Nutrition for Nurses with David Ledgerwood

[00:00] Michelle: In this episode, nutrition for Nurses. The first person I thought of as a guest was David Ledgerwood. David's personal story of how good nutrition improved his performance as a CrossFit athlete is inspiring. His deep understanding of human physiology and how the body utilizes nutrients are instantly apparent. I absolutely love it when he says said food shouldn't make you feel bad. Amen. He gives us actionable strategies for using food as fuel to increase our stamina, endurance and overall health, and to be able to do what we love practice our professions in the five minute snippet. He's not the least bit superstitious. Right here is David ledgerwood. You're listening to the conversing nurse podcast. I'm the Shell, your host. And this is where together we explore the nursing profession one conversation at a time. Well, good morning, David. Welcome to my closet recording studio.
[01:14] David: I'm glad to be here. Thanks for inviting me.
[01:16] Michelle: It's a pleasure. We've known each other for a while, and when I knew I wanted to talk about nutrition for nurses and other health professionals, I said, David is the one. So thank you for being here.
[01:32] David: Well, I appreciate that. I think about nutrition very organically and I think it's a very important aspect of everybody's life.
[01:40] Michelle: We need to eat.
[01:41] David: We need to eat. It's an inevitability. So if we can focus a little more attention on it, then I think we'll be more successful. So I appreciate you asking me to be on.
[01:51] Michelle: Okay, well, I want to kind of delve into your story first. I know you, but probably my audience doesn't know you, so just talk a little bit about your story and your start in fitness and nutrition.
[02:07] David: Yeah, I think my story is like all of ours. I was not super athletic as youth. I did some baseball, some swimming, but really by middle school, early high school, I just went out and stopped doing sports and I started living my life and going to school and got into college and married my wife. And I just put health and wellness on kind of a back burner about in my mid thirty s. I started to notice that I just couldn't consume food the same way I couldn't eat the same things, and it was having a detrimental impact on my health and how I was feeling. So I decided to make some changes and try to develop a fitness routine and try to break free of this kind of stagnant life that I was in. Started by running kind of getting into some half marathons and then some Spartan races and really just kind of focusing on what do I need to do to successfully go through these and not necessarily win anything, but just get moving. Part of that process was starting CrossFit, which I've been doing that now for seven years, but the start of the road was pretty rocky. I went into it with the idea of just losing weight. I just wanted to work out to lose weight. I was at that time £230 and five foot nine. So I was on the on the spectrum of weight or obese by any measure. And so I was just going in there and just working hard and working out, you know, five, six days a week and and, you know, just trying to get started. And I fell in love with the process, but I was still missing the piece of nutrition at that time, seven or eight years ago, the way I lost weight was I just didn't eat. It really restricted what I had. I was in caloric deficit and disciplined versus undisciplined doesn't really matter at that time, that was my goal and I was going to achieve it. And I got from £230 down to £175. So, success. Yeah, everything was good, but I started to notice other problems because I wasn't eating right, I wasn't eating any fat, I wasn't eating enough protein. My hormone levels were all out of whack, and that's my wife now, looking back, she was I was not a happy kid. So I started to really explore what was the next step at that point. I also kind of plateaued at my fitness. I wasn't really getting any stronger, I wasn't getting any faster, and really started to think about what was next. Well, what did I need to do, and consult with the coaching staff there at the gym and some of the people in my life. And the next logical step was to understand nutrition and how what we consume and how we consume it impacts how we feel and how we grow and how we recover, and all of those things that are really important to daily function. And at that time, I went from having really just a macro, counting caloric restriction, and not even counting macros, really just restricting calorically to a more balanced approach. It was called Zone. And really what it was, was just a rudimentary macro counting platform.
[05:39] Michelle: I remember zone. Yeah.
[05:41] David: And it allowed me to realize that one, I wasn't eating enough, and two, I was not eating the right things. I was demonizing food that I thought was bad, when in reality, it was necessary.
[05:58] Michelle: Wow, we do that so much.
[06:00] David: It's very common, right? Very common in the world. It doesn't matter gender, it's really universal. I think we do this just naturally. So I started with that approach and I implemented it wholeheartedly and went into it and did that for about a year, 100% all in. And I went from that £175 up to about £195. But I was a lot more strong or a lot stronger and I was able to recover faster and I felt a lot better. And I just was enjoying life a lot more and got away from this obsession with a scale and really started to understand body composition, skeletal muscle mass relative to water, relative to fat, and really know it's not how. Big I am from a scale standpoint, but it's how I feel and how my body composition is shifting and changing and really diving into that. That's really where the love of kind of the nutrition side of fitness and life really kind of held and spurred in me. And that's where I've come from today, where I really try to focus my attention on eating well and feeling good and not following a diet or lifestyle necessarily, but eating intuitively. One of the books that I recommended for the book club was called Wired to Eat Rob Wolf. Rob Wolf. And he's actually pretty classically story of growth in mentality 

because he wrote the Paleo Solution book and started the Paleo Diet. He really kind of developed that as a dietary trend. And he will tell you, and if you listen to his podcasts and what he's doing today, he'll tell you that he's realized over the years that it's not a diet that's going to solve any problem. It's really understanding and intuitively eating to understand how food interacts with you and how you feel and how food is making you feel. And I've really embraced that because no one cookie cutter approach is perfect for everybody, right? And if we tend to live in a box, we get very bored with that box and we tend to fail in that box. So if we learn that nutrition is broader than that and that our health and everything is surrounded by this thing that is our foundation, then life becomes a lot easier because I'm not worried about I can't eat that because I want to do this and I don't eat that because it makes me feel like this. It's a different mindset and it's really something that we need to develop into. So that's my background. That's where I came from. Hopefully I have a long future in this space. At 41 years old, I feel like I'm the healthiest I've ever been, which most people at my age are going backwards, so I don't want to go backwards.
