Nutrition for Menopause & BRCA Gene: Amber's Story Ep 37

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I'll see you there. Welcome back to the Find Your Edge podcast. I am your host, Christina Fiumara Newport, and I am here today with one of our newest dietitians on staff, Amber D'Angelo. Welcome to the show, Amber.

Thank you. I'm excited to be here.

Well, we are excited to have you, and we've got kind of a cool topic today, an interesting topic talking all about nutrition and cancer specifically related to this BRCA or BRCA gene. Give us a little bit of background first on you and your career, and then we'll get into, into the gene. So go for it.

Well, I am a registered dietitian and I'm also a certified personal trainer and group fitness instructor. I have been in the health and wellness industry for about 20 years. And worked in a lot of different areas of nutrition. I've worked in food service and public health, and now I'm spending my time working more in the sports and performance section. And I really enjoy that, getting to work with people both in the gym and just helping them to accomplish their goals with fitness and in health.

Very cool. Well, we love having you as an addition to the team. Such great wealth of knowledge. So something I've recently learned about, and I think that this is a great topic to discuss, is this BRCA gene. So tell us how you came to— you, you've got a little bit of a journey to share, so I'm excited to hear about your journey here. So please share.

So it has been quite a journey. It started not too long ago. It was last year. My mom was having some symptoms, went to the doctor and found out that she had some tumors on her ovaries. And throughout the testing to kind of figure out what was going on with her, she ended up being diagnosed with stage 3 ovarian cancer. During that testing, they discovered that she has what is called the BRCA2 gene mutation. And what the BRCA gene is, it actually— BRCA stands for breast cancer. And it is— there's a BRCA1 and BRCA2, and everybody has those genes. And they're actually considered tumor suppressor genes. And they help repair— they're proteins or they're genes that produce proteins that help repair damaged DNA. So they help keep cancer from forming and repair DNA so that we don't have cancer growing. In our bodies. If you have a genetic mutation in there, they don't work properly. And so you can have the BRCA1 or 2 genetic mutation that puts you at a higher risk for certain cancers. And it was discovered that my mom had that BRCA2 gene mutation. And after that, as being her child, I have 2 siblings, we had a 50% chance of having that gene also. And so we were all tested or we could get tested. I have one sibling that also has been tested, another who has decided not to get tested yet. But I was tested after real quickly because I turned 40 and risks go up higher after 40. And so I was tested for that gene mutation and found out that I do also carry that genetic mutation, that BRCA2 genetic mutation. And it was overwhelming because when you get that test back, it shows in big letters, high risk cancer, and that's really scary to look at. And then it breaks it down and the cancer risks are elevated for breast, ovarian, pancreatic, melanoma, and ocular melanoma. And those are the ones we just know about. And looking at those numbers, I was looking at an up to 84% chance of breast cancer by the time I was 70, where compared to the normal population, it's a 7% chance. By the time they're 70. So it's extremely elevated. And ovarian cancer was up to 27% chance by the time I'm 70 and potentially more because I have a family history of it. So my mom had ovarian cancer and the normal population is 0.7%. So these are big numbers that are scary. And then with the pancreatic cancer that's elevated, they're not sure. But looking back in our family history, we started digging back through this after we discovered this, that my grandmother had passed away about 5 years ago from pancreatic cancer. She was never tested for the gene. Wish that she was because it just can change your life once you have this information and what you can do to prevent those cancers. So not sure what my risk of pancreatic cancer is. Melanoma, it's just an elevated risk, but that is a lot of information to take in all of a sudden when you're not really expecting it.

So Amber, did you go to your primary care doctor to have this test?

