The Physiology Forum

In this episode, Jake leads us in a discussion of a manuscript entitled Once-Weekly Semaglutide in Adults with Overweight or Obesity (10.1056/NEJMoa2032183). This manuscript is the result of a massive international randomized clinical trial that enrolled 1961 people with overweight and obesity to examine the effect of once-weekly semaglutide on weight loss. These data have the potential to make a big change to how obesity and overweight are treated. Look out for our follow up episode where we look at a similar GLP1 receptor agonist (liraglutide) and the efficacy of adding exercise to the pharmacological treatment.  TIME STAMPS 00:00:00 – 00:16:31                                        Intro/Catch up 00:16:31 – 00:19:31                                        Background 00:19:31 – 00:33:31                                        Description of Lifestyle Intervention 00:33:31 – 00:46:40                                        Trial Description/Methods 00:46:40 – 01:13:20                                        Data!! 01:13:20 – 01:25:06                                        Adverse Events 01:25:06 – 01:26:37                                        Semaglutide + Exercise? 01:26:37 – 01:33:08                                        Cost? 01:33:08 – 01:39:25                                        Muscle Mass Loss and How to Mitigate 01:39:25 – End                                                Wrap Up and Final Thoughts   Reach out to us on Twitter Edwin Miranda @EdwinRay91 Dr. Jake Mey @CakeNutrition Dr. Austin Robinson @AusRob_PhD Dr. Alec Chaves (Yes he is a PhD now) @AbcSience02    

On this episode of the podcast our special guest Dr. Chris Wolff, talk about the interactions between exercise, circadian rhythm and exercise by highlighting a paper published in Cell metabolism in 2019 entitled, “Time of Exercise Specifies the Impact on Muscle Metabolic Pathways and Systemic Energy Homeostasis”.  Dr. Wolff will also discuss some of the workin he is doing as a post doc in Dr. Karyn Esser's lab at the University of Florida in this area.   Time Stamps Introduction                                                                                        00:00:00 – 00:03:07 Catch Up and Wolff's Background                                                      00:03:07 – 00:20:05 Background                                                                                         00:20:05 – 00:26:06 Study Design                                                                                       00:26:06 – 00:38:23 Results Figure 1                                                                                   00:38:23 – 00:48:44 Results Figure 2                                                                                  00:48:44 – 00:51:00 Results Figure 4                                                                                  00:51:00 – 00:57:15 Results Figure 5                                                                                  00:57:15 – 01:06:20 Results Figure 6                                                                                  01:06:20 – 01:12:06 Results Figure 7                                                                                  01:12:06 – 01:19:16 Take Home Messages                                                                         01:19:16 – 01:23:20 Wolff and Karyn Esser's Future Work                                                01:25:29 – 01:37:38 Long-Term Goals and Future Directions of This Work                       01:37:38 – END   Metamex resource: https://www.metamex.eu/ Main Article: https://doi.org/10.1016/j.cmet.2019.03.013 Companion pub: https://doi.org/10.1016/j.cmet.2019.03.012

In this episode, Alec continues our Exercise for Health series, by highlighting a recent article published out of the journal of clinical endocrinology and metabolism, entitled “Lipid Metabolism Links Nutrient-Exercise Timing to Insulin Sensitivity in Men Classified as Overweight or Obese,” which investigates the interplay between timing morning exercise and breakfast to optimize exercise-induced increases in insulin sensitivity in males with obesity.    DOI for the Main Article 10.1210/clinem/dgz104 Episode Time Stamps INTRODUCTION                                                                                                   00:00:00 – 00:01:50 CATCH UP                                                                                                             00:01:50 – 00:09:40 SUBSTRATE METABOLISM, EXERCISE AND INSULIN SENSITIVITY              00:09:40 – 00:17:40 TANGENTAL CONVO: WHY STUDY MOLECULAR MECHANISMS                 00:17:40 – 00:30:00 …BACK TO SUBSTRATE METABOLISM                                                             00:30:00 – 00:42:45 METHODS/STUDY DESIGN – ACUTE STUDY                                                   00:42:45 – 00: 46:00 ACUTE STUDY RESULTS (TABLE 1, FIG 2&3)                                                   00:46:00 – 01:06:40 METHODS/STUDY DESIGN – TRAINING STUDY                                              01:06:40 – 01:22:00 TRAINING STUDY RESULTS (FIG 4-8)                                                               01:22:00 – 02:09:29 SUMMARY AND TAKE HOME MESSAGE                                                           02:09:29 – END Other articles reference in the podcast HOLLOSZY JO 1983 DOI: 10.1152/jappl.1983.55.2.512 HOROWITZ J 2014: 10.1139/apnm-2013-0525 NEUFER PD 2015 DOI: https://doi.org/10.1016/j.cmet.2015.05.011 BURKE LM 2006 “NAIL IN THE COFFIN” DOI: 10.1152/japplphysiol.01238.2005 BURKE LM 2016 “NAIL IN THE COFFIN TOO SOON” DOI: 10.1007/s40279-015-0393-9 BURKE LM 2020 “CRISIS AVERTED” DOI: 10.1371/journal.pone.0234027 VOLEK JS 2016 DOI: 10.1016/j.metabol.2015.10.028 EDINBURGH RM 2021 A “COMPREHENSIVE” REVIEW DOI: 10.1113/JP280748