[08:57] Michelle: Well, I mean, you've done a few things, so you've first of all, I like how you were talking about intuition and to listening to your body intuitively. And I'm going to go out on a limb here and say that maybe nurses don't always do that because of our jobs and all the demands that the job puts on us. We kind of put those things on the back burner and so we don't really listen to what kind of fuel do I need to get through a really busy twelve hour shift? All of those things and talking about Rob Wolf. I recently went Paleo a few months ago, and it was because of hashimoto's and using really food as medicine to heal. Like, I got told by my endocrinologist, you cannot eat weight. Weight for you is destroying your thyroid. You cannot eat dairy. And I was like, no, don't take my dairy. I could do a lot of different things than weight and it's been very healing for me. So I'm starting to heal myself from the inside out with food. So touch on that a little bit as food as medicine because you also made the connection that even though you're older and if we've abused our bodies for decades, now we start getting things like arthritis and arterial sclerosis and all these other things in autoimmune diseases. So talk about kind of using food as medicine.
[10:41] David: Yeah, I think the big thing we have to think about with food is that these types of things like with wheat and with dairy, they're actually irritants. So the reason why you don't necessarily digest or utilize those types of nutrients from wheat is actually inflammation in the gut. So it's an inflammatory response that our body has to these specific proteins or these specific things within the food. And it's unique to everybody. Right. And that's where understanding how food makes you feel and using food as kind of a medicine to heal you is really kind of the right approach because you shouldn't feel bad after you eat hard. Stop. So if you consume something and you feel bad, there was probably something within that meal that's causing a problem and.
[11:39] Michelle: You need to listen to that exactly.
[11:42] David: And remove it and cut it back and really start to focus on how that type of change made your body feel. Right. And it is hard sometimes because we're setting our ways and we're routine beings. We tend to like routine and we like the things that we like. But I think that the reality of it is that as we move forward and as we realize that this is a huge impact and it has a huge impact on your daily activity, including your ability to be successful at your job, it's not just the fuel, it's not just the energy, because that's what food is. It gives us the energy to perform our daily tasks. But if it's causing a detrimental effect to how we feel and our health, then that's also impacting our ability to do our job. So people who focus on health and wellness tend to be at their job longer, be more successful, have less sick days, have less missed days. They're happier, less irritable. There's a whole list of things as why as how medicine, our food, excuse me, can be kind of a medicine without having to take a pill or something to that effect. Because first and foremost, we have to acknowledge that food has an impact on our body. And secondly, it's not all positive. There's a lot of people out there, again, that are in like the carnivore camp where they only eat meat. Well, you know what? To them they have huge gut reactions to anything else. And that elimination diet seems to work extremely well for them. Does that mean it works for everybody? No, but that means that, hey, if I have this certain infliction and I want to try this certain diet to see if it helps with that infliction, then I'd try it. The same thing with hashimoto's and irritabal and even rheumatoid arthritis are now tied. And even some things like Parkinson's and Alzheimer's are now starting to be correlated to how we eat and our gut. And I think that that's something that as nurses, we should start to understand this idea that our microbiome is this multifaceted environment that is our gut microbiome, our skin microbiome, our mouth microbiome, all of these play a unique synergistic role to keep you happy and healthy. And when one's out of whack, I'm sure your audience has seen it more out of whack. It creates some havoc that the body can't fix by itself.
[14:19] Michelle: Exactly. Some of the things that you said really resonated with me in terms of you didn't really say diet fads or trends or anything like that, but you said trying to find out what works for you. And I started working in the mid 1980s, so 1986, and I was really young, 21 year old nurse, new young person in life, all of that. Not educated. I have to say that in the mid eighty s, I don't feel like there was the focus on nutrition that there is now. So one of the diets that came was a low fat diet because people started saying, well, if you're fat, you can't eat fat. So now you go low fat. And for someone who loves carbs, low fat was like great. Because here's what I did. I started my morning before work at 05:00 in the morning, got up, got ready, I'm going to have a large glass of orange juice oh goodness. And coffee.

[15:31] David: Talk about an insulin spike on an.
[15:34] Michelle: Empty stomach, which I felt really good the first hour. Right? Then I'm in Report and I'm taking a nose dive and I'm hypoglycemic and I'm jittery so out of Report, go see my patients do all that and I'm barely making it. And now it's time for breakfast. Now what do I do? I have a bagel with non fat cream cheese and there goes my insulin again. And I was doing this all day long and it took me seriously a few months and also a few pounds of weight gain to say this is not working, this is going the opposite direction.
[16:21] David: Yeah, exactly. And one thing I think that is important to highlight during all of that is that at no point did you consume any protein.
[16:30] Michelle: No. I'm running, running all day long.
[16:36] David: And I think that's really there's two things there the idea behind diet fads are fads for a reason. The number one trend is to start a New Year's resolution and then within 30 days it's gone. And the reason why it is, is because it's not true. Change.
[16:54] Michelle: It's not sustainable.