Yes, primary care doctor. And also once someone in your family does test positive for this gene mutation, mutation, a lot of times the company that did that test will allow you to get tested for 90 days for free, which is great. And so because you have this 50% chance, it's not a cheap test, but once you have the risk, a lot of time you can get that done for free. And so I knew that, went to my primary care doctor, they were able to do that test and then, well, referred me on to genetic counseling where they go through everything. So with the genetic counseling that's out there, they'll take you through everything in your history, they'll have you dig back so you can really see what what the risks are and walk you through everything there. And from that point, I was then referred on to an oncology center after I had that test. And like I said, with BRCA2, once you're 40, they really like to start doing a lot of prevention. BRCA1 tends to show up younger, so they're looking at age 30. BRCA2, I had just turned 40. 3 months before I got all this information.

Oh, happy birthday. Right.

Happy birthday. I'm 40. And your life's about ready to change. So it was a great birthday present. And, you know, but it was scary and overwhelming. But all the doctors were really great. And I was kind of thrust into all of these screenings. So mammograms, MRIs, ultrasounds, just making sure that there was no cancer there already. And we had a little bit of scare with a breast MRI, ended up coming back nothing to worry about. But once you have that scare and once you see these numbers, it makes you— you have to make some decisions about what you want to do going forward. And they really do recommend having prophylactic surgeries or preventative surgeries at age 40 for the BRCA2 mutation. So that's what we decided to do. We decided in that waiting room when we had that scare that they had potentially found a mass on the MRI, we decided We never want to be in that position again if we can help it. So we were proactive. I say we, my husband and I were sitting there. He's been very supportive through this whole journey and we decided to move forward with the preventative surgery. So in September of last year, I had a full hysterectomy, an oophorectomy, which is when they remove your ovaries. So I had ovaries, fallopian tubes, and uterus, cervix, everything taken out. I was thrust right into menopause overnight.

Wow.

We're going to talk a lot about— yes. So I was thrust into menopause overnight, and that has definitely changed my life. But then I also, once I healed from that, I went ahead and had a double mastectomy in December of last year to prevent my risks of breast cancer. And I don't have to have a mammogram or MRI anymore. My risks are so low. It's lower than the normal population now. Reduced my risk significantly by having those surgeries.

So what was that like to literally be— I think as a woman, or perhaps other women might be like, whoa, you— so you like all the things, all the things that sort of make you— I don't know if that's controversial to say— make you a female.

Were removed.

So what was that like?

Yeah, it was definitely overwhelming, a very emotional ride. I decided for the double mastectomy, I did not get traditional reconstruction. I just— I did not decide I did not want implants, and I wanted as few of surgeries as possible. Getting reconstruction is a major surgery, going through maybe expanders and having a second surgery. Maybe fat grafting and everything else. And I just wanted to be done with it, but that I no longer have breasts and I don't have estrogen in my body anymore. So it was a lot to deal with, but being able to make those decisions to protect my health and to actually live, I feel like I am more alive and I feel like a very strong woman. Being able to make those decisions to be here. I have 2 young boys and just to be able to be here to raise them, to be able to be a wife still because I, I didn't have cancer, but I'm fighting back against cancer proactively. It made me feel like a very strong woman and I don't feel like any less of a woman now afterwards. Like I said, I feel stronger. I feel empowered. Very thankful I was able to make these choices and for the support that I had from the doctors going through all of this too, that I was making the absolute right decision for me. I've always taken a lot of pride and joy in being a strong woman. I love, you know, picking up the heavy weights in class, challenging people to do that. And I feel like this has just reinforced that I can, I can be a strong woman without having breasts or ovaries.

So that is really inspiring. Very cool. So now let's tie it back to how you as a healthcare provider, you as a dietitian, like what were some of the things that you were looking into? You were researching perhaps either independently or what you already knew about medical nutrition therapy or MNT for this gene mutation. What were some of those things that you've learned?

