Podcasts about clinical endocrinology metabolism

It's In the News.. a look at the top headlines and stories in the diabetes community. This week's top stories: the FDA has a warning about smart phones and medical alerts, a few companies turn their attention to patch pumps, a new study looks at costs/benefits of CGM vs Fingerstick during pregnancy, T1D in the Super Bowl.. and more! Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX Big warning from the FDA about medical alerts from smart phones. They're warning that they've received multiple reports of users missing or not hearing important medical alerts from their phones, leading to cases of dangerously low blood sugar and even death. But the FDA warns that certain phone settings, such as pausing notifications, may cause patients to miss critical updates. In other cases, connecting the phone to a new audio source, such as a car stereo, could change the volume of the alerts users are accustomed to hearing. They have some recommendations to help, mostly just confirming alarms are working before you need them.. and I'll link up the full story in the show notes. Reading between the lines here, it seems like the problem here may be the thousands of unregulated apps that make health claims – not just for people with diabetes. So it's a good idea to check the apps you're using and the companies that make them. https://www.seattletimes.com/seattle-news/health/patients-using-diabetes-apps-can-miss-critical-alerts-heres-how-to-make-sure-youre-getting-them/ XX What costs less during pregnancy? CGM or finger sticks? In the real word, a new study says CGM costs less… Okay, first keep in mind that the cost savings here wasn't about the glucose monitoring supplies, it was about a lower rate of neonatal ICU admissions. In a base-case analysis in which researchers assumed all women would use seven finger sticks per day as dictated by the American Diabetes Association's guidelines for diabetes management in pregnancy, CGM had a higher per-person cost than SMBG. However, in a real-world analysis in which women with a CGM used three finger sticks per day and those performing SMBG used five finger sticks daily, CGM was more cost-effective. In the real-world analysis, CGM users had a per-person cost of $2,747 for the CGM, $988 for finger sticks and $9,973 for neonatal ICU admissions. For SMBG, finger sticks cost $1,647 and neonatal ICU admission costs were $12,876. The reduction in neonatal ICU admission rates with CGM use led to a mean cost savings of $2,903 in the real-world analysis. “These findings justify paying for CGM devices in type 1 diabetes pregnancies, even in the U.S., which has an expensive health care system,” Polsky said future research should focus on the cost-effectiveness of automated insulin delivery systems in pregnancy.   “Automated insulin delivery use has been shown to improve glycemic outcomes in type 1 diabetes pregnancies, but it is still unclear if it improves maternal or neonatal health outcomes and if it would be cost-beneficial,” Polsky said. https://www.healio.com/news/endocrinology/20250205/cgm-may-lead-to-lower-health-care-costs-for-pregnant-women-with-type-1-diabetes   XX Couple of interesting comments from Medtronic at the recent JP Morgan Chase conference. The CEO says he company is “mainly a type 1 business, moving into type 2,”  He says stated that their patch pumps program remains dynamic.. Medtronic expects its 800-series pump to come in at around half the size of the latest-generation 780G. The post says the company plans for a pivotal study in 2025. Potential features could include extended reservoirs and extended-wear sets, plus a brand-new Android/iOS app. https://www.drugdeliverybusiness.com/medtronic-next-gen-insulin-pumps-coming/ XX Beta Bionics also says they're working on a tubeless patch that they plan to launch in 2027. The company reported the device has two parts. One reusable component holds the electronics that operate the device and motor. A second disposable part includes an adhesive patch, insulin reservoir, insertion device, and the cannula used to deliver insulin. Beta Bionics said the pump is planned for use in people with type 1 diabetes and later will expand its use for people with type 2. The company also reported it is continuing work on an AID system that would, in addition to using insulin to lower blood sugar, also contain glucagon to raise blood sugar. Research is being conducted into dual-hormone systems, but none are available yet for people with diabetes. https://diatribe.org/diabetes-technology/tech-watch-diabetes-tech-news XX New approval for the treatment of diabetic macular edema. Susvimo is the “first and only FDA-approved treatment shown to maintain vision in people with DME with fewer treatments than standard-of-care eye injections,” the release said. This is the second indication for Susvimo, which is also approved for the treatment of wet age-related macular degeneration. https://www.healio.com/news/ophthalmology/20250204/fda-approves-susvimo-for-diabetic-macular-edema XX How about this one… drinking ketones improves heart health, a new small-scale study from the University of Portsmouth has found. This is the first time people with type 2 diabetes (T2D) have been given a drink with ketone esters - a supplement that is meant to plunge your system into ketosis - to monitor the effect on the heart. Ketosis is the metabolic state where your body is forced to burn fats instead of carbohydrates. but more research is needed because we only assessed participants on the day, which means we have no idea what the chronic impact of drinking ketones would be." The study was carried out after research showed  The drug SGLT2i was used to lower glucose in patients with diabetes and longitudinal studies were showing that it was inadvertently protecting the heart. The hypothesis was that the drug induces ketosis and the heart was using ketones, which improved heart health, but the evidence for this was limited so our research set out to prove the connection." https://www.news-medical.net/news/20250205/Drinking-ketones-improves-heart-health-for-people-with-type-2-diabetes.aspx XX Another pump wants into the EU. Modular Medical looks to obtain a CE mark in the first quarter of 2026. The patch pump, MODD1, got FDA clearance last fall. The company says it will be available early this year.. but I haven't heard much about it since the approval.   https://www.drugdeliverybusiness.com/modular-medical-step-forward-ce-mark/ XX New CGM system with a reusable applicator and rechargeable wearable transmitter moves forward. Trinity Biotech announced new pre-pivotal clinical data. This company is based in Ireland and is looking for iCGM approval down the road.. hoping to file with the FDA in 2026. https://www.drugdeliverybusiness.com/trinity-biotech-expects-submit-cgm-fda-2026/ XX Body-weight cycling (also known as yo-yo dieting) has been shown to significantly increase the risk of kidney disease in people with type 1 diabetes, regardless of body mass index (BMI) and other traditional risk factors. This is a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism. Participants with greater weight fluctuations experienced a 40% decline in kidney health from baseline values https://www.news-medical.net/news/20250204/Yo-yo-dieting-found-to-harm-kidney-health-in-type-1-diabetes-patients.aspx XX Eli Lilly's profit doubled in the fourth quarter, propelled by its hot-selling diabetes and obesity treatments, and the drugmaker came out with a mostly better-than-expected 2025 forecast. Overall, Lilly's quarterly profit swelled to $4.41 billion. https://apnews.com/article/eli-lilly-fourth-quarter-mounjaro-zepbound-ca026922525a9e3abb1b75d329628bef XX Abbott starts a new campaign all about bias and misconceptions when it comes to diabetes. I'm excited that they seem to have worked here with the Behavioral Diabetes Institute. Nearly 70% believe there is stigma associated with their condition.1 Diabetes as a Punchline: 85% of people living with diabetes say they have seen inaccuracies about diabetes in the media, including on TV shows, movies, and social media, and 40% of people felt that diabetes is often used as the punchline of a joke.1 Abbott's new Above the Bias initiative aims to help others see the world from the perspective of someone living with diabetes. The initiative builds upon efforts by several diabetes organizations, patient advocacy groups, and experts that continue to work to reduce stigma about diabetes.3 People can learn more about Above the Bias and watch the film at AboveBias.com. https://www.prnewswire.com/news-releases/abbotts-above-the-bias-film-reveals-misconceptions-can-impact-diabetes-care-302367723.html   -- When you watch the Super Bowl this weekend, watch for Noah Grey. .he's the Kansas City Chiefs tight end who backs up Travis Kelce and he's lived with type 1 since age 18. Grey spoke to media this week about how he loves to interact with kids who have T1D and their shared love of fruit gummies to treat lows. (sound here) Grey has been an ambassador for Tandem Diabetes and has talked about how he unhooks the pump but keeps his Dexcom on for games.   https://www.yahoo.com/news/noah-gray-talks-helping-kids-010013649.html https://www.newsobserver.com/sports/college/acc/duke/article299730324.html   -- I want to take a moment to personally send my love and sympathy to the Gaskins family. These are the folks behind the amazing Macey's Believer's charity. Janice Gaskins passed away this week after a long fight with breast cancer. I've been reading all of the posts on her Facebook page – this is a woman who touched and changed a lot of lives.. so much for the better. May her memory be a blessing. Her life certainly was.

Welcome to Walk, Don't Run to the Doctor, an evidence-based podcast with Miles Hassell MD. In this episode, we tackle osteoarthritis and how lifestyle choices can help prevent or alleviate its effects. Dr. Hassell provides practical advice on reducing pain, improving mobility, and possibly avoiding joint replacement through exercise, weight management, and a Mediterranean-style diet. Whether you're dealing with arthritis or looking to maintain healthy joints for the future, this episode is packed with actionable tips to empower your health journey. Key Takeaways: Movement is Medicine: Regular, varied exercises like water walking, tai chi, and resistance training can reduce stiffness, improve function, and lower surgery risks. Weight Loss Matters: Shedding even a few pounds significantly reduces joint stress and pain. Diet is Key: Avoid refined carbs, prioritize fruits, vegetables, and healthy fats like olive oil, and consider natural sources of calcium and probiotics. Supplements for Joint Health: A three-month trial of glucosamine sulfate, MSM, gelatin/collagen, and niacinamide may provide relief for some. Long-term Benefits: Lifestyle changes can reverse type 2 diabetes, normalize blood pressure, and even reduce cancer risks, underscoring the power of daily habits. References: Katz et al. Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA: Journal of the American Medical Association. 2021 Feb 9;325(6):568–78 Gay, C et al. Educating patients about the benefits of physical activity and exercise for their hip and knee osteoarthritis. Systematic literature review. Annals of Physical and Rehabilitation Medicine 2016. 59(3):174-183 OA prevention. Osteoarthritis Action Alliance. 2021 Jonas WB et al. The effect of niacinamide on osteoarthritis: a pilot study. Inflamm Res 1996. Jul;45(7): p. 330-4 Zaharia OP et al. Reduced muscle strength Is associated with insulin resistance in type 2 diabetes patients with osteoarthritis, The Journal of Clinical Endocrinology & Metabolism 2021. 106 (4), 1062–1073 Jonas WB et al. The effect of niacinamide on osteoarthritis: a pilot study. Inflamm Res 1996. Jul;45(7):330-4 Phytomedicine 10(1):3-7, 2003, cited in IM News 1 Nov 2003:19 Pavelka et al. Efficacy and safety of piascledine 300 versus chondroitin sulfate in a 6 months treatment plus 2 months observation in patients with osteoarthritis of the knee. Clinical rheumatology. 2010 29(6):659–670 Vasquez A. Reducing pain and inflammation naturally -- part 3: Improving overall health while safely and effectively treating musculoskeletal pain. Nutritional Perspectives: Journal of the Council on Nutrition. 2005 Apr; 28(2):34–44   See more about the patient story Dr. Hassell shared: https://goodfoodgreatmedicine.com/news/04_05_23.pdf   In his practice, Dr. Hassell recommends his patients use this osteoarthritis cocktail (daily) as a 3 month trial: Glucosamine 1500mg daily MSM 3000 mg daily Gelatin 1 sachet daily Niacinamide 1000mg daily   So what do I do? Ten tips from the pages of Good Food Great Medicine, 4th edition Consider daily exercise a prescription.  Take 30 minutes or more daily to decrease your waistline, reduce heart disease risk, and improve mood and libido.  Add small doses to your routine like 10 jumping jacks every time you brush your teeth (pp. 27 & 72-73). Eat a wide variety of vegetables (p.37) Eat whole, intact grains (pp. 39-40, 66, & 99) Eat whole fruit (pp. 11, 36-37, & 96) Cook with extra-virgin olive oil (p. 41) Eat oil-rich fish, 2-7 servings per week (pp. 11 & 41-43) Eat raw nuts, seeds, beans, & lentils (pp. 11, 38, 41-42, 103 & 105) Have some cultured dairy (full fat plain yogurt, kefir, etc) daily (pp. 47-49 & 118) Eat modest amounts of unprocessed meat, poultry & eggs (pp. 11, 41-42 & 44-45) Enjoy wine (< 5 ounces daily) (pp. 11 & 58) Minimize or avoid: Sitting (get out of your chair and move your body every hour or so), sugars, sweet drinks, white flour, and processed foods (p. 20).