[16:56] David: No, you're driven to want to change, but you're not willing to really make the challenges to change yourself dramatically long term and for the right reason. It's not to lose weight, it's to be healthy. And that's really, I think, what we need to focus on. And being busy is not an excuse, right? But we use it as a crutch. I got a twelve hour shift, I can't have a break. I had to grab something quick. Those are all excuses to justify in your mind why it's okay to grab that bagel or that candy bar, or that bag of chips, or that processed meal, or whatever it is that we're reaching to. But in reality, it doesn't take much time to actually prepare and to focus on a couple of key things that will help you get to the point where you want to be. And that's, again, not about a weight, not about a pound number. It's about how you feel and about being healthy and being here in the long term. The last thing we want is for people who have dedicated their lives to taking care of other people, to not spend a little bit of time taking care of themselves. And that is really the important part of this, is that you can sacrifice everything and then after a nice long career of helping people and dedicating your life to that have nothing left, and be so burnt out and so out of shape and just feel like there's no coming back from it. There's mitigation steps, especially young nurses who are just starting out to really set their lifestyle in the right direction, to really understand that this is long term success road. Right? You work hard, you help people, help yourself. It's okay. It's not selfish. We're here to live and that's important.
[18:43] Michelle: Can you take a drill and drill.
[18:45] David: That into our brain, go back in time and tell everybody in nursing school that and medical school and everything?
[18:52] Michelle: Yeah. Now let's dive into that a little bit. One of the things I want to talk about was fuel. So like you said earlier, food is fuel, food is energy, and it just depends on how we use it. And you also touched on going for that twelve hour shift, and we are incredibly busy. We just out of the gate.
[19:16] David: Boom.
[19:17] Michelle: We're running. Depending on what's going on in the unit, whether you're in an ICU or an emergency room or wherever you are, you can get a sense really quickly that I might not get to eat breakfast today, or it might be very delayed. And so we reach for those things. And I think so much of my audience can really attest to. This is like, we love food, we love celebrating, we love sharing, we love the community of nursing, of medical professionals, respiratory therapists, physicians, all that. We bring a lot of food into the break room, and we bring cookies and people bring donuts and all those things that are like quick energy, quick fuel. And so if we're already anticipating that we're not going to get to eat or that it's going to be delayed if we didn't prepare anything and bring anything, we're much more liable to just grab something, some quick energy. So give us some ways that we can and maybe some foods that we can use as fuel in a quick setting that are not going to spike our insulin, spike our blood sugar, and then we're going to crash a couple of hours later from that.
[20:55] David: Yeah. So I would say the biggest fallacy is that we, as being as humans, have a carbohydrate requirement. We actually don't. We can operate for a very long time without carbohydrates. We have this neat pathway. It's a ketone pathway. So it's actually built as a way to protect us for over long terms of time when we didn't have carbohydrates.
[21:19] Michelle: Over time being in the right, like the hunter gatherers.
[21:24] David: One thing, though, that we do have, we do have some essential fatty acid requirements and we do have some essential amino acid requirements. So I would always tell people that in these types of settings where you're not sure where your next meal is going to come from, you're not exactly sure when you're going to be able to consume it. You got to focus on your protein. You got to find a way to get some lean protein in there. I prefer things like meat sticks that are sugar free because they don't have to carry the sugar with them. Those are really you can pack them, they're easily bring them around with you. You can have them in your bags. I would go to that as a snack and get you through it's a quick consumption. Things like nuts, things like pistachios and almonds. Obviously, those have to be done in some type of moderation, but those also will provide some essential fatty acid requirements as well as fill you up and digest slowly. I think that probably jumping into a donut or cookie is probably not the.
[22:22] Michelle: Best way to orange juice.

[22:24] David: Glass of orange juice is probably not the right choice. It's one of those things where it's accessible and it's easy and it tastes good. So it hits all those dopamine sensors and makes us feel good for the short time, but it's not long term. So I would say that's where I would go, I would focus on my protein. I would get something that I can carry with me, whether it be sugar feed, beef jerky or those meat sticks. That's easy to do.
[22:50] Michelle: Keep it in your pocket.
[22:51] David: Exactly. It doesn't have to be refrigerated. It's easy, accessible. I said it's something that if you're walking down the hallway from patient to patient, you can pull it out and eat it and you can get that taken care of without having to take a lot of time to do it. And it will get you to the next meal, it will get you to that next time where you actually get to sit down and have actually some food. Yeah, that's what I would recommend. Anybody in a fast paced environment, travelers, business people, and nurses.
[23:17] Michelle: Right. Well, because I know you travel for your job and everything, and so there are probably times when you're on the road for a long time driving and there's no food in between, and you just have to make two. Yeah. So let's talk about that a little bit in terms of prepping your food, because I worked in a hospital, and hospitals are notoriously bad, which is really sad for preparing food for patients and for the staff. And so if we didn't bring our food, we were forced to go to the cafeteria and have just really poor food choices. So they had a section that was all like, hamburgers, hot dogs, chicken nuggets, fries, pizza, and they had that every single day. Then they had a salad bar, which was pretty decent. We really relied on the salad bar a lot. It was really fresh, but the entrees were mostly carbohydrates. So like macaroni and cheese, mashed potatoes, solisberry steak with gravy, all the stuff that we love to eat. But when you're trying to feel your body like it wasn't good. So if you didn't want to rely on that, you had to do some kind of food prepping and bringing your food. So talk about what we can do in terms of preparing our food when we don't want to eat the hospital food.
[24:53] David: Yeah, and I think that food prep is kind of a dirty word sometimes with some people just because they think it takes so long to food prep. You got to get really complicated or you've got to somehow weigh everything out. And really, it doesn't have to be that complicated. Some people aren't as picky as others. So if you're not a very picky eating or you don't mind eating the same thing multiple days in a row, like me, I love it. I'm the same way Jessica hates it. I can imagine that there are lots of people that need that palate diversity.