Well, first, just about the whole surgery and everything, I feel like I recovered very quickly because I was in shape or in good health because I was working out. I felt strong. My nutrition was good. So taking care of your health going into surgery and being able to recover was great. So that was wonderful, just knowing that I could take care of my body and bounce back from these surgeries very quickly. But then looking at the cancer diagnosis, I mean, being able to reduce my risk further by choosing to stay active and to stay at a healthy BMI, which is huge for cancer risks and reduction, and then eating good, healthy foods that can help fight back against this as well. And then looking into nutrition and fitness for, for menopause, that's been a big journey for me. I wasn't expecting to go through that at 40, but I am, and I've learned a lot and there's a lot we can unpack with that. But just touching first on just having the BRCA and the nutrition there, you know, maintain a healthy BMI is huge for cancer reduction, like I said. So if you're not at a healthy BMI, you know, try to get there. If you feel like you have a strong family history of cancer or just to be healthy, of course, we as health practitioners encourage that anyway. The other big ones are, of course, you know, eating lots of fruits and vegetables. And then the other things, you know, reducing your alcohol intake, not smoking, those are the ones that the, those big ones that we know for sure reduce our risk of cancer. Yes.

So, and just to clarify, if anybody doesn't know what BMI is, so body mass index, it's basically a ratio of your height and weight, something easily that we can calculate as dietitians and that insurance companies can calculate. And so anyway, basically healthy weight, right?

Healthy weight, be at a healthy weight.

Yes. Cool. Some of the things that I stumbled upon in my research for this were soy and meat consumption. So we got some hot buttons there. What has been some of your findings that you've dug up, or, or maybe you haven't found an answer yet?

Yes.

So tell us about that.

And, you know, it is definitely an interesting area because we're learning so much and the research is growing in this area. So I would encourage everyone just to dig into the research yourself and to find a, a doctor that is willing to dig into that research with you. The soy is a really tricky one because old research showed that it could increase risk of breast cancer. And so that was typically avoided. It does have, you know, some phytoestrogens in it, and we take the ovaries out to not only prevent ovarian cancer, but to reduce our risk of breast cancer. Because it has shown that the estrogen can increase your risk of breast cancer. And so those phytoestrogens have scared a lot of health practitioners away from soy. But some of the new research is showing that it could be very beneficial for women with the BRCA gene mutation or that it can reduce your risk of any women getting breast cancer. But the, the research is just not solid yet. Either way. So I think like most things, it's probably fine in moderation. I have chosen not to go drink a bunch of soy milk right now, just because I still am not sure what that research is showing. And, you know, I'm digging in, like digging into the research, who's doing the research? What are they trying to show? Don't just read the conclusion, read who did the research study. Is there a conflict of interest in the research study? Who's funding the research study? Those are all important things that the media is not going to talk about when they talk about a research study result. So just looking into that information and then what population was the research study done on? Was it done in other countries, in Asian populations where they have a high intake of soy? Well, yes, but their soy intake looks different than ours. They're not eating heavily processed soy like we tend to in a Western diet. Fermented soy is completely different than the soy that might be in a protein bar or in a soy protein powder. So taking things like that and researching what food types were used in those research studies too. So it's a lot. I don't think we have a good solid answer with the soy. Soy in moderation, I think. And each person is individual too. And that's something that I've really embraced throughout this whole journey is that I'm an experiment. I am an experiment. Everyone, you're like, you are an experiment. Some supplements that work for me aren't going to work for someone else. Just because the research says it's going to work, that research was done on a 65-year-old woman. It may not work on a 40-year-old that has the BRCA2 gene mutation who was thrust into menopause overnight and had these sudden onset. So research doesn't always apply, but it's a great starting point to take that research and then dig in and find out how it works for you. The meat consumption, the same thing, looking at the research studies, who's doing it. Something I have found in my research is that for sure, protein is important and that as we talk through menopause, prioritizing protein. And so that does mean meat consumption. And I think, of course, we're not talking like 12-ounce steaks here. We're talking about proper portion sizes of meat consumption. But looking in that research, I think that there's not a solid answer that a good moderate meat consumption, a healthy consumption of meat is necessarily harmful or going to increase your risk of cancer. Of course, there's better choices, maybe avoiding the processed meats. We know that that is linked, you know, to some cancer risks, but protein is definitely important.

