A single mother’s fitness journey
Shebah Carfagna | Ageless Workout
BY PETER BOWES | APRIL 3, 2023
Starting a fitness journey is one of the most challenging things we can do. There are obstacles, excuses and setbacks that many find overwhelming. Shebah Carfagna, a single mother of an autistic child, knew she had to be strong to confront the challenges she faced – not only for the sake of her son, but her own wellbeing. Pre-dawn workouts and a lifetime of learning led to a career in fitness, with movement at its core. The co-founder of Ageless Workout, a Miami-based health and wellness company, Shebah now empowers others to live their best lives.
In this interview we cover:
- Defining an ageless mindset
- A 3:45am gym routine that grew into a career around fitness
- Why movement first, rather than exercise?
- Addressing the barriers and obstacles to a fitness regime
- Maintaining personal strength to care for others
- Teaching the Joy Principle
- The power of walking
“Recent studies show that gait speed, as well as the movement of walking, keeps the body fluid, keeps the joints moving, keeps the muscle length longer.”
- Catering for the 80% of people who’re lost and can’th fathom exercise
- Changing the messaging around fitness to be more inclusive
- Applying the Richard Simmons principle towards exercise, to bring people together
- Ecotherapy to nurture mind, body and soul.
- Maintaining power, strength and purpose as we age.
- Defining a vision of the future for aging individuals in 2030
Read a transcript
You may also enjoy: Episode 199: Nate Wilkins – Living and Ageless lifestyle
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This interview with Shebah Carfanga was recorded on March 28, 2023 and transcribed using Sonix AI. Please check against audio recording for absolute accuracy.
Peter Bowes: Shebah Carfanga’s philosophy is this: She believes in an ageless mindset, in fact, an ageless lifestyle where what we do and what we’re capable of doing is not dictated by a number. Shebah, welcome to the Live Long and Master Aging Podcast.
Shebah Carfanga: Good afternoon, Peter. It’s so nice to be here. Thank you for having me on. To share our story and our perception about aging and longevity.
Peter Bowes: It’s really good to talk to you. Let me ask you first up, what do you understand by the word ageless?
Shebah Carfanga: Well, I understand that it is a state of mind and a mentality and kind of what we call a mindset. And that’s where we want individuals to be, is in that mindset that they want to live a long time and to continue to do the things that they’ve always done.
Peter Bowes: And we’re going to dive into that a lot, and especially as it applies to the way that you work with your clients. A vast range of different clients with different aspirations and different goals. But before we do that, let’s talk about you and how you got to this point in your life, because I know a lot of your ideas and the way that you work now is based on your own personal experience.
Shebah Carfanga: Yes, that is correct. Well, I came to this quite serendipitously. I went to Ohio State and I majored in broadcast journalism because I wanted to work in broadcasting as a broadcast journalist for sports many, many years ago. And that wasn’t where my career took me. It took me on a nonprofit journey for which that I was a fundraiser for any number of years and like everyone else, got married and had children. And and so with my story, my son was born with a condition called autism, which kind of took me in a different direction as a special needs mom. And so looking through career and working through as a single mother of a special needs child was quite stressful for me and almost overwhelming and debilitating. And so managing this corporate fundraising job at University of Miami was overwhelming. And so what I did was I sought exercise. For some reason, it came to me and I met with a personal trainer and started this journey of apprenticeship with him, which was a method to calm me down, to manage with the stresses of a full time job, as well as raising a special needs child in Miami, where I had no family and no relatives and just no one. And so it was kind of like figuring it out, like they dropped me off in the middle of nowhere, and then I had to kind of work through it. And what I found through the exercise was it was very rewarding. It gave me a purpose to be in the morning. It put me with other women who were professionals because there was a group of us. And as the story goes, we had to be at the gym at 3:45 every morning to work out to do this workout. So that gave me a time management purpose to be back home before the day started with my son. And from there I developed a love for this movement and the strength and power that it gave me to navigate the day, which could sometimes be difficult. As you can imagine, juggling two major things, but always my greatest priority was my son. And so that was difficult. Navigating the school system and then navigating the workforce. After joining that about I did that. I started that in 1997 working out and movement and exercise and started to take group fitness classes and enjoyed that because the sense of camaraderie and you’re looking for the same people every time you go and actually met some individuals who were in the school system who actually helped me with my son, led me to an even greater passion for exercise. And so around 2005, I made a decision to not to leave the nonprofit world and focus on raising my son. And I had this passion in my heart that I wanted to do exercise. And so I had done it for since 97 to 2005. So I felt that I could accomplish this and began a series of certifications for personal training and also group fitness exercises through AFAA, which led me to different modalities like BOSU, TRX and just to continue to build my knowledge of exercise modalities, I ended up certifying for group fitness instructors. So that gave me another level of certifications to keep me at that next level up. And so it branched out that I was able to take my previous contacts from development and it was the same market that I was able to market to for the fitness. So individuals knew the quality of my work and so they were engaged with helping me and get started with my business. And around that time I met Nate and we he decided to leave his corporate job and his municipal job, and we ventured out to do an out of the box what we call an out of the box fitness service. So we’ve never really owned a gym, bricks and mortar. It’s not something that we saw as a viable way to be successful. We went into service where we contracted with five star hotels and spas and it kind of worked out and we ended up working all over the city while continuing to gain more knowledge. Knowledge and more knowledge and, you know, kind of living life and meeting more individuals that were in our age group, but also younger individuals, special needs individuals for my son, people from different cultures.