[25:25] Michelle: Oh, my gosh.
[25:27] David: But if you are simple and you know that you can eat the same thing, it's not too difficult. You can do chicken breasts. You can do some lean type of protein to get to start out with. I'm not opposed to any red meat or game meat or anything like that because that's the most nutrient dense meat we can consume. But it is expensive and it's probably something we shouldn't consume every day. So I don't shy away from it. But save that for a Friday night when you're home and you want to have.
[25:55] Michelle: We recently started doing venison steak.
[25:58] David: Wonderful.
[25:59] Michelle: Venison medallion. So they're small. Oh, my gosh, they're so delicious.
[26:02] David: Yeah, wonderful. So that's where I would start. I would start with some chicken breasts. They're relatively cheap. Cook them up on an off day. Spend about an hour just doing kind of some basic prep stuff and then some veggies, some broccoli, some brussels sprouts, some cauliflower, have a fruit, an orange cuties are great. Half an apple, something in there with some quick burn carbohydrates, stay away from the starchy stuff. You don't need the potatoes, you don't need the mashed potatoes, you don't need.
[26:31] Michelle: The you don't need quinoa.
[26:33] David: No, you don't need quinoa. None of that is necessary. Again, you don't have a central carbohydrate requirement to get it. And then I would get a partition container. You can buy them on Amazon for a bucket container. Yes, and you fill one up with protein, you fill one up with veggies and you fill one up with fruit. And that right there you have a meal and that will get you going and it gives you a good clean opportunity to eat. If you want a little fat, that's where I would throw in some almonds, pistachio, some avocado, it's obviously great and that kind of will get you in the right ballpark.
[27:11] Michelle: That is some really good things that we can do right now to start.
[27:17] David: Ground beef is also a good one.
[27:19] Michelle: Oh yeah, lean ground beef. Love it. So one of the things that we love as nurses and other medical professionals and truly probably every person on the face of the earth is caffeine. So sometimes we get our caffeine and we get our caffeine and our fat and our sugar and everything in a drink called a frappuccino and we drink our calories and it can be again, it's like we walk on the unit and it's total chaos. And we know I got to grab something quick and some of us walk in with them. So we already are anticipating and there's a good 500, 800 calories in there. So talk a little bit about how caffeine affects us and how it sometimes can seem like the answer to everything, but it's kind of like an antidote in a lot of ways.
[28:20] David: Yeah, we'll probably unpack the frappuccino thing a little bit more, but I'll go with the caffeine. So caffeine in general is and again, I'm speaking to a medically trained audience. So you guys know how caffeine works in the body by binding to receptor sites to prevent the serotonin from letting us get sleepy or kind of come down. The interesting thing about that is that if you say wake up at 04:00 in the morning for a 530 shift and you jump out to the kitchen and grab a cup of coffee, straight away your serotonin levels haven't dropped yet. And 

guess what? They don't go anywhere. They don't have half life. So they're just floating around, right? So you grab that, you can't pound that coffee, you get dressed, you go to work and about two to 3 hours later, even if you had another cup of coffee, that caffeine starts to wear that serotonin level and circulating serotonin level starts hitting those binding sites and all of a sudden I'm tired. One trick to avoid that you don't want to consume caffeine right away. After you wake up, you wait about an hour to an hour and a half. And what that will allow your body to do is actually while you have heightened dopamine from waking up, it'll actually allow that serotonin to be utilized and catabolized. Right. You metabolize, really. And then when you consume your caffeine about an hour and a half later, you don't get that crash that you think you need another cup of coffee right away because that's one little hack that we can start to implement. It's pretty easy. The other thing is that everybody metabolizes caffeine differently. Some people can drink coffee all day and go to bed at 08:00 at night and not have no problems. Some people have one half a cup of coffee at 06:00 and they're wired till 09:00 at night. And I think that's part of this intuitive kind of nature of us. We have to understand how we react independently and also understand that and acknowledge are we using this caffeine as a crutch for something else or are we trying to get that little bit of uptick in the morning while we're kind of getting things going again through our day. Personally, I stop caffeine. I try to stop caffeine by one or 02:00 in the afternoon.
[30:32] Michelle: Same.
[30:33] David: And that's not necessarily because I don't go to bed, just because I want to make sure that I'm not impeding my sleep. Because part of this whole health cycle is sleep. And we're not going to talk about that here because we're talking about nutrition, but I'm sure you will on other projects. But it does, it affects your ability to get deep sleep, REM sleep. Right. That restored sleep. So I think that that's really important for us to kind of think about and again understand why we're having that caffeine. However we're having that vent frappuccino. Is it something that we're trying to patch or is it just something we're used to? Right. The other side of that thing and people talk about the fat and everything else but it's just sugar.
[31:13] Michelle: Yes. And drinking it early in the morning, so around 04:00 A.m. Is when your blood sugar normally starts coming up from the night and preparing to wake you up and preparing your body to move and all that. And so then we're boom hitting it with more sugar and then we have that crash a few hours later.
[31:34] David: Exactly. So I would say that more importantly than the caffeine of something like that is trying to not consume that mass amount of sugar. And I understand that not everybody wants to drink black coffee either. Right. I drink it. But sugars are special people. We are special people. But I would acknowledge that that's not necessarily everybody. But I would think that there are. Ways to get around it. Instead of going with a frappuccino, you go with latte. You go with something that you can control how many pumps of whatever sugars that they're going to put in. That's really kind of where you start. I'm also not necessarily an advocate for diet soda versus soda.