In this compelling extract from IMMH 2023, Dr. Robert Lustig, a globally recognized  paediatric neuroendocrinologist, delves into the intricate connections between diet, metabolic health and mental health. Dr. Lustig, with a career marked by extensive research and advocacy, shows us how dietary choices profoundly influence brain function and neurochemistry and contribute to various mental health disorders. His pioneering work underscores the critical role of metabolic health for maintaining optimal mental well-being. Dr. Lustig has a stellar academic and clinical career, with a BSc in Nutritional Biochemistry from MIT, an MD from Cornell University Medical College, and an MSL from the University of California, Hastings College of the Law. He is Emeritus Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco (UCSF) and throughout his career has made significant contributions to the understanding of the adverse effects of sugar and processed foods on public health, and has been instrumental in advocating for changes in dietary guidelines and public health policies aimed at combating the global epidemic of chronic metabolic diseases. Dr. Lustig's extensive research portfolio includes over 125 peer-reviewed articles published in renowned journals such as Nature, The Journal of Clinical Endocrinology & Metabolism and The American Journal of Clinical Nutrition. He is also an acclaimed author, with notable books including Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease, The Hacking of the American Mind: The Science Behind the Corporate Takeover of Our Bodies and Brains, and Metabolical: The Lure and Lies of Processed Food, Nutrition, and Modern Medicine. In this episode, learn about: The alarming rise in global metabolic and mental health disorders and their intricate connections Mechanisms by which sugar and fructose function as mitochondrial toxins and cause oxidative stress in neuronal cells, contributing to neurological and psychiatric disorders The therapeutic potential of ketogenic diets in treating neuropsychiatric conditions, including bipolar disorder and schizophrenia The effects of insulin resistance on neuronal energy metabolism and its implications for mental health The impact of gut microbiota and the gut-brain axis on mental health, emphasising dietary interventions to support these systems Evidence-based dietary interventions for improved metabolic and mental health outcomes The role of chronic low-grade inflammation in mood disorders and the influence of dietary factors in modulating inflammatory states We are thrilled that Dr. Lustig is one of our keynote speakers at the IMMH 2024 Conference in Washington DC from 10-13 October, and will be giving two presentations on Technology Addiction in Children and "Amygdala Unchained" Ground Zero for the Syndemic and the Meta-Crisis For more information and to register, visit IMMH. www.immh.org  

Would it surprise you to know that you don't need to lose weight to get out of pain? I frequently get messages that include something along the lines of “I know I need to lose weight but…” which breaks my heart because I believe that life without pain is possible for everyone - no matter what your body looks like or feels like right now. We've been sold this idea that the pain in our joints is directly related to body mass. But time and time again - the research does not find this to be true. You don't need to lose weight to get out of pain. And the idea that some amount of pain is something we have to just “live with” because of our age or body type is nonsense. You'll learn: Why you don't need to lose weight to get out of pain Why focusing on BMI is a waste of time (and missing the point) How there is no definitive scientific link between body mass, weight loss, and pain All the links: The association between chronic pain and obesity. J Pain Res. 2015;8:399-408. Published 2015 Jul 14 Evers Larsson, U. Influence of weight loss on pain, perceived disability and observed functional limitations in obese women. Int J Obes 28, 269–277 (2004). Effect of weight loss on musculoskeletal pain in the morbidly obese. The Journal of Bone and Joint Surgery. British volume 1990 72-B:2, 322-323 Unraveling the Directional Link between Adiposity and Inflammation: A Bidirectional Mendelian Randomization Approach, The Journal of Clinical Endocrinology & Metabolism, Volume 95, Issue 1, 1 January 2010 Join me for the next Movement Mavens Retreat! www.aewellness.com/retreat/ 30 days to more strength + flexibility with the Mobility Mastery Toolkit www.aewellness.com/podcast - Show notes, links and more. Come hang out with me on Instagram @hollaformala : https://instagram.com/hollaformala/ TikTok @ aewellness Bodywork Starter Guide - learn the 6 places you need to roll right now for quick relief, plus the reason why what you've tried so far has only given you a temporary fix. Download the guide for free now at www.aewellness.com/bodywork 818-396-6501 is the Body Nerd Hotline - how do you build consistency and/or where are you getting stuck? Drop me a line and let me know your body nerd hacks - you might just hear your voice on a future episode! Today's episode is brought to you by Mobility Mastery Toolkit. Forget icing and stretching - and get a simple program you can do on your own that actually works. The Toolkit includes 30-days of exercises so you know exactly what to do to improve the mobility of your hips, lower back, feet, neck and shoulders. With video demos and a full-body mobility workout calendar, you're just 15-mins a day from feeling stronger and more flexible. Get $20 off when you use the code MASTERY at www.mobilitytoolkit.co

In this episode, we dive into Relative Energy Deficiency in Sport. You might be missing information when it comes to diagnosing oligomenorrhea, recurrent injuries or illnesses if you're not evaluating your patients for their energy availability. We'll review tools to evaluate your patient for RED-S and you'll learn about energy availability and how even recreational athletes may be at risk for RED-S.  If you want to dig deeper into treatment, you're invited to join Dr. Briana and fellow practitioners in June for the Sports Medicine Update Course. You can learn more here      References Ackerman, K. E., Holtzman, B., Cooper, K. M., Flynn, E. F., Bruinvels, G., Tenforde, A. S., Popp, K. L., Simpkin, A. J. & Parziale, A. L. (2019). Low energy availability surrogates correlate with health and performance consequences of Relative Energy Deficiency in Sport. British Journal of Sports Medicine, 53(10), 628. https://doi.org/10.1136/bjsports-2017-098958 Dave, S. C. & Fisher, M. (2022). Relative energy deficiency in sport (RED – S). Current Problems in Pediatric and Adolescent Health Care, 52(8), 101242. https://doi.org/10.1016/j.cppeds.2022.101242 Dipla, K., Kraemer, R. R., Constantini, N. W. & Hackney, A. C. (2021). Relative energy deficiency in sports (RED-S): elucidation of endocrine changes affecting the health of males and females. Hormones, 20(1), 35–47. https://doi.org/10.1007/s42000-020-00214-w FINN, E. E., TENFORDE, A. S., FREDERICSON, M., GOLDEN, N. H., CARSON, T. L., KARVONEN-GUTIERREZ, C. A. & CARLSON, J. L. (2021). Markers of Low-Iron Status Are Associated with Female Athlete Triad Risk Factors. Medicine & Science in Sports & Exercise, 53(9), 1969–1974. https://doi.org/10.1249/mss.0000000000002660 Gordon, C. M., Ackerman, K. E., Berga, S. L., Kaplan, J. R., Mastorakos, G., Misra, M., Murad, M. H., Santoro, N. F. & Warren, M. P. (2017). Functional Hypothalamic Amenorrhea: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 102(5), 1413–1439. https://doi.org/10.1210/jc.2017-00131 Keay, N. & Francis, G. (2019). Infographic. Energy availability: concept, control and consequences in relative energy deficiency in sport (RED-S). British Journal of Sports Medicine, 53(20), bjsports-2019-100611. https://doi.org/10.1136/bjsports-2019-100611 Koltun, K. J., Williams, N. I., Scheid, J. L. & Souza, M. J. D. (2020). Discriminating hypothalamic oligomenorrhea/amenorrhea from hyperandrogenic oligomenorrhea/amenorrhea in exercising women. Applied Physiology, Nutrition, and Metabolism, 45(7), 707–714. https://doi.org/10.1139/apnm-2019-0640 Logue, D. M., Madigan, S. M., Heinen, M., McDonnell, S.-J., Delahunt, E. & Corish, C. A. (2018a). Screening for risk of low energy availability in athletic and recreationally active females in Ireland. European Journal of Sport Science, 19(1), 1–11. https://doi.org/10.1080/17461391.2018.1526973 Logue, D. M., Madigan, S. M., Heinen, M., McDonnell, S.-J., Delahunt, E. & Corish, C. A. (2018b). Screening for risk of low energy availability in athletic and recreationally active females in Ireland. European Journal of Sport Science, 19(1), 1–11. https://doi.org/10.1080/17461391.2018.1526973 Logue, D. M., Madigan, S. M., Melin, A., Delahunt, E., Heinen, M., Donnell, S.-J. M. & Corish, C. A. (2020). Low Energy Availability in Athletes 2020: An Updated Narrative Review of Prevalence, Risk, Within-Day Energy Balance, Knowledge, and Impact on Sports Performance. Nutrients, 12(3), 835. https://doi.org/10.3390/nu12030835 Loucks, A. B. & Thuma, J. R. (2003). Luteinizing Hormone Pulsatility Is Disrupted at a Threshold of Energy Availability in Regularly Menstruating Women. The Journal of Clinical Endocrinology & Metabolism, 88(1), 297–311. https://doi.org/10.1210/jc.2002-020369 Melin, A., Tornberg, Å. B., Skouby, S., Faber, J., Ritz, C., Sjödin, A. & Sundgot-Borgen, J. (2014a). The LEAF questionnaire: a screening tool for the identification of female athletes at risk for the female athlete triad. British Journal of Sports Medicine, 48(7), 540. https://doi.org/10.1136/bjsports-2013-093240 Melin, A., Tornberg, Å. B., Skouby, S., Faber, J., Ritz, C., Sjödin, A. & Sundgot-Borgen, J. (2014b). The LEAF questionnaire: a screening tool for the identification of female athletes at risk for the female athlete triad. British Journal of Sports Medicine, 48(7), 540. https://doi.org/10.1136/bjsports-2013-093240 Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budgett, R. & Ljungqvist, A. (2014). The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 48(7), 491–497. https://doi.org/10.1136/bjsports-2014-093502 Mountjoy, M., Sundgot-Borgen, J., Burke, L., Carter, S., Constantini, N., Lebrun, C., Meyer, N., Sherman, R., Steffen, K., Budgett, R., Ljungqvist, A. & Ackerman, K. (2015). Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 49(7), 421. https://doi.org/10.1136/bjsports-2014-094559 Mountjoy, M., Sundgot-Borgen, J. K., Burke, L. M., Ackerman, K. E., Blauwet, C., Constantini, N., Lebrun, C., Lundy, B., Melin, A. K., Meyer, N. L., Sherman, R. T., Tenforde, A. S., Torstveit, M. K. & Budgett, R. (2018). IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update. British Journal of Sports Medicine, 52(11), 687. https://doi.org/10.1136/bjsports-2018-099193 Schofield, K. L., Thorpe, H. & Sims, S. T. (2019). Resting metabolic rate prediction equations and the validity to assess energy deficiency in the athlete population. Experimental Physiology, 104(4), 469–475. https://doi.org/10.1113/ep087512 Sim, A. & Burns, S. F. (2021). Review: questionnaires as measures for low energy availability (LEA) and relative energy deficiency in sport (RED-S) in athletes. Journal of Eating Disorders, 9(1), 41. https://doi.org/10.1186/s40337-021-00396-7 Slater, J., McLay-Cooke, R., Brown, R. & Black, K. (2016). Female Recreational Exercisers at Risk for Low Energy Availability. International Journal of Sport Nutrition and Exercise Metabolism, 26(5), 421–427. https://doi.org/10.1123/ijsnem.2015-0245 Souza, M. J. D., Williams, N. I., Nattiv, A., Joy, E., Misra, M., Loucks, A. B., Matheson, G., Olmsted, M. P., Barrack, M., Mallinson, R. J., Gibbs, J. C., Goolsby, M., Nichols, J. F., Drinkwater, B., Sanborn, C. (Barney), Agostini, R., Otis, C. L., Johnson, M. D., Hoch, A. Z., … McComb, J. (2014). Misunderstanding the Female Athlete Triad: Refuting the IOC Consensus Statement on Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine, 48(20), 1461. https://doi.org/10.1136/bjsports-2014-093958

