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Unbeatable™ Podcast

Dr. Daniel and Tana Amen on Brain Health

By June 29, 2016 August 10th, 2020 No Comments

“…everywhere you go, someone’s trying to shove bad food down your throat, put a toxic thought in your head, addict you to a gadget that will steal your attention.” –Dr. Amen on brain health as a battle

Dr. Daniel Amen and his wife Tana talk to Commander Mark Divine about their work with brain health. Daniel is the founder of the Amen clinics and they have both authored several of books, and are both New York Times bestselling authors.  By using SPECT scans, they have been able to identify issues in their patients’ brains. They are then able to help people work on and fix their health issues through the use of nutrition, exercise and meditative practices, as well as more radical measures like hyperbaric oxygen and transcranial magnetic stimulation. They take a warrior’s approach to brain health, and they have two books coming out in the fall about being a Brain Warrior. They share their approach to brain health with Mark in this podcast.

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Transcript & Shownotes

Hey folks, Commander Mark Divine here with the Unbeatable Mind podcast. Thanks so much for tuning in again, I super appreciate it, it’s an amazing thing to have you guys kinda follow us on this journey. My team has been on me to ask you to go rate our podcast on iTunes so that we can be easily found. So go give us a five star rating if you like what we’re doing. And if you’re not on our email list, then go to and subscribe so you can get all the shownotes and other interesting things. So

So I have had a ton of diverse guests on the show, but I’m so excited to talk to two fascinating people today, who are married, and a couple, and both pretty incredible in terms of what they’ve done, and the impact they’re making in the world. It is Doctor Amen and his wife Tana. Did I get that right? Tana?



Tana: Like Tana Banana.

Mark: (laughing) Tana Banana. Okay, so I’m gonna give you just a high-level overview. Dr. Amen, you are a former major in the army. You’re a physician, board certified…double board certified psychiatrist. Ten times New York Times bestselling author. I have read one of your books, and I was rooting around in my bookshelves trying to find it, so I can’t remember the name, but it’ll come to me during the conversation. But excellent, excellent work.

And Tana you’re the executive director… executive vice-president of the Amen clinics, and also a New York Times bestselling author of the “Omni Diet.” Can’t wait to learn what that’s about. And a nationally known speaker and media guest, etcetera, etcetera. You guys are amazing, so thanks very, very much for your time today. I know you’re very busy.

So let me just put it out there… Let’s talk about the personal side first. How did you guys end up together? I mean, that’s a pretty cool that you’re sharing this passion together, and have partnered in this line of work that you’re doing for brain science and helping people improve their lives.

Daniel: Well, when we met she actually almost cancelled our first date because she didn’t want to hang out with a psychiatrist.

Tana: (laughing) You know I’m a neurosurgical ICU nurse, and if you know the psychiatrists that hang out in the hospital, I’m like, “Yeah, maybe not.” So I thought I’d be polite and get through the first date, but then I was so fascinated by his work and I absolutely loved what he did. It was so unique, it was so different from what I know of psychiatry and as a neurosurgical ICU nurse, I thought it was fascinating. And I had no idea that he was he was really trying to do was scan me within the first two weeks.

Mark: (laughing) He gave you a full body scan, I’m sure, before…

Daniel: I wanted to know about the shape of her brain before any other part of her body.

Tana: I never felt so naked in my life.

Obessed by brains


Mark: I can imagine. That’s a pretty strange obsession you have, Daniel.

Daniel: I do. I’m obsessed with brains at Amen clinics. We have six clinics around the country. We have a database of over 120,000 scans on people from 111 countries. And they really provide the database on what we’re so passionate about, which is our work of making brains better. So the book you probably read of mine is “Change your brain, change your life.”

Mark: That’s right.

Daniel: It is just such a huge blessing for us, to be able to take brains that are troubled… So as a former army doctor we scanned hundreds of veteran brains. We did the world’s largest study on active and retired NFL players. And to be able to show the trouble, but then to reverse it. Then to show that you’re not stuck with the brain you have, you can make it better, we can prove it.

Mark: So the scans themselves, do they indicate… I mean, they must indicate areas that need work and can you pinpoint therapies based upon what you see on the images. Or give us an idea on how all that works.

