Heart Rate Variability (HRV) in the Real World
Dr. Emma Mosley
Dr. Cooper: 0:07
Welcome to the latest episode of the Catalyst Health, Wellness and Performance Coaching Podcast. I’m your host, Dr Bradford Cooper and today’s guest is Dr Emma Mosley, a sports psychology specialists from Solan University in the UK, and she has a very interesting focus in research heart rate variability. Or maybe you’ve heard of it is H R. V. Dr. Mosley and I both spoke at a conference in Germany last summer, and I was intrigued by how her research could be so applicable in both athletic as well as general health, health and wellness settings. We start off a little bit technical, but we quickly get in the nuts and bolts in terms of how you can apply H R V to your daily personal, professional, and athletic life in a number of very interesting way. So still hang in there with us to that first section. Before we jump into the interview, we have three really exciting announcements so let me run through those quickly and then we’ll jump into this thing. Starting this Wednesday will be shifting the release date of our core episodes to Wednesday mornings. So this week you’re actually gonna get a double dose. And frankly, with everything going on the world right now, you’re not gonna want to miss this. We’ll be speaking with a nationally recognized author physician who also has a master’s in public health, and he’ll be here to discuss the realities of the Coronavirus. So don’t miss that one Wednesday morning. Then, starting next Monday, we’ll launch our weekly five minute Monday morning catalysts. What is a Monday morning catalyst? You’ll have to tune in to find out, but I can promise you you’re not gonna wanna miss it. Last thing, with all the travel restrictions, many of you are facing with your work or just family situations, we’ve worked closely with the NBHWC, the National Board for Health and Wellness coaching to develop a new option for those who want to pursue the wellness coach certification and sit for the national board exam with travel just not an option right now. So in addition to our current certification programs, which are already aware of you now have access to something called the at home fast track, and it’s available immediately. You can check out all the details at CatalystCoachingInstitute.com. Or, as always, feel free to email us at [email protected]. Now let’s jump into this interview with Dr Emma mostly on this episode of The Catalyst Health Wallace and Performance Guest. Well, it’s my pleasure to welcome Dr Emma Mosley to the show today. Thanks for joining us.
Dr. Mosley: 2:35
No problem. Thanks so much for having me.
Dr. Cooper: 2:38
So let’s talk HR V. We’ll get into what it is here in a second. But how did you come to study H R V is as one of your focal areas?
Dr. Mosley: 2:47
So during my time as an undergraduate, I really enjoyed psychology and physiology. I always kind of found myself between the two areas, really not knowing which one I wanted to specialize in for my dissertation, for example, and I then on my place in the year was a research assistant at the university under professor Mark Jones and they were doing very much the challenge of threat researching using psycho physiology as a means to kind of underpin athletic performance and understanding how people perform under pressure. So I really kind of found my calling through that experience and on from there kind of stumbled across heart rate variability as a measure that was accessible to me at the time on. Then, from there, I I just kind of found that it was the gaps in the research, and that’s pretty much how I them kind of carved my way into this area.
Dr. Cooper: 3:46
So that’s interesting. So we’ve had a couple of guests Carla Man, for example, on the podcast talking about challenge threat. What that’s so literally, this is a tool that you used to help identify the differential between those two?
Dr. Mosley: 4:02
So heart rate variability isn’t actually one of the cardiac markers of challenge and threat. It’s definitely been suggested in really recent research. Actually, papers in 2019 have suggested that it might be something that is worth looking into on that, actually, in terms of challenge and research, it doesn’t fall within the original cardiac markers. And it definitely got spoke for that particular area.
Dr. Cooper: 4:29
Interesting. Okay, so let’s get our listeners and frankly, me too, up to speed on this idea of heart rate variability or H R V, and for our listeners, we will go back and forth between the two so H R V or heart rate variability. My understanding is it’s the variation in the time interval between consecutive heartbeats and we measured in milliseconds. So a normal, healthy heart obviously doesn’t tick exactly evenly like a like a metronome. It instead, it’s a little bit longer between this one and a little bit less between that one. And and this is the confusing part to me. So let’s talk about this for a second. The variability increases during relaxing activities and decreases during stressful activities. Am I getting that right? What else is important in terms of laying the groundwork for folks listening in?