Episode 139: What is PCOS      Future Dr. Salimi explains the pathophysiology, signs, and symptoms of PCOS. Diagnostic criteria and the basics of treatment are also discussed. Dr. Arreaza adds some comments about the treatment of obesity.  Written by Elika Salimi, MS3, Western University of Health Sciences, College of Osteopathic Medicine of the Pacific. Comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Hello there! My name is Elika and I am a third-year medical student at Western University of Health Sciences. Today I will be talking to you about polycystic ovary syndrome AKA PCOS.Do you have a female patient in her reproductive years with irregular menstrual cycles, or no menstrual cycles at all? Is she unable to conceive a child? Did she have an unexpected diagnosis of diabetes? Does she have more acne than she would like, or has hair in unwanted or unexpected areas such as her chin?Does she have a hard time losing weight? If you answered YES to many of these questions, it is possible that your patient is suffering from polycystic ovary syndrome also known as PCOS, which is one of the most common endocrine disorders in women. Pathophysiology:The exact pathophysiology behind this syndrome is unknown; however, per the American College of Obstetricians and Gynecologists committee, some studies have shown a strong association between PCOS and obesity. In a woman with obesity disorder, the excess adipose tissue ends up increasing peripheral estrogen synthesis and as a result, there is a decrease in peripheral sensitivity to insulin which means many of these women tend to have hyperinsulinemia. To be more detailed, it is important to mention that during these anovulatory cycles, the increase in estrogen, which is also unopposed estrogen with a lack of progesterone, can lead to endometrial hyperplasia and consequently increase the risk of endometrial carcinoma.Clinical Features: Unless there is a clear history and physical or if perhaps there was an incidental ultrasound finding of polycystic ovaries, the diagnosis of PCOS is not exactly black-and-white. That is why it is important to increase awareness so that women can put the pieces of the puzzle together and come in to get evaluated. Multiple cysts in ovaries can present in patients without PCOS, and they are common in teenagers. To use the multiple cysts as part of the diagnosis, the patient has to be 2 years after menarche (AAFP). Some of these clinical symptoms typically start during adolescence displaying menstrual irregularities such as she could've had her period and then stopped getting it or she has a very delayed onset of her menstrual cycle. It is also possible to have spotty menstrual cycles also known as breakthrough bleeding or menorrhagia. And very important to many women, she could be infertile or have difficulties conceiving.She could also have diabetes because of insulin resistance that comes with the metabolic syndrome that develops with PCOS, which is also increased if she has obesity. This obesity disorder going hand in hand with the metabolic syndrome, can also increase the risk of having sleep apnea, which could affect the quality of her sleep, finding herself more fatigued than she should be after adequate hours of rest. Other symptoms include skin conditions such as hirsutism which is basically male pattern hair growth in women in areas such as the upper lip, chin, around the umbilicus, back, or even buttocks. She could also have male pattern hair loss on the head or too much acne or oily skin or acanthosis nigricans which are these brown/velvety hyperpigmented streaks on the neck or axilla, or groin. She could also find herself more depressed or anxious.Diagnosis:The diagnostic criteria and treatments are mainly addressed in the Journal of Clinical Endocrinology & Metabolism, an evidence-based guideline for the assessment and management of polycystic ovary syndrome, and the American Family Physician Journal:The diagnosis of PCOS requires the presence of at least two criteria that are not due to any other endocrine disorder such as thyroid disease or hyperprolactinemia, or other. 1) Periods of oligo-ovulation and or anovulation which means she's either having very low ovulatory cycles or she's not ovulating at all. 2) hyperandrogenism and this could be based on her clinical features or laboratory studies showing elevated testosterone levels or LH to FSH ratio and 3) Seeing enlarged and/or polycystic ovaries on a pelvic ultrasound. This means that the pelvic ultrasound shows an ovarian volume of equal to or greater than 10 mL and/or there's multiple cystic follicles that are about 2 to 9 mm in one or both of her ovaries which also usually tend to have a string of pearls appearance.So, if you have 2 out of the 3, you have PCOS. There are ways to confirm that there is in fact hyperandrogenism by doing lab studies and this could mean that her testosterone levels are elevated, or her androstenedione is elevated as well as elevated dehydro-epi-androsterone sulfate (DHEAS) and of course we need to rule out pregnancy and other endocrine disorders as I mentioned earlier. However, if the clinical picture of hyperandrogenism is there then that fulfills the diagnostic criteria for PCOS even if the serum antigen levels are normal. This also applies to an elevated LH:FSH ratio of typically greater than 2 to 1 which is also a characteristic finding of most patients with PCOS but this is not exactly necessary for diagnosis. We also don't need to find cystic follicles in order to diagnose PCOS. Treatment: In family medicine practices and even OB/GYN practice for PCOS the most common recommendation for all patients is to encourage them to increase their physical activity (exercise) and eat healthy and try to consider behavioral modifications to have a target BMI of ideally less than 25 kg/m² because this can reduce estrone production in adipose tissue.Then we are thinking about ways to treat patients who are not planning to conceive versus those that are. For those patients that are not planning to conceive the goal is to regulate their menstrual cycles and irregularities as well as their hyperandrogenism and to treat the comorbidities as well to overall improve their quality of life.The first line treatment for hyperandrogenism to try to regulate menstrual cycle abnormalities is combined oral contraceptives also known as birth control pills. This also reduces endometrial hyperplasia which in turn can decrease the risk of endometrial carcinoma as mentioned earlier and it can reduce menstrual bleeding and you can reduce acne and try to assist with the hirsutism as well. As mentioned earlier, PCOS can also go hand-in-hand with insulin resistance or hyperinsulinemia and therefore we can also use metformin that can improve menstrual irregularities but also address the metabolic side of this as well. Summary: Diet, exercise, combined oral contraceptives, and metformin.Some other more controversial medications to treat hyperandrogenism could be potassium-sparing diuretics such as spironolactone that also inhibits 17-a-hydroxylase or finasteride which is a 5-alpha-reductase inhibitor and flutamide which is an androgen receptor blocker. The mentioned examples are typically for those people that can't really tolerate combined oral contraceptives. Other things to consider for those that are suffering from obesity syndrome are to possibly consider bariatric surgery if of course the criteria are met, and this is on a case-by-case basis. Bariatric surgery may be an answer to many of our metabolic problems that's why it is now called metabolic surgery. For patients who are planning to conceive the goal is to manage their comorbidities such as weight loss but also to try to induce ovulation.Now the first-line therapy for inducing ovulation is a medication called letrozole which is an aromatase inhibitor that in turn reduces estrogen production stimulating FSH secretion and ultimately inducing ovulation, not to get too heavily into the weeds of how these medications work, but basically it improves pregnancy and live birth rate outcomes in patients who are infertile because of the fact that they have anovulatory cycles or a.k.a. they are not ovulating.Then we also have clomiphene which is just an alternative to letrozole and has a different mechanism of action but it also stimulates ovulation by more particularly causing a pulsatile secretion of GnRH and in turn increasing FSH and LH as well, and this medication might be actually preferred over metformin monotherapy in women that are suffering from obesity syndrome who also have anovulatory infertility. However, apparently, clomiphene can cause more chance of multiple gestations versus letrozole.Also, letrozole is preferred over clomiphene to induce ovulation because of a higher rate of live births, but we have the risk of multiple pregnancies with both these methods. Let's talk about the second-line therapies.As mentioned earlier we have this 2 to 1 ratio of FSH to LH in women with PCOS or at least a good amount of them. We said that that is not required to diagnose this disorder but we can also give women exogenous FSH plus human menopausal gonadotropin, but this is really a second-line treatment for ovulation induction and typically we go for second-line treatments if first-line therapies aren't successful. But I will mention that using this exogenous gonadotropin is very expensive and it requires you to have access to specialized healthcare facilities and constant ultrasound monitoring so this may just not be feasible for many people but if you have the resources and it's affordable for you then exogenous gonadotropins are actually preferred over clomiphene and metformin therapy.Metformin can also use as a second-line monotherapy for fertility treatments and this in combination with clomiphene can increase pregnancy rates, especially in women who are suffering from obesity disorder, and of course, this is first-line therapy for insulin resistance.Now if we're talking about an invasive type of procedure for infertility it would be laparoscopic ovarian drilling which basically, we use a laser beam or surgical needle to reduce ovarian tissue to decrease its volume and try to reduce androgen production. Doing this can cause a hormone shift that can induce FSH secretion and ultimately improve ovarian function as well. This is also a second-line treatment for ovulation induction, but it can be performed as a first line if other indications for laparoscopy are present. Third-line therapy would be in vitro fertilization which means that basically we take mature eggs from ovaries and then we fertilize them with sperm in a lab and then the fertilized egg or the embryo is transferred to a uterus to be implanted.For the management of hirsutism, the first-line therapy is usually non-pharmacological and that's electrolysis or light-based hair removal with laser or photo-epilation. For acne, we can consider benzoyl peroxide or topical antibiotics if necessary.Final thoughts: Now I know that was a ton of information but ultimately, we are trying to make women more aware of PCOS and let them know that they are not alone, also we are trying to reduce complications such as cardiovascular problems, diabetes, endometrial cancer, infertility or even pregnancy loss. The best we can do is try to educate more women because many are suffering from this condition and they have no idea. Again, my name is Elika Salimi, and I am a third-year medical student. If you have any questions, you can reach me at elika.salimi@westernu.edu.___________________________Conclusion: Now we conclude episode number 139, “What is PCOS.” Future Dr. Salimi explained that patients with Polycystic Ovary Syndrome present with: Hyperandrogenism, Oligo-ovulation or anovulation, and multiple cysts in ovaries. If your patient meets 2 out of the 3 criteria, then you can confidently give the diagnosis of PCOS. Dr. Arreaza reminded us that by treating obesity you are also treating PCOS. This week we thank Hector Arreaza and Elika Salimi. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology..ACOG Practice Bulletin No. 194: Polycystic Ovary Syndrome..Obstet Gynecol.2018; 131(6): p.e157-e171.doi:10.1097/AOG.0000000000002656Hoeger KM, Dokras A, Piltonen T.Update on PCOS: Consequences, Challenges, and Guiding Treatment.The Journal of Clinical Endocrinology & Metabolism.2020; 106(3): p.e1071-e1083.doi:10.1210/clinem/dgaa839Williams T, Mortada R, Porter S.Diagnosis and Treatment of Polycystic Ovary Syndrome..Am Fam Physician.2016; 94(2): p.106-13.pmid: 27419327.Legro RS, Arslanian SA, Ehrmann DA, et al.Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline.J Clin Endocrinol Metab.2013; 98(12): p.4565-4592.doi:10.1210/jc.2013-2350.International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018.https://www.monash.edu/__data/assets/pdf_file/0004/1412644/PCOS_Evidence-Based-Guidelines_20181009.pdf 

