Podcasts about behavioral medicine research

About two years ago, we released a podcast with Dr. Thomas Wadden of the University of Pennsylvania describing work on a new generation of medications to treat diabetes and obesity. They were really taking the field by storm. Since then, much more is known since many additional studies have been published and so many people have been using the drugs. So many, in fact, the market value of the Danish company, Novo Nordisk, one of the two major companies selling the drugs, has gone up. It is now greater than the entire budget of the country of Denmark. This single company is responsible for about half of Denmark's economic expansion this year. So, a lot of people are now taking the drugs and this is a great time for an update on the drugs. And we're fortunate to have two of the world's leading experts join us: Dr. Wadden, Professor of Psychology and Psychiatry at the University of Pennsylvania School of Medicine and the inaugural Albert J. Stunkard Professor of Psychiatry at Penn. Joining us as well as Dr. Robert Kushner, a physician and professor of medicine at Northwestern University and a pioneer in testing treatments for obesity. Interview Summary Tom, you and I were colleagues at Penn decades ago. And I got frustrated the treatments for obesity didn't work very well. People tended to regain the weight. And I turned my attention to prevention and policy. But you hung in there and I admired you for that patience and persistence. And Bob, the same for you. You worked on this tenacious problem for many years. But for both of you, your patience has been rewarded with what seems to me to be a seismic shift in the way obesity and diabetes can be treated. Tom, I'll begin with you. Is this as big of a deal as it seems to me? Well, I think it is as big of a deal as it seems to you. These medications have had a huge impact on improving the treatment of type 2 diabetes, but particularly the management of obesity. With older medications, patients lost about 7 percent of their starting weight. If you weighed 200 pounds, you'd lose about 15 pounds. That was also true of our best diet and exercise programs. You would lose about 7 percent on those programs with rigorous effort. But with the new medications, patients are now losing about 15 to 20 percent of their starting body weight at approximately one year. And that's a 30-to-40-pound loss for a person who started at 200 pounds. And with these larger weight losses, we get larger improvements in health in terms of complications of obesity. So, to quote a good friend of mine, Bob Kushner, these medications have been a real game changer. Thanks for putting that in perspective. I mean, we're talking about not just little incremental changes in what treatments can produce, which is what we've seen for years. But just orders of magnitude of change, which is really nice to see. So, Bob what are these medications that we're talking about? What are the names of the drugs and how do they work? Well, Kelly, this transformation of obesity really came about by finding the target that is really highly effective for obesity. It's called the gut brain axis. And when it comes to the gut it's starting off with a naturally occurring gut hormone called GLP 1. I think everyone in the country's heard of GLP 1. It's released after we eat, and it helps the pancreas produce insulin, slows the stomach release of food, and reduces appetite. And that's where the obesity story comes in. So pharmaceutical companies have taken this hormone and synthesized it, something similar to GLP 1. It mimics the action of GLP 1. So, you could actually take it and give it back and have it injected so it augments or highlights this hormonal effect. Now, that same process of mimicking a hormone is used for another gut hormone called GIP that also reduces appetite. These two hormones are the backbone of the currently available medication. There's two on the market. One is called Semaglutide. That's a GLP 1 analog. Trade name is Wegovy. Now, it's also marketed for diabetes. Tom talked about how it is used for diabetes and increases insulin. That trade name is Ozempic. That's also familiar with everyone around the country. The other one that combined GLP 1 and GIP, these two gut hormones, so it's a dual agonist, the trade name for obesity is called Zep Bound, and the same compound for diabetes is called Mounjaro. These are terms that are becoming familiar, I think, to everyone in the country. Tom mentioned some about the, how much weight people lose on these drugs, but what sort of medical changes occur? Just to reiterate what Tom said, I'll say it in another way. For Semaglutide one third of individuals are losing 20 percent of their body weight in these trials. For Tirzepatide, it even outpaces that. And I got a third of individuals losing a quarter of their body weight. These are unheard of weight losses. And with these weight losses and these independent effects from weight, what we're seeing in the trials and in the clinic is that blood pressure goes down, blood sugar goes down, blood fats like triglyceride go down, inflammation in the body goes down, because we marked that with CRP, as well as improvement in quality of life, which we'll probably get to. But really interesting stuff is coming out over the past year or two or so, that it is improving the function of people living with congestive heart failure, a particular form called a preserved ejection fraction. We're seeing improvements in sleep apnea. Think of all the people who are on these CPAP machines every night. We're seeing significant improvements in the symptoms of sleep apnea and the apneic events. And lastly, a SELECT trial came out, that's what it was called, came out last year. Which for the very first time, Kelly, found improvements in cardiovascular disease, like having a heart attack, stroke, or dying of cardiovascular disease in people living with obesity and already have cardiovascular disease. That's called secondary prevention. That, Tom, is the game changer. Bob, I'd like to go back to Tom in a minute but let me ask you one clarifying question about what you just said. That's a remarkable array of biological medical benefits from these drugs. Just incredible. And the question is, are they all attributable to the weight loss or is there something else going on? Like if somebody lost equal amounts of weight by some other means, would these same changes be occurring? Those studies are still going on. It's very good. We're thinking it's a dual effect. It's the profound amount of weight loss, as Tom said. Fifteen to 21 to even 25 percent of average body weight. That is driving a lot of the benefits. But there also appear to be additional effects or weight independent effects that are working outside of that weight. We're seeing improvements in kidney function, improvement in heart disease, blood clotting, inflammation. And those are likely due to the gut hormone effect independent of the weight itself. That still needs to be sorted out. That's called a mitigation analysis where we try to separate out the effects of these drugs. And that work is still underway. Tom, one of the most vexing problems, over the decades that people have been working on treatments for obesity, has been long term results. And I'm curious about how long have people been followed on these drugs now? What are the results? And what was the picture before then? How do what we see now compared to what you saw before? The study that Bob just mentioned, the SELECT trial followed people for four years on Semaglutide. And patients achieve their maximal weight loss at about one year and they lost 10 percent of their weight. And when they were followed up at four years still on treatment, they still maintained a 10 percent weight loss. That 10 percent is smaller than in most of the trials, where it was a 15 percent loss. But Dr. Tim Garvey showed that his patients in a smaller trial lost about 15 percent at one year and while still on medication kept off the full 15 percent. I think part of the reason the weight loss in SELECT were smaller is because the study enrolled a lot of men. Men are losing less weight on this medication than women. But to your question about how these results compare to the results of earlier treatment, well with behavioral treatment, diet, and exercise back in the 70s beyond, people lost this 7 or 8 percent of weight. And then most people on average regain their weight over one to three years. And the same was true of medication. People often stopped these earlier medications after 6 to 12 months, in part because they're frustrated the losses weren't larger. Some people were also worried about the side effects. But the long and short is once you stop taking the medication, people would tend to regain their weight. And some of this weight regain may be attributable to people returning to their prior eating and activity habits. But one of the things we've learned over the past 20 years is that part of the weight regain seems to be attributable to changes in the body's metabolism. And you know that when you lose weight, you're resting metabolic rate, which is the number of calories your body burns at rest to maintain basic bodily functions. Your resting metabolic rate decreases by 10 to 15 percent. But also, your energy expenditure, the calories you burn during exercise decreases. And that may decrease by as much as 20 to 30 percent. So, people are left having to really watch their calories very carefully because of their lower calorie requirements in order to keep off their lost body weight. I think one thing these new drugs may do is to attenuate the drop both in resting metabolic rate and energy expenditure during physical activity. But the long and short of it is that if you stay on these new medications long term, you'll keep off your body weight. And you'll probably keep it off primarily because of improvements in your appetite, so you have less hunger. And as a result, you're eating less food. I'd like to come back to that in a minute. But let me ask a question. If a person loses weight, and then their body starts putting biological pressure on them to regain, how come? You know, it's disadvantageous for their survival and their health to have the excess weight. Why would the body do that? Well, our bodies evolved in an environment of food scarcity, and our physiology evolved to protect us against starvation. First, by allowing us to store body fat, a source of energy when food is not available. And second, the body's capacity to lower its metabolism, or the rate at which calories are burned to maintain these basic functions like body temperature and heart rate. That provided protection against food scarcity. But Kelly, you have described better than anybody else that these ancient genes that regulate energy expenditure and metabolism are now a terrible mismatch for an environment in which food is plentiful, high in calories, and available 24 by 7. The body evolved to protect us from starvation, but not from eating past our calorie needs. And so, it's this mismatch between our evolution and our appetite and our body regulation in the current, what you have called toxic food environment, when you can eat just all the time. I guess you could think about humans evolving over thousands of years and biology adapting to circumstances where food was uncertain and unpredictable. But this modern environment has happened really pretty rapidly and maybe evolution just hasn't had a chance to catch up. We're still existing with those ancient genes that are disadvantageous in this kind of environment. Bob back to the drugs. What are the side effects of the drugs? Kelly, they're primarily gastrointestinal. These are symptoms like nausea, diarrhea, constipation, heartburn, and vomiting. Not great, but they're generally considered mild to moderate, and temporary. And they primarily occur early during the first four to five months when the medications are slowly dose escalated. And we've learned, most importantly, how to mitigate or reduce those side effects to help people stay on the drug. Examples would be your prescriber would slow the dose escalation. So. if you're having some nausea at a particular dose, we wait another month or two. The other, very importantly, is we have found that diet significantly impacts these side effects. When we counsel patients on these medications, along with that comes recommendations for dietary changes, such as reducing fatty food and greasy food. Reducing the amount of food you're consuming. Planning your meals in advance. Keeping well hydrated. And very importantly, do not go out for a celebration or go out to meals on the day that you inject or at least the first two days. Because you're not going to tolerate the drug very well. We use that therapeutically. So, if you want to get control on the weekends, you may want to take your injection on a Friday. However, if weekends are your time out with friends and you want to socialize, don't take it on a Friday. Same thing comes with a personal trainer, by the way. If you're going to have a personal trainer on a Monday where he's going to overwork you, don't take the injection the day before. You'll likely be nauseated, you're not eating, you're not hydrating. So actually, there's a lot that goes into not only when to take the dose and how to take the dose, but how to take it to the best ability to tolerate it. Two questions based on what you said. One is you talked about these are possible side effects, but how common are they? I mean, how many people suffer from these? Well, the trials show about 25 to 45 percent or so of individuals actually say they have these symptoms. And again, we ask them mild, moderate, severe. Most of them are mild to moderate. Some of them linger. However, they really do peak during the dose escalation. So, working with your prescriber during that period of time closely, keeping contact with them on how to reduce those side effects and how you're doing out of medication is extremely important. And the second thing I wanted to ask related to that is I've heard that there's a rare but serious potential side effect around the issue of stomach paralysis. Can you tell us something about that? I mentioned earlier, Kelly, that these medications slow gastric emptying. That's pretty much in everybody. In some individuals who may be predisposed to this, they develop something called ileus, and that's the medical term for gastric paralysis. And that can happen in individuals, let's say who have a scleroderma, who have longstanding diabetes or other gastrointestinal problems where the stomach really stopped peristalsis. In other words, it's moving. That's typically presented by vomiting and really unable to move the food along. We really haven't seen much of that. We looked at the safety data in a SELECT trial that Tom mentioned, which was 17,000 individuals, about 8,000 or so in each group. We really did not see a significant increase in the ileus or what you're talking about in that patient population. Okay, thanks. Tom had alluded to this before, Bob, but I wanted to ask you. How do you think about these medicines? If somebody takes them, and then they stop using the medicines and they gain the weight back. Is that a sign that the medicine works or doesn't work? And is this the kind of a chronic use drug like you might take for blood pressure or cholesterol? That's a great way of setting up for that. And I like to frame it thinking of it as a chronic progressive disease, just like diabetes or hypertension. We know that when you have those conditions, asthma could be another one or inflammatory bowel disease, where you really take a medication long term to keep the disease or condition under control. And we are currently thinking of obesity as a chronic disease with dysfunctional appetite and fat that is deposited in other organs, causing medical problems and so on. If you think of it as a chronic disease, you would naturally start thinking of it, like others, that medication is used long term. However, obesity appeared to be different. And working with patients, they still have this sense 'that's my fault, I know I can do it, I don't want to be on medication for the rest of my life for this.' So, we have our work cut out for us. One thing I can say from the trials, and Tom knows this because he was involved in them. If we suddenly stop the medication, that's how these trials were definitely done, either blindly or not blindly, you suddenly stop the medication, most, if not all of the participants in these trials start to regain weight. However, in a clinical practice, that is not how we work. We don't stop medication suddenly with patients. We go slowly. We down dose the medication. We may change to another medication. We may use intermittent therapy. So that is work that's currently under development. We don't know exactly how to counsel patients regarding long term use of the medications. I think we need to double down on lifestyle modification and counseling that I'm sure Tom is going to get into. This is really work ahead of us, how to maintain medication, who needs to be on it long term, and how do we actually manage patients. Tom, you're the leading expert in the world on lifestyle change in the context of obesity management. I mean, thinking about what people do with their diet, their physical activity, what kind of thinking they have related to the weight loss. And you talked about that just a moment ago. Why can't one just count on the drugs to do their magic and not have to worry about these things? Well, first, I think you can count on the drugs to do a large part of the magic. And you may be surprised to hear me say that. But with our former behavioral treatments of diet and exercise, we spent a lot of time trying to help people identify how many calories they were consuming. And they did that by recording their food intake either in paper and pencil or with an app. And the whole focus of treatment was trying to help people achieve a 500 calorie a day deficit. That took a lot of work. These medications, just by virtue of turning down your appetite and turning down your responsiveness to the food environment, take away the need for a lot of that work, which is a real blessing. But the question that comes up is, okay, people are eating less food. But what are they eating? Do these medications help you eat a healthier diet with more fruits and vegetables, with lean protein? Do you migrate from a high fat, high sugar diet to a Mediterranean diet, or to a DASH like diet? And the answer is, we don't know. But obviously you would like people to migrate to a diet that's going to be healthier for you from a cardiovascular standpoint, from a cancer risk reduction standpoint. One of the principal things that people need to do on these medications is to make sure they get plenty of protein. And so, guidance is that you should have about 1 gram of dietary protein for every kilogram of body weight. If you're somebody who weighs 100 kilograms, you should get 100 grams of protein. And what you're doing is giving people a lot of dietary protein to prevent the loss of bodily protein during rapid weight loss. You did a [00:20:00] lot of research with me back in the 80s on very low-calorie diets, and that was the underpinning of treatment. Give people a lot of dietary protein, prevent the loss of bodily protein. The other side of the equation is just physical activity, and it's a very good question about whether these medications and the weight loss they induce will help people be more physically active. I think that they will. Nonetheless for most people, you need to plan an activity schedule where you adopt new activities, whether it's walking more or going to the gym. And one thing that could be particularly helpful is strength training, because strength training could mitigate some of the loss of muscle mass, which is likely to occur with these medications. So, there's still plenty to learn about what is the optimal lifestyle program, but I think people, if they want to be at optimal health will increase their physical activity and eat a diet of fruits and vegetables, leaner protein, and less ultra processed foods. Well, isn't it true that eating a healthy diet and being physically active have benefits beyond their impact on your ability to lose the weight? You're getting kind of this wonderful double benefit, aren't you? I believe that is true. I think you're going to find that there are independent benefits of being physical activity upon your cardiovascular health. There are independent benefits of the food that you're eating in terms of reducing the risk of heart attack and of cancer, which has become such a hot topic. So, yes how you exercise and what you eat makes a difference, even if you're losing weight. Well, plus there's probably the triple one, if you will, from the psychological benefit of doing those things, that you do those things, you feel virtuous, that helps you adhere better as you go forward, and these things all come together in a nice picture when they're working. Tom, let's talk more about the psychology of these things. You being a psychologist, you've spent a lot of time doing research on this topic. And of course, you've got a lot of clinical