[32:18] Michelle: Well, that's my question. What's your take on artificial sweeteners?
[32:22] David: I think your body recognizes them very similarly. So they might not have the same insulin spike, but they still have to be cleared from the system. They still have to be recognized, they still have to be broken down. But I'm also acknowledging the fact that if it's like, hey, I can't just drink water and coffee, it's just not my bill. I would rather you consume one Diet Coke or Diet Pepsi a day versus two regular sodas because at least at that point, you're not consuming the gross amount of caloric sugar that is going to affect you otherwise.
[32:58] Michelle: Right.
[32:59] David: I would try to move as far away from liquid calories as I could. That's one of the things that I don't think we do a good job at recognizing and acknowledging the impact of those high caloric calorie drinks. So I think that understanding that it's a meal and it's not giving you anything but sugar, it's not a good meal. Not a good meal.
[33:25] Michelle: Well, that kind of goes along with my next question, is how it affects you. Sugar, caffeine, all of those things, foods, how they affect you mentally. And right now in nursing and medicine, there is a huge mental health crisis. So people are leaving their professions of choice that they love, that they want to practice because of so many demands made on us. So that's kind of the sad part. So mental health is really at the forefront as it should be. But talk about the effects of food on mental health. How can we be in a good mental space using food?
[34:21] David: Yeah, and I think this comes down to your relationship with food and how important that is to have any relationship, to have a good, honest relationship with food. Perfect. And to acknowledge tell me that. And to acknowledge the fact that we have to work hard at something that we love and there's some sense of satisfaction within that. And there's something that we can use to fuel the way we feel mentally and let that not be a driving factor. We can't get away necessarily from the stresses of work and the stresses of life and all of the things that create that environment of stress that can weigh in on our mental health. I mean, we've all spent the last two and a half years trying to figure out how this works. And I know that my kids are still struggling with it, and there's millions of other kids and young adults and adults that are struggling with it today. And I think that by bettering our relationship with food, and understanding how food impacts us from a health and wellness standpoint takes that stress out of it, takes that stress away from it. So now when I eat, I feel good. I don't necessarily have this drag or this low or my gut just doesn't feel good. I'm kind of fearful of food because I don't 

know what to eat and I don't know where I'm going to go.
[35:43] Michelle: I'm depressed because of just the choices and all of that and not knowing what to do next.
[35:50] David: Exactly.
[35:51] Michelle: So kind of using food to mitigate some of those things that we feel when we don't use it in a.
[35:57] David: Good way, well, and they can be contributors to it. I mean, we all get a dopamine hit from eating a donut. Even I do. And I haven't had a donut in a long time, but it makes us feel good for the minute. And then when that goes away, then we start to feel bad because we kind of know that we shouldn't have consumed it. Right. We know. And then we go, well, I feel bad now. I feel bad about myself. And the worst thing you should do is feel bad about yourself. We're not perfect. I'm not perfect. I don't make all the right decisions when it comes to nutrition. I still make mistakes now, and I will continue to make mistakes into the future. The trick is to not let them control you and not let it be a cascading cycle and understand that, hey, I made a mistake. That's okay, tomorrow will be a better day. And with that mentality and that mindset, first and foremost, you know that, hey, if you're out there on a health track and nutrition, you're going to hit it hard this year and say you get into February and you go out to dinner and you have a dessert and don't feel bad about it.
[37:03] Michelle: Yeah, and we've beat ourselves up.
[37:04] David: Don't beat yourself up.
[37:05] Michelle: And life is about enjoying things. And in moderation, I definitely after going paleo and then missing some of the things I've learned lessons, I'm like, oh my God, I miss pizza so bad. And I'm still working on the paleo pizza crust and I haven't perfected that yet. So it's like a few weeks after going paleo, I was feeling so good and I'm like, I just want one piece of pizza. And then I felt bad for like 24 hours. Not bad emotionally, but bad physically. And I said, you can't go back now. You know that this is hurting you. You can't deny it anymore. You can't eat like that anymore. And now it's like when I made that decision in my mind and that realization with my body, it was like, pizza doesn't hold any power over me now. And I am looking towards ways of like, how can I perfect the paleo pizza crust? Because this is going to get that pizza fix in and it's not going to hurt me physically.
[38:19] David: I always tell people as they start their journey, really pay attention to things like that fruit is another one. If you ever consume fruit nowadays, if your thought is, man, this fruit just isn't sweet, chances are you're just eating a lot of really sweet stuff.
[38:34] Michelle: That's right.
[38:35] David: Right. So cut that sweet that you're eating out and go back and eat that fruit, and you're like, best tasties, best.
[38:41] Michelle: Fruit Sandra I've ever had.
[38:44] David: And that's a success. That's what we have to relish in right now. You're like, wow, I never tasted something like that.
[38:50] Michelle: Yes, well, another thing I wanted to talk about was hydration, because we hear that a lot. And again, working in a hospital, working in a school, if you're a school nurse, like nurses, doctors, respiratory therapists, you know, social workers, all these people that work together, like, we're busy. We're running around. We're not carrying around our, you know, 64 ounce water bottles. They're away from us. They're in a room somewhere where we might not always have access to. So, I mean, talk about how important hydration is in terms of just your body functioning correctly. And we've heard a little bit about, like, if you're having a lot of cravings, you might not really be hungry, but you might be thirsty. So just talk a little bit about that.