This episode kicks off our series on Exercise for Health. In this series we will highlight several benefits that exercise has on general health as well as the current literature examining the potential mechanisms providing these benefits, if there is an optimal mode/intensity/timing of exercise, and much more! This episode starts by framing everyone's expectations of exercise, especially when it comes to eliciting weight loss.  What should the expected weight loss from an exercise regimen be? Is more exercise better? This discussion covers all of these concepts and more as we discuss a recent article that was published in the journal of Medicine and Science in Sport and Exercise entitled, “ Exercise for Weight Loss: Further Evaluating Energy Compensation with Exercise”. Manuscript DOI: 10.1249/MSS.0000000000002376 Obesity and Energetics Offerings Subscription (it's free!): https://obesityandenergetics.org/subscription Link to NYT article: https://www.nytimes.com/2020/12/09/well/move/to-lose-weight-with-exercise-aim-for-300-minutes-a-week.html Link to Opinion Piece in response to NYT article: https://conscienhealth.org/2020/12/exercise-for-weight-loss-the-lie-that-wont-die/ Link to Yoni Freedhoff's twitter thread discussing this paper and NYT article coverage: https://twitter.com/YoniFreedhoff/status/1337040020398600194 Time Stamps Introduction                                                                                              00:00:00 – 00:03:55 Catch Up (Alec's delusions about Cleveland Sports)                          00:03:55 – 00:16:52 Manuscript Background                                                                          00:16:52 – 00:27:24 Methods and MATH Models                                                                   00:27:24 – 00:49:45 Results                                                                                                      00:49:45 – 01:00:58 Caloric Intake Regulation in Response to Energy Expenditure           01:00:58 – 01:18:41 Wrap Up and Take Home Message                                                       01:18:41 – End   Supporting Article from Kansas Med and Texas Tech DOI: 10.1002/oby.23022

In this episode, Jake leads our discussion to close out our series on the topic of bariatric surgery. Our focus will be on the STAMPEDE trial, which was a randomized clinical trial investigating the impact of bariatric surgery versus medical therapy (lifestyle) in patients with diabetes. Here we discuss 3 papers from the trial, all published in NEJM and discuss their clinical outcome results and metabolic implications at 1, 3 and 5-year time points.    DOI for main articles: 1-year - 10.1056/NEJMoa1200225 3-year - 10.1056/NEJMoa1401329 5-year - 10.1056/NEJMoa1600869 7-year (LABS) - 10.1210/clinem/dgaa849/6006261   Time Stamps: Introduction                                                                                                      00:00:00 – 00:01:37 Catching up                                                                                                      00:01:37 – 00:14:36 Manuscript Background                                                                                  00:14:36 – 00:16:23 Stampede Study Description/Methods                                                         00:16:23 – 00:26:20 STAMPEDE 1 Year Follow Up Results                                                            00:26:20 - 00:42:39 STAMPEDE 3 & 5 Year Follow Up Results                                                     00:42:39 – 01:06:44 LABS 7 Year Follow Up Results                                                                      01:06:44 – 01:16:00 Wrap Up                                                                                                            01:16:00 – End    