Cool. Okay. Yeah. Great tips there. I love that you are your best experiment. N equals 1, right? And then I'd love to get into some of the menopause things, but just, I think you mentioned like processed soy and whatnot, like edamame and tofu and tempeh versus things like soy protein bars and places where soy can be in. It's— I definitely encourage people to talk to their healthcare provider, talk to you about like, okay, well, I'm a little nervous about this. I think if people get nervous, then they just like cut it off completely, you know? Okay, I'm just not going to eat meat.

I'm not going to eat soy.

It's like, okay, well, now we're— now we got other issues because we've eliminated all these other things. I also think it's hard for people to really dig into the research because this is, you know, it's hard.

It's hard.

So yeah, that's why I think not to have like a shameless plug, but totally have a shameless plug, like talk to your dietitian about those types of things and make that decision together as to whether that's a good choice for you rather than just being like, oh, I'm just going to avoid it altogether.

Right. Cool.

Okay. So who nutrition for menopause? I know there's a lot to unpack. Let's see what we can do in a short amount of time, but Maybe what were some of the most overwhelming things for you, whether it be thrust to that position and maybe also from like a nutritional perspective?

Definitely being thrust into that position overnight was, it was, it was overwhelming and not knowing how I was going to respond. Everyone has a different menopause journey. And so, like I said, I was here, my own experiment. How am I going to respond to having no hormones all of a sudden and how bad are my symptoms going to be? And then there are some symptoms that you deal with every day, right? Hot flashes, sleep disturbances, things like that. And then there are some that may creep up over time. Weight gain that, you know, I want to be very proactive about that because I gain weight, then my quality of life goes down, but also my chance of cancer goes up. And then there's the ones that you just can't see— bone loss. Cognitive issues that are long-term. That— so looking at that big picture was overwhelming. But I also was thrust into horrible hot flashes, just really, really intense, where I felt like I was going to burst into flames every 2 hours. Immediately, I need to deal with this. And there's some nutrition component of that. But there's also, you know, medications and supplements. And HRT is another hot button here with menopause. So there's a lot of research out there, not necessarily nutrition related, but I do think it's very important to touch on that. Again, digging into that research and the fears that surrounded HRT were from a study back like 20 years ago that was halted abruptly because it's shown that women that were taking combination HRT, so progestin and estrogen, were at a higher risk of cancer. Blood clots, heart disease, everything. And so that research was halted. Now, as they've dug back through that big research, and it was the WHI, the Women's Health Initiative study, to reference that, a lot of research has been done coming from that, but also going back and analyzing that. And they really found out that it was mostly in women over 60 that were having these, not necessarily a woman who is 40 or 50. And women who waited longer than 10 years to start hormone replacement therapy were having these issues. So the recommendation has changed that we've now realized that estrogen alone doesn't increase your risk and estrogen in younger women. So starting it right away, like early in your menopause, before you've been in that for less than 10 years, that your risks of these things don't increase with estrogen only. Now, if you still have your uterus, you can't just take estrogen. You have to take progestin. So like I said, everyone's an experiment. It differs, but taking HRT or hormone replacement therapy can help with a lot of the menopause-related issues. Now, I tried to go for a while without it. Like I said, I got to the point where I thought I was going to lose my mind. I couldn't sleep. I was so hot. And so I did go on a very low dose recommended by the oncology center, low-dose estrogen. And it has helped.

Not completely.