[39:47] David: Yeah, I think that that's another one of those secret things that you can look at and say, well, where is my hydration? Am I getting my eight cups of water a day? Or whatever they say you need to get? And if your simple answer is, well, no, well, that's one point. To start finding ways to get more water in is awesome. But also finding ways to get more water and electrolytes in, that's the one forgotten thing that people think, I just take drink water, and I'm fine. But really, our electrolyte balance, specifically our salt, potassium, those types of things, magnesium are the big ones. I'm not saying go out there and.
[40:24] Michelle: Get Gatorade all day. We have to know. Gatorade out of the.
[40:32] David: PDI is not a bad one, but it's a very important aspect of your nutrition. How you consume that water throughout the day and how you drink that water is super important with digestion, with just overall energy levels. So it is really important, even though it is hard. Again, I won't discourage the fact that it's hard, but it is a very important aspect to overall health and nutrition, is consuming enough water throughout the day and having that water not coming in, forms of coffee and tea and juice.
[41:07] Michelle: Bang, energy drinks rental.
[41:09] David: No, that's the same thing as saying, my beer has got water in it. Right. I think it's really important for us to look at it and say, no, water is super important. And finding little tricks, little hacks that you can do to consume more is great. Maybe it's not a huge HydroFlask. But maybe again, in your pocket, you've got a little bottle, right, that you can carry around just every once in a while while walking from patient to patient or doing your charts, you can go and grab that and just sip on that. And again, I like electrolytes. There are some stick versions of electrolytes that you can throw in your water. So if you don't like the taste of just plain water, you can do that and it'll flavor the water a little bit. So pallet wise, it isn't off putting. Yeah, but there's plenty of them. And 

you can argue back and forth whether or not the ones with sugar in them and the ones without sugar or matter just consume something. Thanks. Getting you hydrated. That's not a soda.
[42:03] Michelle: Yes, thank you.
[42:04] David: Or a frappuccino.
[42:05] Michelle: Yes, that's a good point. Now we joke with each other about wearing, like, those camelbacks.
[42:11] David: Camelbacks, yeah. That's not a bad idea.
[42:14] Michelle: Well, that holds what, elite? A couple of liters. That would look really funny. But we could put it under our uniforms, our scrubs, and wear it around. That's how we get. And then of course, the other part of drinking so much water is now your kidneys are really working and now you got to go to the bathroom all the time. So then we joke about putting in a fully catheter, and it's like we're just machines. Just have our water on our back and our catheter in our pocket and our little meat stick in our other.
[42:47] David: Pocket and go, go, rock and roll.
[42:50] Michelle: Yes.
[42:52] David: Problem solvers.
[42:53] Michelle: I know. Well, we have to sometimes make a joke of it because it is really our life and it's serious.
[43:01] David: It's serious. But you have to laugh. You have to laugh about it. Just because it's serious doesn't mean we can't have a few jokes, too.
[43:09] Michelle: Yeah. We're in this profession and we do hard things every single day. And so we are not immune to doing hard things. But when it comes to choices that we make and like I had discussed with you prior, it's like we're a community and we all take care of each other, but we're also highly influenced by each other. So here's a common scenario that happens in break rooms, in hospitals everywhere, right? So I've brought my food. I've prepped this week and I have my macros and I have my good energy food, and it's in the refrigerator. And then someone says, let's order out today, or let's order in, or whatever the term is. And we are so quick to go, yeah, I'm not going to eat my fruit and my ground beef and my vegetables. I want something exciting and good. I want a juicy burger and fries or whatever it is. So how do we, as medical professionals who know, how can we start practicing what we preach, give us some strategies for doing hard things and taking care of ourselves?
[44:35] David: I think it comes down to leading by example. I say this and I go back to you inferred the fact that I travel a lot and I do and I have. I've spent about four years being on the road, three weeks out of the month. And in doing so, it's hard to find good food. Say you're eating out a lot. So you make simple adjustments to what you consume. Things like instead of fries, you take salads. Salads with no dressing or dressing on the side, double the protein on the salad. I consume the protein first, and then I eat until I'm full. So these types of things where you can still eat out, you can still do things that are still fun with your friends in the community, but you can make just subtle modifications to what you consume and how you consume it, that it will make changes to how you eat. But going back to that leading by example, I can guarantee you in that break room, there are people that are struggling with trying to find their direction. And maybe that person who suggested eating out hasn't quite got down the prep work. So flip the script, share your meal with them and say, hey, look what I brought today. I've got a little bit more I can share with you, and then maybe can spend that little bit of time talking about what you do to prep. Say, hey, it doesn't take me that long. Literally, it's an hour on my day off, and I've got all those meals prepped for the week.
[45:58] Michelle: I love that.
[45:59] David: And that gives them the encouragement to go, hey, I want to try that.
[46:02] Michelle: Yeah.
[46:03] David: Because again, you guys are all in the medical profession. You all see the ramifications of poor health and nutrition on your patients every single day. 90% of the people that are in, unless you're an emergency room nurse that are dealing with accidents, but even some of those are made worse because of poor nutrition and poor health. You see the impact of it in a day to day basis. All we have to do is a little self reflection. We're not immune. Your audience isn't immune. I'm not immune. You're not immune. My kids aren't immune. My wife isn't immune. We all have our personal responsibilities. And the trick with this one is that if you don't take it seriously, it's not like a library fee. It's your life. It's longevity. It's your ability to be there for your kids activities. And if you put that in perspective, that's where I go. We'll leave by example. Talk to them about the importance of it. Talk to them about why you are doing what you're doing. Because unlike kind of the locker room or high school where you'll get snickered at and made fun of, most of those people in there are probably looking for direction too.