In this episode Dr. Austin Robinson and I are joined by Dr. Rich Severin to discuss the paper we covered on the last episode of the podcast which examined the effects of obesity and bariatric surgery on cardiovascular health and carotid intima-media thickness at a 3-year follow-up. We also discussed some of the exciting work Rich currently is doing as a part of his dissertation on the effects of obesity and endothelial function as well as his recent review paper entitled, “Endothelial Function in Obesity and Effects of Bariatric and Metabolic Surgery” (DOI below). Rich is a Doctor of Physical Therapy and a PhD candidate at the University of Illinois at Chicago under Dr. Shane Philips. Review Article DOI: 10.1080/14779072.2020.1767594  TIME STAMPS Episode Introduction                                                                                            00:00:00 – 00:01:26 Catching Up with Rich and Rich's Background                                                 00:01:26 – 00:16:25 State of the Literature and The “Fat Years” Concept                                       00:16:25 – 00:30:25 Effect of Metabolic Surgery on Intima Media Thickness (IMT)                        00:30:25 – 00:36:25 Potential Role of Improved Sleep Following Metabolic Surgery on IMT          00:36:25 – 00:43:30 Potential for Exercise to Modulate Endothelial Function in Obesity                00:43:30 – 00:48:00 Overcoming Physical and Psychological Barriers Associated with Obesity   00:48:00 – 00:54:00 Rich's Other Interests, Projects and Next Steps                                                00:54:00 – 01:03:00 Rich's Contacts on Social Media                                                                          01:03:00 – End

In this episode Dr. Austin Robinson is leading our discussion of a paper entitled, “Bariatric Surgery-Induced Changes in Intima-Media Thickness and Cardiovascular Risk Factors in Class 3 Obesity: A 3-Year Follow-Up Study”. This paper was published in the journal of Obesity this August and continues our discussion of the many beneficial effects of bariatric surgery. Along with this episode we will also be posting a discussion with one of our colleagues at UIC Dr. Rich Severn. Rich is a DPT and PhD candidate at UIC whom we all worked with when we were at UIC. Be sure to catch our discussion with him on the awesome work he and his mentor Shane Phillips have done in collaboration with a bariatric surgery group at UIC examining the microvascular benefits of bariatric surgery.    Main article DOI: 10.1002/oby.22905 DOIs for other relevant references: Arteriole Function in Obese Visceral Adipose (Boston Med) - DOI: 10.1161/ATVBAHA.111.235846 Arteriole Function in Obese Visceral Adipose (Shane Philips UIC) -  DOI: 10.1111/micc.12164 NO Dependent Dilation and FMD -DOI: 10.1038/ajh.2012.8   Time Stamps Episode Introduction                                                                                      00:00:00 – 00:02:00 Catching Up                                                                                                    00:02:00 – 00:13:24 Austin's Previous Work with Microvessels from Adipose Biopsies               00:13:24 – 00:26:19 Potential Consequences of Poor Adipose Vascular Function                        00:26:19 – 00:31:42 Manuscript Introduction and Methods                                                          00:31:42 – 00:42:17 Framingham Score and Study                                                                        00:42:17 – 00:45:13 Study Design                                                                                                   00:45:13 – 00:54:04 Results (Table 1)                                                                                              00:54:04 – 00:58:29 Results (Table 2)                                                                                             00:58:29 – 01:04:24 Results (Figure 1)                                                                                            01:04:24 – 01:11:18 Results (Figure 2)                                                                                            01:11:18 – 01:13:33 Results (Table 3)                                                                                             01:13:33 – 01:14:33 Discussion/Main Take Away                                                                           01:14:33 – 01:24:51 Closing Remarks                                                                                             01:24:51 – End    

In this companion episode we had the pleasure of talking with metabolism expert Dr. Lynis Dohm about his manuscript that we discussed in the last episode and his Vicious Cori Cycle hypothesis. In this episode we talk a lot about the ability of lactate to provide insight into metabolic health. Lactate, the seemingly inauspicious metabolite wrought with misleading narratives including those that implicate it as a cause of muscle fatigue with exercise, has never been so exciting!  