Daniel: So SPECT is the study we do, stands for Signal Photon Emission Computed Tomography. It’s a nuclear medicine study that looks at blood flow and activity, and it basically tells us three things. Good activity, too little or too much. And then our job is to balance it, and we do it with diet, we do it with exercise, we do it with simple supplements, and more sophisticated things, like hyperbaric oxygen, transcranial magnetic stimulation, but what we get really excited about is teaching people today, right now. You know you can hurt your brain. You can make it older, smaller, less efficient. You know, if you have a head injury, if you drink too much alcohol, if you’re sleep deprived. But if that’s true that you can hurt your brain–and it is true–you can help your brain. That’s what our work is all about. ‘Cause with a better brain comes a better life.

Mark: Sure.

Tana: It’s very exciting, and we see these stories every day. And it doesn’t take as long as people think. They get results fairly quickly. Now we want them to stay on our program a long time, but they start to feel better quicker than they think they will.

Invisible Brain Trauma


Mark: Right. Now, you know I come from a background as a Navy SEAL. I’ve been a yoga practitioner for close to twenty years. A martial artist for more like thirty now, and I’m dating myself. And the fact that you can improve your structural brain and also the felt experience of the mind is pretty much common sense in those traditions. I mean, why is it so remarkable to people to learn that they can actually affect the quality of their life by improving the way they used their brain, by improving the processes and deliberately taking a role in their brain’s health?

Daniel: Well nobody cares really, ’cause you can’t see it. You can see the wrinkles in your skin or the fat around your belly, and you can do something when you’re unhappy. But even as a Navy SEAL, how many times did you do breaching exercises. And nobody’s thinking, “Well, what kind of damage is that causing to my brain?” Just like someone who gets tackled, and their head hits the turf. That happens repeatedly, and nobody was really saying, “Hey, that’s a bad idea,” when I did the first NFL study, the NFL was actually lying they had a problem. They knew it.

Mark: They got in big trouble for that, didn’t they? That was more of a recent…

Daniel: But we’re just so excited about identifying the trouble, and then doing things to change it.

War and a Healthy Brain


Tana: And it’s not just the physical trauma. I mean, we know soldiers come back from war, and they’ve got not just physical trauma to their brains, they’ve got a lot of emotional trauma. They’ve got PTSD and other problems. And it’s not just soldiers though. There’s a study out that shows that children who grow up in homes with emotional trauma actually have the same affect on their brain as soldiers coming home from war. And no one thinks about that. They don’t think about emotional trauma to their brain and what it does. Like what happens to a developing brain, it affects for the rest of their lives. You know, their hormones, their immune system all these problems that may affect them later in the way they function on a daily basis.

Mark: Right. So let me pick that apart a little bit. So… let’s say I’m a Navy SEAL, because I am. And I was into breaching, as you said Dr. Amen. And I’ve had a thousand explosions affect me, right? And there was no dialogue about any type of post-breaching recovery training, or methods to kind of mitigate the effect of that impact, just like in the NFL. So what does my brain look like, after getting breached a thousand times. With all the ricochet effect and what’s happening. What does that look like to you when you scan me?

Daniel: Well we would typically see lower activity in the front part of your brain. So think of things like forethought, judgment, impulse control, organization, planning, empathy and decreases in your temporal lobe. Because they sit behind a very sharp bony ridge, your brain was not made or evolved to do breaching, and have that kind of repetitive impact. And that can be involved with things like mood instability, irritability, temper, learning, memory issues. Now it’s fortunate for you, that you have engaged in meditative practices, martial arts training, as long as you don’t get the brain injuries. Tana actually has two black belts, one in Tae Kwon Do, and one in Kenpo. And she’s actually the reason… we have two books coming out in November called “The Brain Warrior’s Way” and “The Brain Warrior’s Way Cookbook.” There’s just no question that it’s war for the health of our brains. But by engaging in those things that helps, but at some point you probably should come to the clinic and go, “Okay, what’s the impact.” And what’s really exciting it’s not just, “Oh well, that’ll bum me out.” It’s well–can you do more, can you do even more to get better brain function, ’cause that will matter.

Tana: And, you know, ’cause you’re probably a really goal driven person, I mean, you’re a Navy SEAL. So when you see something and you’re like, “Hey wait, that could be better.” That’s the whole point. And guess what? You can make it better. That’s what’s really exciting. We see it every day.

