they consume? Avocados, olive oil. I think olive oil is the secret sauce of the Mediterranean diet. I’ve always believed that. And olive oil does everything right including supporting hydration. I mean, you won’t see that in the literature. Olive oil changes pro-inflammatory genes, it makes it less inflammatory. It supports HDL, it raises HDL, and it can make small particle LDL a little more fluffier. It can lower LDL as well. It can have an impact on Lp(a). I mean, there’s a lot of things that olive oil can do but it also supports hydration as well. And that’s what the public doesn’t know. So avocado is a mono-unsaturated fat. Olive oil, certainly, I think, is the best, extra virgin olive oil. My last name is Sinatra and I grew up on olive oil. And I think the best olive oils right now are the ones coming out of California because they’re extra virgin, they’re 100% extra virgin. If you get a California growers seal of approval, it’s the COOC, if you get the council’s seal of approval, well, then you have 100% extra virgin olive oil, which I think is really liquid gold.

Gina:          Liquid gold. Well, the key word there is liquid, right?

Dr. Sinatra: Yes.

Gina:          And the joke is oils are deeply hydrating, especially if you apply them to your skin.

Dr. Sinatra: Oh yeah, the Italians do that all the time. Their face, their skin and everything else. No, it keeps moisture in and I’m sure it does it at the cellular level as well.

Gina:          It’s doing it on a cellular level. Write down that you think of the membrane of the cell as your external skin at an another point. It’s that same permeability and softening and then the electricity function of course that oils can also conduct. It’s extraordinary to talk about the role of fat and hydration. It’s a new conversation just like walking barefoot on the beach is a new conversation in hydration and we’re really so pleased to have your voice in that conversation help other physicians really get that role of hydration, how primary it is to returning ourselves to that capacity for self generation, the stem cell regeneration, just as you spoke of in the beginning. So I wanted to ask you how do you hydrate. You probably do practice what you’re preaching, right?

Dr. Sinatra: I do, I do. I mean, I need to drink more water but one of the things I do before bedtime, though, is I have a big glass of water and I include [inaudible][26:08] fiber in it and I use my electrolyte drink which has 500 milligrams of potassium and 100 milligrams of grape seed extract and I combine that with probiotics and prebiotics and I drink it at night. And before bedtime I’ll take in about 15 ounces of fluid, which is good because you want to be hydrated. And I really do that because the extra fiber and the probiotics and prebiotics assist with bowel cleansing and stuff like that. So it’s a detoxification remedy that I use. And I love grounding. I ground all the time. Like I mentioned before, I eat a lot of berries – blueberries, raspberries, blackberries, organic berries. They’re very hydrating. I do a lot of lettuce. I’m a big salad person. I’m an avocado freak because I strongly believe in the medicinal aspects of avocados, not only the mono-unsaturated fats like olive oil mostly but they support glutathione in the body, which I think is one [inaudible][27:18] of cardiovascular health. So I do practice what I preach. And, again, I’m a big vegetable and fruit lover and I incorporate it in my diet every day.

Gina:          Would you mind sharing with us, Dr. Sinatra, one or two people who’ve been influential, who’ve been mentors? We love asking this question because it gives doctors a chance to sort of share their own gratitude and also show what the lineage is around healing medicine, that this hasn’t come out of nowhere, we continue to learn, people change direction. Tell me a little bit about who some of your …

Dr. Sinatra: Well, there’s two people that come to mind – Tommy Rosa, who went to heaven, had a big impact on my life. And there was Jacob Ritz. I don’t know if you ever heard of him. He was a Dutch chemist. I first received my cardiovascular boards, I was board certified in Internal Medicine, took my cardiovascular boards and I passed them at age 31. So I was a board certified cardiologist at a very early age. And I’ll never forget this, it was in the fall just after I passed my boards and I was a razor sharp well-trained invasive of cardiologists, I saw a patient in my office who was referred by a Dutch chemist from Ohio. And he wanted me to see this individual for his high blood pressure. And the patient asked me if I would call this chemist. I said “Sure, I’ll call him.” I get on the phone with him. He was 91 years old then. He refused cardiac surgery. He told me he developed a cure for atherosclerosis. Now you got to understand it’s back in like 1978-79 when I passed my boards, in ’78 I passed my boards or it could have been ‘77 even. And I’m on a phone with a chemist who says he developed a cure for atherosclerosis and he started to talk about phosphatidylserine, phosphatidylcholine. I didn’t even know what the words were. I mean, I know a little bit about magnesium and vitamin E but I didn’t know about the in-depth he was he was going into. You know, Gina, I became an alternative cardiologist and recovery at the end of the phone call. He had a big impact on me because not only was he 91, he was sharp, erudite, and funny. I just couldn’t believe how much he had it together. And I said to myself “Jeez, if I ever made it to 91, I’d like to have his cerebration, his vocal voice, and stuff like that.” So he had a big impact on me. So I started to look at nutritional healing at a very, very early age. So I was blessed.