[47:12] Michelle: Yeah. And we're all adults here, and we're all adults. Yeah.
[47:15] David: We can all acknowledge the fact that having a greasy burger and fries four days out of the week is probably not a good idea. One time, maybe it's okay, but four to five times and the pizza on Friday night probably when we're getting older and we're not working out. So our metabolisms are changing, and muscle loss is a real deal. Sarcopenia is a real deal, and it elevates after your 30s. It's not middle aged, but that's when you start to see muscle loss start to become real, and it's harder to put back on in your forty s and fifty s. So it's 

not impossible, but it's hard. So what we try to do is we try to build a bank. So all I'm trying to do is take a bank account, savings account. I'm trying to do all the good stuff, set the foundation so that as I grow older, that I could just withdraw a little bit and live on a little bit.
[48:04] Michelle: Well, that's important. I mean, age, the average age of the nurse is 43.5 years. So the nursing force is aging. And those women, men in their 40s, are starting to see your personal story of these choices that I made in my teens and my 20s when I really maybe didn't know better. They're starting to affect me now. And the bottom line is we want to have energy. We want to have sound mental health, to be able to do the things we love, take care of people, practice our profession. But to do that, I think we're finally realizing that we need to put ourselves first in that category. Just as a parent. Anybody that's caring for someone, if you don't give yourself that first, you cannot give to anyone else. I say it all the time. You can't pour from an empty cup. And I say it a lot because I'm finally learning that as someone who's 58 years old and had a lot of struggles along the way, and now I'm putting myself first in that category before I can take care of anybody else. So I think as medical professionals, anybody in life, we need to learn how to do that.
[49:37] David: That's a really good point. It's very easy to say, well, I can't do it today because I've got to do this. And the real reality of that is we're going to run out of days.
[49:51] Michelle: Yeah. Our lives are not they're not infinite. They're not infinite.
[49:55] David: No. And the trick with all of this is realizing this before it becomes too difficult. It's never impossible to start. It's harder as you get older. It's harder to get the motivation, whether you're working out or starting a diet program or nutrition program. I hate the word diet. New nutrition program where you're trying to make positive impacts on your life as you get older. It's really easy to say, oh, that's too hard. There's a lot of hard stuff.
[50:25] Michelle: It's true.
[50:26] David: At our gym, we call everybody athletes from the day one to the people who've been there for ten years, because we consider everybody an athlete who wants to make positive change in their life, and it doesn't matter. And because what it does is it encourages people who feel like they're not athletic to understand. No, you getting in here and doing what you're doing, making change. You spending a little bit of time meal prepping and trying to make good choices 80% of your time. That's all you can do.
[50:57] Michelle: Little things add up for sure.
[50:59] David: Little things add up.
[51:01] Michelle: Well, is there anything else that you want to impart for our listeners today? Anything before I get to my last question, anything you wanted to talk about?
[51:11] David: My biggest recommendation to anybody interested in starting this journey is small bites. Don't think you have to eat the whole cow in one bite. Just start with small bites. Before you know it, it's gone. But if you try to do it all at once, it's overwhelming. So anybody out there looking to change, just remember small bites.
[51:35] Michelle: I think that's such a good message because people in our profession, we really are perfectionists at heart, and it serves us well in some ways, because if you have a nurse or a doctor taking care of you, you appreciate perfectionism. You want to be cared for the right way, the best way. But we're really hard on ourselves when it comes to perfectionism, because if we quote, mess up, it's like we just really beat ourselves up, and then we got to feel like we have to start all over again. So that's such a good message to kind of help us just really care for ourselves a little bit better. In terms of small bites, I love it. How do you climb a mountain? One step at a time. How do you eat a cow? One bite at a time. So my last question was going to be and you kind of touched on it, but maybe expound on a little bit. Let's talk about some daily practices that we can begin right now to have a healthy relationship with food and with our body, like over our lifespan.
[52:52] David: I think the daily practice that I would always recommend when you're looking at what can I do? Is the first forgotten nutrient is protein. It's the last thing we think about. It's the last thing we put on our plate. It's the last thing we try to consume. I would say leave with it, leave with your protein. Making sure you're getting enough of that, it changes lives. And understanding that it's a journey to that small bite and one step at a time scenario is that you can make mistakes. It's okay. And those daily struggles are what we all go through. And to acknowledge that they happen, let's know you have the next day to get back on it. The next hour, the next meal, the next try. That's okay too.
[53:39] Michelle: We don't have to wait till the next Monday?
[53:41] David: No, the next year. And it doesn't have to happen at January 1 either, through that 2023.
[53:47] Michelle: So I'm not going to make any changes till 2024.
[53:50] David: So I would just say that those types of daily reminders that, hey, you don't have to be perfect. We're not going here to lose weight. We're not going here to fit in a bikini. We're just trying to be healthy. And if you remind yourself of that daily and you walk in that, you'll find a relationship with your health and your body, and you'll realize that I'm not going to be what I was in my 20s, but that's okay. I don't want to be 20 again.
[54:20] Michelle: Yeah, I'm not 20. I'm 40 or 50 or whatever.
[54:23] David: I am what I am. I am where I am in the stage. Be present and never pine for something that you've always wanted.

[54:32] Michelle: Right.
[54:33] David: Just focus on being healthy. Focus on your body. Focus on how you feel, and realize that you shouldn't feel bad. Feeling bad is bad.