Peter Bowes: I’m going to stop you there because I want to backtrack a little bit. We’ll bring the story up to date. But I do want to backtrack to the point where you said because it made me sit back and think you said you had to be in the gym. This is quite a few years ago at a 3:45 in the morning, 3:45 a.m. And this is the time that you were bringing up your son. You were getting into fitness. Time management must have been a huge and difficult issue for you at that time. That is such an unsociable hour for so many people. Considering everything else that you had to do during your day.
Shebah Carfanga: Well, yes, you’re absolutely right. And to this day, we get up around here at 4:00. So we’ve taken 15 minutes and we don’t have to be in the gym. It was a difficult decision, but we you know, I found at that time it was the most peaceful time for me to do what I needed to do. And I think from that, we’ve developed a saying that says never let the condition manage you. You have to manage the condition. And so to make the commitment with my son and families always first I needed to be back home in time to get him ready for school. And so that was the only time I could do it and then to get ready for the school bus. So it was a commitment somewhat to myself because I needed that release in that time to think and very much to family. And then very much my commitment to my job during the day, because sometimes you have to work late, you can’t go to the gym. And so it it addressed obstacles, something that you hear a lot about now. People talk about what are the obstacles for individuals about going to out to do exercise, not necessarily to the gym, but exercise. You know, it’s cold outside or the younger generations are cooked to their to their computers, their Macs all day, or most recently the pandemic. What were the barriers and obstacles people had to face? And somehow I stumbled into that early on. And here I am today. My son is 33, 33 years later. We’re still up at 3:45 in the morning. We used to take clients at five, but now we take them at six and seven and eight. And so it allows you to get in a full day for us. That doesn’t mean you have to get up at 3:45. You just have to do what you’ve said, which is manage your time wisely. If you’re not a morning person who likes to move around, exercise, work out. And there’s three different schools of thought with those three words, that’s why I’m bringing them up. Then you do it in the afternoon and you have to make time for that. You know, it could simply be a walk.
Peter Bowes: And I think. A lot of people might be wondering if you’re getting up that early in the morning, what time do you go to bed? Because as I’m sure you will appreciate, sleep is so important for our health and longevity.
Shebah Carfanga: Sleep is critically important. You are absolutely right. You couldn’t have said that better a lot of times around 2 or 3 in the afternoon, I take a break and take a power nap. And recent studies have shown that a power nap can be quite effective to allow you to rest that time you’re resting your mind, you’re resting your body, and then you can get up and continue with your day. I would say pretty much go to bed around 9,10. And so we get that 5 to 6 hours in there, but we find that a power nap or break in the middle of the day is a good thing. And so if you work in an office and you have a 30 minute lunch, let’s go on the shorter end and you go outside and you have your lunch and relax, it actually helps you regroup to go back in. We’re big proponents of eco therapy and I can talk about that as well at some point. But you have to have that time where you can break away. You know, if you get up at ten. I have clients that don’t that rise at 12 in the day and I see them at 130, but they go longer at night. So it’s the beginning of the day for them. It really just depends on what your lifestyle is. And I’d love to be able to unpack that and talk about how we meet individuals where they are.