See all the Healthcasts at https://www.biobalancehealth.com/healthcast-blog There is an interesting conflict between the truth and the mainstream medical protocols surrounding statins, that we have noticed in our practice for a decade.  Patients who are placed on statins soon develop weight gain and Type II diabetes, and those patients who already have AODM, become worse, gain weight and need more diabetic medications. I have questioned the brilliance of the FDA letting this side effect through their testing process for years. More importantly, why are statins always prescribed for people who have diabetes, even if their lipids are normal? Finally, here is a recent study that documents this side effect, decades after we noticed this phenomenon. The study is found in The Journal of Clinical Endocrinology & Metabolism, Volume 108, Issue 2, February 2023, Pages 385–396.  The reason for the study: “Statins and possibly other lipid modifiers increase type 2 diabetes risk and body mass index (BMI). However, to what extent BMI mediates the diabetogenic effects of lipid modifiers remain unclear. “ The findings: ‘Genetically mimicked effects of statins and ezetimibe, but not PCSK9 inhibitors were associated with higher risk of type 2 diabetes (odds ratio [OR] 1.74 [95% CI, 1.49 to 2.03]; 1.92 [1.22 to 3.02]; 1.06 [0.87 to 1.29] per SD reduction in low-density lipoprotein (LDL)-cholesterol). Of these lipid modifiers, only genetic mimics of statins were associated with higher BMI (0.33 SD [0.29 to 0.38] per SD reduction in LDL- cholesterol), which explained 54% of the total effect of statins on type 2 diabetes risk.  Statins were considered a miracle drug for people who had had heart disease in the past, which is what statins were made for. To prevent another heart attack or stroke in this particular group.   For some reason, as they were distributed as samples to doctors by pharmaceutical representatives they were pitched as preventive drugs to prevent heart attacks and strokes in normal people with high cholesterol.  Statins became the drug to choose to prevent heart disease in normal people and that is where they hit a snag.   There are many side effects that statins cause as seen in the recent study, and they also have not been tested by the FDA in women, who are the group of people who have the worst side effects and the lowest rate of MI from atherosclerosis.  In addition it was sold as a drug without risk, and I even heard internal medicine doctors telling patients it should be put in the drinking water….a joke but that is what they almost did…they gave it to many people who had no plaque in their vessels and who were not going to have a heart attack in the future. The risks then outweighed the benefits and doctors should stop giving it to women and low risk patients, especially diabetics and patients who are obese, which is 50% of the US adult population. Statins often have lasting side effects, such as statin dementia and severe sarcopenia (loss of muscle) as well as severe muscle-aches and pains that stop people from exercising.  What should happen in medicine is that a doctor should weigh the risks verses the benefits.  If they don't know if a patient has atherosclerosis that patient should have an x-ray called Cardiac Calcium Scan every 5-7 years and if they don't have plaque, then they should not get a statin.  In addition, there is a genetic test to see if the severe effect of sarcopenia (muscle loss) will happen and if a person has that genetic snip, they should take something which is not a statin.  If everyone was tested for these two things most people would not take a statin! The blood sugar increases and the increase in obesity are side effects of statins that were evident in our patients who we test for testosterone deficiency, and who were later put on a statin by their primary care. We found that their lab parameters for diabetes immediately worsened.  For those who had visible side effects, we stopped the statins and found that the lab tests went to normal after stopping the statins, and the side effects went away in most of them.  We have been waiting for this research study ever since, and now it is official.  The research matches our clinical experience!

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: learning more about Lilly's plan to lower the price of some insulins, Abbott's Libre 2 and Libre 3 get FDA approval to work with automated insulin delivery systems like Control IQ and Omnipod 5, Medicare expands coverage of CGMs for people with type 2, an old blood pressure medication shows promising results in a T1D study, and more!   Please visit our Sponsors & Partners - they help make the show possible! Take Control with Afrezza  Omnipod - Simplify Life Learn about Dexcom  Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines happening now XX In the news is brought to you by Athletic Greens XX Insulin prices https://www.statnews.com/2023/03/06/eli-lilly-insulin-medicaid-rebates/ Drugmaker Eli Lilly & Co. on Wednesday said it will cut prices of its most commonly prescribed insulins by 70% and cap monthly out-of-pocket costs at $35 at certain retail pharmacies for people who have private insurance.   Lilly will list its Lispro injection at $25 a vial effective May 1 and slash the price of its Humalog and Humlin injections by 70% starting in the fourth quarter.   The announcement comes amid growing federal pressure to lower the cost of insulin. The Inflation Reduction Act capped insulin prices for Medicare beneficiaries at $35 per month but did not protect people with private insurance or who don't have coverage from higher prices. Eli Lilly would've had to pay Medicaid about $150 for each vial of insulin used in the program if it hadn't dramatically cut the list prices for some of its older products this week. The company was about to run into a Medicaid penalty for raising the price of it's drugs faster than the rate of inflation. https://www.cnbc.com/2023/03/01/lilly-cuts-insulin-prices-70percent-cap-prices-at-35-per-month-for-private-insurance.html XX The FDA has cleared Abbott's Freestyle Libre 2 and Libre 3 continuous glucose monitors (CGM) for integration with automated insulin delivery (AID) systems. These devices have also been cleared for younger children, extended wear time, and for use during pregnancy.   The FDA on March 6 cleared Abbott's Freestyle Libre 2 and Freestyle Libre 3 CGM for use with automated insulin delivery (AID) systems.   AID systems connect a CGM, insulin pump, and smartphone to automatically adjust insulin dosing in real-time in response to changing glucose levels. These systems have been demonstrated to help many people with diabetes improve their time in range and reduce the time spent thinking about managing glucose each day.   With this new clearance from the FDA, Libre 2 and 3 CGMs and the connected smartphone app will soon integrate with insulin pumps to adjust insulin dosing.   Freestyle Libre 2 and Libre 3 CGMs were previously cleared for use by people with diabetes ages 4 and older. Freestyle Libre 3, cleared in the United States in May 2022, is compatible with both iOS and Android smartphones. Among several upgrades made from Libre 2, Libre 3 no longer requires users to manually scan their device with their smartphone to see glucose levels – data is sent to the mobile app automatically.   In the announcement, Abbott said the device has also been cleared for an extended wear time of 15 days, for use by children as young as age 2, and for use during pregnancy by women with type 1, type 2, or gestational diabetes.   Current users of Libre CGMs should note that the devices available now cover people with diabetes ages 4 and older, can be worn for 14 days, and are not cleared for use during pregnancy. According to Abbott, the modified Libre 2 and 3 sensors will be available in the U.S. later this year. https://diatribe.org/fda-clears-freestyle-libre-2-and-3-use-automated-insulin-delivery XX Medicare will cover continuous glucose monitors for a broader group of patients, starting in April, according to an updated policy published by the Centers for Medicare and Medicaid Services.   The policy change included broader language and also came earlier than expected, making it a “welcome surprise,” and could double the market for the devices, J.P. Morgan analyst Robbie Marcus wrote in a research note.   Dexcom and Abbott Laboratories had expected coverage to start in mid-year.   In an earlier draft of coverage guidelines, CMS had suggested covering the devices for people with diabetes who take daily insulin, or who have a history of problematic hypoglycemia. Now, the policy includes people with non-insulin treated diabetes and a history of recurrent level 2 or at least one level 3 hypoglycemic event.   “At first glance, it seems that the finalized CMS language is broader and no longer includes daily insulin language,” Marcus wrote.   The policy change could open up a bigger opportunity for broader coverage by commercial insurers over the next year or two, he added. Currently, just 25% of people with Type 2 diabetes who are intensive insulin users (taking multiple shots per day) use a CGM. Covering people who take basal (daily) insulin could double the U.S. market opportunity of about 2 million people with Type 1 diabetes and 2 million people with Type 2 diabetes who are intensive insulin users, a group currently covered by CMS, Marcus wrote. https://www.medtechdive.com/news/Medicare-CGM-coverage-Dexcom-abbott-ABT-DXCM/644019/ XX Bigfoot Biomedical receives FDA clearance for the Android mobile app for Bigfoot Unity. The mobile app allows users to input and review therapy recommendations from healthcare professionals. Users can also access a glanceable display of their current glucose range and receive real-time alerts.   Last month Bigfoot sold its closed-loop automated insulin delivery (AID) system technology to Insulet. CEO Jeffrey Brewer said he has confidence in the makers of the omnipod to utilize Bigfoot's “great asset” in its focus on simplicity and ease of use for pump users. He said the limited rollout generated “great data” to support Bigfoot Unity in the type 2 population. That includes ease of use, especially for people who might not be tech-savvy.   The big focus for Bigfoot Biomedical, Brewer explained, remains the pharmacy channel. He said the company is currently in discussions with Express Scripts, Optum and CVS to utilize their wide reach. Brewer said that getting an agreement with one or more of those companies will enable a more broad launch this year. By wrapping the insulin delivery around CGM, Bigfoot Biomedical believes it can address the type 2 market in a new way.   https://www.massdevice.com/bigfoot-biomedical-next-steps-diabetes-management/ XX Although the use of diabetes technology has increased across all racial and ethnic groups, inequities persist, according to research published in the Journal of Endocrinology & Metabolism. In the United States, race and ethnicity have been associated with inequities in diabetes treatment and outcomes. Non-Hispanic Black and Hispanic indi- viduals with type 1 diabetes (T1D) have higher hemoglobin A1c (HbA1c), higher rates of severe hypoglycemia and dia- betic ketoacidosis, and are more likely to visit emergency departments and hospitals than individuals with T1D who identify as non-Hispanic White.   Researchers used a version of Optum's deidentified Clinformatics Data Mart to select Medicare Advantage beneficiaries with T1D between January 1, 2017, and December 31, 2020.   Investigators found that overall, use of an insulin pump, a CGM, both insulin pump and CGM, and either insulin pump or CGM increased during the 4-year study period When evaluating the data by racial and ethnic group, investigators found that the prevalence of each outcome did increase; however, “within each annual cohort and outcome, there were significant differences between racial/ethnic groups,” with gaps in prevalence between White individuals and individuals of other races and ethnicities remaining “generally increase[ing] or remaining stable” between 2017 and 2020.   When evaluating data from the 2020 cohort, there were significant differ- ences noted in the use of insulin pump and/or CGM technology based on demographic and socioeconomic factors.   According to the researchers, the “persistent inequities” in diabetes technology access found in the current study have implications “not only for patients and providers, but also for health care systems and policymakers” and require multiple policy changes to improve equitable access.     https://www.drugtopics.com/view/racial-ethnic-inequities-persist-in-diabetes-care XX The CLVer study tested whether improved blood glucose control using a hybrid closed loop insulin pump (also known as an automated insulin delivery or AID system) and/or verapamil preserves beta cell function one year after diagnosis.. The trial showed that verapamil, but not better blood glucose control, improved beta cell function over the year-long study.   In October, the FDA approved the drug Tzeild (teplizumab) for people with diabetes antibodies but who did not yet have type 1 diabetes. This therapy was the first approved medicine to delay the onset of type 1 diabetes by an average of 2 years.   The CLVer study offers further hope for researchers by showing that another medication can have additional impact in type 1 diabetes, and lays the groundwork for further study. By seeing preserved c-peptide levels in the study participants, the trial demonstrated that taking verapamil improved beta cell function.   