Still having lots of, lots of hot flashes, but they're manageable. I don't feel like I'm catching on fire anymore. But they interrupt my sleep. And so I think that out of all of the things, so I think about the risks that I have, sleep, stress, anxiety, insomnia, weight gain, bone, cognitive, all these things that come with menopause. The most important one to fix first is sleep because without sleep, we can't deal with any of the rest. We can't manage our stress. We can't go to the gym and work out and lift heavy. And we can't relax. We can't do anything that if we're not sleeping properly. So dealing first with that and hormone replacement therapy was a big thing, but it didn't help completely. So I had to look into what might be triggering my hot flashes, what might help me fall asleep. And I turned to nutrition because I'm a dietitian and that's what we do. We turn to nutrition. And so looking into what could help with hot flashes, and there are definitely some triggers and I mean, different people have different triggers, but you know, alcohol is a trigger. Sugar can be a trigger for some people. Just maybe eating a little too much can be a trigger of those hot flashes. And so I found that I do feel like with my intake specifically, I found that my insulin resistance has gotten changed a little bit. I'm a little more carb sensitive than I used to be. And so managing that. Through managing my carb intake and increasing my protein intake and combining protein with carbs and not having that blood sugar spike that would trigger a hot flash for me. And so managing that has been very helpful. I'm not going to bed with a very full stomach has been helpful. It helps me fall asleep. It helps me not have as many hot flashes throughout the night. And then there's some supplements in there too that have worked for me. Some haven't. So we can talk about the supplements if you want to, or we can talk more about nutrition.

Oh, well, both. So yes, since you touched on it, because sleep is a huge thing for a lot of women, right? And when you're in that situation, I feel like it's like throw the kitchen sink at it. I will do whatever possible. So then we end up taking this massive handful of things and we don't know what works.

Right.

And then it's a lot of like, oh, well, my neighbor told me this helped her and my doctor's telling me something else. And, you know, it's like, okay, well, I'll just take them all. And then quality of the supplement.

So anyway, right.

Tell us what, what are some of the things that you tried or are still on?

Yeah. And with the supplements, you know, again, look at the research, but then try one thing at a time because we don't want to just be taking supplements for no reason. Try one thing and I say, give it a month. You know, and if it doesn't work for you, it might not be the supplement for you and try something else. And that's— I went through that process trying different supplements and just— and first, before I tried supplements, I did other things like having good sleep habits. So just cooling down before bed if you're having hot flashes, you know, not taking a hot shower, making sure that you're cooling that core temperature down, having ice water available at all times. And then, you know, making sure that you're just calming down before bed, turning the screens off. Things like that, getting yourself ready for sleep before you turn to supplements. There might be something that, you know, that just needs to be dealt with that has nothing to do with a supplement helping. It might not help if you have poor sleep habits.

So, or your pajamas, you know, like your bedding.

Yes.

The thermostat, all that kind of stuff.

I have to have a fan on now because I can't cool down without that fan on, you know, our air conditioner is running a lot. So a little bit more of expense there on the electric bill. But what are you wearing? What are you piling blankets on? You know, get the change. Those— and they even have really cool things now like cooling blankets and cooling mattresses that you can look into. And before you go down the supplement route, or if supplements just aren't working, a supplement that has worked and it has a lot of benefits in other areas of menopause is magnesium. A lot of people are deficient in magnesium. And so a good magnesium supplement, it helps calm things down. It can help relieve stress, anxiety, help calm me down for bed. It's also going to help with bone loss and cognitive function. So that's a huge one that has lots of benefits in menopause. And that has worked for me. One that has not worked is ashwagandha. And there's a lot of research going on with that one. And it does work for some people. There's a lot of promising research out there. That research is kind of new, kind of ongoing.

Yeah, I'm, I'm struggling to find like what's exactly the right dose. Does it have to be in combination with something else? But you're right, I feel like, okay, we got something here, but we're not quite, quite, not quite there yet. Yeah.

And so I did try that one and I did not see any impact for me, so I stopped it because if it's not working, why am I going to keep taking it? And especially when, you know, the research is still kind of out there. So I did not take that one. One that I've seen huge benefit from is L-theanine, and that's in green tea. It's in all tea, but pretty high doses in green tea. And, and I've found that has benefit. So I've struggled with anxiety, some anxiety and some mood stuff in menopause also. And that has just helped. And there's something about sitting down with a cup of tea that just is calming anyway. So having green tea has helped calm me throughout the day, but then having either some decaf green tea or just L-theanine supplement before bed really calms me down and has helped me sleep. And I don't wake— either I'm not having the hot flashes or I might not— they might not be disturbing me enough to wake me up. So I can get a longer, about 5 hours worth of uninterrupted sleep when I take L-theanine. So then that's like being a new mom again, isn't it?