Peter Bowes: I think it’s a fascinating issue. And the other thing that struck me was that you during this difficult time in your life when you had so much to do, you had your son with with with his own difficulties and you were a parent caring for him at a time in your life that you might have. And a lot of people might neglect their own physical activity and their own physical health that oftentimes you’re so engrossed in looking after the most important person in your life, your child, that you actually turn to exercise as a way to strengthen yourself.
Shebah Carfanga: Yes that right.Correct. Strengthen myself, my mind. Strength in my body to deal with the uncertainty of what’s next, you know? Fear is an interesting commodity, if you will. And so you have to be strong to face the issues that that are a part of what you see. So what my issues are may not be an issue for you, but it’s very real to me and in my face. All right. And so that’s how we deal with our clients, actually. And that’s where I learned the power of that. But, you know, if you think about what they tell you on an airplane, they always tell you to put the mask on your face first so then you can help others around you. And I think that is the critical thing because you can’t, you know, just fall apart and become lost. And in a role, as most women, at least women in America I can speak for. We are the central kind of central nucleus of what goes on in the home. Not always, but we’re you know, we’re mothers. We’re caregivers. We give to the husband, we run the house, and then we go out and work a corporate, you know, or some sort of job to bring in income. And that is a delicate balance in our lives and a lot. And I’m seeing that you one of the things I’m teaching is something called the Joy Principle. I gathered this information from a psychologist, and she believes that women should have the joy principle. So if you rose this morning to go to the gym at 6:00 and they called you from work and you had to go in early, you’re so disappointed. You know, you’re you’re all thrown off in your day that you go, oh, well, I just won’t go to the gym at all. And that defeats you. So then another day passes and another day passes and you feel defeated in your mind. And this is where the ageless mindset comes in that you should then just readjust your schedule like we do everything else. You know, if you go to the grocery store and they’re out of tomatoes, you know, you decide to use something else in place of that. What that that’s an analogy. But where that says is if you didn’t work out in the morning or do what is what you enjoy, then perhaps you go for a walk after dinner with your spouse, with your children. You know, walking is the key to longevity. So recent studies show that gait speed, as well as the movement of walking, keeps the body fluid, keeps the joints moving, keeps the muscle length longer. And so you feel that you’ve done something even if it’s around a block, or you attend your child’s soccer game. And while they’re at the soccer game, you walk around. This notion of movement is critically, critically, critically important to longevity.
Peter Bowes: I couldn’t agree with you more. I’m a huge proponent of walking, walking every day, difficult walks up, difficult terrain, climbing up a hill, making sure that you’re out of breath for at least part of that walk to get your your blood moving and get your heart beating. And the other thing that strikes me from what you’ve just been saying is and this is again, something that I feel quite strongly about, is that ultimately it’s up to ourselves. It’s our own personal responsibility to decide the regime that works best for us while still prioritizing the element of exercise at some point during our day. Because we’re all very different, aren’t we, in terms of our lifestyles, our other responsibilities, the things that we have to do to to just to get through the day and to to earn money and to to keep a house and all the things that all of us have to consider. And very often, as I mentioned just now, it can be that personal exercise, that personal nurturing of our health that can go by the wayside. And we need to figure out a regime that works for us.
Shebah Carfanga: No, I couldn’t agree with you more. And so one of the things if I could unpack this and talk to you about it is we know that there’s 100% of the population, 20% of the population is like you and I. They want to work out. They want to feel good and they understand it. 80% are lost. They don’t know. They don’t like to go to the gym. The word exercise and workout is just something that they just can’t fathom. All right. And so with this formula, we are after currently the 80% and we never use the word exercise or workout with them. We use movement. So if you’re in that 80% and you’re potentially a client, you come to me. What I talk to you about is what is it you like to do? And we call this the ‘meet you where you’ are principle. What do you enjoy? What? Why are you coming to me? And so they’ll say, Well, my doctor said that I had to take my medicine at a regular time and I don’t take it. Or he said I had to lose 50 pounds and I don’t want to work out. We backtrack and listen to actually what you are telling us and say to you, Well, what is it you like to do? Do you like to go to Zumba? Do you like horseback riding? You know, well, I don’t like to do anything. Well, you walk. So is it possible that you could walk, put walking in your regiment? Or if you’re at an office all day, could you stand up and sit down ten times every every hour? And so we can start at the very basic level and build upon that so that the person feels accomplished. I think a lot of times individuals don’t feel accomplished when you say exercise and work out because the message in this, you know, multi-million dollar industry is you have to look a certain way. You know, you need to be buff and you need to be fit and you need to be lean. And that’s messaging that has been put across in this business forever. And I think one step at a time, what we do is to try to change that messaging so everyone’s included at the level that they are comfortable. And then you get this, you know, kind of movement going on. The prime example that I like to use, and I’m sure you’ve heard of him, you ever do you remember Richard Simmons?