experience with people. So as people are losing weight and using these drugs, what do they experience? And I'm thinking particularly about a study you published recently, and Bob was a coauthor on that study that addressed mental health outcomes. What do people experience and what did you find in that study? I think the first things people experience is improvements in their physical function. That you do find as you've lost weight that you've got less pain in your knees, you've got more energy, it's easier to get up the stairs, it's easier to play with the children or the grandchildren. That goes a long way toward making people feel better in terms of their self-efficacy, their agency in the life. Big, big improvement there. And then, unquestionably, people when they're losing a lot of weight tend to feel better about their appearance in some cases. They're happy that they can buy what they consider to be more fashionable clothes. They get compliments from friends. So, all of those things are positive. I'm not sure that weight loss is going to change your personality per se, or change your temperament, but it is going to give you these physical benefits and some psychological benefits with it. We were happy to find in the study you mentioned that was conducted with Bob that when people are taking these medications, they don't appear to be at an increased risk of developing symptoms of depression or symptoms of suicidal ideation. There were some initial reports of concern about that, but the analysis of the randomized trials that we conducted on Semaglutide show that there is no greater likelihood of developing depression or sadness or suicidal ideation on the medication versus the placebo. And then the FDA and the European Medicines Agency have done a full review of all post marketing reports. So, reports coming from doctors and the experience with their patients. And in looking at those data the FDA and the European Medicines Agency have said, we don't find a causal link between these medications and suicidal ideation. With that said, it's still important that if you're somebody who's taking these medications and you start them, and all of a sudden you do feel depressed, or all of a sudden you do have thoughts like, maybe I'd be better off if I weren't alive any longer, you need to talk to your primary care doctor immediately. Because it is always possible somebody's having an idiosyncratic reaction to these medications. It's just as possible the person would have that reaction without being on a medication. You know, that, that can happen. People with overweight and obesity are at higher risk of depression and anxiety disorders. So, it's always going to be hard to tease apart what are the effects of a new medication versus what are just the effects of weight, excess weight, on your mood and wellbeing. You know, you made me think of something as you were just speaking. Some people may experience negative effects during weight loss, but overall, the effects are highly positive and people are feeling good about themselves. They're able to do more things. They fit in better clothes. They're getting good feedback from their environment and people they know. And then, of course, there's all the medical benefit that makes people feel better, both psychologically and physically. Yet there's still such a strong tendency for people to regain weight after they've lost. And it just reinforces the fact that, the point that you made earlier, that there are biological processes at work that govern weight and tendency to regain. And there really is no shame in taking the drug. I mean, if you have high blood pressure, there's no shame in taking the drug. Or high cholesterol or anything else, because there's a biological process going on that puts you at risk. The same thing occurs here, so I hope the de-shaming, obesity in the first place, and diabetes, of course, and then the use of these medications in particular might help more people get the benefits that is available for them. I recommend that people think about their weight as a biologically regulated event. Very much like your body temperature is a biologically regulated event, as is your blood pressure and your heart rate. And I will ask people to realize that there are genetic contributors to your body weight. just as there are to your height. If somebody says, I just feel so bad about being overweight I'll just talk with them about their family history of weight and see that it runs in the family. Then I'll talk to them about their height. Do you feel bad about being six feet tall, to a male? No, that's fine. Well, that that's not based upon your willpower. That's based upon your genes, which you received. And so, your weight, it's similarly based. And if we can use medications to help control weight, cholesterol, blood pressure, blood sugar, let's do that. It's just we live in a time where we're fortunate to have the ability to add medications to help people control health complications including weight. Bob, there are several of the drugs available. How does one think about picking between them? Well, you know, in an ideal medical encounter, the prescriber is going to take into consideration all the factors of prescribing a medication, like any other medication, diabetes, hypertension, you name the condition. Those are things like contraindication to use. What other medical problems does the patient have that may benefit the patient. Patient preferences, of course and side effects, safety, allergies, and then we have cost. And I'll tell you, Kelly, because of our current environment, it's this last factor, cost, that's the most dominant factor when it comes to prescribing medication. I'll have a patient walk in my room, I'll look at the electronic medical record, body mass index, medical problems. I already know in my head what is going to be the most effective medication. That's what we're talking about today. Unfortunately, I then look at the patient insurance, which is also on the electronic medical record, and I see something like Medicaid or Medicare. I already know that it's not going to be covered. It is really quite unfortunate but ideally all these factors go into consideration. Patients often come in and say, I've heard about Ozempic am I a candidate for it, when can I get it? And unfortunately, it's not that simple, of course. And those are types of decisions the prescriber goes through in order to come to a decision, called shared decision making with the patient. Bob, when I asked you the initial question about these drugs, you were mentioning the trade name drugs like Mounjaro and Ozempic and those are made by basically two big pharmaceutical companies, Novo Nordisk and Eli Lilly. But there are compounded versions of these that have hit the scene. Can you explain what that means and what are your thoughts about the use of those medications? So compounding is actually pretty commonly done. It's been approved by the FDA for quite some time. I think most people are familiar with the idea of compounding pharmacies when you have a child that must take a tablet in a liquid form. The pharmacy may compound it to adapt to the child. Or you have an allergy to an ingredient so the pharmacy will compound that same active ingredient so you can take it safely. It's been approved for long periods of time. Anytime a drug is deemed in shortage by the FDA, but in high need by the public, compounding of that trade drug is allowed. And that's exactly what happened with both Semaglutide and Tirzepatide. And of course, that led to this compounding frenzy across the country with telehealth partnering up with different compounding pharmacies. It's basically making this active ingredient. They get a recipe elsewhere, they don't get it from the company, they get this recipe and then they make the drug or compound it themselves, and then they can sell it at a lower cost. I think it's been helpful for people to get the drug at a lower cost. However, buyer beware, because not all compounded pharmacies are the same. The FDA does not closely regulate these compounded pharmacies regarding quality assurance, best practice, and so forth. You have to know where that drug is coming from. Kelly, it's worth noting that just last week, ZepBound and Mounjaro came off the shortage list. You no longer can compound that and I just read in the New York Times today or yesterday that the industry that supports compounding pharmacies is suing the FDA to allow them to continue to compound it. I'm not sure where that's going to go. I mean, Eli Lilly has made this drug. However, Wegovy still is in shortage and that one is still allowed to be compounded. Let's talk a little bit more about costs because this is such a big determinant of whether people use the drugs or not. Bob, you mentioned the high cost, but Tom, how much do the drugs cost and is there any way of predicting what Bob just mentioned with the FDA? If the compounded versions can't be used because there's no longer a shortage, will that decrease pressure on the companies to keep the main drug less expensive. I mean, how do you think that'll all work out? But I guess my main question is how much these things cost and what's covered by insurance? Well first how much do the drugs cost? They cost too much. Semaglutide, known in retail as Wegovy, is $1,300 a month if you do not have insurance that covers it. I believe that Tirzepatide, known as ZepBound, is about $1,000 a month if you don't have insurance that covers that. Both these drugs sometimes have coupons that bring the price down. But still, if you're going to be looking at out of pocket costs of $600 or $700 or $800 a month. Very few people can afford that. The people who most need these medications are people often who are coming from lower incomes. So, in terms of just the future of having these medications be affordable to people, I would hope we're going to see that insurance companies are going to cover them more frequently. I'm really waiting to see if Medicare is going to set the example and say, yes, we will cover these medications for anybody with a BMI of 40 or a BMI of 35 with comorbidities. At this point, Medicare says, we will only pay for this drug if you have a history of heart attack and stroke, because we know the drug is going to improve your life expectancy. But if you don't have that history, you don't qualify. I hope we'll see that. Medicaid actually does cover these medications in some states. It's a state-by-state variation. Short of that, I think we're going to have to have studies showing that people are on these medications for a long time, I mean, three to five years probably will be the window, that they do have a reduction in the expenses for other health expenditures. And as a result, insurers will see, yes, it makes sense to treat excess weight because I can save on the cost of type 2 diabetes or sleep apnea and the like. Some early studies I think that you brought to my attention say the drugs are not cost neutral in the short-term basis of one to two years. I think you're going to have to look longer term. Then I think that there should be competition in the marketplace. As more drugs come online, the drug prices should come down because more will be available. There'll be greater production. Semaglutide, the first drug was $1,300. Zepbound, the second drug Tirzepatide, $1,000. Maybe the third drug will be $800. Maybe the fourth will be $500. And they'll put pressure on each other. But I don't know that to be a fact. That's just my hope. Neither of you as an economist or, nor do you work with the companies that we're talking about. But you mentioned that the high cost puts them out of reach for almost everybody. Why does it make sense for the companies to charge so much then? I mean, wouldn't it make sense to cut the price in half or by two thirds? And then so many more people would use them that the company would up ahead in the long run. Explain that to me. That's what you would think, for sure. And I think that what's happened right now is that is a shortage of these drugs. They cannot produce enough of them. Part of that is the manufacturing of the injector pens that are used to dispense the drug to yourself. I know that Novo Nordisk is building more factories to address this. I assume that Lilly will do the same thing. I hope that over time we will have a larger supply that will allow more people to get on the medication and I hope that the price would come down. Of course, in the U. S. we pay the highest drug prices in the world. Fortunately, given some of the legislation passed, Medicare will be able to negotiate the prices of some of these drugs now. And I think they will negotiate on these drugs, and that would bring prices down across the board. Boy, you know, the companies have to make some pretty interesting decisions, don't they? Because you've alluded to the fact that there are new drugs coming down the road. I'm assuming some of those might be developed and made by companies other than the two that we're talking about. So, so investing in a whole new plant to make more of these things when you've got these competitor drugs coming down the road are some interesting business issues. And that's not really the topic of what we're going to talk about, but it leads to my final question that I wanted to ask both of you. What do you think the future will bring? And what do you see in terms of the pipeline? What will people be doing a year from now or 2 or 5? And, you know, it's hard to have a crystal ball with this, but you two have been, you know, really pioneers and experts on this for many years. You better than anybody probably can answer this question. Bob, let me start with you. What do you think the future will bring? Well, Kelly, I previously mentioned that we finally have this new therapeutic target called the gut brain axis that we didn't know about. And that has really ushered in a whole new range of potential medications. And we're really only at the beginning of this transformation. So not only do we have this GLP 1 and GIP, we have other gut hormones that are also effective not only for weight loss, but other beneficial effects in the body, which will become household names, probably called amylin and glucagon that joins GLP 1. And we not only have these monotherapies like GLP 1 alone, we are now getting triagonists. So, we've got GIP, GLP 1, and glucagon together, which is even amplifying the effect even further. We are also developing oral forms of GLP 1 that in the future you could presumably take a tablet once a day, which will also help bring the cost down significantly and make it more available for individuals. We also have a new generation of medications being developed which is muscle sparing. Tom talked about the importance of being strong and physical function. And with the loss of lean body mass, which occurs with any time you lose weight, you can also lose muscle mass. There's drugs that are also going in that direction. But lastly, let me mention, Kelly, I spend a lot of my time in education. I think the exciting breakthroughs will not be meaningful to the patient unless the professional, the provider and the patient are able to have a nonjudgmental informative discussion during the encounter without stigma, without bias. Talk about the continuum of care available for you, someone living with obesity, and get the medications to the patient. Without that, medications over really sit on the shelf. And we have a lot of more work to do in that area. You know, among the many reasons I admire the both of you is that you've, you've paid a lot of attention to that issue that you just mentioned. You know, what it's like to live with obesity and what people are experiencing and how the stigma and the discrimination can just have devastating consequences. The fact that you're sensitive to those issues and that you're pushing to de-stigmatize these conditions among the general public, but also health care professionals, is really going to be a valuable advance. Thank you for that sensitivity. Tom, what do you think? If you appear into the crystal ball? What does it look like? I would have to agree with Bob that we're going to have so many different medications that we will be able to combine together that we're going to see that it's more than possible to achieve weight losses of 25 to 30 percent of initial body weight. Which is just astonishing to think that pharmaceuticals will be able to achieve what you achieve now with bariatric surgery. I think that it's just, just an extraordinary development. Just so pleased to be able to participate in the development of these drugs at this stage of career. I still see a concern, though, about the stigmatization of weight loss medications. I think we're going to need an enormous dose of medical education to help doctors realize that obesity is a disease. It's a different disease than some of the illnesses that you treat because, yes, it is so influenced by the environment. And if we could change the environment, as you've argued so eloquently, we could control a lot of the cases of overweight and obesity. But we've been unable to control the environment. Now we're taking a course that we have medications to control it. And so, let's use those medications just as we use medications to treat diabetes. We could control diabetes if the food environment was better. A lot of medical education to get doctors on board to say, yes, this is a disease that deserves to be treated with medication they will share that with their patients. They will reassure their patients that the drugs are safe. And that they're going to be safe long term for you to take. And then I hope that society as a whole will pick up that message that, yes, obesity and overweight are diseases that deserve to be treated the same way we treat other chronic illnesses. That's a tall order, but I think we're moving in that direction. BIOS Robert Kushner is Professor of Medicine and Medical Education at Northwestern University Feinberg School of Medicine, and Director of the Center for Lifestyle Medicine in Chicago, IL, USA. After finishing a residency in Internal Medicine at Northwestern University, he went on to complete a post-graduate fellowship in Clinical Nutrition and earned a Master's degree in Clinical Nutrition and Nutritional Biology from the University of Chicago. Dr. Kushner is past-President of The Obesity Society (TOS), the American Society for Parenteral and Enteral Nutrition (ASPEN), the American Board of Physician Nutrition Specialists (ABPNS), past-Chair of the American Board of Obesity Medicine (ABOM), and Co-Editor of Current Obesity Reports. He was awarded the ‘2016 Clinician-of-the-Year Award' by The Obesity Society and John X. Thomas Best Teachers of Feinberg Award at Northwestern University Feinberg School of Medicine in 2017. Dr. Kushner has authored over 250 original articles, reviews, books and book chapters covering medical nutrition, medical nutrition education, and obesity, and is an internationally recognized expert on the care of patients who are overweight or obese. He is author/editor of multiple books including Dr. Kushner's Personality Type Diet (St. Martin's Griffin Press, 2003; iuniverse, 2008), Fitness Unleashed (Three Rivers Press, 2006), Counseling Overweight Adults: The Lifestyle Patterns Approach and Tool Kit (Academy of Nutrition and Dietetics, 2009) and editor of the American Medical Association's (AMA) Assessment and Management of Adult Obesity: A Primer for Physicians (2003). Current books include Practical Manual of Clinical Obesity (Wiley-Blackwell, 2013), Treatment of the Obese Patient, 2nd Edition (Springer, 2014), Nutrition and Bariatric Surgery (CRC Press, 2015), Lifestyle Medicine: A Manual for Clinical Practice (Springer, 2016), and Obesity Medicine, Medical Clinics of North America (Elsevier, 2018). He is author of the upcoming book, Six Factors to Fit: Weight Loss that Works for You! (Academy of Nutrition and Dietetics, December, 2019). Thomas A. Wadden is a clinical psychologist and educator who is known for his research on the treatment of obesity by methods that include lifestyle modification, pharmacotherapy, and bariatric surgery. He is the Albert J. Stunkard Professor of Psychology in Psychiatry at the Perelman School of Medicine at the University of Pennsylvania and former director of the university's Center for Weight and Eating Disorders. He also is visiting professor of psychology at Haverford College. Wadden has published more than 550 peer-reviewed scientific papers and abstracts, as well as 7 edited books. Over the course of his career, he has served on expert panels for the National Institutes of Health, the Federal Trade Commission, the Department of Veterans Affairs, and the U.S. House of Representatives. His research has been recognized by awards from several organizations including the Association for the Advancement of Behavior Therapy and The Obesity Society. Wadden is a fellow of the Academy of Behavioral Medicine Research, the College of Physicians of Philadelphia, the Obesity Society, and Society of Behavioral Medicine. In 2015, the Obesity Society created the Thomas A. Wadden Award for Distinguished Mentorship, recognizing his education of scientists and practitioners in the field of obesity.