It is. You're like, a miracle, 5 hours.

And so that has been beneficial for me. It might not help other people. And then there's some interesting research out there with melatonin also. And I feel like that one can be overused sometimes, especially in children, but in menopause, looking specifically at menopause, melatonin drops with our estrogen levels. So we just aren't producing as much. So that point makes sense to use melatonin in menopause. And it has also, there's some research out there showing that it can help bone loss in menopause, and it can also help with mood. And that mood—

yeah, it's a really strong antioxidant too.

Yeah. So, yeah, so I think— and again, you know, we're not grabbing huge handfuls. We don't need a lot of melatonin. And I think take that in too high of doses. So, you know, working with a dietitian or your doctor to find the right dose. And I'm a big fan of starting with the smallest dose and to see if that works. And if not, you can increase it. Yeah.

So what were your L-theanine and melatonin doses that maybe you started with and you have at least ended up with now?

Um, so the melatonin dose, I'm not necessarily taking, I'm taking that as needed. I don't take it every night. So I started with about 3 milligrams, I think with that. And, um, occasionally I would take 5. So I don't think I ever have taken more than 5 milligrams for that. And I found that to be really helpful when I do take that. And then the L-theanine, I am just taking in green tea. So I prefer to get it. I prefer to get my supplements through natural sources, through food sources if possible. And so I will have— I'll drink green tea throughout the day and I'll switch over to decaf tea at night and drink the decaf green tea because L-theanine is still in there. I know when we take the caffeine out, it can affect some of the antioxidants and things like that. But the L-theanine is still there in high doses in the tea.

So yeah, so probably like your eGCG may be slightly affected, but yeah, then there's caffeine and we don't want the caffeine to keep us awake, although it's very— it's relatively low dose, but everybody has a different sensitivity to caffeine. Are you drinking hot tea with like hot flashes or are you timing it?

Yeah, I'll drink cold before bed. So, okay. All right. Nice.

Before bed.

Yes. Yes, but I'll drink it hot during the day. I'm either really hot or really cold. I'm either freezing or I'm hot. There's like no happy, happy medium.

Oh man.

Yeah. Wow. I just adjust what I'm drinking on how I'm feeling. But yeah, before bed, I used to love having hot tea before bed and that just doesn't work anymore. It's iced for sure. Yeah. Okay.

All right. So we talked about good sleep hygiene, some supplements. Some food. Anything else you want to touch on from a food perspective for sleep? For any of it?

Anything?

Yeah, the BRCA gene, the menopause, for sleep. Yeah, I think, uh, yeah, it's all very helpful.

It is. So I think, you know, we're looking at maintaining a healthy weight, and I had touched on the being a little bit more sensitive to carbs in menopause, and I think that's very common with women And so not that carbs are bad, we need carbs, carbs that give us energy. Our brain likes energy, but thinking about the sources that we get them from and what we combine them with. And so nutrient timing, I feel like is really important going into menopause. So changing, you know, majority of my carbs come from vegetables, fruits, high fiber grains.

And then, so this is not a no-carb diet. Right. They've not been eliminated. Okay. I like it, Amber. That needs to be your new diet. The good carb diet.