And you’re already so many things. So that’s really…

Mark: Right, right. And that’s kind of the essence of what we try to teach but it’s fascinating to me to bring that what I would call that 3rd quadrant perspective, to use the integral model, the external perspective is going to validate, just by looking at the brain, and saying, “Okay, here’s the structure of the brain, this isn’t working. These regions need some help, here’s some things. And then that kinda supports my approach which is really more subjective and internal focused. You gotta basically sense or hope that the training is having an impact. As you’re aware it’s very hard to know when you do meditative or contemplative yoga, these types of different practices, it’s hard to know the effect or the impact or where you’re making progress. Because you can’t see the results unless you hook yourself up to an EEG machine or do a SPECT scan or something like that.

Tana: Which we’ve done.

Mark: Which you’ve done, yeah. So I think that is really cool. It’d be fun to…

Meditative Practice


Daniel: We’ve published 3 studies on a Kundalini form of meditation of meditation called Kirtan Kriya that found it activated frontal lobe function. It’s really exciting to demonstrate something that people have known for thousands of years.

Tana: And something really simple. We actually scanned a woman… you know, something that someone could take away today… a woman who was focusing on gratitude. She was being scanned during a time that she was focusing on gratitude. And then we did a follow-up scan with her because she was writing a book about it. And then she was focusing on being angry and hateful about the things she didn’t like about her life and the scans were radically different. And from the Navy SEAL’s perspective, you’ll love this, the part of her brain that got really affected was the back part of her brain, her cerebellum, which affects coordination. So, really important if you’re focusing on the things you love, it affects your brain in a really positive way for performance. And if you’re focusing on the things you hate, really quickly it just drops that part of the brain. And not only do you make worse decisions, but you’re not going to execute as well.

Mark: Yeah, that’s cool. But, you know, showing through a scan that a meditative practice affects or impacts an area of the brain when you’re doing the practice, is different than showing that you’re healing part of the brain over time. Have you been able to prove that different practices heal different parts of the brain? Or actually through neuroplasticity if I come to you and I’m not a meditator and I’m a Navy SEAL who you can show has some damage in the neocortex, and then you say, “Okay, go home, change your diet and begin meditating.” And I come back to you a year later, can you show that it’s improved in that specific area? Can you show that the brain has actually changed for the better?

Daniel: Yeah, that’s kinda that whole point of what we do.

Mark: Yeah, that’s what I thought.

Daniel: We have this great case that just was last week. Somebody came to work with us just about a year ago. And when we scanned her, her brain looked awful. And then I learned that she had eight concussions, she had been electrocuted, she had arsenic poisoning, and I’m like, “Oh my goodness.” But she fell in love with her brain, and just did everything that we asked her to…

Tana: Including yoga.

Daniel: And a year later her brain was fuller, fatter… I mean we were like so excited for her, because by doing that we literally changed the trajectory of her life and the lives of her children. So she was an older mother, so at 63, she has 20 year-old children, and can you imagine if she just kept going the way it was. Twenty years from now she would be a burden. She wouldn’t be functioning anywhere near where she could be. And he young children would then have the burden of a mother who was, you know, headed toward dementia. But by knowing, and then getting serious… that’s the brain warrior’s way or idea, they’re serious… with the right tools, training and habits, you can make a radical difference.

Mark: What about aging itself? You know, if… let’s say that someone has not had any TBI, has had a pretty normal life time. But we all know the brain shrinks and becomes less effective as we age. I imagine the scans can show that. And I imagine also… (laughing) I’m answering my own question for you… that the practices can slow down the aging process.

Daniel: Or even reverse it in some cases. And you’re right. After looking at 120,000 scans what happens to the brain over time is it just gets less and less and less active. So sort of like….

Mark: And it even shrinks doesn’t it?

Daniel: It does. Just think of your skin. As you age your skin begins to fall off your face.

Mark: Kinda depressing actually.

Daniel: That same process happens in the brain. But it doesn’t have to. And that’s the exciting thing. But if you’re not serious, if you’re not a warrior, a lot of bad things are going to happen. You know, one of the reasons we called the book “The Brain Warrior’s Way,” is everywhere you go, someone’s trying to shove bad food down your throat, put a toxic thought in your head, addict you to a gadget that will steal your attention. Alzheimer’s is expected to quadruple, depression is skyrocketing. Two-thirds of us are overweight, and as your weight goes up the size and function of your brain goes down. It’s the greatest brain drain in the history of the United States. If you’re not armed and prepared, you’re going to lose the fight of your life.