Bipolar disorder expert Dr. Sheri Johnson and mental health advocate Robert Villanueva breaks down why what and when you eat is vital for people with bipolar disorder. They also dive into the science behind two emerging and promising approaches to eating for bipolar disorder: the Mediterranean Diet and Time-Restricted Eating.(00:00) About Sheri & Robert(03:40) Treating Bipolar with Metabolic Health(06:11) Mediterranean Diet(10:52) Time-Restricted Eating (TRE)(14:40) WHEN You Eat Matters for Bipolar(24:20) Fasting Damages Your Heart? (27:09) Keto & Carnivore Diets(31:07) The Research Study (Mediterranean vs TRE)(32:12) Prioritizing Bipolar Voices(37:03) Being Adaptable with DietsDr. Sheri Johnson is a professor of psychology at the University of California Berkeley, where she directs the Calm Program. She has published over 300 manuscripts, including publications in leading journals such as the Journal of Abnormal Psychology and the American Journal of Psychiatry. She is co-editor or co-author of five books, including Emotion and Psychopathology and a best-selling textbook on Abnormal Psychology (Wiley Press). She is a fellow for Association for Behavioral and Cognitive Therapies (ABCT), the Association for Behavioral Medicine Research and the American Psychological Society. Robert Villanueva is an international mental health advocate, speaker and mentor in arena of lived experience of bipolar disorder. His advocacy journey began over 25 years ago when he received a diagnosis of bipolar disorder. Robert collaborates with researchers, academics, and policymakers both in the United States and globally, providing insights drawn from his own journey and representing the often-overlooked voices of the “ordinary” population. He currently chairs the lived experience advisory board for the “Healthy Lifestyles with Bipolar Disorder” research study at the University of California, Berkeley. Robert's bipolar disorder story: https://talkbd.live/bipolar-in-the-bay/- - -STUDY NOW OPEN INTERNATIONALLYHelp to compare Mediterranean Diet vs. Time-Restricted Eating for bipolar disorder. The Healthy Lifestyles for Bipolar Disorder Research Study is an international online study comparing the benefits of two approaches to eating: Mediterranean and Time-Restricted Eating. Neither food plan is meant to be a diet or a treatment. In this study, you will be asked to consume the same amount of food that you normally would and to continue your regular medical care for bipolar disorder. Those who take part in the study will be paid at a rate of $25/hour for their time completing assessments. More details/sign up: https://calm.berkeley.edu/participate-in-psychology-researchold/healthy-lifestyles-bipolar-disorder - - -Special thanks to the Wellcome Trust. This episode is hosted by Dr. ⁠⁠⁠⁠Erin Michalak⁠⁠⁠⁠ and produced by Caden Poh. #talkBD Bipolar Disorder PodcasttalkBD gathers researchers, people with lived experience, healthcare providers, and top bipolar disorder experts from around the world to discuss and answer the most important questions about living with bipolar disorder. Learn more about talkBD: ⁠⁠⁠⁠⁠⁠⁠⁠⁠https://talkBD.live⁠⁠Follow Us

Dr. Kim Waddell is an Assistant Professor in Physical Medicine and Rehabilitation at the University of Pennsylvania's Perelman School of Medicine as well as a faculty member with the Center for Health Incentives and Behavioral Economics, a Senior Fellow in the Leonard Davis Institute of Health Economics, and Research and Innovation Manager in the Penn Medicine Nudge Unit at the University of Pennsylvania. In addition, Kim is a Research Health Scientist at the VA Center for Health Equity Research and Promotion. Kim's research focuses on behavior change and how to help motivate people to make decisions that are more aligned with their longer term goals. She is particularly interested in physical activity and using approaches from behavioral science to motivate adults who have had a stroke or have Parkinson's disease to increase their daily activity. Another area that Kim is interested in is designing clinical decision support systems and ways to improve decision making to make sure that people are getting the right amount of the right kind of rehabilitation after stroke. When she's not working, Kim tries to go running as often as possible to clear her head and disconnect from technology. She also enjoys cooking, particularly trying new recipes, as well as watching local sports teams and traveling. Kim received her BS in Health Science from Truman State University and her Master's degree in Occupational Therapy from the University of North Carolina at Chapel Hill. She then attended Washington University in St. Louis where she earned her PhD in Movement Science and her Master's degree in Clinical Investigation. Kim conducted postdoctoral research at the VA and Penn before joining the faculty there. Recently, she was awarded the 2024 Academy of Behavioral Medicine Research's Early-Stage Investigator Award, and in our interview, she shares more about her life and science.

Welcome to episode 48 of the Inner Game of Change Podcast where I focus on exploring the multi layers of managing and enabling organisational change. Today, my guest is David Altman;   The Chief Research and Innovation Officer of the Center for Creative Leadership (CCL), a global non-profit organization with offices throughout the world (www.ccl.org). David oversees global research, partnerships and innovation, and portfolio/leadership solutions with a particular focus on EDI.  With extensive leadership and research achievements, David was selected as one of 40 Americans for the three year W.K. Kellogg Foundation National Leadership Program. A prolific author of many articles on leadership and change, today David and I chat about the case for incremental change as an effective approach to successfully managing complex changes.  I am grateful to have David chatting with me today. Topics include :What's the case for Incremental change?Examples of transformative incremental changes including ChatGPT.Concept and advantages of small wins. What's the power butterfly effect and its compounding effect. Overview of Improvement Science methodologies. Industries that take real advantage of incremental change.The role of communication in driving incremental change and navigate through he status quo bias . A brief list of pros and cons of incremental change. Measuring success for incremental change. David's key takeaways and advice to the change practice community. and much more. About David (In his own words) David Altman, Ph.D., is Chief Research and Innovation Officer of the Center for Creative Leadership (CCL), a global non-profit organization with offices throughout the world (www.ccl.org). He oversees global research, partnerships and innovation, and portfolio/leadership solutions. He also facilitates leadership development programs, particularly with senior teams and on topics related to EDI. Before joining CCL, he spent 20 years working in academic medical centers. He received his M.A. and Ph.D. degrees in social ecology from the University of California, Irvine and his B.A. in psychology at the University of California, Santa Barbara. He is Adjunct Faculty at Wake Forest University. He was selected as one of 40 Americans for the three year W.K. Kellogg Foundation National Leadership Program. He rode his bicycle from California to North Carolina to raise public awareness about hunger and endowment funding for an international hunger relief organization. He is a Fellow in three divisions of the American Psychological Association and a member of the Society of Public Health Education and Academy of Behavioral Medicine Research. Contact DavidDavid's Profilelinkedin.com/in/david-g-altmanWebsites ccl.org (Company)kelloggfellowsconsultinggroup.org (Speakers Circle/Kellogg Fellow)Emailaltmand@ccl.org Ali Juma @The Inner Game of Change podcast

Dr. Kirk Erickson is Director of Translational Neuroscience and Mardian J. Blair Endowed Chair of Neuroscience at the AdventHealth Research Institute, Neuroscience Institute. Dr. Erickson received his Ph.D. at the University of Illinois at Urbana-Champaign and was a post-doctoral scholar at the Beckman Institute for Advanced Science and Engineering. He was also a Professor of Psychology and Neuroscience at the University of Pittsburgh before starting at AdventHealth. Dr. Erickson's vast research program focuses on the effects of physical activity on brain health across the lifespan. This research has resulted in > 250 published articles and 15 book chapters. Dr. Erickson's research has been funded by numerous awards and grants from NIH, the Alzheimer's Association, and other organizations. He has been awarded a large multi-site Phase III clinical trial examining the impact of exercise on cognitive function in cognitively normal older adults. His research resulted in the prestigious Chancellor's Distinguished Research Award from the University of Pittsburgh. He was named a Fellow of the Academy of Behavioral Medicine Research in 2016, and a Distinguished Scientist Award by Murdoch University in 2018. He currently holds a Visiting Professor appointment at the University of Granada, Spain. Dr. Erickson was a member of the 2018 Physical Activity Guidelines Advisory Committee, and chair of the Brain Health subcommittee charged with developing the second edition of the Physical Activity Guidelines for Americans. His research has been featured in a long list of print, radio, and electronic media including the New York Times, CNN, BBC News, NPR, Time, and the Wall Street Journal.   This podcast episode is sponsored by Fibion Inc. | Better Sleep, Sedentary Behaviour and Physical Activity Research with Less Hassle --- Learn more about Fibion Sleep and Circadian Rhythm Solutions: https://sleepmeasurements.fibion.com/ --- Collect, store and manage SB and PA data easily and remotely - Discover ground-breaking Fibion SENS: https://sens.fibion.com/ --- SB and PA measurements, analysis, and feedback made easy.  Learn more about Fibion Research : fibion.com/research --- Fibion Kids - Activity tracking designed for children. https://fibionkids.fibion.com/ --- Collect self-report physical activity data easily and cost-effectively https://mimove.fibion.com/ --- Follow the podcast on Twitter https://twitter.com/PA_Researcher Follow host Dr Olli Tikkanen on Twitter https://twitter.com/ollitikkanen Follow Fibion on Twitter https://twitter.com/fibion https://www.youtube.com/@PA_Researcher

Dr. Kirk Erickson is Director of Translational Neuroscience and Mardian J. Blair Endowed Chair of Neuroscience at the AdventHealth Research Institute, Neuroscience Institute. Dr. Erickson received his Ph.D. at the University of Illinois at Urbana-Champaign and was a post-doctoral scholar at the Beckman Institute for Advanced Science and Engineering. He was also a Professor of Psychology and Neuroscience at the University of Pittsburgh before starting at AdventHealth. Dr. Erickson's vast research program focuses on the effects of physical activity on brain health across the lifespan. This research has resulted in > 250 published articles and 15 book chapters. Dr. Erickson's research has been funded by numerous awards and grants from NIH, the Alzheimer's Association, and other organizations. He has been awarded a large multi-site Phase III clinical trial examining the impact of exercise on cognitive function in cognitively normal older adults. His research resulted in the prestigious Chancellor's Distinguished Research Award from the University of Pittsburgh. He was named a Fellow of the Academy of Behavioral Medicine Research in 2016, and a Distinguished Scientist Award by Murdoch University in 2018. He currently holds a Visiting Professor appointment at the University of Granada, Spain. Dr. Erickson was a member of the 2018 Physical Activity Guidelines Advisory Committee, and chair of the Brain Health subcommittee charged with developing the second edition of the Physical Activity Guidelines for Americans. His research has been featured in a long list of print, radio, and electronic media including the New York Times, CNN, BBC News, NPR, Time, and the Wall Street Journal.   This podcast episode is sponsored by Fibion Inc. | Better Sleep, Sedentary Behaviour and Physical Activity Research with Less Hassle --- Learn more about Fibion Sleep and Circadian Rhythm Solutions: https://sleepmeasurements.fibion.com/ --- Collect, store and manage SB and PA data easily and remotely - Discover ground-breaking Fibion SENS: https://sens.fibion.com/ --- SB and PA measurements, analysis, and feedback made easy.  Learn more about Fibion Research : fibion.com/research --- Fibion Kids - Activity tracking designed for children. https://fibionkids.fibion.com/ --- Collect self-report physical activity data easily and cost-effectively https://mimove.fibion.com/ --- Follow the podcast on Twitter https://twitter.com/PA_Researcher Follow host Dr Olli Tikkanen on Twitter https://twitter.com/ollitikkanen Follow Fibion on Twitter https://twitter.com/fibion https://www.youtube.com/@PA_Researcher

How can good people make terrible decisions? To fully understand brainwashing, more formally known as “coercive persuasion,” mental health clinicians must dive into the potentially dangerous outcomes that can result from a mix of factors such as high stress situations, sleep deprivation and isolation.On this episode of The Menninger Clinic's Mind Dive podcast, Dr. Joel Dimsdale joins hosts Dr. Bob Boland and Dr. Kerry Horrell for a discussion on the history of brainwashing, the ease of slipping into Stockholm Syndrome and modern tools of persuasion—like social media—and the effects that clinicians need to be mindful of in patient care. Bringing a unique perspective to the conversation, Joel Dimsdale, MD, began his exploration of brainwashing and its pervasive role in the 20th century after living next door to the Heaven's Gate religious group, led by Marshall Applewhite until the group's highly publicized mass suicide in 1997. He is also the author of “Dark Persuasion: A History of Brainwashing from Pavlov to Social Media.”Dr. Dimsdale is a distinguished professor emeritus and research professor in the department of psychiatry at UC San Diego. He is also an active investigator and past president of the Academy of Behavioral Medicine Research, the American Psychosomatic Society and the Society of Behavioral Medicine. “Much of my work reflects that I feel coercive persuasion—brainwashing—is not an old wives tale,” said Dr. Dimsdale. “It still exists in the modern day, and we have to be on the lookout for it.” Follow The Menninger Clinic on Twitter, Facebook, Instagram and LinkedIn to never miss an episode of Mind Dive. To submit a topic for discussion, email podcast@menninger.edu. Visit www.menningerclinic.org to learn more about The Menninger Clinic's research and leadership role in mental health. Listen to Episode 22: Preventing Shame & Loneliness in Childhood Trauma with Dr. Melissa Goldberg Mintz Resources mentioned in this episode: “Dark Persuasion: A History of Brainwashing from Pavlov to Social Media” by Dr. Joel Dimsdale 

Professor Dr. Sheri Johnson (University of California Berkeley) and mental health educator Victoria Maxwell discuss the relationship between creativity and bipolar disorder, how to maintain creativity outside of mood episodes, and answer questions from the TalkBD audience. Hosted by Dr. Erin Michalak. Dr. Sheri Johnson is a professor of psychology at the University of California Berkeley, where she directs the Calm Program. Her work has been funded by the National Alliance for Research on Schizophrenia and Depression, the National Institute of Mental Health, the National Science Foundation, and the National Cancer Institute. She has published over 200 manuscripts, including publications in leading journals such as the Journal of Abnormal Psychology and the American Journal of Psychiatry. She is co-editor or co-author of five books, including Emotion and Psychopathology and a best-selling textbook on Abnormal Psychology (Wiley Press). She is a fellow for Association for Behavioral and Cognitive Therapies (ABCT), the Association for Behavioral Medicine Research and the American Psychological Society. Since being diagnosed with bipolar disorder, psychosis, and anxiety, Victoria Maxwell has become one of North America's top speakers and educators on the lived experience of mental illness and recovery, dismantling stigma and returning to work after a psychiatric disorder. As a performer, her funny, powerful messages about mental wellness create lasting change in individuals and organizations. By sharing her story of mental illness and recovery she makes the uncomfortable comfortable, the confusing understandable. The Mental Health Commission of Canada named her keynote That's Just Crazy Talk as one of the top anti-stigma interventions in the country. #TalkBD is a series of free, online community gatherings to share support and tips for bipolar wellness. Learn more about the upcoming and all past TalkBD episodes at www.talkBD.live.