Additionally, although AID users had greater time in range of 78% compared to non-users' 64%, which is a 3.4 hour/day difference, the trial found that AID did not provide a significant improvement in insulin secretion. This study was partially funded by JDRF   “Safe, effective therapies are urgently needed to delay disease progression in people recently diagnosed with type 1 diabetes,” said Dr. Sanjoy Dutta, chief scientific officer at JDRF. “This is the second trial showing that verapamil, a cheap and widely used blood pressure medication, can preserve beta cells in the new onset period. The CLVer trial moves us one step closer to our goal of having disease modifying therapies widely available for people with type 1 diabetes.” https://diatribe.org/impressive-results-show-verapamil-preserves-insulin-producing-cells-newly-diagnosed-type-1-diabetes XX Some advances in cell transplantation to treat type 1: Vertex gets FDA clearence for their application to study VX-264, a stem cell-derived, pancreatic islet cell therapy encapsulated into an immunoprotective device with the potential to treat type 1 diabetes (T1D). The VX-264 program does not require the use of immunosuppression, which may broaden the population of people with T1D that this investigational therapy could reach. This clearance means they can begin clinical trials. AND Sernova Corp. (TSX:SVA) (OTCQB:SEOVF) (FSE/XETRA:PSH), a clinical-stage company and leader in cell therapeutics, announced today that the first two patients in the second cohort of its active U.S. Phase 1/2 clinical trial for the treatment of type 1 diabetes (“T1D”) and hypoglycemia unawareness (the “T1D Study”) received their first islet transplant into the higher capacity 10-channel Cell Pouch™.   These patients will be monitored for safety and efficacy for three months after which a second dose of islets is anticipated to be transplanted in accordance with the protocol. Additionally, a third enrolled patient has now been implanted with the higher capacity Cell Pouch and awaits islet transplant in the coming weeks. While they are working towards not using immunosuppression, the patients in the current trial do still require immunosuppression to start after implantation of the Cell Pouch SystemTM   https://www.businesswire.com/news/home/20230308005894/en/Vertex-Announces-FDA-Clearance-of-Investigational-New-Drug-Application-for-VX-264-a-Novel-Encapsulated-Cell-Therapy-for-the-Treatment-of-Type-1-Diabetes https://finance.yahoo.com/news/sernova-announces-initial-islet-transplantation-120000700.html?guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAH6NwHdjldrxbueuanlpUGXou6yHP2dKNpYXN31GEMLWCyhkJkgwlhn9ScIDMTX5GGtf5V242uN3EvZzFtTd56z0YZaQgOss37DT2dksdasEONxWa7OOdgnWvDlwUd0-s2RPyMTPi1sw8z08CK6DUMLIrrA6dmCDZeozlwos_CDB XX Two classes of drugs prescribed off-label for some patients with Type 1 diabetes can provide significant benefits but also come with health concerns, according to a study by UT Southwestern Medical Center researchers. The findings, published in The Journal of Clinical Endocrinology & Metabolism, provide a rare view of real-world use of these medications, which are growing in popularity among patients with Type 1 diabetes as adjuvants to insulin. Type 1 diabetes is universally treated with insulin injections. However, explained Dr. Lingvay, because only a fifth of patients with Type 1 diabetes in the U.S. achieve the blood sugar control that the American Diabetes Association recommends, doctors are increasingly prescribing medications known as glucagon-like peptide-1 receptor agonists (GLP-1RAs) and/or sodium-glucose cotransporter-2 inhibitors (SGLT2is) to help patients reach this goal. Furthermore, both classes of medications have been shown in patients with Type 2 diabetes to decrease the risk of cardiac and renal events and help promote weight loss, effects that also would greatly benefit patients with Type 1 diabetes. However, the risk-benefit ratio of these medications has not been fully vetted in this patient population.   In fact, both classes of drugs have been associated with increased risk of severe hypoglycemia and DKA when used in patients with Type 1 diabetes. Because both positive and negative effects of GLP-1RAs and SGLT2is were shown in strictly regulated clinical trials, their real-world effects have been unclear.   To examine their efficacy, Dr. Lingvay, along with colleagues Khary Edwards, M.D., a former Endocrinology fellow at UTSW, and Xilong Li, M.B.A., Senior Database Analyst at UTSW, searched medical records for Type 1 diabetes patients treated at UT Southwestern who used any GLP-1RAs and/or SGLT2is for at least 90 days before Oct. 31, 2021. Their search turned up 104 patients: 65 who had used GLP-1RAs exclusively, 28 who had used SGLT2is exclusively, and 11 who had used both either concurrently or sequentially.   After a year of use, patients on GLP-1RAs had significant reductions in weight, glycated hemoglobin A1C (a three-month average measure of blood sugar), and total daily dose of insulin. SGLT2i users had significant reductions in hemoglobin A1C and basal insulin, a baseline dose delivered outside of meals.   However, SGLT2i users were about three times more likely than GLP-1RA users to experience DKA. Just over a quarter of patients taking either class of drugs stopped due to side effects such as gastrointestinal problems.   The study authors say these results suggest both types of drugs can be beneficial to patients with Type 1 diabetes, but close monitoring is required. Specifically when using SGLT2is, extreme caution is advised in selecting patients with the lowest risk of DKA, performing detailed education about the risk of DKA, and ensuring careful monitoring to prevent its occurrence.   https://www.utsouthwestern.edu/newsroom/articles/year-2023/february-type-1-diabetes.html XX XX   XX Athletic Greens XX COVID-19 patients who took the diabetes drug metformin for two weeks after a diagnosis were less likely to develop long COVID-19 symptoms, according to results from a clinical trial.   The trial enrolled about a thousand participants who were symptomatic with a COVID-19 infection for less than a week. Participants were randomly selected to receive a placebo or one of three drugs: metformin, ivermectin or fluvoxamine. About 6 percent of people who took metformin later developed long COVID-19, as determined by a medical diagnosis. In the placebo group, 10.6 percent of participants developed long COVID-19.   This meant that overall people who took metformin were 42 percent less likely to develop long COVID-19 compared to people who got the placebo.   The authors also note that the beneficial effect is potentially stronger for people who started taking metformin less than four days from symptom onset compared to people who started the medication four or more days after their first symptoms. The participants who received the two other drugs, ivermectin and fluvoxamine, did not see any benefits in terms of preventing long COVID-19. https://thehill.com/policy/healthcare/3889797-diabetes-drug-proves-beneficial-in-preventing-long-covid-in-clinical-trials/ XX Great article.. https://www.nytimes.com/2023/03/03/sports/baseball/garrett-mitchell-brewers.html XX On the podcast next week.. Ginger Vieira, author and diabetes advocate. Our last episode was with a family whose son was treated with Tzield to delay his T1D diagnosis. That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.  

It's in the News.. the top diabetes stories of the past seven days. This week, the first drug to prevent T1D for any length of time is approved, Eli Lilly takes a financial hit from a Twitter impersonation stunt, Medtronic's 7-day pump infusion set is ready for consumers, Dexcom's G7 gets great reviews from older folks and educators for ease of use, a new study about light at night and diabetes and more! Learn more about the T1D Exchange: www.t1dexchange.com/stacey  Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here Episode Transcription Below (or coming soon!) Please visit our Sponsors & Partners - they help make the show possible! *Click here to learn more about OMNIPOD* *Click here to learn more about AFREZZA* *Click here to learn more about DEXCOM*   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. XX In the news is brought to you by T1D Exchange! T1D Exchange is a nonprofit organization dedicated to improving outcomes for the entire T1D population. https://t1dexchange.org/stacey/ XX And by my new book “Still The World's Worst Diabetes Mom: More Real Life Stories of Parenting a Child With Type 1 Diabetes” available on Amazon in paperback and for kindle. XX Our top story  this week, the US U.S. Food and Drug Administration approves teplizumab, the first drug to delay the onset of type 1 diabets. We've been following this for a long time and I'll ink up our previous interviews with Provention Bio, the company that makes it. The brand name will be Tzield (teplizumab-mzwv) and it's an injection to delay the onset of stage 3 type 1 diabetes in adults and pediatric patients 8 years and older who currently have stage 2 type 1 diabetes.   Tzield is administered by intravenous infusion once daily for 14 consecutive days. Lots of questions here and we'll follow up with an interview and more as soon as I can. https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-can-delay-onset-type-1-diabetes https://diabetes-connections.com/delaying-a-t1d-diagnosis-the-fda-considers-teplizumab/ XX Our top story this week – the kerfuffle over on Twitter where a couple of accounts spoofed Ely Lilly. The insulin makers stock tanked 6% over just one day late last week, wiping billions of dollars from its market cap. On Nov.10, someone pretending to be Lilly's corporate account tweeted: “We are excited to announced insulin is free now.” You may know that Twitter under new owner Elon Musk was verifying any account with any name for just 8-dollars. Another verified but fake Lilly account tweeted profanities and taunted people who use insulin with higher pricing, again, also fake. Other major insulin makers Sanofi and Novo Nordisk were also caught up in the crossfire, with their stock prices dipping and questions over the high cost of insulin back in the headlines. In the understatement of the year, Lilly CEO David Ricks said – quote – “it probably highlights that we have more work to do to bring down the cost of insulin for more people” XX Mice with diabetes appeared cured after transplantation of insulin-secreting pancreatic islet cells, according to a Stanford Medicine study. The animals' immune systems were coaxed to accept the donated cells prior to transplantation through a three-pronged process that could be easily replicated in humans, the researchers said. No immune-suppressing treatments were necessary after the transplant to prevent rejection of the foreign islet cells. The technique, which builds on earlier work at Stanford Medicine, may open the door to a new type of organ transplant that doesn't require an immunologically matched donor or years on immune-suppressing medication. The difference here is that they do two transplants.. first doing a partial blood stem cell transplant which makes the new pancreas cells recognized as the body's own and less likely to be rejected. Long way to go here, but promising idea. https://med.stanford.edu/news/all-news/2022/11/islet-transplant-diabetes.html XX The first and only 7-day infusion set is ready to go.. after approval more than a year ago – in September of 2021, Medtronic says customers can now order the Medtronic Extended for the 600 and 700 series pumps. In clinical studies of the Medtronic Extended infusion set, study participants observed a decrease in the number of times an infusion set needed to be changed by 50% and the number of infusion set failures associated with high glucose levels was lowered.3,4 Study participants using the Medtronic Extended infusion set commented on the new infusion set being more comfortable to wear compared to their previous infusion sets and were happy with the longer wear feature in helping reduce the overall burden of insulin pump therapy.3,4 Additionally, use of the Medtronic Extended infusion set is estimated to result in annual costs savings of insulin of up to 25% due to a reduced number of infusion set and reservoir changes that result in unrecoverable insulin, as well as plastic waste reduction of up to 50%. https://www.prnewswire.com/news-releases/medtronic-launches-worlds-first-and-only-infusion-set-for-insulin-pumps-that-doubles-wear-time-up-to-7-days-in-us-301677790.html XX Recall for omnipod. This is an issue with the Omnipod 5 Controller charging port and cable. This does not impact the Omnipod 5 Pod, the Omnipod® DASH Insulin Management System, the Omnipod® Insulin Management System, or compatible Android smartphone devices that have the Omnipod 5 App installed. No serious injuries have been reported, but insulet has received reports tht the omnipod 5 controller chargting port or cable is discoloring or even melting due to excess heat. Customers are instructed to called insulet or login to an fda site. I'll link up all of that info in the show notes. at 1-800-6). Additional informati41-2049, which is available 24 hours a day, 7 days a week. Alternatively, Omnipod 5 users can utilize the FDA's MedWatch Adverse Event Reporting program either online (www.fda.gov/medwatch/report.htmExternal Link Disclaimer), by regular mail, or by fax (1-800-FDA-0178on, including instructions to customers to mitigate risk, can be found on the Company's