In this episode Alec leads our discussion on work published out of East Carolina University's Metabolic Surgery Research Group, the translational research institute in Florida, and Duke University Medical Center, investigating the effects of obesity and bariatric surgery on plasma lactate and skeletal muscle glucose handling entitled “Plasma lactate as a marker of metabolic health: Implications of elevated lactate for impairment of aerobic metabolism in the metabolic syndrome” published in Surgery last year in June.  Follow along by accessing the link to the article here: https://doi.org/10.1016/j.surg.2019.04.017  Look out for our companion interview coming soon in which we interview the corresponding author and exercise metabolism legend Dr. Lynis Dohm!

This episode follows up on our discussion of Sam Klein's NEJM manuscript (Episode 9: Released on October 13th) which attempts to compare the effects of diet and bariatric surgery-mediated weight loss on glucose control and diabetes.  Dr. Phil Schauer is a world-renown bariatric surgeon and also a scholastic leader in research surrounding the pathophysiology of obesity and diabetes and outcomes of metabolic surgery. Notably, Dr. Schauer performed the first laproscopic bariatric surgery in 1997 and his work on the STAMPEDE trial was one of the first trials to demonstrate the ability of bariatric surgery to cause remission of type 2 diabetes in obese participants which has over 3500 citations. He was recently recruited to the Pennington Biomedical Research Institute as a Professor of Metabolic Surgery and the Director of the Bariatric and Metabolic Institute.  Dr. Vance Albaugh is a surgeon scientist who also recently made the move to PBRC as an Assistant Professor of Metabolic surgery following his training at Vanderbilt University and the Cleveland Clinic. Dr. Albaugh in his relatively young career has over 600 citations and 29 publications in the areas of obesity and metabolic surgery. You can follow Dr. Phil Schauer on twitter @PSchauerMD and Dr. Vance Albaugh @metabolic_knife. 

In this episode we discuss a manuscript entitled “Effects of Diet Versus Gastric Bypass on Metabolic Function in Diabetes”. DOI: 10.1056/NEJMoa2003697 This manuscript was recently published online in the August issue of The New England Journal of Medicine out of the laboratory of Dr. Sam Klein at Washington University in St. Louis. In a later companion episode to follow this one, we will be speaking about the concepts presented in this paper with Dr. Phil Schauer who is a world expert in bariatric surgery. Dr. Schauer performed the 1st laproscopic bariatric surgery in 1997 and was one of the first to demonstrate the ability of bariatric surgery to cause diabetes remission in the landmark STAMPEDE trial. Follow this DOI for the 5-year outcomes for that study: 10.1056/NEJMoa1600869.   Other references from our discussion: "Metabolically healthy" obesity and health risk - DOI: 10.1111/obr.13127 Fit v. Fat - DOI: 10.1093/eurheartj/ehs174 Fit v. Fat - DOI: 10.1016/j.jacc.2014.01.022 Weight loss counter-regulation - DOI: 10.1002/oby.21653    

In this episode we discuss a manuscript entitled “Effects of 4- and 6-h Time-Restricted Feeding on Weight and Cardiometabolic Health: A Randomized Controlled Trial in Adults with Obesity”. This manuscript was recently published online in Cell Metabolism and will be available in print this September. This paper comes from Dr. Krista Varady's lab at the University of Illinois at Chicago.  For this episode we had the pleasure of having the first author, Sofia Cienfuegos, join us to discuss her manuscript. Sofia is a registered dietitian and a PhD candidate in Dr. Varady's lab who led this clinical trial as part of her dissertation work.  https://doi.org/10.1016/j.cmet.2020.06.018 Episode 8 Time Stamps (hh:mm:ss) Introduction/Special Guest:                                                                          00:00:00 – 00:02:11 Publishing in Cell Metabolism:                                                                     00:02:10 – 00:04:06 Sofia's Scientific Background:                                                                     00:04:06 – 00:06:41 Switching Labs:                                                                                               00:06:41 – 00:13:41 Background/Forms of TRF:                                                                           00:13:41 – 00:15:26 Fasting Mimicking Diet:                                                                                 00:15:26 – 00:21:48 Why TRF/Fasting in General:                                                                         00:21:48 – 00:27:21 Purpose of the Study:                                                                                     00:27:21 – 00:30:14 Previous Work and Study Design:                                                               00:30:14 – 00:33:07 Methods/Figure 1:                                                                                           00:33:07 – 00:35:49 Early vs. Late TRF Window:                                                                           00:35:49 – 00:45:12 Outcome Measures and Participant Demographics:                                    00:45:12 – 00:51:08 Results/Figure 3:                                                                                            00:51:08 – 00:54:43 Skipping Breakfast/Setting Intentions to Prevent “Out Eating” the Fast: 00:54:43 – 00:59:58 Our Experiences with TRF and Fasting:                                                         00:59:58 – 01:02:37 TRF and Skeletal Muscle Insulin Sensitivity:                                                 01:02:37 – 01:08:14 Figure 4/Body Composition Changes:                                                           01:08:14 – 01:11:40 Limitations of the Study:                                                                               01:11:40 – 01:14:22 Figure 4/Insulin Sensitivity:                                                                           01:14:22 – 01:19:16 Figure 5/Ox Stress and Inflammatory Markers:                                           01:19:16 – 01:28:11 Figure 6/Adverse Events:                                                                               01:28:11 – 1:31:17 Dietitians are Awesome!:                                                                              01:31:17 – 01:35:41 Future Directions:                                                                                          01:35:41 – 01:37:51 Fit Bit Data and Outro:                                                                                   01:37:51 - End  