Daisy Chen https://alphaconverge.com/ About our guest ... Daisy Chen is the founder of a “Best Big Data" and"Most Innovative Machine Learning" company in Nevada, Daisy hasalmost two decades of experience in tackling complex projects forhighly matrixes fortune 500 companies, leading management consultingfirm, and top media & advertising agencies. She started to lead topcompanies' analytics functions in her 20s, and have a proven track recordof building & evangelizing best practices, mentoring analytics talents,cultivating collaborative relationships, and deliver solid business resultsin diverse industries.Daisy is a partner at AlphaConverge, a management consulting firm thatis recognized as one of the best in big data, data integration, businessintelligence and machine learning. Daisy has extensive experience inleading top companies' analytics functions and tackling complexprojects at highly matrixed fortune 500 companies, leading managementconsulting firms and top advertising agencies. Dr. Karin Espositohttps://medicine.roseman.edu/home/leadership/https://www.linkedin.com/in/karin-esposito-md-phd-43391350/Dr. Karin Esposito is Professor and Senior Executive Deanfor Academic and Student Affairs at Roseman University College of Medicine(RUCOM). She is the Chief Academic Officer for the medical school and will serve asthe faculty lead for accreditation. She has held previous roles in curriculum, advising,and student affairs and also has experience as a residency program director. Dr.Esposito received her PhD in biochemistry and molecular biology, as well as her MD,from the University of Miami, and she completed her residency training in psychiatryat Jackson Memorial Hospital in Miami, Florida. Her research interests have spannedbasic and clinical research, education research, and hospital-based qualityimprovement research at various times in her career.Prior to coming to Roseman, Dr. Esposito held roles at Florida International UniversityHerbert Wertheim College of Medicine as Executive Associate Dean for StudentAffairs, Associate Dean for Curriculum and Medical Education and as Associate Deanfor Academic Affairs and for Women in Medicine and Science. Dr. Esposito was alsothe founding program director for the psychiatry residency at Citrus Health Network.  Dr. Jaime Fairclough https://www.linkedin.com/in/jamie-fairclough-phd-mph-ms-2901564b/ Dr. Jamie Fairclough serves as Associate Dean, Professor,and Director of the Data Science & Analytics Unit at Roseman University Collegeof Medicine (RUCOM). As a data leader, Dr. Fairclough oversees the datainfrastructure and analytics strategy plans and leads current cloudadoption/transformation efforts in the medical school. Before coming toRUCOM, Dr. Fairclough held faculty appointments at Florida InternationalUniversity (Herbert Wertheim College of Medicine), Florida State University(College of Medicine), and Palm Beach Atlantic University (Gregory School ofPharmacy). She also worked in government operations, managing a statewiderisk surveillance system for the Florida Department of Health (Bureau ofEpidemiology) in collaboration with the Centers for Disease Control & Prevention(CDC). Dr. Fairclough earned her BS, MPH, and MS degrees from the University ofFlorida and her PhD from Florida State University. She subsequently completedpostdoctoral fellowship training in Behavioral Medicine Research at DukeUniversity Medical Center, as well as postgraduate/executive training in medicalstatistics at Stanford University; data science, AI, and machine learning at theUniversity of Texas at Austin; data engineering at the University of Chicago; andHealthcare AI at Harvard Medical School. Dr. Fairclough holds a secondaryappointment as Adjunct Professor of Data Science at Noorda College ofOsteopathic Medicine and was recently selected as an NWCCU | SACSCOC2022-2023 Data Equity Fellow.

Gary E. Schwartz, Ph.D., is Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of the Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. He received his Ph.D. in psychology from Harvard University in 1971 and was an assistant professor at Harvard for five years. He later served as a Professor of Psychology and Psychiatry at Yale University, Director of the Yale Psychophysiology Center, and Co-Director of the Yale Behavioral Medicine Clinic, before moving to Arizona in 1988. He has published more than four hundred and fifty scientific papers, including six papers in the journal Science. He has co-edited 11 academic books. His science books for the general public include The Afterlife Experiments (2002), The Energy Healing Experiments (2007, a Nautilus Book Award Gold Winner in 2008), The Sacred Promise (2011), An Atheist in Heaven (2016), and Super Synchronicity (2017). In 2012 he won the Distinguished Contribution to the Science of Psychology award from the Arizona Psychological Association for his research in energy psychology and spiritual psychology. Gary is a Fellow of the American Psychological Association, the American Psychological Society, the Society for Behavioral Medicine, and the Academy for Behavioral Medicine Research.Check out all the great radio and TV programming available On-Demand at www.XZBN.net

In this episode, Dr. David Hanscom continues his discussion with Dr. Joshua Smyth. He explains that while unwanted repetitive thoughts (URTs) are very common, people differ in their response to them. Each person has a different level of adaptability and resilience that determines how well they can handle URTs. These repetitive patterns can drain a person's resources and cause problems with their health or psychology. Cognitive behavioral therapy, in combination with better sleep, exercise and diet, can calm the nervous system and help patients modulate their body's response to URTs and then eventually slow their frequency.Joshua Smyth is a Distinguished Professor of Biobehavioral Health and of Medicine at Penn State and Hershey Medical Center and serves as Associate Director of Penn State's Social Science Research Institute (SSRI). Smyth is an internationally recognized expert on ambulatory assessment and intervention, with a focus on the interplay of stress, emotion, physiology and behavior in everyday life.   He is a Fellow of the Royal Society of Medicine, the Academy of Behavioral Medicine Research, and the Society of Behavioral Medicine. Dr. Smyth has served as an editorial referee for more than four dozen journals, served as Editor and Associate Editor for several journals, and has been active in Society leadership for the American Psychosomatic Society, the Society of Behavioral Medicine, and the Society for Ambulatory Assessment. Dr. Smyth has widely shared his research in interviews with ABC, CBS, CNN, NBC, PBS, Newsweek, Time and the New York Times, among many others, and recently published (with James Pennebaker) a popular science book on expressive writing interventions. Finally, he is an active and engaged teacher, and has received numerous accolades and awards for teaching and mentoring of students and trainees.

In this episode, Dr. David Hanscom continues his discussion with Dr. Joshua Smyth. He explains that while unwanted repetitive thoughts (URTs) are very common, people differ in their response to them. Each person has a different level of adaptability and resilience that determines how well they can handle URTs. These repetitive patterns can drain a person's resources and cause problems with their health or psychology. Cognitive behavioral therapy, in combination with better sleep, exercise and diet, can calm the nervous system and help patients modulate their body's response to URTs and then eventually slow their frequency. Joshua Smyth is a Distinguished Professor of Biobehavioral Health and of Medicine at Penn State and Hershey Medical Center and serves as Associate Director of Penn State's Social Science Research Institute (SSRI). Smyth is an internationally recognized expert on ambulatory assessment and intervention, with a focus on the interplay of stress, emotion, physiology and behavior in everyday life.   He is a Fellow of the Royal Society of Medicine, the Academy of Behavioral Medicine Research, and the Society of Behavioral Medicine. Dr. Smyth has served as an editorial referee for more than four dozen journals, served as Editor and Associate Editor for several journals, and has been active in Society leadership for the American Psychosomatic Society, the Society of Behavioral Medicine, and the Society for Ambulatory Assessment. Dr. Smyth has widely shared his research in interviews with ABC, CBS, CNN, NBC, PBS, Newsweek, Time and the New York Times, among many others, and recently published (with James Pennebaker) a popular science book on expressive writing interventions. Finally, he is an active and engaged teacher, and has received numerous accolades and awards for teaching and mentoring of students and trainees.

In this episode, Dr. David Hanscom talks with Dr. Joshua Smyth about the nature and mechanisms for unwanted repetitive thought (URT) patterns. These are thought patterns that persist over time and can have a negative effect on a person's health and psychology. Dr. Smyth explains that these thoughts often have lots of very emotional associations and can be very experiential / visual. Ironically because of this, trying to suppress them consciously typically just reinforces them. They can damage our health because they trigger the body's threat response. Joshua Smyth is a Distinguished Professor of Biobehavioral Health and of Medicine at Penn State and Hershey Medical Center and serves as Associate Director of Penn State's Social Science Research Institute (SSRI). Smyth is an internationally recognized expert on ambulatory assessment and intervention, with a focus on the interplay of stress, emotion, physiology and behavior in everyday life.   He is a Fellow of the Royal Society of Medicine, the Academy of Behavioral Medicine Research, and the Society of Behavioral Medicine. Dr. Smyth has served as an editorial referee for more than four dozen journals, served as Editor and Associate Editor for several journals, and has been active in Society leadership for the American Psychosomatic Society, the Society of Behavioral Medicine, and the Society for Ambulatory Assessment. Dr. Smyth has widely shared his research in interviews with ABC, CBS, CNN, NBC, PBS, Newsweek, Time and the New York Times, among many others, and recently published (with James Pennebaker) a popular science book on expressive writing interventions. Finally, he is an active and engaged teacher, and has received numerous accolades and awards for teaching and mentoring of students and trainees.

In this episode, Dr. David Hanscom talks with Dr. Joshua Smyth about the nature and mechanisms for unwanted repetitive thought (URT) patterns. These are thought patterns that persist over time and can have a negative effect on a person's health and psychology. Dr. Smyth explains that these thoughts often have lots of very emotional associations and can be very experiential / visual. Ironically because of this, trying to suppress them consciously typically just reinforces them. They can damage our health because they trigger the body's threat response.Joshua Smyth is a Distinguished Professor of Biobehavioral Health and of Medicine at Penn State and Hershey Medical Center and serves as Associate Director of Penn State's Social Science Research Institute (SSRI). Smyth is an internationally recognized expert on ambulatory assessment and intervention, with a focus on the interplay of stress, emotion, physiology and behavior in everyday life.   He is a Fellow of the Royal Society of Medicine, the Academy of Behavioral Medicine Research, and the Society of Behavioral Medicine. Dr. Smyth has served as an editorial referee for more than four dozen journals, served as Editor and Associate Editor for several journals, and has been active in Society leadership for the American Psychosomatic Society, the Society of Behavioral Medicine, and the Society for Ambulatory Assessment. Dr. Smyth has widely shared his research in interviews with ABC, CBS, CNN, NBC, PBS, Newsweek, Time and the New York Times, among many others, and recently published (with James Pennebaker) a popular science book on expressive writing interventions. Finally, he is an active and engaged teacher, and has received numerous accolades and awards for teaching and mentoring of students and trainees.

The history of coercive persuasion, from Pavlov to social media. Dr. Joel E. Dimsdale, M.D attended Carleton College and then Stanford University, where he obtained a MA in Sociology and an MD degree. He obtained psychiatric training at MGH and was on the faculty of Harvard Medical School from 1976-1985, when he moved to University of California, San Diego, where he is now Regent Edward A. Dickson Emeritus Professor and Distinguished Professor of Psychiatry Emeritus. His clinical subspecialty is consultation psychiatry. He is a former career awardee of the American Heart Association and is past-president of the Academy of Behavioral Medicine Research, the American Psychosomatic Society, and the Society of Behavioral Medicine. He is editor-in-chief emeritus of Psychosomatic Medicine and is a previous guest editor of Circulation and former editor-at-large of Journal Psychosomatic Research. He has been a consultant to the President's Commission on Mental Health, the Institute of Medicine, the National Academies of Science, the Department of Justice, NASA, and NIH and was Advisor to the UC Regents Health Sciences Committee. He was a member of the DSM 5 taskforce and chaired the workgroup studying somatic symptom disorders. His research interests include stress physiology, ethnicity, and sleep. He is the author of more than 500 publications, including Anatomy of Malice: the enigma of the Nazi War Criminals, Yale University Press, 2016 and Dark Persuasion: the History of Brainwashing from Pavlov to Social Media, Yale University Press, 2021.