Dr. Mosley: 5:18
Yeah, okay, so this is definitely a little bit of confusion potentially around what heart rate variability actually is and then what we can use as kind of researchers and practitioners in terms of indexing what that measure actually means. So you’re definitely right. Heart rate variability is the time measured between, the R peaks in a QRS complex, so those people listening that don’t necessarily have a medical background, the QRS complex comes from an ECG and the R peaks are the big part on the ECG that represent on heartbeat. So we’re measuring the time in between those two peaks which is also known as the the interval and so heart rate variability does correspond to that interval. So that’s definitely what heart reverberates is like you said and like you also said, a healthy heart isn’t a metronome so you know our heart isn’t beating on every single second on across a minute. If you check your heart rate over a minute, it is not just beating every single second. It is always changing, which is good. So we want a variable heartbeat. This means that we are adapting to our environment. We’re able to kind of face the challenges that we are having in our environment and were able to self regulate within that for the cyclist ideological level. Now, what is of interest particularly to to ask them to me and my research is what actually controls heart rate variability and this is where a lot of the research actually is in around this area. So the control of heart rate is obviously linked to two areas of the autonomic nervous system. So you know the system that sizzles in fight or flight. That example will be quite recognized by a lot of your listeners. Now, previously it was thought that we could kind of index our sympathetic activity on so the side of the autonomic nervous system that sort of speeds, everything up. With heart rate variability, now this isn’t necessarily the case, because it’s not necessarily fast enough, you know, to be able to impact our heart rate to change it from that interval. Now we know that the parasympathetic influence on the heart is actually fast enough to create this change in into the interval. Now the reason for this is because it’s innovated by the vagus nerve. Now the vagus nerve comes from the brain, and it directly innervates the heart and it actually changes our heart rate. So this is why, if anyone’s kind of looked into any of the research, they’re talking a lot about cardiac beta activity and rather than heart rate variability in itself, the heart rate variability is more about the measure. So the way in which we get that information the cardiac beta activity is actually what we’re interested in in terms off on theory on research.
Dr. Cooper: 8:29
Okay, so let’s bring it down to the practical level. For example, I’ve got a Garmin that I used for triathlon training, running, training, that kind of stuff. And it provides an option where you can go in and do an H R V measurement each morning. And they were very particular about you wanna, you know, purge. Don’t have your coffee, don’t eat anything. Don’t actually just get up, go to the bathroom and then do this test, and it will give you not an HRV number but a stress number on a 0 to 100 scale. Are those meaningful? Are they accurate? Do they tell us anything? Or is it just a little game we’re playing for now until we can really dial it in more accurately?
Dr. Mosley: 9:06
Yeah, it’s quite difficult because it’s not necessarily a representation off stress. Um, it would also be important to know what kind of measurement they’re using, which then gives you the number so it will be obviously on a scale of 0 to 100, 100 obviously being a more variable heart rate, which is better. There are definitely benefits of doing that, and particularly when you’re waking up in the morning because heart rate variability is a very sensitive measure. So,
for example, affected by lack of sleep, etcetera. So we can look at that and it can help to inform training. For example, let’s say, you’ve been training three days in a row and you have been doing really kind of like heavy lifting or during stuff, and you look at your heart of variability in the morning and it’s lower than your normal baseline. Now that would suggest that maybe you need to train slightly lighter on that day because you’re potentially little bit fatigue. And I will perhaps not gonna be able to adapt to the to the environment and the stresses that might be in that environment on that particular time. So there’s definitely a benefit of using, like your Garmin or the polar heart rate monitors on. But we also definitely advise that that’s not necessarily the best practice the research based on evidence but in terms of like day to day, wellness is definitely a benefit in doing that.
Dr. Cooper: 10:37
Okay, so are there other things that are readily available to folks that maybe instead of using the Garmin they pull up and then are those, do those mix with the Garmin heart rates or the polar heart rates? What would you suggest to the person that’s out there saying either, and we’ll talk about specifically athletes here in a minute and specifically generally health and wellness. But just any suggestions out of the gate that would be readily available and better than maybe a Garmin or a polar or something provides.