Tana: And warriors are serious. I mean, they’re dead serious and they’re committed and that’s the whole point is that we want people to understand how committed they need to be, and none of this “Oh, I’ll do it for two weeks.” Yeah, that never works.

Mark: Won’t we have designer food and nanobots to solve all that in fifteen or twenty years?

Tana: (laughing) Aah! That’s the problem.

Mark: I can just keep drinking and eating crap because technology’s going to solve it. I’m just kidding. (laughing)

Tana: That’s what got us into this mess.

Mark: I agree with you.

Omni Diet


Mark: Tana, let me ask you about the Omni Diet. It sounds like an interesting name. Like omni sounds like omnipotent or omnivorous.

Tana: More like omnivorous and more all-inclusive, for everyone type of thing. And while it wasn’t designed for vegans, it clearly is adaptable, and so that is where the name originally came from. And its the program we use for our patients. So… and it’s the same program that’s in our new books as well, it’s just the new books are the combination of what we both do. So…

Mark: So what’s the general theme, give me the high-level view.

Tana: The general theme is about getting rid of all the garbage that’s hurting you, it’s an anti-inflammatory program and it’s 70% plant-based foods, 30% high quality proteins–even if you’re vegan, we want you to still adapt that way with plant-based proteins–but making sure you get those proteins, so that you increase your focus, decrease your hunger, stabilize blood sugar, and lots of plants for the obvious reason. They’re great for the cancer fighting properties. But definitely not low-fat and not low-calorie. So we want people eating the right foods, because you get to eat a whole lot more. And we want you to benefit your body in those ways and that actually boosts brain function.

Daniel: And there’s over a hundred recipes. See a lot of people think, “Well if I’m gonna eat really healthy that’s going to be awful and boring. And I think one of Tana’s best gifts is taking really healthy food, I mean medicine quality food, and make it taste amazing.

Mark: Nice. So I tried to be a vegetarian a few years ago. (laughing) I almost ate my arm off. I could not get enough protein. I was just craving it. Because, you know, I didn’t change my training plan.

Tana: Right! If you’re an athlete it’s hard!

Mark: So… but let’s say I was really committed to maintaining my SEALfit training and being a vegetarian. What are the best sources of plant protein? And how much do I have to eat to get kinda the same macronutrient quality as eating a steak or chicken?

Tana: So if you are vegetarian it’s a little easier cause you can eat eggs, and there’s some things you can eat the vegans don’t eat. If you’re not a vegetarian, you’re a vegan, then what I usually tell people is you’ve got to radically increase the fats with the Omega-3 fatty acids in your diet. Probably take some amino acids in supplement a little bit. So fats are going to be your friend, for sure, in that case. But definitely supplement with things like some organic tofu. For men we usually don’t want them eating too much tofu for the estrogen properties, but then, you know, there are plant-based protein powders. You gotta make sure you’re getting enough of those things. But overall you have to get enough calories and enough balanced amino acids, so they’re just going to have to really up their fat intake as well and supplement. They have to supplement.

Mark: Yeah. I love that message ’cause we’re all about increasing fat as well. And I’m sure you’re about to say that fat is really good for your brain. ‘Cause it is, isn’t it? The primary source of fuel for your brain.

That brings me to a question about being a vegetarian and ketogenesis. Is it possible to be ketogenic, or have a ketogenic effect when you’re a vegetarian or you’re eating mostly a whole food diet?

Tana: Well, they can eat the fat, the really high fat. The protein part would be more difficult. But, I mean, they can… there’s coconut oil, there’s avocados, but it’s pretty difficult if that’s all you’re eating because most vegans really surround their diet… not just plant-based foods.

And here’s my big gripe is that, vegan is not synonymous with health. So if you’re loading up on lots of pasta, rice, potatoes, and, you know, french fries, that’s not healthy obviously. So that’s the tricky part, is getting people to realize that just because your vegan doesn’t mean you’re eating the right foods.

Mark: Yeah, I mean more and more people are aware now it seems to me, that quality over quantity is trump. I mean, I remember earlier the Zone diet didn’t say anything about quality, it was all about portion control and the percentages. But you could eat whatever crap you wanted. And obviously that’s not going to go well.