Gary E. Schwartz, Ph.D, is a Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of its Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. Gary received his PhD from Harvard in 1971, was an Assistant Professor at Harvard, and was a Professor of Psychology and Psychiatry at Yale University and director of the Yale Psychophysiology Center before moving to the University of Arizona in 1988. He is a Fellow of the American Psychological Association, the American Psychological Society, the Society of Behavioral Medicine, and the Academy of Behavioral Medicine Research. He has published more than 450 scientific papers, including six papers in the journal Science, co-edited 11 academic books, and is the author of The Energy Healing Experiments (2007), The G.O.D. Experiments (2006), The Afterlife Experiments (2002), The Truth about Medium (2005), and The Living Energy Universe (1999). His research integrates mind-body medicine, energy medicine, and spiritual medicine. His new book The Sacred Promise: How Science is Discovering Spirit's Collaboration with Us in Our Daily Lives will be published in January 2011. He has appeared on hundreds of television and radio shows. - www.sacredpromiseuniverse.com and www.drgaryschwartz.com.******************************************************************To listen to all our XZBN shows, with our compliments go to: https://www.spreaker.com/user/xzoneradiotv*** AND NOW ***The ‘X' Zone TV Channel on SimulTV - www.simultv.comThe ‘X' Chronicles Newspaper - www.xchroniclesnewspaper.com ******************************************************************

Gary E. Schwartz, Ph.D., is Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of the Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. He received his Ph.D. in psychology from Harvard University in 1971 and was an assistant professor at Harvard for five years. He later served as a Professor of Psychology and Psychiatry at Yale University, Director of the Yale Psychophysiology Center, and Co-Director of the Yale Behavioral Medicine Clinic, before moving to Arizona in 1988. He has published more than four hundred and fifty scientific papers, including six papers in the journal Science. He has co-edited 11 academic books. His science books for the general public include The Afterlife Experiments (2002), The Energy Healing Experiments (2007, a Nautilus Book Award Gold Winner in 2008), The Sacred Promise (2011), An Atheist in Heaven (2016), and Super Synchronicity (2017). In 2012 he won the Distinguished Contribution to the Science of Psychology award from the Arizona Psychological Association for his research in energy psychology and spiritual psychology. Gary is a Fellow of the American Psychological Association, the American Psychological Society, the Society for Behavioral Medicine, and the Academy for Behavioral Medicine Research. XZBN radio shows archives and programming include: A Different Perspective with Kevin Randle; Alien Cosmic Expo Lecture Series; Alien Worlds Radio Show; Connecting with Coincidence with Dr. Bernard Beitman, MD; Dick Tracy; Dimension X; Exploring Tomorrow Radio Show; Flash Gordon; Jet Jungle Radio Show; Journey Into Space; Know the Name with Sharon Lynn Wyeth; Lux Radio Theatre - Classic Old Time Radio; Mission Evolution with Gwilda Wiyaka; Paranormal StakeOut with Larry Lawson; Ray Bradbury - Tales Of The Bizarre; Sci Fi Radio Show; Seek Reality with Roberta Grimes; Space Patrol; Stairway to Heaven with Gwilda Wiyaka; The 'X' Zone Radio Show with Rob McConnell; and many others! To listen to all our XZBN shows, with our compliments go to: https://www.spreaker.com/user/xzoneradiotv *** AND NOW *** The ‘X' Zone TV Channel on SimulTV - www.simultv.com The ‘X' Chronicles Newspaper - www.xchroniclesnewspaper.com

Gary E. Schwartz, Ph.D., is Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of the Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. He received his Ph.D. in psychology from Harvard University in 1971 and was an assistant professor at Harvard for five years. He later served as a Professor of Psychology and Psychiatry at Yale University, Director of the Yale Psychophysiology Center, and Co-Director of the Yale Behavioral Medicine Clinic, before moving to Arizona in 1988. He has published more than four hundred and fifty scientific papers, including six papers in the journal Science. He has co-edited 11 academic books. His science books for the general public include The Afterlife Experiments (2002), The Energy Healing Experiments (2007, a Nautilus Book Award Gold Winner in 2008), The Sacred Promise (2011), An Atheist in Heaven (2016), and Super Synchronicity (2017). In 2012 he won the Distinguished Contribution to the Science of Psychology award from the Arizona Psychological Association for his research in energy psychology and spiritual psychology. Gary is a Fellow of the American Psychological Association, the American Psychological Society, the Society for Behavioral Medicine, and the Academy for Behavioral Medicine Research. XZBN radio shows archives and programming include: A Different Perspective with Kevin Randle; Alien Cosmic Expo Lecture Series; Alien Worlds Radio Show; Connecting with Coincidence with Dr. Bernard Beitman, MD; Dick Tracy; Dimension X; Exploring Tomorrow Radio Show; Flash Gordon; Jet Jungle Radio Show; Journey Into Space; Know the Name with Sharon Lynn Wyeth; Lux Radio Theatre - Classic Old Time Radio; Mission Evolution with Gwilda Wiyaka; Paranormal StakeOut with Larry Lawson; Ray Bradbury - Tales Of The Bizarre; Sci Fi Radio Show; Seek Reality with Roberta Grimes; Space Patrol; Stairway to Heaven with Gwilda Wiyaka; The 'X' Zone Radio Show with Rob McConnell; and many others! To listen to all our XZBN shows, with our compliments go to: https://www.spreaker.com/user/xzoneradiotv *** AND NOW *** The ‘X' Zone TV Channel on SimulTV - www.simultv.com The ‘X' Chronicles Newspaper - www.xchroniclesnewspaper.com

Gary E. Schwartz, Ph.D., is Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of the Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. He received his Ph.D. in psychology from Harvard University in 1971 and was an assistant professor at Harvard for five years. He later served as a Professor of Psychology and Psychiatry at Yale University, Director of the Yale Psychophysiology Center, and Co-Director of the Yale Behavioral Medicine Clinic, before moving to Arizona in 1988. He has published more than four hundred and fifty scientific papers, including six papers in the journal Science. He has co-edited 11 academic books. His science books for the general public include The Afterlife Experiments (2002), The Energy Healing Experiments (2007, a Nautilus Book Award Gold Winner in 2008), The Sacred Promise (2011), An Atheist in Heaven (2016), and Super Synchronicity (2017). In 2012 he won the Distinguished Contribution to the Science of Psychology award from the Arizona Psychological Association for his research in energy psychology and spiritual psychology. Gary is a Fellow of the American Psychological Association, the American Psychological Society, the Society for Behavioral Medicine, and the Academy for Behavioral Medicine Research. Thank you for listening to this XZBN Show episode. XZBN radio shows archives and programming include: A Different Perspective with Kevin Randle; Alien Cosmic Expo Lecture Series; Alien Worlds Radio Show; Connecting with Coincidence with Dr. Bernard Beitman, MD; Dick Tracy; Dimension X; Exploring Tomorrow Radio Show; Flash Gordon; Jet Jungle Radio Show; Journey Into Space; Know the Name with Sharon Lynn Wyeth; Lux Radio Theatre - Classic Old Time Radio; Mission Evolution with Gwilda Wiyaka; Paranormal StakeOut with Larry Lawson; Ray Bradbury - Tales Of The Bizarre; Sci Fi Radio Show; Seek Reality with Roberta Grimes; Space Patrol; Stairway to Heaven with Gwilda Wiyaka; The 'X' Zone Radio Show with Rob McConnell; and many others! To listen to all our XZBN shows, with our compliments go to: https://www.spreaker.com/user/xzoneradiotv *** AND NOW *** The ‘X' Zone TV Channel on SimulTV - www.simultv.com The ‘X' Chronicles Newspaper - www.xchroniclesnewspaper.com

DR GARY E SCHWARTZ - Sacred Promise: How Science is Discovering Spirit's Collaboration with Us in Our Daily Lives - Gary E. Schwartz, Ph.D, is a Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of its Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. Gary received his PhD from Harvard in 1971, was an Assistant Professor at Harvard, and was a Professor of Psychology and Psychiatry at Yale University and director of the Yale Psychophysiology Center before moving to the University of Arizona in 1988. He is a Fellow of the American Psychological Association, the American Psychological Society, the Society of Behavioral Medicine, and the Academy of Behavioral Medicine Research. He has published more than 450 scientific papers, including six papers in the journal Science, co-edited 11 academic books, and is the author of The Energy Healing Experiments (2007), The G.O.D. Experiments (2006), The Afterlife Experiments (2002), The Truth about Medium (2005), and The Living Energy Universe (1999). His research integrates mind-body medicine, energy medicine, and spiritual medicine. His new book The Sacred Promise: How Science is Discovering Spirit's Collaboration with Us in Our Daily Lives will be published in January 2011. He has appeared on hundreds of television and radio shows. - www.sacredpromiseuniverse.com and www.drgaryschwartz.com. For Your Listening Pleasure all the radio shows available on The 'X' Zone Broadcast Network with our compliments, visit - https://www.spreaker.com/user/xzoneradiotv. The ‘X' Zone Broadcast Network Shows and Archives - https://www.spreaker.com/user/xzoneradiotv The ‘X' Zone TV Channel on SimulTV - for more information visit http://www.simultv.com The ‘X' Chronicles Newspaper - www.xchroniclesnewspaper.com

DR GARY E SCHWARTZ - Sacred Promise: How Science is Discovering Spirit's Collaboration with Us in Our Daily Lives - Gary E. Schwartz, Ph.D, is a Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of its Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. Gary received his PhD from Harvard in 1971, was an Assistant Professor at Harvard, and was a Professor of Psychology and Psychiatry at Yale University and director of the Yale Psychophysiology Center before moving to the University of Arizona in 1988. He is a Fellow of the American Psychological Association, the American Psychological Society, the Society of Behavioral Medicine, and the Academy of Behavioral Medicine Research. He has published more than 450 scientific papers, including six papers in the journal Science, co-edited 11 academic books, and is the author of The Energy Healing Experiments (2007), The G.O.D. Experiments (2006), The Afterlife Experiments (2002), The Truth about Medium (2005), and The Living Energy Universe (1999). His research integrates mind-body medicine, energy medicine, and spiritual medicine. His new book The Sacred Promise: How Science is Discovering Spirit's Collaboration with Us in Our Daily Lives will be published in January 2011. He has appeared on hundreds of television and radio shows. - www.sacredpromiseuniverse.com and www.drgaryschwartz.com.For Your Listening Pleasure all the radio shows available on The 'X' Zone Broadcast Network with our compliments, visit - https://www.spreaker.com/user/xzoneradiotv.The ‘X' Zone Broadcast Network Shows and Archives - https://www.spreaker.com/user/xzoneradiotvThe ‘X' Zone TV Channel on SimulTV - for more information visit http://www.simultv.comThe ‘X' Chronicles Newspaper - www.xchroniclesnewspaper.com

Dave Siever, C.E.T., graduated from the Northern Alberta Institute of Technology (NAIT) in 1978 in Telecommunications. In 1980, he accepted a position at the University of Alberta, Faculty of Dentistry, as a design technologist. He conducted research with Dr. Norman Thomas, an internationally recognized specialist in the area of temporo-mandibular dysfunction and myofacial pain. During his employment there, Dave developed equipment for the TMJ research laboratory and the Educational Psychology Department, including TENS stimulators, biofeedback devices, gnathodynamometers, signal processing equipment, and EMG spectral analysis equipment. From late 1985 to 1987, Dave provided TMJ consulting services to 5 dentists in the Edmonton area. Over the years, Dave has helped treat approximately 1,500 patients with TMJ and MPD. During this time, Dave realized that many TMJ problems were psychologically-related, prompting him to pursue his interest in biofeedback. This led to the inception of the original D.A.V.I.D. 1 in the spring of 1985, which was used in the Faculty of Arts to help acting students overcome stage fright.In the time since, Dave has continued developing several audio-visual entrainment (AVE), cranio-electro stimulation (CES), transcranial DC Stimulation (tDCS), and biofeedback devices, with each new development responding to technology changes and market demands. Dave still designs new products related to personal growth and well-being.Dave travels throughout North America and around the world lecturing to dentists, chiropractors, medical groups, biofeedback and neurofeedback professionals, teachers, and the general public at various conferences about the using these technologies as an alternative method to improved health, accelerated learning, and peace of mind.Dave has also developed and written a stimulation technologies/entrainment course for the Behavioral Medicine Research and Training Foundation and instructs it along with Dr. Cynthia Kerson. https://mindalive.com