Peter Bowes: Oh, yes, of course.
Shebah Carfanga: Richard Simmons. Everyone was included race, creed, color, national origin, heavy, thin. Everyone was part of that movement. And he made everyone feel like a part of that. He didn’t necessarily call it exercise or workout. It was just all of us getting together. And so we believe that that notion is important, a purpose going to meet individuals. If it’s just the trainer or a class that is important to have that part of that mindset and then a better quality of life. So as we get older, in the year 2037, there will be more people that are in our age group than are our younger people. And so as you get older, you want a better quality of life. And we’ve never had that notion presented a better quality of life. Well, what does that mean? That means, you know, if you’re over 65, you have one morbidity issue, diabetes or something. And if you’re even a little older and less fortunate, you have two, which is going to reduce your ability to live a long time, but let alone you won’t have as good a quality of life. And that’s where we are. We want individuals to have a better quality of life. So if that means you walk around the block every day or you take the dogs out or you go out to a soccer game, that will increase your quality of life. Recent studies again show that walking will increase your longevity. You’ll feel better. You’re out breathing the fresh air ecotherapy, which is where you go out and breathe the fresh air. You listen to the birds. You take a minute away from being inside where the air conditioning and everything is, and you just kind of relax and engage in a slower time, if you will, or a better time to relax. You know, all of those things are important.
Peter Bowes: This is the Live Long and Master Aging podcast. Our guest is Shebah Carfagna, who is a co-founder of The Ageless Workout, which is a miami based health and wellness company. So Sheba, let’s just delve into that a little bit more because I find it fascinating. You say ecotherapy is just pausing. It’s just cooling down and it’s appreciating, as you put it, the birds around us and perhaps our own solitude.
Shebah Carfanga: Absolutely it is. It is. And in a time when we’ve been self contained or sheltered in place after the pandemic, all over the world, everyone is now sitting more. So prior to the pandemic, people were moving around even if they did not perform movement, exercise and workouts, they were moving around where there was more opportunity to get out in the fresh air because you had to travel to work. You had to travel here. You had to travel there. With the pandemic, everyone has become this, you know, shelter in place. Let’s just sit. And so that has become part of our culture universally for, what, three, four years now? And so people are less apt to get up and go because now this is the new mindset. If you take that break and enjoy the birds and and, you know, rest your mind it is a good thing because in addition to this sitting all day, we’re bombarded with social media. We’re bombarded with no good news. The news is now 24 over seven, eight days a week. I mean, it’s just amazing. And and the access to streaming and movies and, you know, the world’s a much faster place and our minds are always engaged, engaged, engaged, engaged. And so the ability to push back is a skill set. It’s a coping skill. You have to know when to push back and take some time for yourself to regroup and think. And, you know, because there’s so much coming at us now, look at our children. There’s so much coming at them. Even my son is a prime example. He just came back from a cruise. I think he was averaging seven hours a day on his iPhone. He averaged 21 minutes for the week. So it’s reset his mind because that engagement of here all day long in the eyes and quite honestly who knows what that means going forward on our eyes or in our cognition, let alone on our bodies in the you know, and the aspect that we’re not moving as much.
Peter Bowes: And did that reduction in screen time as far as your son was concerned, did he appreciate the benefits of just cutting off for a while?
Shebah Carfanga: I think he has. I think we’re trying to establish some situations where there’s a time to turn off the phone. I mean, certainly any of us, special needs or certified or like I like to say, un certified have no control over how much adults or children are on their phone. But I think you have to be able to turn off and I think it’s made him better. He’s moving a little more, he’s doing a little more sports. And so because you just, you know, it just pulls your mind into it and you become a kind of an observer for hours and hours and hours.