And then there was Tommy Rosa. Hey, look, when a Tommy Rosa steps into your life, you really got to step back, you really got to step back. When you meet somebody who has been on the other side, and it’s amazing, I’ve been going to a lot of conferences, a lot of them out of the country, there’s a few in this country, on life after death and it’s just absolutely amazing. I mean, I spoke with Dr. Von Pennell from Holland who looked at 420 cases of people crossing over, over a 10-year period of survivors of sudden cardiac death. When you meet people who have been on the other side, who come back with this knowledge and this insight, it has an effect on you. So I was blessed to meet Tommy Rosa. And then we wrote a book Health Revelations From Heaven and I just feel that Jacob Ritz, 91; Tommy Rosa, a lot younger, were maybe the two major, I would say, mentors for my growth and development.

Gina:          I love Health Revelations From Heaven And Earth: Eight Divine Teachings From A Near Death Experience. I wondered how this book has affected your own life how you’re living it now.

Dr. Sinatra: Oh, that’s a great question. I’ve been at the bedside of hundreds, and that’s not an exaggeration, believe me, of people in their last moments, cardiac resuscitations …

Gina:          Let’s just hold that for a moment. It’s so easy to say it but that extraordinary moment, it’s so important that we live it, we don’t just rush by it, that we hear and collect experiences and tell stories. Doctors have such a unique place in our life cycle. And the fact that you’ve been there over a hundred times …

Dr. Sinatra: Well over. Oh my gosh!

Gina:          Wow!

Dr. Sinatra: it’s just an amazing… It’s a gift.

Gina:          Yes.

Dr. Sinatra: I saved a lot of people, I lost people, but it’s a gift to be in that space. I didn’t realize it at the time because I was so busy. I was a midnight hero day and night, I worked in heart disease, but after meeting Tommy Rosa I realized how special it was but I’ll tell you, Gina, because I was at the bedside of many, many dying people, I feared my own death. It’s almost by association and I had a fear of death until I met Tommy. And then after hearing Tommy’s story, I don’t fear it anymore. Look, we’re all going to a better place. I am absolutely convinced. And, look, it’s not just Tommy’s experience. I was prepped for Tommy. I mean, I had 20 survivors of sudden death who came back and forth but I never understood the depth of it until I met Tommy. I mean, I had people tell me “Doctor, I saw you resuscitating me. I was on the ceiling, floating on the ceiling and I saw you trying and I was rooting for you.” I had people telling me all these different stories. I had two bad stories but most of them were really good and it made me think and ponder but after meeting Tommy, I finally was connected. So Tommy really inculcated into me that we’re all going to a better place and death is a new beginning for many of us and it’s a different dimension and it’s not anything to fear. So that was one of the best, I guess, associations I had after meeting Tommy.

Gina:          Well, the message that death is not something to fear is a profound one. It is a dimension between our bodily life and what comes after. We spend so much time trying to care for our bodies or we don’t do such a great job and mercy on the body while we’re here is such a, I don’t know, it’s a profound and important message, mercy on our bodies while we’re here, our self mercy towards our own bodies. And I think that hydration story for me started with my mom in the nursing home when she was so chronically dehydrated. And here I was studying desert communities and how they hydrate in drought. And I think we’re given stories, they’re chapters, they’re stepping stones.

Dr. Sinatra: Oh, absolutely, they’re placed in that path for a reason.

Gina:          Yes, yeah.

Dr. Sinatra: Your mother was placed in your path for a reason, so you could write a really cool book. It’s so important.

Gina:          Thank you. And more to talk about larger … Again, just going back to this phrase “mercy on the body,” I can’t think of a more merciful thing to do to your body than to pour water into it, right?

Dr. Sinatra: Right.

Gina:          We just want to thank you here at the Hydration Foundation, Dr. Sinatra. You’ve been such a champion for us and your own lifelong work to heal anybody in your sphere, that love of that. We just want to thank you for using your gifts. And writing, it’s tough work. It’s as hard as doctoring. And the fact that you’ve written and that increases your range and your ability to heal, we just thank you for that work.

Dr. Sinatra: Thanks so much, Gina. It was a pleasant conversation. I hope your viewers enjoy it as well.

Gina:          Bless you. Thanks again. Bye, bye.

Dr. Sinatra: All right. Bye, bye.