Here’s why eating garlic and onions can prevent hypertension and diabetes Federal University of Technology (Nigeria), April 16, 2021 n a recent study, researchers at the Federal University of Technology in Nigeria investigated the benefits of eating garlic, white onion and purple onion against serious conditions like diabetes and hypertension. They confirmed these by looking at how extracts from the three alliums affect the activity of diabetes-related enzymes, such as a-amylase and a-glucosidase, and the hypertension-related enzyme, angiotensin-converting enzyme (ACE). The researchers reported their findings in an article published in the Journal of Dietary Supplements. Garlic, white onion and purple onion show antioxidant, antidiabetic and antihypertensive properties Garlic and onions are spices commonly used in cooking. They also serve as ingredients in several traditional delicacies in Nigeria that are known to contain plenty of polyphenols. To assess the beneficial properties of garlic, white onion and purple onion, the researchers first obtained extracts from each and assessed their inhibitory effects on certain enzymes. They also conducted assays to determine the antioxidant capacities of the extracts. ACE is the enzyme responsible for converting angiotensin I into angiotensin II, the hormone that increases blood pressure, as well as body water and sodium content. Angiotensin II elevates blood pressure by constricting the blood vessels; hence, chemicals that can inhibit the activity of ACE, which is responsible for the production of angiotensin II, are used for the treatment of hypertension. (Related: Meet the “two-day cure” plant: An African medicinal plant that can naturally lower blood pressure.) a-Amylase is the enzyme that breaks down starch and glycogen into glucose and maltose (two glucose molecules bound together). In humans, this enzyme is produced by the salivary glands and the pancreas. a-Glucosidase, on the other hand, is responsible for breaking down carbohydrates in the small intestine and facilitating the absorption of glucose. Inhibiting the activity of this enzyme is one of the strategies currently used to prevent the rise of blood sugar levels following a carbohydrate-filled meal. The researchers reported that the garlic, purple onion and white onion extracts inhibited the activities of ACE, a-amylase and a-glucosidase in vitro in a concentration-dependent manner. At a half maximal inhibitory concentration (IC50) of 0.59 mg/mL, the purple onion extract exhibited a higher inhibitory effect on ACE than the white onion extract (IC50 = 0.66 mg/mL) and the garlic (IC50 = 0.96 mg/mL) extract. Meanwhile, the white onion extract showed a significantly stronger inhibitory effect on a-amylase at an IC50 of 3.93 mg/mL than the garlic extract (IC50 = 8.19 mg/mL) and the purple onion (IC50 = 8.27 mg/mL) extract. The garlic extract, on the other hand, showed a similar inhibitory effect (IC50 = 4.50 mg/mL) on a-glucosidase as the white and purple onion extracts. All three extracts also showed dose-dependent free radical scavenging activity and reducing power in the antioxidant assays. Based on these findings, the researchers concluded that garlic, white onion and purple onion can be used to treat or prevent diabetes and hypertension, thanks to their ability to inhibit ACE, a-amylase and a-glucosidase activity, as well as lipid peroxidation in the pancreas and the heart.   Adolescents with lack of empathy show early signs of psychopathy   University of Coimbra (Portugal), April 14, 2021 A pioneering study with the Portuguese population shows that adolescents with high levels of callous-unemotional traits demonstrate lower levels of anticipated guilt towards the possibility of committing an immoral act and struggle to judge an immoral act as a wrong one. Researchers have evaluated the callous traits, that is, the lack of empathy and disregard for the wellbeing and feelings of others, of 47 adolescents between 15 and 18 years old. The teenagers watched video animations portraying examples of moral transgressions, such as incriminating someone or keeping money that fell from someone else's pocket. "This approach allowed us to create more realistic scenarios that happen in daily life," explains Oscar Gonçalves, a neuroscientist at Proaction Lab and co-author of the study. The adolescents were asked how guilty they would feel if they were the ones to commit the moral transgressions and how wrong they think the actions were.  Although the callous-unemotional traits in adolescents are known to be precursors of psychopathy in adulthood, the results of the study differ from what is known about psychopaths. "Adults with psychopathic traits show low levels of anticipated guilt but consider immoral actions as wrong. However, in our study, adolescents with high CU levels show levels of guilt and judge immoral actions as less wrong," explains Margarida Vasconcelos, first author.  However, researchers have found evidence of a dissociation between moral emotions and moral judgment, that is, between the feelings of guilt and the judgment of immoral actions. "Even in adolescents with sub-clinical levels of callous-unemotional traits, this dissociation typical in psychopathy in adulthood is already happening during development," explains the study coordinator Ana Seara Cardoso.  The results of the study will "contribute to the development of a severe anti-social behavior model" and allow the "development of intervention targets, rehabilitation and early prevention of anti-social behavior," says Ana Seara Cardoso.   Omega-3 supplements do double duty in protecting against stress   Ohio State University, April 20, 2021 A high daily dose of an omega-3 supplement may help slow the effects of aging by suppressing damage and boosting protection at the cellular level during and after a stressful event, new research suggests. Researchers at The Ohio State University found that daily supplements that contained 2.5 grams of omega-3 polyunsaturated fatty acids, the highest dose tested, were the best at helping the body resist the damaging effects of stress. Compared to the placebo group, participants taking omega-3 supplements produced less of the stress hormone cortisol and lower levels of a pro-inflammatory protein during a stressful event in the lab. And while levels of protective compounds sharply declined in the placebo group after the stressor, there were no such decreases detected in people taking omega-3s. The supplements contributed to what the researchers call stress resilience: reduction of harm during stress and, after acute stress, sustained anti-inflammatory activity and protection of cell components that shrink as a consequence of aging. The potential anti-aging effects were considered particularly striking because they occurred in people who were healthy but also sedentary, overweight and middle-aged—all characteristics that could lead to a higher risk for accelerated aging. "The findings suggest that omega-3 supplementation is one relatively simple change people could make that could have a positive effect at breaking the chain between stress and negative health effects," said Annelise Madison, lead author of the paper and a graduate student in clinical psychology at Ohio State. The research is published today (Monday, April 19, 2021) in the journal Molecular Psychiatry. Madison works in the lab of Janice Kiecolt-Glaser, professor of psychiatry and psychology and director of the Institute for Behavioral Medicine Research at Ohio State. This paper is a secondary analysis of one of Kiecolt-Glaser's earlier studies showing that omega-3 supplements altered a ratio of fatty acid consumption in a way that helped preserve tiny segments of DNA in white blood cells. Those short fragments of DNA are called telomeres, which function as protective caps at the end of chromosomes. Telomeres' tendency to shorten in many types of cells is associated with age-related diseases, especially heart disease, and early mortality. In the initial study, researchers were monitoring changes to telomere length in white blood cells known as lymphocytes. For this new study, the researchers looked at how sudden stress affected a group of biological markers that included telomerase, an enzyme that rebuilds telomeres, because levels of the enzyme would react more quickly to stress than the length of telomeres themselves. Specifically, they compared how moderate and high doses of omega-3s and a placebo influenced those markers during and after an experimental stressor. Study participants took either 2.5 grams or 1.25 grams of omega-3s each day, or a placebo containing a mix of oils representing a typical American's daily intake. After four months on the supplements, the 138 research participants, age 40-85, took a 20-minute test combining a speech and a math subtraction task that is known to reliably produce an inflammatory stress response. Only the highest dose of omega-3s helped suppress damage during the stressful event when compared to the placebo group, lowering cortisol and a pro-inflammatory protein by an average of 19% and 33%, respectively. Results from blood samples showed that both doses of omega-3s prevented any changes in telomerase levels or a protein that reduces inflammation in the two hours after participants experienced the acute stress, meaning any needed stress-related cell repair—including telomere restoration—could be performed as usual. In the placebo group, those repair mechanisms lost ground: Telomerase dropped by an average of 24% and the anti-inflammatory protein decreased by an average of at least 20%. "You could consider an increase in cortisol and inflammation potential factors that would erode telomere length," Madison said. "The assumption based on past work is that telomerase can help rebuild telomere length, and you want to have enough telomerase present to compensate for any stress-related damage. "The fact that our results were dose-dependent, and we're seeing more impact with the higher omega-3 dose, would suggest that this supports a causal relationship." The researchers also suggested that by lowering stress-related inflammation, omega-3s may help disrupt the connection between repeated stress and depressive symptoms. Previous research has suggested that people with a higher inflammatory reaction to a stressor in the lab may develop more depressive symptoms over time. "Not everyone who is depressed has heightened inflammation—about a third do. This helps explain why omega-3 supplementation doesn't always result in reduced depressive symptoms," Kiecolt-Glaser said. "If you don't have heightened inflammation, then omega-3s may not be particularly helpful. But for people with depression who do, our results suggest omega-3s would be more useful." The 2.5-gram dose of omega-3s is much higher than what most Americans consume on a daily basis, but study participants showed no signs of having problems with the supplements, Madison said.           Want to be robust at 40-plus? Meeting minimum exercise guidelines won't cut it 5 hours of moderate activity a week may be required to avoid midlife hypertension, UCSF-led study shows University of California at San Francisco, April 15, 2021 Young adults must step up their exercise routines to reduce their chances of developing high blood pressure or hypertension - a condition that may lead to heart attack and stroke, as well as dementia in later life. Current guidelines indicate that adults should have a minimum of two-and-a-half hours of moderate intensity exercise each week, but a new study led by UCSF Benioff Children's Hospitals reveals that boosting exercise to as much as five hours a week may protect against hypertension in midlife - particularly if it is sustained in one's thirties, forties and fifties.  In the study publishing in American Journal of Preventive Medicine on April 15, researchers followed approximately 5,000 adults ages 18 to 30 for 30 years. The participants were asked about their exercise habits, medical history, smoking status and alcohol use. Blood pressure and weight were monitored, together with cholesterol and triglycerides.  Hypertension was noted if blood pressure was 130 over 80 mmHg, the threshold established in 2017 by the American College of Cardiology/American Heart Association.  The 5,115 participants had been enrolled by the Coronary Artery Risk Development in Young Adults (CARDIA) study and came from urban sites in Birmingham, Ala., Chicago, Minneapolis and Oakland, Calif. Approximately half the participants were Black (51.6 percent) and the remainder were White. Just under half (45.5 percent) were men.  Fitness Levels Fall Fast for Black Men Leading to More Hypertension Among the four groups, who were categorized by race and gender, Black men were found to be the most active in early adulthood, exercising slightly more than White men and significantly more than Black women and White women. But by the time Black men reached age 60, exercise intake had slumped from a peak of approximately 560 exercise units to around 300 units, the equivalent to the minimum of two-and-a-half hours a week of moderate intensity exercise recommended by the U.S. Department of Health and Human Services. This was substantially less exercise than White men (approximately 430 units) and slightly more than White women (approximately 320 units). Of the four groups, Black women had the least exercise throughout the study period and saw declines over time to approximately 200 units. "Although Black male youth may have high engagement in sports, socio-economic factors, neighborhood environments, and work or family responsibilities may prevent continued engagement in physical activity through adulthood," said first author Jason Nagata, MD, of the UCSF Division of Adolescent and Young Adult Medicine. Additionally, Black men reported the highest rates of smoking, which may preclude physical activity over time, he noted. Physical activity for White men declined in their twenties and thirties and stabilized at around age 40. For White women, physical activity hovered around 380 exercise units, dipping in their thirties and remaining constant to age 60. Rates of hypertension mirrored this declining physical activity. Approximately 80-to-90 percent of Black men and women had hypertension by age 60, compared with just below 70 percent for White men and 50 percent for White women.  "Results from randomized controlled trials and observational studies have shown that exercise lowers blood pressure, suggesting that it may be important to focus on exercise as a way to lower blood pressure in all adults as they approach middle age," said senior author Kirsten Bibbins-Domingo, MD, PhD, of the UCSF Department of Epidemiology and Biostatistics.  "Teenagers and those in their early twenties may be physically active but these patterns change with age. Our study suggests that maintaining physical activity during young adulthood - at higher levels than previously recommended - may be particularly important." More Exercise from Youth to Midlife Offers Best Protection Against Hypertension When researchers looked at the 17.9 percent of participants who had moderate exercise for at least five hours a week during early adulthood - double the recommended minimum - they found that the likelihood of developing hypertension was 18 percent lower than for those who exercised less than five hours a week. The likelihood was even lower for the 11.7 percent of participants who maintained their exercise habits until age 60.  Patients should be asked about physical activity in the same way as they are routinely checked for blood pressure, glucose and lipid profiles, obesity and smoking, Nagata said, and intervention programs should be held at schools, colleges, churches, workplaces and community organizations. Black women have high rates of obesity and smoking, and low rates of physical activity, he said, and should be an important group for targeted intervention.  "Nearly half of our participants in young adulthood had suboptimal levels of physical activity, which was significantly associated with the onset of hypertension, indicating that we need to raise the minimum standard for physical activity," Nagata said. "This might be especially the case after high school when opportunities for physical activity diminish as young adults transition to college, the workforce and parenthood, and leisure time is eroded."     Study finds association between periodontal disease and low intake of minerals, vitamins and dietary fiber in young adult women Tokyo Medical and Dental University, April 12, 2021 According to news reporting out of Tokyo, Japan, research stated, “Dietary habits of middle-aged and elderly individuals affected by periodontal disease (PD) differ from those who are unaffected by it, according to previous reports. However, in young adults, there are only a few reports that show a correlation between nutrient/food intake and PD.” Our news journalists obtained a quote from the research from Tokyo Medical and Dental University (TMDU), “Moreover, no report till date has assessed the correlation between dietary habits and PD using a self-administered diet history questionnaire (DHQ). Therefore, we assessed this correlation using a DHQ in young adult women who are likely to develop PD. The participants were enrolled from 2 universities and included 120 female college students a mean age of 20.4 y. The participants were assessed for the presence of PD according to the community periodontal index and were divided into two groups, the PD group and the non-PD group. Their dietary habits were investigated using a DHQ and the level of difficulty in chewing food was assessed. The PD group had a significantly lower nutrient intake of minerals, fat-soluble vitamins, water-soluble vitamins, and dietary fiber than the non-PD group. In terms of food groups, the PD group consumed significantly lesser amounts of green and yellow vegetables (GYV) than the non-PD group. Multivariate analysis revealed that the PD group had significantly lower intakes of vitamin E and GYV than the non-PD group. The PD group consumed significantly lesser amounts of hard foods than the non-PD group.” According to the news editors, the research concluded: “Young adult women who were evaluated for PD by a screening test had a significantly lower nutrient/food intake than those without a PD.” This research has been peer-reviewed.       Just 2 days of increased sugar intake can harm your gut health, warn researchers University of Alberta, April 16, 2021 Researchers from the University of Alberta in Canada found that short-term increases in sugar intake can increase the risk of inflammatory bowel disease. Their finding, which was published in Scientific Reports, is a reminder that eating healthy must be sustained in order to keep your gut in good shape. “Surprisingly, our study shows that short-term sugar consumption can really have a detrimental impact, and so this idea that it’s OK to eat well all week and indulge in junk food on the weekend is flawed,” said Karen Madsen, one of the study researchers. Increased sugar intake is bad for the gut Previous studies have shown that diets can affect your susceptibility to disease. Western diets, for example, have been implicated in the development of inflammatory bowel disease. But it’s still unclear when a poor diet begins to take a toll on your health, much less how it does so. To investigate, the researchers placed adult mice on a chow diet or a high-sugar diet and treated them with dextran sodium sulfate to induce ulcerative colitis, one of the major forms of inflammatory bowel disease. Disease severity was assessed daily. After two days, the mice on the high-sugar diet were at great risk of developing colitis. Their immune response also weakened while their gut permeability increased, allowing more bacteria and toxins to enter their bloodstream. “We wanted to know how long it takes before a change in diet translates into an impact on health. In the case of sugar and colitis, it only took two days, which was really surprising to us. We didn’t think it would happen so quickly,” said Madsen. The researchers attributed these effects to sugar’s impact on the gut bacteria. Eating sugary foods decreases the amount of “good” gut bacteria that produce short-chain fatty acids, which are critical for a strong immune response. Meanwhile, sugar feeds “bad” bacteria that promote inflammation and weaken your immunity.  Fortunately, the researchers found that supplementing with short-chain fatty acids helped reduce the negative effects of a high-sugar diet. Having these supplements as an option will be great for people struggling to change their bad eating habits. “People want to eat what they want to eat, so short-chain fatty acids could possibly be used as supplements to help protect people against the detrimental effects of sugar on inflammatory bowel disease,” said Madsen.     Rose water is an antimicrobial and anti-inflammatory remedy for skin infections Teikyo University (Japan), April 15, 2021 Rosa damascena, commonly known as Damask rose, is one of the most important and medicinally useful members of the Rosaceae (rose) family. It is an ornamental plant widely used to make perfumes and is reported to have plenty of beneficial properties. According to multiple studies, Damask rose has anti-HIV, antibacterial, antioxidant, antitussive, hypnotic and antidiabetic properties. It has also shown relaxant effects on the tracheal chains of guinea pigs. In a recent study, researchers at Teikyo University in Japan investigated two biological properties of Damask rose, specifically it’s antimicrobial and anti-inflammatory properties. They tested rose water made from high-quality Damask rose petals on two microbial pathogens, namely, Candida albicans and methicillin-resistant Staphylococcus aureus (MRSA), which commonly cause skin infections. The researchers reported their findings in an article published in Biological and Pharmaceutical Bulletin. Damask rose water is a natural antibiotic and anti-inflammatory agent Damask rose is a multipurpose plant widely known for its culinary and medicinal applications, among other things. Edible parts of Damask rose are used in various cuisines, including its young shoots, petals, fruits, leaves and seeds. Damask rose petals are used to make jams and add flavor to beverages, baked goods and desserts. They are also used for cooking dishes. Rosewater, which can be sweetened to produce rose syrup, is a byproduct of rose oil production. It is usually obtained by steam distilling Damask rose petals and taking the hydrosol portion of the rose petal distillate.  In different parts of the world, rose water, rose oil and a decoction made of Damask rose roots are used in traditional medicine for the treatment of various ailments, such as abdominal and chest pain, digestive problems and inflammation, especially of the neck. In North America, Indian tribes use the decoction as a cough remedy for children. Rose oil is used to treat depression and reduce stress and tension. Inhaling the vapor produced by heating rose oil is also believed to be an effective remedy for allergies, headaches and migraine. Damask rose water, on the other hand, is traditionally used to treat skin conditions, such as erythema (skin redness), itchiness and swelling. To evaluate its antimicrobial and anti-inflammatory properties, the researchers tested Damask rose water against C. albicans and MRSA and assessed its effects on the function of neutrophils, which are white blood cells that serve as key regulators of inflammatory reactions. The researchers reported that Damask rose water (2.2. percent solution) inhibited the mycelial growth of C. albicans and reduced the viability of MRSA within an hour of treatment. Damask rose water (five to 15 percent) also suppressed the activation of neutrophils induced by treatment with lipopolysaccharide (LPS), a bacterial toxin; tumor necrosis factor-alpha (TNF-a), a cell-signaling protein produced by immune cells; and N-formyl-Met-Leu-Phe (fMLP), a macrophage activator. Additionally, Damask rose water reduced LPS- and TNF-a-induced cell surface expression of the adhesion-related molecule, cluster of differentiation 11b (CD11b), which is rapidly elevated by the activation of neutrophils. The amount of CD11b in neutrophils is said to correlate with their activation and inflammation. However, Damask rose water did not affect the migratory capacity of neutrophils (with or without a chemoattractant). Based on these findings, the researchers concluded that Damask rose water can reduce the pathogenicity of microbes and attenuate neutrophil stimulation, thus inhibiting skin inflammation caused by microbial infections.     Study shows how chronic stress may inhibit the body's cancer-fighting ability University of Western Ontario, April 15, 2021 New research from Western University has shown how psychological stress hinders the immune system's defenses against cancer. By investigating the effects of chronic stresson the immune system's "emergency responders," researchers at the Schulich School of Medicine & Dentistry found that a stress-induced hormone impairs the ability of these immune cells to carry out their cancer-fighting function. Led by Mansour Haeryfar, Ph.D., the research looked specifically at innate-like T cells, which when functioning properly enable the immune system to look for potentially cancerous cells in the body and destroy them. The study was published today in Cell Reports. Innate-like T cells include invariant natural killer T (iNKT) and mucosa-associated invariant T (MAIT) cells, which were the subjects of this investigation. iNKT cells are present in small numbers in many tissues but are especially enriched in the human omentum, an apron-like layer of fatty tissue. MAIT cells are present in relatively high numbers in the human peripheral blood, gut, lungs and liver among other organs. "These innate-like T cells are our immune system's emergency responders," said Haeryfar. "They react quickly to pathogens and cancer cells and are in a pre-activated mode, so they are like loaded guns, ready to respond." Previous studies have shown that when a person experiences chronic psychological and emotional stress, the body's immune system is suppressed, dampening its ability to fight cancer and opportunistic infections. This happens in large part because stress hormones kill off some of the body's immune cells. However, Haeryfar and his team showed that innate-like T cells actually don't die as a result of chronic stress but their cancer-fighting abilities are drastically impaired by stress-induced hormones called glucocorticoids. This impairment led to a striking increase in cancer metastasis in a mouse model. "We found that innate-like T cells survive when the host is under stress, but their functions are compromised," Haeryfar said. "The cells cannot make enough of their beneficial mediators to help fight cancer, so the metastatic burden is increased because of the stress." The team also looked at the effects of natural and synthetic glucocorticoids on innate-like T cells in human blood and liver tissue, where they are abundant. This was important to providing initial evidence that some of the discoveries made in the mouse models were valid for human cells as well, said Patrick Rudak, Ph.D. Candidate in Haeryfar's lab. One of the important implications of this work is that innate-like T cells are currently being investigated for cancer immunotherapy treatment. This study demonstrates that their therapeutic potential can be dampened by psychological stress, said Haeryfar, and this finding needs to be considered when designing or administering those therapies. Rudak added: "Our study demonstrates that, despite being capable of instigating robust anti-tumor immune responses under normal conditions, innate-like T cells completely fail to protect against tumors during psychological stress." Because the study also uncovered the mechanisms by which stress diminishes T cell function, the researchers hope they can use the information to help design immunotherapies involving these cells that will still be effective in psychologically stressed patients.