And, uh, you know, getting the biggest bang for your buck from those carbs, looking for the carbs that are going to give us the most nourishing nutrients, you know, the vitamins, minerals, the antioxidants, the fiber. And, um, they're giving us a protective protection from not only cancer, but lots of other diseases. And, um, just helping us feel good. But I, I don't like to ever have a carb on its own. I always say, don't, don't eat a carb naked. Dress it up. I like that. Dress it up. I've said, you know, multiple times today that protein is super important in menopause and for muscle loss. It's harder to build muscle in menopause. And so protein is going to help with that. And protein is very important and protein needs to be spread out throughout the day. You can't store protein. So spreading protein out throughout the day is really important. And combining that carb with the protein helps with the carb sensitivity or that insulin resistance that we have. And so I'm always eating— do I have a carb? Do I have a protein? You know, carb and protein, carb and protein. And a lot of times that carb is coming from color or fruits and vegetables. So I think that's really important in weight management, going into menopause and just feeling good and in disease management. But also, you know, talking about maintaining and trying to build muscle in menopause also. And I think there's this huge— like diving into the menopause world, I feel like we're not like getting to menopause and like, oh, our life is stopping. It's a pause. No, like it's time to be fierce. Like we can still compete in menopause. We can still, you know, be active and we can still have muscle and do all the things that we love to do. And it's— we still have lots of life ahead of us, even though I was in surgical menopause. Going through menopause naturally, you don't have to stop doing what you love. We just have to make some adjustments, um, you know, to your fitness routine and your nutrition.

So that's great tips. So I think that's, um, holy smokes. First of all, we could talk about this for like forever. Um, and I definitely want to continue talking about it, but let's at least for now, maybe we wrap it up here and, and encourage people definitely to schedule an appointment with you.

Yeah. Yeah.

Right. Like, cause I find that this is especially working with athletes. It's a bit of a mindset shift of like, I want to keep doing all the things that I love doing. I may not be able to have maybe the same times or lift the same weight or And instead of stopping and getting frustrated with that, I love your tip of just, you know, like, you just got to keep going.

It just looks—

it might look a little different. Yeah, so that's really cool. Okay, so we always like to try to tie things up here with a couple of tips for people to walk away with. In their sort of health and fitness journey, what would be some of the 2 or 3 takeaways that you would encourage people, whether female or maybe male loved one of a woman who's in menopause or has this BRCA gene? So yeah, what would be tips?

I don't want to get off on another topic, but the BRCA gene, it can be in men too. And so that this, you know, can apply to men. This first tip is to own your own health. And so know your family history, take ownership of that. If you think that there's, you know, genetic cancer in your family, to get tested. And because it, it can be scary to look at those numbers, but you can take steps to prevent that. So with women, you know, it's the breast and the ovarian cancer, and you can take steps to really, really reduce your risks of that. Men, it'll show— it can show up as breast cancer in men, and it elevates the pancreatic and the prostate cancer risks too. So just knowing your risks gives you— can you open up so much information and power to take ownership of your own health. Along that same line, own your health, meaning do the research yourself. You know, dig into that research, find a dietitian, you know, or healthcare provider that's going to help you dig through that research and find out what's going to work for you, remembering that you are an experiment. And so don't get frustrated if something doesn't work for you that works for your neighbor. And just keep digging until, you know, you find something that works for you. So that's tip number 1. Tip number 2 is, you know, deal with the biggest— the issue that's going to have the biggest impact to start. And like I said, I think that's sleep for a lot of people in menopause. So figure that out. What's going to help that and fix that first instead of trying to fix 6 things at once. Fix something that's going to fix the sleep because it's going to help your weight. It's going to help your mood. It's going to help everything so that you can move forward from that, that position. And then number 3 is, you know, just I would take it back to the, to the, to the food, whether you're in menopause or not. We can all benefit from eating more color, more fruits and vegetables, and balancing those meals out and listening to your body. Like I said, I guess that goes back to tip number 1, you know, owning your health. Listen to your body, eat what makes you feel good, and, you know, get rid of the stuff that makes you not feel well. So our bodies are amazing and powerful, and they give us a lot of good information when we tune in and listen to them.

Great tips. Amber D'Angelo, Amazing dietitian and fitness instructor, personal trainer, all the things. Thank you so much for sharing your journey, for sharing these amazing tips on menopause and the BRCA gene. And I'm sure we will be back for more.

Lots to talk about still. I'll look forward to it. Yeah.

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