In this episode, Alec will be leading our discussion on work published out of the University of Oregon amongst others,  investigating the effects of maternal obesity compounded with a high fat western-style diet on offspring insulin action and sensitivity entitled “Maternal Obesity and Western-style Diet Impair Fetal and Juvenile Offspring Skeletal Muscle Insulin-Stimulated Glucose Transport in Nonhuman Primates” published in Diabetes this April. You can follow along by accessing the article through the DOI link: 10.2337/db19-1218. Please comment or hit us up on Twitter to join in on the conversation and if you enjoy the podcast be sure to give us a follow so you will never miss an episode!!   Episode 7 Time Stamps (hh:mm:ss)   Introduction/Catching up:                                               00:00:00 – 00:17:22 Background/Notable Authors:                                        00:17:22 – 00:24:25 Ethical Concerns Surrounding Animal Research:       00:24:55 – 00:37:32 Disclaimer:                                                                           00:37:32 – 00:37:57 Methods/Study Design:                                                    00:37:57 – 00:42:15 Western Blotting Methods:                                              00:42:15 – 00:49:44 Description of Metabolic Tests:                                      00:49:44 – 00:53:27 Table 1 – Baseline Characteristics:                                 00:53:27 – 01:01:34 Table 2:                                                                                 01:01:34 – 01:06:14 Obesity & Nursing Mothers' Milk:                                   01:06:14 – 01:09:43 Muscle Fiber Type & Glucose Uptake:                           01:09:43 – 01:12:09 Figure 2:                                                                                01:12:09 – 01:20:01 Figure 3:                                                                                01:20:01 – 01:25:29 Figure 4:                                                                                01:25:29 – 01:40:55 Figure 5:                                                                                01:40:55 – 01:44:18 Figure 6:                                                                                01:44:18 – 01:54:12 Paternal Role for Offspring Metabolic Health?:            01:54:12 – 02:05:48 Outro:                                                                                     02:04:48 – 02:07:11   Correction(s) When discussing a potential influence of paternal health on offspring metabolic health, I mention data out of Dr. Laurie Goodyear's lab. Dr. Goodyear's lab does have some fantastic data surrounding this topic, but instead of studying epigenetic changes of sperm as I had said in the episode, they actually analyzed micro RNA changes in the sperm. You can find her paper by following this DOI Link: 10.2337/db18-0667   References Alec makes references this article at 1:56:24 when discussing the long term risk associated offspring are exposed to by being born to mothers who have obesity during pregnancy: 10.1136/bmj.f4539