Peter Bowes: So you believe in the idea of an ageless mindset and a discussion, A debate that I’ve been having recently with people is about just that. And that is mindset as we grow older. And I know that a lot of people fear being old, and even the use of the word old can be putting off for some people, it can be almost frightening that one day you’re going to be old and associated with the word old is incapable decrepit not good enough anymore. And I just wonder if those people like yourself working in this industry give some thought to how you describe what it’s like to be old and the potential benefits of being old as opposed to what most people think of. And that is the downside of being old. And from my perspective, getting old is a privilege. And if you are 70 or 80 and healthy, that’s something to celebrate. Yes, you’re still old, but it’s something to celebrate.
Shebah Carfanga: Well, I think to to expand on what you’ve said, the whole notion of being old is fearful for everyone because the way it’s been positioned, getting old is big business. If you think about it from a different perspective, that means that someone is going to take away your independence, that you’re not going to be able to move your body, that they’re going to store you in a place where all these old people are and you’re going to die there. And so that’s a that’s how it’s been marketed, actually, quite honestly, you get these diseases. No one wants to socialize with you. They only want, you know, you’re kind of pushed to the side. So that’s where the real fear of getting old is associated with that word. What we strive to do is to help individuals maintain independence through cognition exercises, cognition, well, let’s say cognition activities, let’s call them activities for those that don’t enjoy exercise, cognitive activities, daily living activities that you’re able to squat down and pick up something off the floor. You’re able to reach up in a cabinet, you’re able to move your body. So our focus is on that and making this better quality of life. So we’ve got cognition. Strength training is absolutely critical. That is one of the hottest things in our business now, is maintaining strength and power. So strength is one thing, okay? Power is the speed at which you move the strength. So because we are losing muscle mass and losing movement, we want to refocus on that strength training as a as a whole and power. So if you ask me to get up out of a chair, would I get up slowly or would I get up quickly? Because that’s the best way to do it. That is an example of strength and power. And so keeping people in their own homes longer, we’re seeing that’s happening now. There’s there’s the loneliness is is somewhat eliminated because as people mature because of the pandemic, one of the best things that has come out of the pandemic is Zoom is this opportunity to talk to someone online and to still be included. I have clients who tell me, please don’t tell people how old I am because they won’t want to be associated with me, you know? And on the other hand, it is that you are wise. You know, you have much wisdom. You’re able to promote that you know that you’re not what people think of as as old today. Earlier today, I heard someone say about chronological age and biological age, My chronological age is 65. My biological age is somewhere around 35 or 40 because I practice this movement. My heart rate is my resting heart rate is around 40, which is that of a 30 year old. And I believe that I can do the movements. You know, it’s you know, and that’s where you have to live in your heart and in your mind is that you believe you want to maintain your independence, that you believe you want to do the things you used to do that you want to get out. And I had a client tell me and crawl through the wooden castle with her two year old and her five year old at 68. That’s where you want to be engaged constantly with your family and enjoying life at this age, because most individuals are retired. And if you’re not, we’re not retired. But you want to enjoy life and build a passion. And this is our passion. I don’t know that we’ll ever retire.
Peter Bowes: Well, no. And I know a lot of people in your position. In my position, retirement is something that doesn’t even come into the mindset that the the idea of stopping what we’re doing. And I mean more and more people these days who and it’s the world that we live in that the idea of just stopping or even slowing down would be negative because your whole body depends on, at least as far as I’m concerned, are moving forward. And we come back to that word of movement and retirement. For me, although you could be you could stop working to earn money and you could still live a very active lifestyle. But I think life is a jigsaw and it involves lots of different pieces. And for most of us, I think that involves an element of of work, whether it’s physical work or mental work, to to keep us involved and to keep us connected.
Shebah Carfanga: Yes, I would agree with you. I think we need to continue to have purpose. So even in retirement, that is an opportunity for you to do the things that you love to do that you’ve always wanted to do, that you perhaps couldn’t totally do, when years ago, because you had a career you were building or working every day just to get by or raising your children. This is a great opportunity in your 60s, whether you’re retired, semi retired, but you still need to maintain purpose and movement. And I think it’s probably the best time of life. I talk to women all the time and I’m tapped to talk to women about strength training over 50 and how important that is after going through menopause and raising your children and an empty nest syndrome, where are you in all of this? Because you’ve given so much to family, you’ve given so much to career. You know, you’ve given so much to your own parents and those generations. You’ve done all the Thanksgiving dinners and you’ve either decided that that’s not what you want, you know, you wish to do, but you’ve passed it on and now you have this time on your hands to really where you need to focus and devote to yourself.