website at www.omnipod.com/insulet-alertsExternal Link Disclaimer. https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/insulet-issues-nationwide-voluntary-medical-device-correction-omnipodr-5-controller XX Small study shows that using the Dexcom G7 is easier for older adults to insert and use. Results indicate that G7 CGM system required half as many steps to set up and deploy as the G6 system, with the system's system usability scale survey scores indicating excellent usability. The current study was launched to better understand ease of use and task burden of uptake of Dexcom's G7 CGM system. To do so, investigators designed their study as a formal task analysis with the intent of identifying the number and complexity of tasks associated with deployment of the G7 CGM system compared to the fifth- and sixth-generation systems in adults aged 65 years or older. A cohort of 10 older adults with no prior CGM experience and 10 CDCESs were recruited for inclusion in the investigators' formal task analysis. This analysis assessed ease of use among CDCESs through a survey after hands-on insertion and initiation of the system. For older adults in the study, ease of use was assessed using system usability scale (SUS) survey scores. In the post-test survey and SUS survey given to older adults, no responses lower than neutral were recorded and the SUS score for setup and insertion of the G7 system was 92.8, which investigators noted was reflective of an excellent usability rating. https://www.endocrinologynetwork.com/view/study-finds-dexcom-g7-set-up-is-easier-requires-fewer-tasks-for-older-adults-than-previous-generations XX Control IQ for people with type 2 works well and is safe. New study from Tandem Diabetes Care shows people with type 2 spent 3.6 hours a day long in target range after switching to the tslim x2 pump / Dexcom system from multiple daily injections or basal insulin only https://www.medtechdive.com/news/tandem-pump-dexcom-CGM-Type-2-diabetes/636448/ XX New program from Walgreens to help give more people access to information and diabetes services. Walgreens is teaming up with its Health Corners and third-party clinics to offer free A1C and blood glucose testing and diabetes education during November, Diabetes Awareness Month. For participating locations, visit Walgreens.com/FreeDiabetesScreening and I'll link that up. Walgreen is the largest provider of continuous glucose monitors including the Dexcom G6 and FreeStyle Libre 2 which track glucose levels all day and night – fewer finger sticks required. 7. Affordable care options and tools including Walgreens Prescription Savings Club and Find Rx Coverage which offer insulin savings programs and affordable, predictable copayments on select insulins. Walgreens Find Care provides access to in-person and virtual healthcare expertise from the comfort of one's home. XX Sleeping in a room exposed to outdoor artificial light at night may increase the risk of developing diabetes, according to a huge study of nearly 100,000 Chinese adults. People who lived in areas of China with high light pollution at night were about 28% more likely to develop diabetes than people who lived in the least polluted areas. We told you about a study published earlier this year that showed Sleeping for only one night with a dim light, such as a TV set with the sound off, raised the blood sugar and heart rate of the young people during the sleep lab experiment. These researchers caution that any direct link between diabetes and nighttime light pollution is still unclear, however, because living in an urban area is itself a known contributor to the development of diabetes https://www.cnn.com/2022/11/14/health/night-light-pollution-diabetes-sleep-wellness/index.html XX Researchers are recruiting 20,000 children for a trial to try to identify those at high risk of developing type 1 diabetes. If left undiagnosed or untreated, the condition can lead to life-threatening complications. The trial, led by the University of Birmingham, could mean access to new treatments for children at high risk. The researchers say it may also offer insights that could make screening for type 1 diabetes a possibility. ADVERTISEMENT Type 1 diabetes is an autoimmune condition where the immune system attacks and destroys cells in the pancreas which produce insulin. Insulin is crucial because it moves energy from food from the blood to the cells of the body - without it, the body cannot function properly. Approximately 29,000 children in the UK currently have type 1 diabetes, out of a total of about 400,000 people. For them, managing the condition involves injecting insulin and testing blood glucose levels regularly. The condition is very different to type 2 diabetes, which is often linked to poor diet or an unhealthy lifestyle. The organisers want children aged three to 13 to sign up for the trial, which will analyse their blood - through finger prick and vein tests - for autoantibodies. These are linked to the development of type 1 diabetes. Those with two or more autoantibodies have an 85% chance of having the condition within 15 years, and are almost certain to develop it in their lifetime. 'A simple test could have saved my son' Parth Narendran, professor of diabetes medicine, and Dr Lauren Quinn, clinical research fellow at the University of Birmingham, said there was a need to explore if screening children for type 1 diabetes in the UK would be possible in the UK. "Screening children can reduce their risk of DKA (diabetic ketoacidosis) at diagnosis around fivefold and can help them and their families settle into the type 1 diagnosis better," they said. DKA is a life-threatening complication of type 1 which can occur when diagnosis does not happen quickly. Rachel Connor, director of research partnerships at JDRF UK, which is co-funding the study, said new drugs that target the immune system were progressing through trials. "We are demonstrating that it is possible to delay the need for intensive insulin treatment in those most at risk. When these drugs become available in the UK, we need to be ready to use them straight away," she said. Dr Elizabeth Robertson, from Diabetes UK, which also funded the study, said: "Extra years without the condition means a childhood no longer lived on a knife-edge of blood sugar checks and insulin injections, free from the relentlessness and emotional burden of type 1 diabetes." https://www.bbc.com/news/health-63622084 XX New study on pancreas transplants. These researchers say Up to 90% of people who received a pancreas transplant enjoy freedom from insulin therapy and the need for close glucose monitoring. Biggest drawback is having to take immunosuppressants for the rest of their life. The number of pancreas transplants has declined in recent years. New paper this week in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism. Another downside is that this isn't a long-term cure.. the paper says the median graft survival is around eight years and the transplanted pancreas does not always work well, so the patient might not be completely insulin-free. However, I do believe that the combined kidney/pancreas transplant should be considered for all patients with type 1 diabetes with an indication for a kidney transplant.” https://www.healthline.com/health-news/type-1-diabetes-the-benefits-and-limitations-of-a-pancreas-transplant XX Medtrnoic sending emails out regarding the CareLink™ Software outages. . For most of our customers, we were able to resolve the issue relatively quickly through an application fix that took effect when individuals logged out and then logged back into their CareLink™ accounts (reminder of these recommended actions available here). But we know this was not the experience for all, and for some of you the experience was extremely frustrating and lasted longer. Medtnoic is still working to resolve the issue for some customers. They stress this was not because of a security breach but don't give further details. https://app.medtronicdib.mdtpatient.com/e/es?s=357929245&e=822474&elqTrackId=b0ce7494b5bd47ad9b9c672c71086a1c&elq=3155b86a3ca045f0a2e27c182f392387&elqaid=7514&elqat=1&fbclid=IwAR1XYIdfEFpkUrdk-yTk6WKSvlsdncJBNrSy_OpdeuJhHXD2zi78WnxaSG8 XX Women with polycystic ovary syndrome (PCOS) were found to be at higher risk for developing type 2 diabetes over a 30-year period, according to new research presented at the 2022 American Society for Reproductive Medicine (ASRM) Scientific Congress & Expo, and described in an article at Healio. PCOS is a hormonal disorder that causes enlarged ovaries containing small fluid-filled sacs, and it can have painful symptoms. Hormonal changes related to PCOS can also have effects throughout the body — including effects related to diabetes. One study estimated that nearly one in five adolescent girls with type 2 diabetes also has PCOS, although the nature of the link between PCOS and diabetes is still not fully understood. Many scientists believe, though, that insulin resistance — when tissues in the body become less sensitive to insulin, which is a large part of the disease process in type 2 diabetes — also plays a role in the development of PCOS. There is also evidence that correcting the hormonal imbalances seen in PCOS may reduce the risk of developing type 2 diabetes. A recent study showed that taking oral birth control pills as a treatment for PCOS reduced the risk for type 2 diabetes. https://www.diabetesselfmanagement.com/news-research/2022/11/16/polycystic-ovary-syndrome-linked-to-higher-risk-for-type-2-diabetes/ XX XX Back to the news in a moment but first.. The T1D Exchange Registry is a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. The platform is open to both adults and children with T1D living in the U.S. Personal information remains confidential and participation is fully voluntary. Once enrolled, participants will complete annual surveys and have the opportunity to sign up for other studies on specific topics related to T1D. The registry aims to improve knowledge of T1D, accelerate the discovery and development of new treatments and technologies, and generate evidence to support policy or insurance changes that help the T1D community. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy. The registry is now available on the T1D Exchange website and is simple to navigate, mobile and user-friendly. For more information or to register, go to www.t1dregistry.org/stacey XX SAFE TRAVELS to all en route to San Francisco for the Fall 2022 #Diabetes Mine #Innovation Days. Can't wait to see u all in person! Nov 17 and 18 XX XX On the podcast next week.. My daughter Lea talks about siblings and type 1. Last week was all about Eversense E3 and the future of long-term CGM sensors. Listen wherever you get your podcasts That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Videos : Robby Soave: PayPal Threatens To Take $2,500 From Users Who Promote ‘Misinformation' (9:26) ED DOWD: COVID AND THE GLOBAL FINANCIAL COLLAPSE: A TALE OF CATASTROPHES AND COVER-UPS (32:50 – 42:50) Tidal energy could be huge – why isn't it? (4:00) Back To the Future of Wind Energy Technology with Paul Gipe (7:23) No, this angry AI isn't fake (see comment), w Elon Musk. (3:24) Dr. Bhakdi Clip (7:27)   Study shows inexpensive, readily available chemical (GABA) may limit impact of COVID-19 University of California, Los Angeles, October 25, 2022 Preclinical studies in mice that model human COVID-19 suggest that an inexpensive, readily available amino acid might limit the effects of the disease and provide a new off-the-shelf therapeutic option for infections with SARS-CoV-2 variants and perhaps future novel coronaviruses. A team led by researchers at the David Geffen School of Medicine at UCLA report in Frontiers in Immunology that an amino acid called GABA, which is available over-the-counter in many countries, reduced disease severity, viral load in the lungs, and death rates in SARS-CoV-2-infected mice. This follows up on their previous finding that GABA consumption also protected mice from another lethal mouse coronavirus called MHV-1. In both cases, GABA treatment was effective when given just after infection or several days later near the peak of virus production. The protective effects of GABA against two different types of coronaviruses suggest that GABA may provide a generalizable therapy to help treat diseases induced by new SARS-CoV-2 variants and novel beta-coronaviruses.  