In this episode of the podcast, Dr. Jacob Mey leads our discussion of the article entitled "Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake". This manuscript was led by Dr. Kevin Hall who is a obesity researcher at the National Institutes of Health and one of the world's experts in energy balance and body weight regulation. We also briefly discuss one of Dr. Hall's more recent pre-prints entitled "A Plant-Based, Low-Fat Diet Decreases Ad Libitum Energy Intake Compared to an Animal-Based, Ketogenic Diet: An Inpatient Randomized Controlled Trial".    Ultra-Processed Diet DOI: https://doi.org/10.1016/j.cmet.2019.05.008  Pre-Print Link: https://osf.io/preprints/nutrixiv/rdjfb/   Time Stamps (hh:mm:ss)   Introduction 00:00 – 01:30 Catching Up 01:30– 22:28 Background/Kevin Hall 22:28 – 30:00 The Problem 30:00 – 31:45 Definition of Ultra-Processed Food 31:45 – 38:12 Ultra-Processed Food and Energy Balance 38:12 – 40:28 Statement of the Purpose 40:28 – 42:24 Study Design/Methods 42:24 – 48:13 Table 1/Methods Cont. 48:13 – 58:50 Methods Cont. 58:50 – 1:04:41 Main Outcome 1:04:41 – 1:08:05 Subjective Measures/Figure 2 1:08:05 – 1:22:21 Body Composition/Figure 3 1:22:21 – 1:29:52 Energy Expenditure and RQ/Table 2 1:29:52 – 1:34:16 Oral Glucose Tolerance Test/Figure 4 1:34:16 – 1:36:59 Circulating Factors and Hormone Changes/Table 3 1:36:59 – 1:39:52 Discussion/Energy Density 1:39:52 – 1:45:29 Discussion/ Pre-Print 1:45:29 – 2:05:37 Outro 2:05:37 – End  

In this Episode the panel is joined by Dr. Alison Ludzki, a post-doctoral fellow at the Karolinska Institutet, to discuss a paper from her lab that uses carbon-14 abundance in lipids extracted from adipose to determine how lipid turnover changes over the course of years and in response to weight loss.  https://doi.org/10.1038/s41591-019-0565-5 Time Stamps Introduction: 0 - 2min, 10sec Dr. Ludzki's Background: 2min, 10sec - 20min, 15sec Notable Authors (Dr. Kirsty Spaulding): 20min, 15sec - 22min, 15sec Discussing Interdisciplinary Research: 22min, 15sec - 30min, 15sec Notable Authors (Drs. Peter Arner and Mikael Ryden): 30min, 15sec - 36min Purpose of This Paper: 36min - 41min, 33sec Description of Study Cohorts: 41min, 33sec - 50min, 51sec Figure 1, Method Validation: 50min, 51sec - 52min, 43sec Definitions of Primary Outcomes: 52min, 43sec - 55min, 34sec Lipid Mobilization or Storage For Metabolic Health: 55min, 34sec - 60min, 24sec Recap of Primary Outcomes: 60min, 24sec - 61min, 7sec Figure 2: 61min, 7sec - 65min, 52sec Figure 3: 65min, 52sec - 82min, 14sec Summary/Discussion: 82min, 14sec - 92min, 54sec Future Directions: 92min, 54sec - End  

In this episode Dr. Jacob Mey leads our discussion of a paper that was recently published in the American Journal of Clinical Nutrition titled, “Whey protein but not collagen peptides stimulate acute and longer-term muscle protein synthesis with and without resistance exercise in healthy older women: a randomized controlled trial.” In this paper, the authors aimed to determine the effects of ingesting either whey protein or collagen protein on acute and longer-term muscle protein synthesis with or without resistance exercise. You can follow along with us by accessing the article link bellow.   https://doi.org/10.1093/ajcn/nqz332

In this episode of the podcast Alec leads a discussion of a recent manuscript entitled "Metformin blunts muscle hypertrophy in response to progressive resistance exercise training in older adults: A randomized, double-blind, placebo-controlled, multicenter trial: The MASTERS trial.". https://doi.org/10.1111/acel.13039  

In this episode, the panel and I discuss a recent paper by Park et. a. entitled,"Vasodilatory and Vascular Mitochondrial Respiratory Function with Advancing Age: Evidence of a Free Radically-Mediated Link in the Human Vasculature". (doi: 10.1152/ajpregu.00268.2019)

This episode of The Physiology Forum is an introductory episode where the panel and I discuss our backgrounds in science, what projects we are currently working on and what you as the listener can expect from this podcast. 

This is the first episode in our series on aging. In this episode the panel and I discuss a recent paper out of Ball State's Human Performance lab entitled "Skeletal Muscle Size, Function and Adiposity with Life Long Aerobic Exercise". (doi:10.1152/japplphysiol.00426.2019)