[54:42] Michelle: I love that that's where you started. Like, you shouldn't feel bad after eating, and that's, like, the greatest message to end. You shouldn't feel bad. So wow. Thank you so much. I think you've just given our listeners so many gems and things that actionable, things that we can take into our lives to do what we love to do, and that's to care for people that are in need of our care. So thank you so much.
[55:12] David: Thank you for having me. It was fun.
[55:14] Michelle: Very fun. And you weren't even freaked out by the dolls?
[55:17] David: No, they're fun. They're cool. I love them.
[55:21] Michelle: Okay, well, you know, at the end, I do this thing called the five minute snippet, and it's just five minutes of pure fun, and it's for our listeners to kind of see the off duty side of David ledgerwood. Okay. The most difficult obstacle in the Spartan.
[55:48] David: Race, I believe it's called Olympus, and it is a wall that's set at a 45 degree angle that you have to traverse across, and you can use chains, rock climbing grips, or holes in the obstacle. When it was wood, I could do it, but now that they've made it kind of a cutting board material, so it's very similar to the nylon cutting boards, I have a heck of a time. My last probably six Spartan races, it's the only obstacle that I've failed.
[56:21] Michelle: I did see a picture of it, and it looks completely terrifying. Did you get a lot of splinters when it was wood?
[56:28] David: No, actually, it was all spring.
[56:29] Michelle: Really?
[56:30] David: Okay.
[56:31] Michelle: Your favorite ride at Disneyland?
[56:33] David: Oh, that's a hard one. I think that from my standpoint, my favorite ride probably is Thunder Mountain Railroad. I think from a family standpoint, it's got to be Haunted Mansion.
[56:49] Michelle: Oh, yeah. I love Haunted Mansion, especially at the holidays.
[56:52] David: Yeah, we like the holidays. We love the nightmare before christmas movies.
[56:58] Michelle: Very fun, very much fit. I love it. Okay, well, today is actually Friday the 13th, and we did not come to an end. There's no ghost in the closet or anything like that. But do you have any superstitions or anything that you're superstitious about?
[57:17] David: It's kind of funny that it's Friday the 13th, but actually I surprised my wife. Your wife is super like well, I surprised my wife. I actually don't like the number 13.
[57:28] Michelle: Okay.
[57:29] David: It's just a weird share that when I'm counting up in reps, I'll stop at twelve and then I'll start counting down. But yeah, that's the only one that I kind of have that I don't know why or where it came from, but that's it.
[57:43] Michelle: You never stay in, like, room number 13 and you never fly on the 13th?
[57:49] David: No, I know.
[57:51] Michelle: I'm the same. That's so funny. Okay, so you gave our listeners, like, six really good book recommendations, and those will be up on your website on bookshop.org, so they'll be able to check that out. What book do you think should be mandatory for everybody on the planet?
[58:12] David: I think if we're talking nutrition, I lean towards wirety. I think it's a great all around kind of starting point for anybody on a nutrition program or plan or where they're going. Path, I guess, is how you describe it. I think that's great. I think it's from a personal standpoint, I think extreme ownership would be another one. The jacko willock. I think the idea behind that it's a leadership book, but I think ultimately it gives everybody an idea about how do you individually become a leader. And leadership doesn't necessarily always mean commander or boss or whatever. We own our own leadership in our family, in our personal life, and I think that's a really great read for people who are looking to understand what that actually means.
[58:59] Michelle: I love it. Be the leader of yourself before you try to lead anybody else. If you were in charge, what three items would you have in the office? Vending machine?
[59:10] David: I would have sugar free beef jerky.
[59:13] Michelle: Oh, yeah. Okay.
[59:14] David: I would have almonds or nuts of some sort. Almonds or pistachio.
[59:18] Michelle: Okay.
[59:19] David: And then I would try to somehow get in a fruit an apple or something like that.
[59:24] Michelle: Not a Fruit Roll Up?
[59:26] David: Not a Fruit Roll Up. Fruit leather, but dehydrated. Fruits are not always great, but they're better than nothing. But those would be the three things.
[59:33] Michelle: Okay. I would like to work in your office. That would be good. What's the most annoying bill you have to pay? Just, like, every time. It just grades on you right now.
[59:43] David: It's a gas bill. Dang, that's horrible.

[59:46] Michelle: Exactly.
[59:47] David: It's too cold here.
[59:48] Michelle: I know. Okay. Something on your to do list that never gets done.
[59:54] David: I think the only thing on my to do list that never gets done.
[59:58] Michelle: There can't be many things.
[01:00:00] David: There's not a lot. Yeah. I don't tend to leave things on my to do list.
[01:00:05] Michelle: Maybe your wife's to do list.
[01:00:07] David: She actually is good. She didn't put stuff on my list. I don't know. I would say probably just kind of finalizing the backyard and getting things kind of where we can live out there on a road.
[01:00:17] Michelle: Okay. All right, we have 20 seconds. What is one thing people buy that you think is a total waste of money?
[01:00:27] David: Soda, chips, processed food, anything that comes in a bag that's I think a total waste of money does Gene get.
[01:00:35] Michelle: Wow. So much good stuff. I love it. And our time is up. David, thank you so much.
[01:00:43] David: You're welcome.
[01:00:43] Michelle: I really appreciate you being here. We have learned so much, and we have so much that we can take forward, and I really appreciate it.
[01:00:53] David: Well, you're welcome.
[01:00:54] Michelle: Thank you. You have a great rest of your day.
[01:00:57] David: You too.
[01:00:58] Michelle: Thank you. Bye.