Their previous studies showed that GABA administration protected mice from developing severe disease after infection with a mouse coronavirus called MHV-1. To more stringently test the potential of GABA as a therapy for COVID-19, they studied transgenic mice that when infected with SARS-CoV-2 develop severe pneumonia with a high mortality rate. “If our observations of the protective effects of GABA therapy in SARS-CoV-2-infected mice are confirmed in clinical trials, GABA could provide an off-the-shelf treatment to help ameliorate infections with SARS-CoV-2 variants. GABA is inexpensive and stable at room temperature, which could make it widely and easily accessible, and especially beneficial in developing countries.” The researchers said that GABA and GABA receptors are most often thought of as a major neurotransmitter system in the brain. Years ago, they, as well as other researchers, found that cells of the immune system also possessed GABA receptors and that the activation of these receptors inhibited the inflammatory actions of immune cells. Taking advantage of this property, the authors reported in a series of studies that GABA administration inhibited autoimmune diseases such as type 1 diabetes, multiple sclerosis, and rheumatoid arthritis in mouse models of these ailments. Other scientists who study gas anesthetics have found that lung epithelial cells also possess GABA receptors and that drugs that activate these receptors could limit lung injuries and inflammation in the lung. The dual actions of GABA in inflammatory immune cells and lung epithelial cells, along with its safety for clinical use, made GABA a theoretically appealing candidate for limiting the overreactive immune responses and lung damage due to coronavirus infection. Working with colleagues at the University of Southern California, the UCLA research team in this study administered GABA to the mice just after infection with SARS-CoV-2, or two days later when the virus levels are near their peak in the mouse lungs. While the vast majority of untreated mice did not survive this infection, those given GABA just after infection, or two days later, had less illness severity and a lower mortality rate over the course of the study. Treated mice also displayed reduced levels of virus in their lungs and changes in circulating immune signaling molecules, known as cytokines and chemokines, toward patterns that were associated with better outcomes in COVID-19 patients. Thus, GABA receptor activation had multiple beneficial effects in this mouse model that are also desirable for the treatment of COVID-19. Yoga as effective as traditional pulmonary rehab in patients with COPD  All India Institute of Medical Sciences (India), October 19, 2022 Researchers from the Department of Pulmonary Medicine and Sleep Disorders and All India Institute of Medical Sciences, New Delhi, India, studied the effects of yoga as a form of pulmonary rehabilitation on markers of inflammation in the body. Results from this study showed yoga exercises provide improvements that are just as effective as traditional pulmonary rehabilitation methods in improving pulmonary function, exercise capacity, and indices of systemic inflammation. Sixty patients with COPD were randomly divided into two groups, one of which was taught yoga exercises while the other underwent a structured pulmonary rehabilitation program. These groups were tested on shortness of breath, serum inflammation, and lung function tests. Each group participated in 1 hour of training twice a week for the first 4 weeks, then training every 2 weeks for 8 weeks, and the remaining weeks were at home. Results showed that yoga and pulmonary rehabilitation exercises resulted in similar improvements in pulmonary function, 6-minute walk distance, Borg scale, severity of dyspnea, quality of life, and levels of C-reactive protein after 12 weeks of training. “This study suggests yoga may be a cost-effective form of rehabilitation that is more convenient for patients,” said Mark J. Rosen, MD, Master FCCP, CHEST Medical Director. “The authors recommended adoption of yoga programs as an option as part of long-term management of COPD. These findings should be confirmed in new studies and the potential mechanisms explored.”  Resveratrol can help correct hormone imbalance in women with PCOS University of California, San Diego, October 19, 2022 Resveratrol–a natural compound found in red wine and grapes–can help address a hormone imbalance in women with polycystic ovary syndrome (PCOS), a leading cause of infertility in women, according to a  study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism. Women who have PCOS produce slightly higher amounts of testosterone and other androgen hormones than average. Although these reproductive hormones are typically associated with men, women also have small amounts. The elevated levels in women with PCOS can contribute to irregular or absent menstrual periods, infertility, weight gain, acne or excess hair on the face and body. Women who have PCOS also face a higher risk of developing other health problems, such as diabetes. “Our study is the first clinical trial to find resveratrol significantly lowers PCOS patients' levels of testosterone as well as dehydroepiandrosterone sulfate (DHEAS), another hormone that the body can convert into testosterone,” said the study's senior author, Antoni J. Duleba, MD, of the University of California, San Diego in La Jolla, CA. “This nutritional supplement can help moderate the hormone imbalance that is one of the central features of PCOS.” Thirty women with PCOS completed the randomized, double-blind, placebo-controlled trial conducted at Poznan University of Medical Sciences in Poland. The women were randomly assigned to either take a resveratrol supplement or a placebo pill daily for three months. The participants had blood samples drawn at the beginning and end of the study to determine levels of testosterone and other androgen hormones.  The researchers found total testosterone levels fell by 23.1 percent among the women who received the resveratrol supplement. In comparison, testosterone levels increased 2.9 percent in the placebo group. DHEAS declined by 22.2 percent in the resveratrol group, while the placebo group experienced a 10.5 percent increase in DHEAS levels. In addition to moderating androgen hormones, the women who received resveratrol showed improvement in diabetes risk factors. Among the resveratrol group, fasting insulin levels dropped by 31.8 percent during the three-month study. The researchers also found the women who received resveratrol during the study became more responsive to the hormone insulin over the course of the study. Fluoridated water calcifies your arteries: study University of Zaragoza (Spain), October 22, 2014  A major promoter of heart disease in the U.S. today could be a chemical that the government has been intentionally dumping into the water supply for decades on the premise that it prevents tooth decay. Fluoride, according to a study published in the journal Toxicology, shows demonstrated cardiotoxic effects, which include the calcification and hardening of arteries. Researchers from the University of Zaragoza in Spain looked at the effects of water fluoridation on the progression of vascular calcification in renal (kidney) disease. The team used real-world concentrations of fluoride as recommended by the World Health Organization (WHO) for optimal oral health — 1.5 milligrams per liter (mg/L) — administering this amount to rats via water in the same way humans would receive it. It was observed that, for five days, the rats, all of whom had experimental chronic kidney disease (CKD), experienced calcification of their aortic smooth muscle cells. The rats also experienced further declines in renal function as a result of exposure to fluoride, demonstrating the nephrotoxicity of this common water additive. “[F]luoridation of drinking water… dramatically increased the incipient aortic calcification observed in rats with experimental chronic kidney disease,” wrote the authors. “[T]he WHO's recommended concentrations in drinking water become nephrotoxic to CKD rats, thereby aggravating renal disease and making media vascular calcification significant.” Previous research, as noted in the new study, has confirmed that 90 percent or more of digested fluoride is absorbed through the intestines and distributed throughout the body to soft tissues, calcified structures and blood plasma. At WHO-recommended doses, fluoride can still get lodged throughout the body and remain there for many years. In healthy individuals, plasma fluoride is cleared through the dual action of calcifying tissues and expelling through the kidneys. But in those with renal disease, the kidneys are not up to the task of removing fluoride from the body, greatly amplifying both the calcification process and the advancement of renal failure. Lower magnesium levels linked with increased mortality risk during up to 40 years of follow-up Jiao Tong University School of Medicine  (China), October 20 2022.  In an article in the journal Clinical Nutrition, Xi Zhang of Shanghai Jiao Tong University School of Medicine and colleagues reported an association between decreased serum levels of magnesium and a greater risk of dying from any cause during a follow-up period of up to 40 years. The study included data from 14,343 participants in the National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study.  There were 9,012 deaths during a median follow-up of 28.6 years. In comparison with subjects whose serum magnesium levels were between 0.8 and 0.89 micromoles per liter (mmol/L), having a deficient level of less than 0.7 mmol/L was associated with an adjusted 34% greater risk of dying over follow-up. Those with magnesium levels of less than 0.7 mmol/L had more than two and a half times the risk of dying from stroke than subjects with magnesium levels of 0.8-0.89 mmol/L. Further analysis found the strongest protective association for magnesium in men. “Several mechanisms may explain the beneficial effects of magnesium, including maintaining glucose and insulin homeostasis, improving lipid metabolism, enhancing the vascular or myocardial contractility and vasodilation, and providing antiarrhythmic and antiplatelet effects,” the authors write. “Moreover, several small secondary prevention randomized trials have shown that oral magnesium supplementation improved endothelial function, reduced thrombosis, and increased cardiopulmonary function and left ventricular ejection fraction among cardiovascular disease patients.” “Our findings support the hypothesis that serum magnesium may be clinically useful for predicting long-term health outcomes and mortality in the general population,” they conclude. Anxiety Makes It Harder to Listen to Your Intuition Freie Universität Berlin, Psychologische Hochschule Berlin, University of Basel,  October 19, 2022 As an anxious person, I find the mantra “go with your gut” endlessly frustrating. What's so trustworthy about my gut instinct, which has, at various times, convinced me I'm dying of brain cancer, or about to get on an airplane doomed to crash, or destined to be alone forever? My therapist has had to remind me many times over that my so-called instincts have been wrong before and will be wrong again. But I've remained somewhat convinced that there is a “real” gut instinct somewhere beneath all my fake ones, and if only I knew how to access it, I would finally be perfectly wise, centered, and calm. A new study suggests this is probably not the case. In their study, researchers attempted to examine and compare the intuitive decision-making abilities of anxious, neutral, and optimistic people. More than a hundred participants were randomly assigned to each of these three groups, and “inducted” into the corresponding mood by viewing a series of emotionally coded sentences and images. For example, participants in the optimism group read: “The affection of those we love makes us feel particularly safe and confident. There is always someone who loves us,” and were then shown a picture of a smiling young couple with a shark mascot. (Huh.) Those in the anxious group read: “Safety is not guaranteed neither in our neighborhoods nor in our own homes,” followed by a picture of a man with his arm hooked around a woman's neck. I'm anxious just reading about it. Once the mood was set, participants were asked to fill out a questionnaire designed to assess their tendency to make intuitive decisions, and how effectively they did so. While the researchers found that the decision-making abilities of the positive and the neutral mood groups were relatively unaffected by their moods, the anxious group showed a significantly reduced ability to use their intuition.  The researchers hypothesized that anxiety's effects on our decision-making is damaging for several reasons: Anxiety makes us risk-averse, pessimistic, and less confident — all qualities which make us likelier to choose what we perceive as the most safe, routine, and unchallenging decision. In some cases, anxiety can also effectively paralyze us, resulting in no decision made at all. Using one's intuition, the researchers argue, requires confidence and trust in oneself. If anxious people don't have that confidence and trust, they may be more likely to ignore subtle emotional or bodily cues which indicate a “hunch.” BFor many anxious people, the psychosomatic symptom possibilities are endless, and only infrequently indicate that something is actually wrong. In many cases, it's wiser for us to ignore these “signs” and symptoms than to take them seriously.