Interview with Janice Kiecolt-Glaser, Distinguished University Professor, and Brumbaugh Chair in Brain Research and Teaching, and Director of the Institute for Behavioral Medicine Research at the Ohio State University.  Interview on December 4, 2020. 

Nicotine is shrouded in controversy. Dr. Neil Grunberg has published >180 papers addressing behavioral medicine, stress, and leadership. Dr. Grunberg has received awards from the U.S. Surgeon General, CDC, FDA, American Psychological Association, NIH, Society of Behavioral Medicine, and USU. He has served as President of the USU Faculty Senate and has chaired many USU committees. In this fascinating conversation, Dr. Grunberg and I chat about the neurobiology of addiction, the potential for nicotine in pharmaceutical drugs, what nicotine does to your brain, and Dr. Grunberg's thoughts on the growing psychedelics movement.Who is Dr. Neil Grunberg? Neil E. Grunberg, Ph.D., is Professor of Military & Emergency Medicine (MEM), Medical & Clinical Psychology (MPS), and Neuroscience (NES) in the Uniformed Services University (USU) School of Medicine (SOM); Professor in the Graduate School of Nursing (GSN); Director of Research and Development in the USU Leadership Education and Development (LEAD) program; and Director of Faculty Development for MEM. He is a medical and social psychologist who has been on faculty at USU since 1979. His role in LEAD is to ensure that the LEAD program and sessions are based upon sound evidence and scholarship and to oversee original research relevant to leadership education and training.Dr. Grunberg earned baccalaureate degrees in Medical Microbiology and Psychology from Stanford University (1975); earned M.A. (1977), M.Phil. (1979), and Ph.D. (1980) degrees in Physiological and Social Psychology from Columbia University; and received doctoral training in Pharmacology at Columbia University’s College of Physicians & Surgeons under a National Research Service Award (NRSA, 1976-79). Dr. Grunberg helps train physicians, psychologists, and nurses to serve in the Armed Forces or Public Health Service, and scientists for research positions. He has published >180 papers addressing behavioral medicine, stress, and leadership. Dr. Grunberg has received awards from the U.S. Surgeon General, CDC, FDA, American Psychological Association, NIH, Society of Behavioral Medicine, and USU. He has served as President of the USU Faculty Senate and has chaired many USU committees.Dr. Grunberg is a fellow of the American Psychological Association, Academy of Behavioral Medicine Research, and Society for Behavioral Medicine. He is a founding member of the Society for Research on Nicotine and Tobacco, and a member of the Association for Psychological Science, the Society for Neuroscience, Sigma Xi, and the Academy of Medicine of Washington, D.C. He has been an editor for Addiction, Annals of Behavioral Medicine, Nicotine and Tobacco Research, and US Surgeon Generals' Reports. He serves as a scientific consultant to the Maryland Tobacco Prevention and Cessation Resource Center, the Maryland Smoking Cessation Quitline (MD Quit), and the Maryland State Mental Health and Substance Abuse treatment programs. He is a member of the Society of Behavioral Medicine's Wisdom Council, the editorial board of Pharmacology Biochemistry and Behavior, and a contributing reviewer to F1000 (an electronic biomedical research journal source).Highlights[5:01] What was Dr. Grunberg's first interest to study?[9:00] Nicotine dosing and addiction[16:50] Neurobiology of addiction[22:48] The effect of different delivery mechanisms[35:45] Are there benefits to nicotine?[46:07] Are lower doses addictive?[53:41] Who should avoid nicotine?[1:02:20] What does Dr. Grunberg think of the resurgence of psychedelics?ResourcesStanley Schachter1988 Nicotine reportNicotine Dependence by Dr. Rachel TyndaleYerkes Dodson functionZen in the Art of ArcherySponsorsBiOptimizers If you’re over 35, your enzyme levels have already begun to decline and your immune system can be more susceptible to viruses.Enzymes are the workhorses of digestion. They break your food down into usable macro and micronutrients. Research shows that by the time someone hits 65, their saliva and pancreatic secretions, both of which are involved in enzyme activity—can have declined by as much as 50%! This decline creates chronic indigestion, setting the stage for gut issues, yeast and mold overgrowth, even malnutrition. This is why I’m a big fan of enzyme and probiotic supplementation and one of the best companies I’ve ever found that specializes in optimizing your digestion through both of these supplements are my friends at BiOptimizers.During the entire month of November, BiOptimizers are running a sale over the entire month of November offering free shipping and up to 40% off on select products.They're even giving away free bottles of MassZymes with select ordersHead on over to www.bioptimizers.com/boomer and use coupon code BOOMER to get all those deals.Vielight Vielight combines science and engineering ingenuity to develop unique devices that deliver photons to the brain and inner systems. Their mission is to create photobiomodulation devices that are safe and effective – to help improve one’s quality of life. The Neuro Alpha is a staple in my stress resilience and sleep improvement routine. I get better sleep, better focus, and less anxiety around public speaking. And… increased ability to drop into flow.Go to vielight.com and use the coupon code BOOMER to get 10% off on your purchase.Continue Your High Performance Journey with Dr. Neil GrunbergPublicationsLinkedInDisclaimer This information is being provided to you for educational and informational purposes only. This is being provided as a self-help tool to help you understand your genetics, biodata and other information to enhance your performance. It is not medical or psychological advice. Virtuosity LLC, or Decoding Superhuman, is not a doctor. Virtuosity LLC is not treating, preventing, healing, or diagnosing disease. This information is to be used at your own risk based on your own judgment. For the full Disclaimer, please go to (Decodingsuperhuman.com/disclaimer). See acast.com/privacy for privacy and opt-out information.

Have you always felt that you could make of your life pretty much what you want to make of it? Once I make up your mind to do something, do you stay with it until the job is completely done? And when things don’t go the way you want them to, do you just work harder? And one last question – are your poor, or working class, or live in a highly segregated area? If you strongly agree with the first questions, and answer yes to the last one, your coping is likely putting you at greater risk for a raft of health problems. That’s a key finding of Duke University epidemiologist Sherman James, who describes what he terms ‘John Henryism’ in this Social Science Bites podcast. The health effects, which James has studied since the 1980s, have come into sharper focus as the Coronavirus pandemic exacts a disproportionate toll on communities of color in the United States. Based on the John Henryism hypothesis, James tells interviewer David Edmonds, members of those communities are likely to develop the co-morbidities which help make COVID more deadly. And since many of them have to physically go to work, John Henryism helps “elucidate what some of these upstream drivers are.” James defines John Henryism as “strong personality disposition to engage in high-effort coping with social and economic adversity. For racial and ethnic minorities … who live in wealthy, predominantly white countries – say, the United States – that adversity might include recurring interpersonal or systemic racial discrimination.” It can be identified by using James’ John Henryism Active Coping Scale, (JHAC12, pronounced ‘jack’), which asks 12 questions with responses from ‘strongly agree’ to ‘strongly disagree’ on a 5-point Likert scale. High-effort coping, over years, results in excessive “wear and tear” on the body, damaging such things as the cardiovascular system, the immune system, and the metabolic system. Focusing on the cardiovascular system, James notes that this “enormous outpouring of energy and release of stress hormones” damages the blood vessels and the heart. James notes that the damage doesn’t occur solely because someone is a Type A personality – it’s the interaction with poverty or segregation that turns someone from a striver to a Sisyphus (with the attendant negative effects on their cardiovascular health). In fact, James says, research finds that having resources and a John Henry-esque personality does not lead to an earlier onset of cardiovascular disease. The eponymous John Henry is a figure from American folklore. The ‘real’ John Henry probably was a manual worker, perhaps an emancipated slave in the American South, James explains. His legendary doppelganger was a railroad worker, “renowned throughout the South for his amazing physical strength,” especially when drilling holes into solid rock so that dynamite could be used. A boss challenged John Henry to compete against a mechanical steam drill. It was, says James, “an epic battle of man – John Henry – against the machine. John Henry actually beat the machine, but he died from complete mental and physical exhaustion following is victory.” A folk song memorializes the battle. As one version (there are many, but all telling the same story) recounts: John Henry he hammered in the mountains His hammer was striking fire But he worked so hard, it broke his heart John Henry laid down his hammer and died, Lord, Lord John Henry laid down his hammer and died That narrative – dying from the stresses of being driven to perfection but in a dire environment – the Jim Crow South – gave its name to James’ hypothesis. James himself grew up in small town in the rural American South, beginning his higher education in the early 1960s at the historically Black Talladega College near Birmingham, Alabama. Birmingham was the heart of the civil rights struggle in the Civil Rights era, and James was an activist, too. He decided then that “whatever I did would have to have some bearing on social justice, on working to make America a more just society in racial and social class terms.” He trained as a social psychologist with a special emphasis on personality, earning his Ph.D. Washington University in St. Louis in 1973, and focused his career on identifying social conditions that drive health inequalities. His own studies conducted amid the farmers, truckers and laborers of eastern North Carolina provided early, and strong, confirmation for John Henryism. While John Henryism seems focused on African-American men, other research – in Finland, on African-American women, and more – bears out John Henryism’s premise in the global population. In the podcast, James discusses a real John Henry – John Henry Martin – he met while doing research, and offers some societal prescriptions that would allow African Americans and others to “pursue their aspirations in ways that do not accelerate their risk for cardiovascular disease, morbidity and mortality” James is the Susan B. King Distinguished Professor Emeritus of Public Policy and a professor emeritus in the Sanford School of Public Policy at Duke, where he is also a core member of the Center for Biobehavioral Health Disparities Research. He was elected to the National Academy of Medicine of the National Academy of Sciences in 2000. James was president of the Society for Epidemiologic Research in 2007-08. He received the Abraham Lilienfeld Award from the Epidemiology section of the American Public Health Association for career excellence in teaching epidemiology in 2001, and in 2016 received the Wade Hampton Frost Award for outstanding contributions to epidemiology from the same section. He is a fellow of the American Epidemiological Society, the American College of Epidemiology, the American Heart Association, and the Academy of Behavioral Medicine Research. In 2016, he was inducted into the American Academy of Political and Social Sciences as the Mahatma Gandhi Fellow, and in 2018 was a fellow of the Center for Advanced Study of Behavioral Science.