Dr. Mosley: 11:08
Yeah, So the polar I’ve used myself, and I find in terms of like a date today, measurement is pretty reliable on using the elite HRV app. I don’t know if you are aware of that one. That’s also quite a good one. It could be used with a polar and you also get that kind of similar data monitoring. But what you can also do using this app is almost have this kind of like live feedback of what your heart rate variability is doing during potential activity so you could use this to you when you’re working with an athlete on the court. So a tennis player for example, and it just gives you a nice idea of what’s happening in the moment. Again, kind of that disclosure of it’s not necessarily 100% accurate. Obviously HRV can also get affected by movement. Um but it’s also a good measure to potentially see how well something a pre performance routine might work before serving in tennis, for example. So if they’re implemented some kind of breathing strategy, it might show they’re able to increase that number before they then do a serve. But there’s definitely apps out there that you can use kind of in the moment, and I definitely recommend that the kind of like coaching purposes. It’s a nice way to kind of index what’s happening in the moment in terms of heart rate variability
Dr. Cooper: 12:32
And the practical application of that, so you mentioned tennis. You would literally or I’m thinking of a free throw shooter. In basketball, you’re not. You’re not saying, let’s look at how do they bring their heart rate down from 142 while they’re standing in the free throw line, see if they’re relaxed. You’re saying the H R V can give us additional insights into whether that breathing technique is working to relax them prior to taking that shot or HRV doesn’t have anything to do with relaxation and you kind of the psycho biological and it’s all about just bodies recovery.
Dr. Mosley: 13:07
Yeah, I think again. That’s a really good question. So it’s not necessarily that heart rate variability is an index of stress or relaxation, but it’s more about self regulation. So is this athlete able to use the breathing strategy, which we know can actually influence heart rate very pretty quick, significantly. And to be able to better prepare themselves for a challenge that they might face? Um so a lot of the kind of research around this is that the higher are HRV or cardiac activity scientifically is actually better in terms of our executive function. So the higher our heart rate variability, actually, the better our decision making, for example, or emotional control or inhibition so and it’s not necessarily I’m stressed or and relax. It’s more about how well can I adapt how well I function in this environment because of the link between the heart and the brain.
Dr. Cooper: 14:07
That is so interesting, Okay, so let me run down a slightly different path. If I’m, some people, actually, their heart rates come up as they are preparing for something important that their excitement level their energy, whatever it is. And you’re saying that for the H R V is you’re not simply looking at, did you bring your basic heart rate level down to 52 or whatever it’s saying? It doesn’t matter if it’s it. 80 85 100. We can still measure HIV and see if you’re more prepared for that challenge approach versus potentially the threat approach.
Dr. Mosley: 14:42
Yeah, so it is definitely more about self regulation than just heart rate itself, because they’re looking more the kind of neural control of the heart rather than just heart rate itself.
Dr. Cooper: 14:56
This is fascinating. Excellent. Excellent. Good start. Okay, so H R V is linked to quality of sleep recovery performance overall health. Can you talk us through the relationship of how we can in practical ways beyond what we started talking about here, how we could utilize H. R. V on a daily basis or weekly basis? Or it kind of sounds like almost hour by hour, too. What, let’s start with athletes and then let’s go to general population.
Dr. Mosley: 15:21
Yeah, so for an athletic population, it’s definitely widely used within kind of like high performance environments. So they might use this, particularly in the training context. They do heart rate variability as the training load measure and it’s also linked to potentially overtraining and burnout. Now, obviously, there is a physiological element associated with this. So, for example, if we’re faced with a very fatigued athlete, heart rate variability is probably going to be lower because we don’t necessarily have this kind of self regulation resources left to be able to actually kind of adapt to the environment that might be that they need a rest day, for example. From the most kind of psychological standpoint, definitely taking those kind of daily HRV measures and really having that kind of self care. So understanding on where you’re at every single morning it is useful, but also kind of having that understanding of what’s happening to me in contact. So, for example, I’m going to the basketball free throw and, like you mentioned, it’s not a control of the situation which we know that is. We know that they’re gonna happen. Can we then maybe test the psychological intervention that we’ve given to that athlete? So maybe a pre performance routine that has breathing within it? Are they able to get to a particular of like a physiological state and can they know on better? They’re understanding the information that the act of giving them, for example, on there in psychological state. That’s really good for self awareness, training of athletes as well on so kind of understanding okay, this is how I feel. And actually, this is being reflected in my physiology as well. So again, that self awareness is really important. And I’ve used it with athletes in that way as well.
Dr. Cooper: 17:20
Very good, very good. Okay. And then general population suggestions there on how folks that are saying, Hey, I’m just trying to live a better life when I’m just trying to up my game at work or or be more focused at home. Anyways, that we can utilize it in that context?