Peter Bowes: Now, you’ve mentioned Nate a number of times during this interview, Nate Wilkins, your partner, who of course has been a guest on this podcast a few months ago. And if you go to the index on whatever platform, you’re either watching us or listening to us, you can just put Nate Wilkins name in there and you can hear his conversation as well. And we actually tackle quite a few of the the subjects that you and I are talking about now. Shebah, right at the beginning of the interview, you were going through your your life and I kind of stopped you just before you brought us completely up to date with the last few years. And of course, you continue to work with Nate, working with a very diverse population of clients.
Shebah Carfanga: Yes, Yes. Our work continues. We are currently in a process of developing a program and a service that will facilitate active aging adults. And so we don’t we don’t really want to call them older adults, active aging adults. And we see that as a market that is greatly underserved. And so because most individuals don’t know where to go at this age, they’ve not had an opportunity to work with a trainer. And if they have, it’s very different now working with a younger trainer, not that they don’t have the qualifications. It’s not what I’m saying. What I’m saying is the market is so different for an active aging adult. You need to look at a number of different things that are important to that. The cognition I’m back to that, the balance, you know, the strength, the agility, what is going to prevent a fall, You know, how do you survive a joint replacement? You know, how do you manage your diabetes? Do you do you just go to the doctor and you say, well, you know, you need to take this medication for your diabetes? Well, that’s a problem with medicine, and I’m really not going to get into that. But you can do some things yourself with a little research and proper guidance. And what we hope to do is to bring all this together with co practitioners to make it so that individuals are educated about their options. You know, I was diagnosed as pre-diabetic last year. They wanted to give both Nate and I something, and I can’t recall what it is. We won’t take anything. Pretty much. I hate to say that, but this is what works for us because we know our bodies. And all you really need to do is if your physician really recommends it. I’m not saying go against your physician. I am not a doctor, but there are some other things you can do. You can also change what you eat, change your diet, take matters in, you know, become more about yourself. What is it you can do?
Peter Bowes: So I just want to Shebah, in summing up, ask you about your personal aspirations for the future. This is a podcast about human longevity and looking to the future. Is that something that you think about what you are going to be doing, what your life is going to be like in the decades to come? And do you live your life every day? With that in mind in terms of nurturing your own body?
Shebah Carfanga: Yes, that’s a great question. You know, recently I was selected to give a presentation for research on what exercise workouts movement will look like for aging active aging individuals in 2030. And so that’s only seven years from now. That sounds like a really far time away, but I see myself as continuing to do this work. I’m passionate about this work as I am about my son and even bringing that movement to special needs individuals. So there is that commitment. Obviously, I want to be around for quite some time to see him into the future and to continue to see his adulthood. But for me, I feel really great. At this age. I feel really great. I want to continue to feel great. I see people from years ago that say, You haven’t changed, and I think this really was my passion, my, my career and what I studied for. You know, it didn’t go that way, but it went another way. And, you know, and because of the way life has presented itself, I think that is a testament for individuals to be for me to be inspirational and aspirational and not so much a role model, but a pied piper of what it would mean to live a long and productive life. And that’s really where I want to be a better quality of life leading to longevity.
Peter Bowes: And I think that is a great way to end this. I really appreciate your passion. You just used the word passion, and Shebah wish you all the best for the future. Thank you so much for talking to us.
Shebah Carfanga: Thank you so much, Peter, for having me as a guest. I so appreciate the opportunity to share our thoughts and perspectives.
Peter Bowes: You’re very welcome. Thank you. This has been a Healthspan Media production. You can contact me by direct message at Peter Bowes or email Peter@LLAMApodcast.com. It’s always good to hear your feedback on the interviews that we do. Thank you so much for listening.
The Live Long and Master Aging podcast, a HealthSpan Media LLC production, shares ideas but does not offer medical advice. If you have health concerns of any kind, or you are considering adopting a new diet or exercise regime, you should consult your doctor. The information contained within this interview is for educational and entertainment purposes only. It is not intended to replace the advice or attention of health care professionals.