We chat with Dr. Meghan Herron, veterinary behaviorist and Senior Director of Behavioral Medicine Research, Education, and Outreach at Gigi’s. […]

With each new year comes a wave of good intentions as people aim to be better. They want to lose weight, exercise more, be nicer, drink less and smoke not at all. They want to change behavior, and as Susan Michie knows well, “behavior is related to absolutely everything in life.” Michie is a clinical and health psychologist who leads the Centre for Behaviour Change at University College London. She specializes in behavior related to health – for behavior or health practitioners, patients and population as a whole – and in looking at how behavior impacts the natural environment. And while you might think that the essentials of human behavior are pretty similar, one of the things Michie quickly tells interviewer Dave Edmonds in this Social Science Bites podcast is that it can be unwise to jump to conclusions when studying behavior (or trying to change it). She notes, for example, that lots of behavioral research is done in North America, where there’s relatively abundant funding for studies, “but the biggest need [for research] is often where there’s the least investment. There’s no point in developing an intervention based on research evidence conducted in parts of the world that are very far away from the type of context we want to implement the findings in – only to find out it’s not going to work.” So yes, she says, do look at both the rigour of the research, but also base any potential application of the findings on deep understanding of local conditions and using local knowledge. Michie and her team describe this using a model, COM B, to account for the ‘capability, ‘opportunity’ and ‘motivation’ necessary to change behavior. Changing behaviors is important – “In order to solve any of these big social challenges we need people at different positions in society to change their behavior” -- so these considerations matter. But that begs the questions of what behaviors need changing – and who decides what those selected behaviors are.. “There’s a big issue about who decides what the key issues are,” Michie says. “But I think there are certain problems which are very self-evident – there are people dying unnecessarily as a result of smoking, obesity but also environmental conditions – poor housing, etc. There are areas where the social consensus is that things needs to change, and I’d say those are the ones we start with.” In the interview, Michie also addresses the ethics of behavior change and how algorithms and machine learning will be “absolutely vital” to parse through all the relevant data . Her own Human Behaviour Change Project is a collaboration between behavioral scientists and computer scientists combing the global literature to see what works, with an initial focus on smoking cessation. A comprehensive tobacco control strategy, she details, involves those infamous “nudges” beloved of policy makers, but also the legislation, services and taxation, that need to work synergistically to effect real change. Michie had a long career as a research fellow and clinician before joining the Psychology Department of University College London in 2002. She’s a fellow of the Academy of Medical Sciences, the Academy of Social Sciences, the Academy of Behavioral Medicine Research, the Society of Behavioral Medicine, the European Health Psychology Society, the British Psychological Society and a Distinguished International Affiliate of the American Psychological Association. 

Dr. Richard Sherman is the chair of the Department of Psychophysiology College of Integrative Medicine & Health Sciences at Saybrook University in Oakland, California. In addition, he is the director of the Behavioral Medicine Research and Training Foundation in Port Angeles, Washington. Dr. Sherman is best known for his research on identifying the physiological mechanisms causing phantom pain and treatment of migraine headaches with pulsing electromagnetic fields. He has over 150 publications, with at least 46 articles in peer reviewed journals.On episode 19 of the Roscoe's Wetsuit Podcast, Dr. Sherman and I discuss utilizing biofeedback techniques, modifying heart rate, muscle tension, and brain waves to treat conditions ranging from headaches to peak athletic performance. We discuss the future of applying psychophysiology research into real-world applications.

Summary Brian Mayer talks about how verbal conflict when it gets out of hand has been correlated to physical ailments and other medical conditions.  As a child, we were told that sticks and stones may break your bones but words can never hurt.  New scientific research says that words can actually hurt just like sticks and stones.  Today we will talk about this important issue.  We hope you enjoy today's episode.  For more information and additional resources please visit our website at http://www.theremarriedlife.com Today's Goodies In relationships and marriages we spend a lot of time working on getting the communication and the connection between two people just right.  This is a good thing for lots of reasons.  It is good to connect on an emotional level.  It is good for the kids, good for families, good for your ability to balance work, friends, and families.  However, did you know that relationships that are happy can also have a positive impact on your health.  This is the piece that most people don't know, but new scientific research has shown a correlation between an unhappy relationship and your physical health.  A study from Ohio State University's Institute for Behavioral Medicine Research worked with 42 couples.  They made some tiny suction wounds on on their hands.  Then the couples were asked to talk about a tense subject.  The researchers also paid attention to the way in which they argued and how long it took for the couple to bounce back. The results of this study were somewhat astounding.  They discovered that couples whose disagreements were marked with lots of criticisms, put downs, interrupting had wounds that healed 40% slower than those couples whose disagreements still had lots of listening, respect, humor, and the ability to move on.  This study and others like it also showed that for women the results are even more tough.  Women according to study are biologically have a different reaction to hostility for a couple of reasons: Women tend to evaluate negativity accurately while men are somewhat oblivious. Men forget exchanges rather quickly while women can replay them over and over again.  The same researchers at Ohio State also did another study of newlywed couples and looked at stress hormone release after an argument or disagreement.  In this study they found that, the stress hormones like cortisol and other remained elevated.  For women, the levels remained elevated much longer.  Other studies, especially one from the University of Utah also took a closer look at women and what is known as metabolic syndrome and the issues surrounding that as it relates to happy and unhappy relationships.  According to the Mayo clinic, Metabolic syndrome is a cluster of conditions, increased blood pressure, high blood sugar, excess body fat especially around the waist, high cholesterol and triglyceride levels.  All of these factors contribute to the risk of heart disease, diabetes, and stroke.  So back to the study – men and women were both assessed for what they saw as positive and also what they saw as negative in their marriage.  Interestingly enough, a higher percentage of women that had depression about their marriage were more likely to have metabolic syndrome than men.  Again suggesting that while marital strain is tough for each gender, that it is tougher on women.  So what does all this mean?  To put it bluntly, you will suffer health consequences and even have the potential to die an early death if relationship problems are not corrected.  Did you know that the secret to living longer may be held in your social life.  According to a Ted Talk by Susan Pinker which is linked in the Resources section, she cited an interesting study that pointed this out.  The tiny Italian island of Sardinia has six times as many centenarians (100+ year olds) as does the mainland and ten times as many as North America It was discovered that two of the keys to long life there centered around being social integrated and also close relationships.  Believe it or not, things like not smoking, not drinking, exercising were found to not have as strong a link as these social and relationship components.  What can you do to fight against these issues? First recognize the cycles of arguments that you get into with each other.  Notice the ways in which you each react and respond.  There is no doubt a pattern that you will see emerge in how you escalate. Secondly, work to know what your triggers are.  Maybe things don't go well between the two of you when you have already been chewed out at work or if one of the kids is sick.  You may react to something different when you are under other stress.  Instead of reacting, make it known in a respectful calm way that you are stressed and that another time to discuss would be helpful.  Ask your partner for what you need.  If that is to be talked to more gently or to be heard a bit more then ask for that.  Talking about how you argue when you are calm can go much better typically.  It is not full proof but can help.  Just remember, your constant escalation of arguments that cause bitterness and resentment are also affecting your body.  Also remember the way in which you speak to partner also has been shown to correlate with their physical health.  Think about this the next time you discussion starts to get off the rails.    Resources The High Price of a Bad Relationship Bad Marriages Harder on Women's Health The Secret To Living Longer by Susan Pinker – Ted Talk Video Thanks For Listening! With so many things that take time in our lives, I more grateful than you know that you took time to listen to this podcast episode.  If you liked this episode and believe that it would be beneficial to a friend, family member, or colleague, please share it using the social media buttons on this page. The Remarried Life Facebook Group is a community of people just like you who get and give support.  Please join today!  ​ As always remember that marriage is nothing something you have, it is something you do.  Talk to you next week unless you are binge listening in the future in which case I will talk to you in about a minute!  Take care.    

Gary E. Schwartz, Ph.D., is Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of the Laboratory for Advances in Consciousness and Health. He is also co-founder and President of the new Academy for the Advancement of Postmaterialist Sciences. He received his Ph.D. in psychology from Harvard University in 1971 and was an assistant professor at Harvard for five years. He later served as a Professor of Psychology and Psychiatry at Yale University, Director of the Yale Psychophysiology Center, and Co-Director of the Yale Behavioral Medicine Clinic, before moving to Arizona in 1988. He has published more than four hundred and fifty scientific papers, including six papers in the journal Science. He has co-edited 11 academic books. His science books for the general public include The Afterlife Experiments (2002), The Energy Healing Experiments (2007, a Nautilus Book Award Gold Winner in 2008), The Sacred Promise (2011), An Atheist in Heaven (2016), and Super Synchronicity (2017). In 2012 he won the Distinguished Contribution to the Science of Psychology award from the Arizona Psychological Association for his research in energy psychology and spiritual psychology. Gary is a Fellow of the American Psychological Association, the American Psychological Society, the Society for Behavioral Medicine, and the Academy for Behavioral Medicine Research.

Gary E. Schwartz, Ph.D., is Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of the Laboratory for Advances in Consciousness and Health. He is also co-founder and President of the new Academy for the Advancement of Postmaterialist Sciences. He received his Ph.D. in psychology from Harvard University in 1971 and was an assistant professor at Harvard for five years. He later served as a Professor of Psychology and Psychiatry at Yale University, Director of the Yale Psychophysiology Center, and Co-Director of the Yale Behavioral Medicine Clinic, before moving to Arizona in 1988. He has published more than four hundred and fifty scientific papers, including six papers in the journal Science. He has co-edited 11 academic books. His science books for the general public include The Afterlife Experiments (2002), The Energy Healing Experiments (2007, a Nautilus Book Award Gold Winner in 2008), The Sacred Promise (2011), An Atheist in Heaven (2016), and Super Synchronicity (2017). In 2012 he won the Distinguished Contribution to the Science of Psychology award from the Arizona Psychological Association for his research in energy psychology and spiritual psychology. Gary is a Fellow of the American Psychological Association, the American Psychological Society, the Society for Behavioral Medicine, and the Academy for Behavioral Medicine Research.

Gary E. Schwartz, Ph.D., is Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of the Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. He received his Ph.D. in psychology from Harvard University in 1971 and was an assistant professor at Harvard for five years. He later served as a Professor of Psychology and Psychiatry at Yale University, Director of the Yale Psychophysiology Center, and Co-Director of the Yale Behavioral Medicine Clinic, before moving to Arizona in 1988. He has published more than four hundred and fifty scientific papers, including six papers in the journal Science. He has co-edited 11 academic books. His science books for the general public include The Afterlife Experiments (2002), The Energy Healing Experiments (2007, a Nautilus Book Award Gold Winner in 2008), The Sacred Promise (2011), An Atheist in Heaven (2016), and Super Synchronicity (2017). In 2012 he won the Distinguished Contribution to the Science of Psychology award from the Arizona Psychological Association for his research in energy psychology and spiritual psychology. Gary is a Fellow of the American Psychological Association, the American Psychological Society, the Society for Behavioral Medicine, and the Academy for Behavioral Medicine Research.

Gary E. Schwartz, Ph.D., is Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of the Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. He received his Ph.D. in psychology from Harvard University in 1971 and was an assistant professor at Harvard for five years. He later served as a Professor of Psychology and Psychiatry at Yale University, Director of the Yale Psychophysiology Center, and Co-Director of the Yale Behavioral Medicine Clinic, before moving to Arizona in 1988. He has published more than four hundred and fifty scientific papers, including six papers in the journal Science. He has co-edited 11 academic books. His science books for the general public include The Afterlife Experiments (2002), The Energy Healing Experiments (2007, a Nautilus Book Award Gold Winner in 2008), The Sacred Promise (2011), An Atheist in Heaven (2016), and Super Synchronicity (2017). In 2012 he won the Distinguished Contribution to the Science of Psychology award from the Arizona Psychological Association for his research in energy psychology and spiritual psychology. Gary is a Fellow of the American Psychological Association, the American Psychological Society, the Society for Behavioral Medicine, and the Academy for Behavioral Medicine Research.

Gary E. Schwartz, Ph.D., is Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of the Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. He received his Ph.D. in psychology from Harvard University in 1971 and was an assistant professor at Harvard for five years. He later served as a Professor of Psychology and Psychiatry at Yale University, Director of the Yale Psychophysiology Center, and Co-Director of the Yale Behavioral Medicine Clinic, before moving to Arizona in 1988. He has published more than four hundred and fifty scientific papers, including six papers in the journal Science. He has co-edited 11 academic books. His science books for the general public include The Afterlife Experiments (2002), The Energy Healing Experiments (2007, a Nautilus Book Award Gold Winner in 2008), The Sacred Promise (2011), An Atheist in Heaven (2016), and Super Synchronicity (2017). In 2012 he won the Distinguished Contribution to the Science of Psychology award from the Arizona Psychological Association for his research in energy psychology and spiritual psychology. Gary is a Fellow of the American Psychological Association, the American Psychological Society, the Society for Behavioral Medicine, and the Academy for Behavioral Medicine Research.

Gary E. Schwartz, Ph.D., is Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of the Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. He received his Ph.D. in psychology from Harvard University in 1971 and was an assistant professor at Harvard for five years. He later served as a Professor of Psychology and Psychiatry at Yale University, Director of the Yale Psychophysiology Center, and Co-Director of the Yale Behavioral Medicine Clinic, before moving to Arizona in 1988. He has published more than four hundred and fifty scientific papers, including six papers in the journal Science. He has co-edited 11 academic books. His science books for the general public include The Afterlife Experiments (2002), The Energy Healing Experiments (2007, a Nautilus Book Award Gold Winner in 2008), The Sacred Promise (2011), An Atheist in Heaven (2016), and Super Synchronicity (2017). In 2012 he won the Distinguished Contribution to the Science of Psychology award from the Arizona Psychological Association for his research in energy psychology and spiritual psychology. Gary is a Fellow of the American Psychological Association, the American Psychological Society, the Society for Behavioral Medicine, and the Academy for Behavioral Medicine Research.

Dr. Jon Godbout is an Associate Professor in the Department of Neuroscience at The Ohio State University Wexner Medical Center as well as a faculty member of the Institute for Behavioral Medicine Research and the Center for Brain and Spinal Cord Repair. He received his PhD in Population Biochemistry from the University of Illinois at Urbana and completed a postdoctoral fellowship there afterwards before joining the faculty ranks at OSU. Jon is joining us today to tell us about his journey through life and science.

12pm PST --- One on One with Michele ----MICHELE MEICHE shares her weekly 2012 & beyond update, answers your questions, and does channeled readings--- 12:45pm PST --- Welcome our Awakened Guest: Dr. Gary Schwartz Gary E. Schwartz, Ph.D, is a Professor of Psychology, Medicine, Neurology, Psychiatry, and Surgery at the University of Arizona and Director of its Laboratory for Advances in Consciousness and Health. He is also Corporate Director of Development of Energy Healing at Canyon Ranch. Gary received his PhD from Harvard in 1971, was an Assistant Professor at Harvard, and was a Professor of Psychology and Psychiatry at Yale University and director of the Yale Psychophysiology Center before moving to the University of Arizona in 1988. He is a Fellow of the American Psychological Association, the American Psychological Society, the Society of Behavioral Medicine, and the Academy of Behavioral Medicine Research. He has published more than 450 scientific papers, including six papers in the journal Science, co-edited 11 academic books, and is the author of The Energy Healing Experiments (2007), The G.O.D. Experiments (2006), The Afterlife Experiments (2002), The Truth about Medium (2005), and The Living Energy Universe (1999). His research integrates mind-body medicine, energy medicine, and spiritual medicine. His new book The Sacred Promise: How Science is Discovering Spirit's Collaboration with Us in Our Daily Lives will be published in January 2011. He has appeared on hundreds of television and radio shows, including HBO, Discovery, Arts & Entertainment, Fox, NPR, and Coast to Coast AM. Currently he is promoting his newest book "The Sacred Promise: How Science is Discovering Spirits Collaboration with Us In Our Daily Lives" by Dr. Gary Schwartz. Further connect through his websites http://www.drgaryschwartz.com/ http://www.sacredpromiseuniverse.com/