Dr. Mosley: 17:37
Yeah, sure, It is almost very similar because we’re still looking at things that kind of like a performance of wellness basis. So for people that are looking at kind of more general well being, we know that higher heart rate variability is associative with better wellness and better health. So if you think about kind of the physiology of it, if our heart is able to adapt on being very variable to kind of stresses and things in the environment, our body is actually coping with those demands.
Dr. Cooper: 18:12
So if you can build on that that the general health and wellness where, where, where can people utilize that on a daily basis to help them if they are trying to monitor changes in alcohol or changes in sleep or travel stressors or those kinds of things? Is there an application to daily life?
Dr. Mosley: 18:32
Yeah, there definitely is an application to daily life because heart rate variability really is something that is changing all of the time and like I said in the beginning, a healthy car should be variable, so we should be seeing these adaptations in our heart. So we know that getting plenty of sleep is gonna improve heart rate variability and actually physical fitness, improved heart rate variability as well. So we know that those people who are obviously more physically fit and then increase their heart rate, that it is really doing those kind of day to day things that we know are good for us getting enough sleep, making sure that we keep the distracted eating on particular things could also increased heart rate variability, for example, oily fish on their studies have found that that increases heart rate variability as well. Again, I’m kind of avoiding those things that we know lead to decreased heart rate variability. So, for example, on excessive alcohol smoking, obesity on that could also influence the variability. But really, what I would suggest as the kind of day to day monitoring of this is really knowing your baseline. So if you’re monitoring every single day understanding where you’re kind of that day to day on, then if you’re not necessarily meeting at baseline you know you’re under the baseline perhaps reflects on your week and think OK, well, why am I below my baseline? Well actually, I got a really bad my sleep last night or have a really stressful week at work. It’s the end of the week, and I need a bit of a relaxing weekend to kind of help me recharge. I think really knowing your own baseline in terms of HRV is really good. Just the day to day wellness.
Dr. Cooper: 20:14
Well, and I think the other thing that plays here is when it comes to wellness, one of the struggles we all have, whether with ourselves or folks we’re working with is there’s not an immediate feedback mechanism. If you start eating better, you might feel slightly better. But it tends to take weeks, months, years to see that influence. Exercise, you know, the first month it doesn’t feel that great, but they want to get into. It starts to feel good, you know, sleeping better. So it sounds like this would be something that maybe it’s not an immediate change, but we could see some gradual improvement in that H R V as we make changes as a feedback mechanism.
Dr. Mosley: 20:54
Yeah, for sure. And I, you know one really kind of potent thing that will directly influence your heart rate variability when you do it is it slow paced breathing. So actually slowing your breathing down on so you can download the breathing apps that you can use for this. My particular favorite is called Breath Pacer, and it’s a little sunflower icon. If you actually slow your, just for those listening so that they can find it. And yeah, you could let you slow your breathing down to a particular right, and actually that will automatically increase your heart rate variability. So and that is something that is quite instant in terms of the increasing heart rate variability, and the research is definitely improving around this area. For example, we we ran a study on them using a breathing before sleep in comparison to kind of like iPhone usage on other mobile phones are available on on. What we found was those people who were actually using a slow pace breathing app had significantly improved kind of subjective sleep quality, although hard, very. But it didn’t necessarily change the other night. We did see that if it did improve, so that’s definitely something that we should be kind of instantaneously with HRV.
Dr. Cooper: 22:22
is H R V age and or sex specific? Can a person compare their each HRV at let’s say age 30 to age 62 the change over time similar to something like Max heart rate as we age, even if staying fit and healthy, what are some of the suggestions along those lines?
Dr. Mosley: 22:40
So yes, definitely there are individual differences that we have to take into consideration with heart rate variability. For example, gender, so women do have higher levels of cardiac activity than men as a kind of like a general observation and then in terms off age that obviously also influences heart rate variability of well, so HRV actually decreases every 10 years until you’re around 40 years old. Here we do see that it does start to drop off, so we can’t necessarily compare somebody who’s 20 with somebody who’s 40 because there will be a difference in that. And that’s something that we have to control for in research as well.
Dr. Cooper: 23:26
Let’s circle back once more on when to do your assessment, because again, I see different things we talked about. Morning is the Garmin recommendation you mentioned using something like an elite H R V app that you could do it throughout the day. Would it would there be value and and say, I’m gonna check it every day at lunch, that kind of see how my stress has been in the morning. I’m gonna check it at lunch and end of the day and see any suggestions along if there’s value in doing those kinds of things?