Tana: No, cause if you’re in brain inflammation it doesn’t matter if you’re cutting calories way back. Eventually it’s going to catch up to you. That inflammatory process is going to make you sick, and it’s going to hurt your brain.

Mark: Right. So let’s draw that link between nutrition, sleep and practice–and what I mean by practice is, you know, things like meditation and contemplation and prayer and yoga. So those three to me seem to be the triune that are going to lead to brain health or healing of brain. Dr. Amen can you tell us why… what is it about changing your diet, changing your sleep patterns and doing things… some of these contemplative type practices… what is going on in our body physiologically that’s leading to healthier brain?

Sleep and the Brain


Daniel: Well, for example, if you don’t sleep it turns off 700 health promoting genes. They recently just discovered so why do we sleep? Because that’s when your brain cleans or washes itself and gets it ready for the next day. So if you’re not sleeping 7 or 8 hours, which you know, as a SEAL you often would go without proper sleep.

Mark: Sleep is a big problem in the SEAL teams.

Daniel: That gunk or trash builds up in your brain, and it then makes it harder to think. There’s one study on soldiers, put them on the range and if they got 7 hours of sleep they were 98% accurate on the range. But those that just got 6 hours of sleep were 50% accurate on the range. Those who got 5 hours were 28% accurate, and 4 hours they were 15% accurate. It was a disaster, they were dangerous.

Tana: So that’s affecting the quality of decisions you make with nutrition because you’re not thinking clearly, and your frontal lobes are affected. It also affects your daily practices, like whether or not you meditate. Is it even effective, are you able to really engage. So it’s affecting everything.

Mark: Sure. Yeah, you’re right. It’s very difficult to train when you’re sleep deprived. And most often that’s the first thing to go. In fact, most people on the SEAL teams are more likely to bang out a high-intensity workout to get that instant energy hit, which then depletes them further and jacks their cortisol and it perpetuates the sleep problem. And so that doesn’t work either.

Daniel you said something about “gunk” in the brain. Are you talking about psychological gunk, or actual gunk? Like, is there something that builds up…?

Daniel: No, physical gunk. like beta-amyloid plaques. Your brain needs time to clean itself up. You know, imagine, here at the office of Amen clinics if the housekeepers didn’t come in at night. After a couple of days things would look pretty ragged. The same thing is true for your brain.

Tana: So the brain is an energy hog. Even as small as it is, that 2 to 3 pounds is using 25 to 30% of your calories. So it’s using so much energy and it needs time to really clean itself and rest.

Mark: So you need to basically floss your brain everyday, and sleep is a brain floss… nutrition will floss it. Okay.

Daniel: And you need to floss your teeth. ‘Cause if you have gum disease, you have a higher risk of Alzheimer’s disease. So I think of you know when I floss my teeth at night that it’s a brain exercise.

Mark: Right. Interesting. Yeah, they’ve made that direct link between flossing and Alzheimer’s? Fascinating.

I think that I heard the UK actually treats Alzheimer’s… no, maybe not Alzheimer’s… but some common disease like that as a nutritional problem.

Tana: Interesting.

Mark: Have you heard that?

Daniel: I have. The standard American diet significantly increases your risk for Alzheimer’s disease. And then, you know, if you think of the standard American diet associated with obesity that’s obvious. We published two studies that say as your weight goes up, the actual physical size and function of your brain goes down. And, you know, when I first learned about that I lost thirty pounds. Because I’m not gonna be a dinosaur, you know… big body, little brain. And, no, you don’t want that.

Mark: (laughing) No. Let’s talk about… we only have a few minutes left. I know you guys are busy and you gotta get outta here pretty soon and go off and scan some brains.

What about your personal practices? What does your day look like? What do you guys do to maintain those pristine brains of yours?