Dr. Mosley: 23:57
Yeah, so that the reason that you kind of see morning measurements of the recommendation is that that’s obviously going to be you know influenced by, like, our circadian rhythm. It also means we’re just waking up. So we haven’t necessarily eaten breakfast. We haven’t done in any of our usual routines yet. So it means that are baseline is gonna be more reliable on because heart rate variability could be influenced by so many different variables. I would definitely recommend taking it in the morning to get a baseline, to compare it to say, for example, your then taking it at lunchtime. Your lunchtime might look very different day today, so that reading isn’t necessarily gonna be comparable. You might be able to use them. I understand speculating in that environment, maybe. And I can’t get a quickly look at my heart rate variability before I go into this really important presentation to work on where is it at? Okay. And then afterwards you might then look at it because it might be that it’s depleted over that kind of stressful situation that you’ve been in. So it might be that we could do that, created a scenario like that and that if we’re comparing day today, I would definitely say look at kind of that morning routine because it be more comparable, but potentially looking at your heart rate variability before on after might be something interesting people to look at.
Dr. Cooper: 25:24
Okay, Okay, good. All right. Totally off topic here. But I saw you’re a pretty serious netball player, and I have to admit, I didn’t even know what the sport was. So after, after looking into it a little bit, I understand it’s it’s somewhat similar to basketball, but there’s no dribbling, no running, there are seven players. You gotta pass the ball within three seconds, the ball in the basket, a little bit smaller. There’s no backboard, which it sounds crazy to me and then you’re designated to a certain area. Totally off topic, but just can you enlighten us a little bit about this sport? And why, how you fell into it and why it’s become one of your hobbies?
Dr. Mosley: 26:00
Yeah, it’s really funny because it really is not well known, in the US and Canada. Yeah, it’s exactly how you described the kind of a blend of ice, a kind of basketball and handle. You have, like specific positions or attack on defend jury to kind of like an attack over defender. Yes, great. It’s really growing on particularly over in the corner, Australia, New Zealand and South Africa are really kind of great. It’s really approving. We just had last year the the Devil Well cup tested in the UK as well, which is really, really good. And I yeah, I just got into it because I’m tall. So it does benefit to be tall in the sport, like basketball. Yeah, it’s really growing. It’d be great to get in the Olympics one day.
Dr. Cooper: 26:53
Very fun. Very fun. Yeah, just curious when I saw that about you. All right, just a couple more. How you’re using HRV in your own life either in your sport or your profession, your daily life talk, talk us through what you’re doing with it. Aside from the research, what are you doing with it with you?
Dr. Mosley: 27:10
I’m so something that I really like to do on because of me. I have a portable ECG, which is what we used through our research. And I tend to put that on if I know that I’m maybe doing something that’s quite stressful, or I’m potentially doing something out of the ordinary because you can then really kind of reflect. So what was happening in your heart during that time. I’ve worn it in a presentation before and, it’s quite shocking how high your heart rate can
get confrontation, but also kind of depleting natural that on your self regulation resources on. So I think in one presentation my heart rate goes up. So I was pretty pretty stressed, I think during that. But also, you see a difference in heart rate variability. So, um, just off the top of my head, using a measure, which is a reflection of cardiac activity, I think my resting rate was around kind of 80. And during the presentation, it went down to around kind of 25. So um, it really just shows you that, you know, I was really kind of working hard to do my best to the presentation, and it was really quite taxing on. But I think looking at that I find really interesting and also something that I do in my daily life is also using the breathing techniques. I’m not necessarily always measuring heart reverberates. I know the impact that it has on your overall ability. So, using it before bed. So again, just using that breath technique to change the breathing rate. Kind of like 4.5 seconds for an inhale and 5.5 seconds for an exhale, using that for kind of sleep. But I also use that for any kind of situations where I said, I need to perform in netball, for example, when the ball is coming back down towards my end of the court, or potentially, that the game is getting on quite like competitive and we’re getting close.
Yeah, I definitely used those techniques that I knew were gonna influence my heart rate variability in that moment in time.
Dr. Cooper: 29:20
So when it went from 80 to 25 what happened afterwards? Did it come right back up? Or was there a depleting factor? Where, then, for the next hour, it stayed 30 35?