Tana: My husband is mellower than I am. I always say he grounds me. So I’m a very intense person. For that reason, everything that I talk about and that I write about is absolutely critical in my own life. So I… when people say, “how do you even have time to eat as healthy as you do? How are you so disciplined? How do you have time to exercise with all the travel?” For me it’s very simple, because I’ve been very sick in the past. And I’m really well now. I don’t have time not to. It’s that simple. It’s not even an option, so I have to make that time. I get up early enough to check my heart-rate variability, you know, I eat really clean. I meditate every day. I do my exercise–exercise comes before almost everything else I schedule. And I’m very regimented that way. And if I don’t do all of it, I don’t feel well. You’re a bit mellower. He’s not quite as extreme as I am, and, you know, he’s just… his brain type…

Daniel: But for me, you know, the best brain game in the world is table tennis. Where you have to get your hands and feet and eyes all to work together while you think about the spin on the ball. So I have three sessions a week, where I have a coach, I play in a tournament locally, and that’s an important part of my life.

Tana: For him it’s more about play. (laughing)

Daniel: And I do weights twice a week, because the stronger you are as you age, the less likely you are to get Alzheimer’s disease. I am very conscious about what I eat, because I know food serves me, or food hurts me. And you know, given my own devices I would stay up ’til midnight or one o’clock. I have a lot of energy. I’d be writing, doing a project, and I realize now that that’s just the dumbest thing I can do. So by ten o’clock I’m in bed, and I try to get 8 hours of sleep every night. And, you know, one thing we haven’t talked about, is I’ve learned not to believe every stupid thing I think.

Mark: (laughing) Hallelujah!

Tana: And that’s hard for people who have a trauma background. If they’ve been exposed to things that are pretty ugly. You know, their brains can kind of go to that negative place…

Daniel: But it’s a meditative practice to just sort of watch what’s going on inside your own mind, and when you get the bad thoughts–we call them ANTS–Automatic Negative Thoughts–kill them. Gotta get rid of them. Because otherwise they will infest you with negativity. Tana and I have a live class we do called “The Brain Warrior’s Way.” If people want to sign up for it, they can just go to We archive all the lessons, so they can watch the ones in the past, and last night we did a whole lesson on killing the ANTS, or you know the things that make you fat, depressed or feeble-minded. So yes, it’s the physical habits, but it’s also the mental habits as well.

Mark: Absolutely. Well that is a great place to segue, because that is kind of the core focus or where we start with Unbeatable Mind, is learning how to think properly, learning how to use your mind more positively. Feeding the courage wolf. Killing… starving fear, I should say. Getting rid of the ANTS, I love the ANTS. And learning how to improve your life through physical, mental, emotional, intuitional and spiritual practices. And it sounds like you guys are right there with us, and you guys are doing amazing work. I really, really hope to meet you in person some day. Maybe we can have you to our Unbeatable Mind annual retreat someday. And we can do some scans or do something really cool. That’d be fun, wouldn’t it?

And if there’s anything that we can do help support you, let us know. Tell the Unbeatable Mind folks listening where… so your book “The Brain Warrior’s Way” is not out yet, right?

Daniel: It’s coming out November 22nd, so they can pre-order it. We’d be grateful. And if they want to learn more, sign up for our live class at

Mark: That’s available right now?

Daniel: Right now. It’s free. They can tune in every Wednesday, or they can watch the archived ones, and learn all about the tools that we have for them.

Mark: That sounds terrific. And that’ll be a great way to support the book launch, of course, and get more people to go to learn how to kill the ANTS.

If you were to ask the folks to read one book of yours, either one, between the two of you, you’ve written about a hundred books. But which one besides this one coming out in October, would they…

Tana: “Change your brain, Change your life.”

Mark: “Change your brain, Change your life.”

Daniel: And “The Omni Diet.” I mean, people just get radically well in the short period of time…

Tana: And the reason we did “Warrior’s Way,” is because it’s the combination of those two.

Mark: Combines those two. Cool. Awesome.

All right, thank you very, very much…

Tana: Such an honor…

Mark: Really, really nice to meet you all…

Daniel: Look forward to seeing you and maybe your brain sometime soon.

Mark: (laughing) I’d be scared to take a look at my brain. Might be very revealing. Might explain a lot about my life. Awesome guys. Thank you very much.

Daniel: Take care.

Tana: Bye-bye.

Mark: All right everyone, thank you very much for tuning in. And thanks again to Dr. Daniel Amen and his beautiful wife Tany? Tana? Right?

Daniel: Tana Banana.

Mark: And don’t forget to go rate this podcast, give us five stars. Go check out Let’s support these guys in getting their word out and helping people get healthier. And I guess that’s it. Train hard, stay focused, and we’ll see you next time.


Coach Divine out.