Dr. Mosley: 29:32
Yeah, again, off it off my head. I don’t have the numbers that I definitely didn’t get back to resting level on, so I didn’t get my cup to where I was before. And I, if we think about life in kind of like a daily life stressor or sporting stressor scenario, we don’t necessarily just have the one thing thrown us in one certain situation with constantly faced with multiple stress is it is working in life and sport. So, actually, how can we then bounce back? And you know, we’ve been depleted. How do we get back and improve our heart rate variability for the next challenge? So I definitely didn’t get back to resting levels and it’s really thinking about how can I get back to the baseline levels as quickly as possible?
Dr. Cooper: 30:20
You got me thinking on a totally different path here and feel free to say no, we have no idea at this point Brad, but I’m thinking of a cyclist or a runner and instead of you know, some people train or race based on heart rate. So they want to stay at X percent of their max heart rate during a 10K 1/2 marathon or marathon, whatever event. Could this be a tool in that situation where you know you need to keep your H R V at this level, and if it’s not, you need to dial it back a little bit. Taking a little more fluid. Has that been looked at it all or do you have some hypotheses on that potential?
Dr. Mosley: 30:56
I think the main thing that we really struggle with, particularly being a sports psychology researcher, is the fact that when movement or excessive movement is then introduced, we know that heart rate variability it really can’t be a reliable measure anymore. We also then, have you think about this actual physical exercise on heart rate variability. So when that then happened, sympathetic activity is going to be completely taking over control if you like. So there is apparently somebody out there developing an algorithm to still get that information from heart rate variability while movement is taking place and while activity is taking place, and I haven’t seen that come out yet, but that will be really interesting to be able to kind of pare back will be this is the kind of physical exercise movements that resting heart rate variability on, being able to kind of pull out that kind of more neural control. But at this moment in time, we don’t have that, unfortunately, so stay tuned, I don’t know how long it will take though.
Dr. Cooper: 32:00
Very good. Well, last question. Just any final words of wisdom for folks that are looking to either help others improve their health and wellness, using H R. V or trying to prove their own personal or athletic pursuits that you’d like to share that we haven’t talked about yet or you want to build on?
Dr. Mosley: 32:15
I think the column main message is, really if you want to measure heart rate variability today definitely take it at the same time of day, ideally in the morning, because that’s gonna give you a really reliable measure to compare against. I would also recommend looking at how you adapt in certain situations that kind of take a resting measure, then take a measure, or have a look at your heart rate variability during a task, then potentially look at your recovery rate. So really start to look at those kind of three phases of heart rate variability so that the rest the kind of task element and then actually the recovery. So by doing that, you really start to understand how you regulate in those situations. So I think it’s more than just looking at Baseline. It’s also thinks about well, how can I take this and maybe look at it before and during a stressful meeting. Or how can I use this before a match and then look at it after a match. So I think kind of moving away from just looking looking at the different situations might give people a bit more of a use for HRV.
Dr. Cooper: 33:22
Very interesting Dr Mosley. Love this stuff. How come people follow you if they want to keep track of what you’re working on? Your latest research, those kind of things.
Dr. Mosley: 33:30
Yeah, sure. I’m on Twitter so you can follow me at Emma_Mosley. Quite simple on M O S. L E y. For those that don’t know how to spell it. So yeah, follow me on there. Feel free to drop me a DM and I can answer any question more specifically on that.
Dr. Cooper: 33:46
Fantastic. Thanks so much. Really appreciate it.
Dr. Mosley: 33:49
No problem. Thank you.
Dr. Cooper: 33:58
A big thank you again to Dr Emma. Mosley. I don’t know about you, but I have added a note in my calendar to start regularly checking my HRV. Very interested to start seeing what kind of patterns grow up in those how it relates to athletic and general daily performance. Also, the app she recommended is called the elite H R V app. As I looked into some more details about it. She’s not the only scientist that leans that way. Thank you, as always for joining us. The podcast is growing almost four times over the last year, and it’s thanks to you. Thanks for sharing with friends and peers. Keep up the great work there. It really makes a difference. If you ever have questions related to health and wellness coaching, you can reach out to us at our website CatalystCoachingInstitute.com or email us anytime [email protected]. Now let’s go get better. Today is the day the next step in our journey, folks starts right now. Let’s do this. This is Dr Bradford Cooper signing off. Make it a great rest of your day and I’ll speak with you soon on the next episode of the Catalyst Health, Wellness and Performance podcast.