VIDEOS: 1. The Anti-Smartphone Revolution – (13:23) ColdFusion 2. Gravitas Plus: Explained: The China-Taiwan conflict (9:11)   HEALTH NEWS Astonishing effects of grapes, remarkable potential for health benefits Frequent nut consumption associated with less inflammation Body posture affects how oral drugs absorbed by stomach [why not supplements too?]  Lifting Weights Beats Out Cycling, Swimming For Vegans Wanting Stronger Bones Perfectionism Linked To Burnout At Work, School And Sports, Research Finds  Mindfulness Therapy Better Than Antidepressants Astonishing effects of grapes, remarkable potential for health benefits Western New England University, August 8, 2022 Recent studies released by Dr. John Pezzuto and his team from Western New England University show “astonishing” effects of grape consumption and “remarkable” impacts on health and on lifespans. Published in the journal Foods, one study showed that adding grapes in an amount equal to just under two cups of grapes per day to a high-fat diet, typically consumed in western countries, yielded reductions in fatty liver and extended lifespans.  Noting that these studies add an entirely new dimension to the old saying ‘you are what you eat,' Pezzuto, who has authored over 600 scientific studies, said that the work with grapes showed actual changes in genetic expression. “That is truly remarkable.” Adding grapes to a high-fat diet also increased levels of antioxidant genes and delayed natural death.  Acknowledging that it is not an exact science to translate years of lifespan from a mouse to a human, Pezzuto said that his best estimate is the change observed in the study would correspond to an additional 4-5 years in the life of a human. Another study by Dr. Pezzuto and his team published in the journal Antioxidants, reported that grape consumption altered gene expression in the brain and had positive effects on behavior and cognition that were impaired by a high-fat diet.  Frequent nut consumption associated with less inflammation Brigham and Women's Hospital, August 1, 2022 In a study of more than 5,000 people, investigators from Brigham and Women's Hospital have found that greater intake of nuts was associated with lower levels of biomarkers of inflammation, a finding that may help explain the health benefits of nuts. The results of the study appear in the American Journal of Clinical Nutrition. “Population studies have consistently supported a protective role of nuts against cardiometabolic disorders such as cardiovascular disease and type 2 diabetes, and we know that inflammation is a key process in the development of these diseases,” said corresponding author Ying Bao, MD, ScD, an epidemiologist in BWH's Channing Division of Network Medicine. “Our new work suggests that nuts may exert their beneficial effects in part by reducing systemic inflammation.” In the current study, the research team performed a cross-sectional analysis of data from the Nurses' Health Study, which includes more than 120,000 female registered nurses, and from the Health Professionals Follow-Up Study, which includes more than 50,000 male health professionals. The team assessed diet using questionnaires and looked at the levels of certain telltale proteins known as biomarkers in blood samples collected from the study participants. They measured three well-established biomarkers of inflammation: C-reactive protein (CRP), interleukin 6 (IL6) and tumor necrosis factor receptor 2 (TNFR2). After adjusting for age, medical history, lifestyle and other variables, they found that participants who had consumed five or more servings of nuts per week had lower levels of CRP and IL6 than those who never or almost never ate nuts. In addition, people who substituted three servings per week of nuts in place of red meat, processed meat, eggs or refined grains had significantly lower levels of CRP and IL6. Peanuts and tree nuts contain a number of healthful components including magnesium, fiber, L-arginine, antioxidants and unsaturated fatty acids such as α-linolenic acid.  Body posture affects how oral drugs absorbed by stomach [why not supplements too?]  Johns Hopkins School of Medicine, August 8, 2022 A common, economic, and easy method of administering drugs is orally, by swallowing a pill or capsule. But oral administration is the most complex way for the human body to absorb an active pharmaceutical ingredient, because the bioavailability of the drug in the gastrointestinal tract depends on the medication's ingredients and the stomach's dynamic physiological environment. In Physics of Fluids, researchers from Johns Hopkins School of Medicine employ a biomimetic in-silico simulator based on the realistic anatomy and morphology of the stomach—a “StomachSim”—to investigate and quantify the effect of body posture and stomach motility on drug bioavailability. “”When the pill reaches the stomach, the motion of the stomach walls and the flow of contents inside determine the rate at which it dissolves. The properties of the pill and the stomach contents also play a major role. Stomach contents, motility, and gastric fluid dynamics all play a role in a drug's bioavailability, and stomach contractions can induce pressure and generate complex pill trajectories. This results in varying rates of pill dissolution and nonuniform emptying of the drug into the duodenum and, sometimes, gastric dumping in the case of modified-release dosage. The modeling appears to be the first of its kind to couple gastric biomechanics of posture with pill movement and drug dissolution to quantify an active pharmaceutical ingredientpassing through the pylorus into the duodenum. The model enabled the researchers to calculate and compare the emptying rate and the release of a dissolved active pharmaceutical ingredient into the duodenum for a variety of physiological situations. Lifting Weights Beats Out Cycling, Swimming For Vegans Wanting Stronger Bones Medical University of Vienna (Austria), August 2, 2022 When it comes to bone health, a new study finds people on a plant-based diet should grab the dumbbells. Researchers in Austria have found that lifting weights is the best form of exercise for vegans – trumping cycling and swimming. The team found that vegans who do resistance training once a week – such as machine-work, free weights, or bodyweight resistance – have stronger bones than plant-based eaters who do other forms of exercise. The new study, published in the Journal of Clinical Endocrinology & Metabolism, found vegans who did resistance training had similar bone structure to omnivores — people who eat both meat and vegetables. For at least five years, authors followed 43 men and women on a plant-based diet and 45 men and women who eat meat as well. “Our study showed resistance training offsets diminished bone structure in vegan people when compared to omnivores.” Perfectionism linked to burnout at work, school and sports, research finds  York St. John University (UK), July 31, 2022 Concerns about perfectionism can sabotage success at work, school or on the playing field, leading to stress, burnout and potential health problems, according to new research published by the Society for Personality and Social Psychology.  In the first meta-analysis of the relationship between perfectionism and burnout, researchers analyzed the findings from 43 previous studies conducted over the past 20 years. It turns out perfectionism isn't all bad. One aspect of perfectionism called “perfectionistic strivings” involves the setting of high personal standards and working toward those goals in a pro-active manner. These efforts may help maintain a sense of accomplishment and delay the debilitating effects of burnout, the study found.  The dark side of perfectionism, called “perfectionistic concerns,” can be more detrimental when people constantly worry about making mistakes, letting others down, or not measuring up to their own impossibly high standards, said lead researcher Andrew Hill, an associate professor of sport psychology at York St. John University in England. Previous research has shown that perfectionistic concerns and the stress they generate can contribute to serious healthproblems, including depression, anxiety, eating disorders, fatigue and even early mortality. The study was published online in the Personality and Social Psychology Review. The study found that perfectionistic concerns had the strongest negative effects in contributing to burnout in the workplace, possibly because people have more social support and clearly defined objectives in education and sports. A student can be rewarded for hard work with a high grade, or a tennis player can win the big match, but a stellar performance in the workplace may not be recognized or rewarded, which may contribute to cynicism and burnout.  “People need to learn to challenge the irrational beliefs that underlie perfectionistic concerns by setting realistic goals, accepting failure as a learning opportunity, and forgiving themselves when they fail,” Hill said. “Creating environments where creativity, effort and perseverance are valued also would help.”  Mindfulness Therapy Better Than Antidepressants University of Exeter (UK), July 31, 2022  Antidepressants are big business.  But for the same money, and without the side effects, a little mindfulness can do the same job.  A new study from the University of Exeter in the UK suggests that mindfulness-based cognitive therapy (MBCT) is just as good as drugs – and maybe even better   MBCT is a structured training program for the mind and body.  It was developed to help people deal with repeated bouts of depression.  It teaches them skills to recognize and respond constructively to the thoughts and feelings associated with relapse.  In other words, it helps patients re-focus their thoughts as a way to avoid falling back into depression. Prior studies have shown that MBCT reduces the risk of relapse or recurrence of depression by about 34% compared to usual care or placebo.  B The research published in The Lancet  followed a group of 424 depressed patients for two years. The patients had all suffered three or more previous major depressive episodes.  And they were all taking a maintenance course of antidepressants. The MBCT group attended eight group therapy sessions in which they learned mindfulness practices and cognitive-behavioral skills, and participated in group discussions.   After two years, relapse rates were worse in the drug group.  The drug group relapsed at the rate of 47% compared to only 44% for the mindfulness group.  The researchers concluded that MBCT may be an effective alternative to antidepressants for prevention of depressive relapse with no significant difference in cost. And it may be a good alternative for people who choose not to use drugs.  But they also suggested MBCT was more beneficial than drugs in preventing relapses in patients who were at highest risk of relapse especially those who reported severe childhood abuse.

With us this week is Extreme Human Performance Specialist Mike T Nelson, PhD. Mike has spent 13+ years working with clients, focusing on how to properly condition the body to burn fat and become stronger, more flexible, and healthier. He's been called in to share his techniques with top government agencies, universities and colleges, fitness organizations and fanatics. The strategies he's developed and the results Mike generates for his clients have been featured in international magazines, in scientific publications, and on websites across the globe. Today Mike joins Megan Hall to talk about the power and practicality of using metabolic flexibility to achieve exceptional body composition, health, and performance. Mike talks about the surprising psychological factors that go into designing a personalized diet and the system he's developed that works with the freedom-craving, flexible nature of your typical human. His system is called the Flex Diet, and it combines the science of metabolic flexibility with the autonomy of choose-your-own-adventure interventions to keep clients motivated, consistent, and inspired to take on their next challenge. If you're a trainer or health practitioner who values flexibility, Mike is running a rare special offer this week on his Flex Diet Certification Course. Here's the outline of this episode with Mike T Nelson: [00:00:35] Previous podcasts featuring Dr. Mike T. Nelson: 1, 2, 3, 4, 5. [00:01:03] The psychology of behavior change: Why an intervention might look good on paper but not work in real life. [00:08:21] The Flex Diet: What it is, how it came about.  [00:13:12] Problems with relying on fat for fuel. [00:16:38] Fuel used during exercise; Studies: 1. Goedecke, Julia H., et al. "Determinants of the variability in respiratory exchange ratio at rest and during exercise in trained athletes." American Journal of Physiology-Endocrinology And Metabolism 279.6 (2000): E1325-E1334. 2. Helge, J. W., et al. "Interrelationships between muscle fibre type, substrate oxidation and body fat." International journal of obesity 23.9 (1999): 986-991. 3. Nelson MT, Biltz GR, Dengel DR. Repeatability of Respiratory Exchange Ratio Time Series Analysis. J Strength Cond Res. 2015 Sep;29(9):2550-8 [00:18:21] Ketogenic diets and fasting. [00:19:39] Book: Eat Stop Eat: Intermittent Fasting for Health and Weight Loss, by Brad Pilon. [00:21:31] How to know if you're metabolically flexible. [00:23:09] Lumen CO2 sensor. [00:28:56] Tips for fasting with different end goals. [00:30:02] Protein synthesis study: Horstman, Astrid MH, et al. "The muscle protein synthetic response to whey protein ingestion is greater in middle-aged women compared with men." The Journal of Clinical Endocrinology & Metabolism 104.4 (2019): 994-1004. [00:34:14] Using HRV to assess stress; Who shouldn't fast. [00:35:18] Psychological benefits for fasting. [00:37:35] Differences between men and women regarding metabolic flexibility. [00:42:54] Dr. Ben House; Podcasts with Ben: How to Manage Testosterone and Estrogen in Athletes, and Ben House, PhD on Strength Training: a Discussion at the Flō Retreat Center in Costa Rica. [00:43:58] How many carbs? How much fat? [00:46:24] Overfeeding and changes in Nonexercise Activity Thermogenesis (NEAT); Study: Levine, James A., Norman L. Eberhardt, and Michael D. Jensen. "Role of nonexercise activity thermogenesis in resistance to fat gain in humans." Science 283.5399 (1999): 212-214. [00:47:50] Enroll in the Flex Diet Certification Course.

Omega-3 and cancer recovery: How supplementation helps reduce hospital stays after operations Capital Medical University (China) Omega-3 supplementation boosts immunity and helps reduce inflammation among gastrointestinal cancer patients after surgery, new meta-analysis reports. Recent studies have indicated that nutritional intervention can reduce these problems, with omega-3 polyunsaturated fatty acids (n-3 PUFAs) particularly promising because of their inflammation benefits. Results showed that patients on an n-3 PUFAs regime had lower levels of inflammation markers. The academics, from China's Capital Medical University, stated: “The results of our study showed that n-3 PUFAs significantly decreased the level of inflammation and increased immune function. “Thus modulation of immune responses and reduction of inflammatory responses together lessens postoperative hospital stay for GI cancer patients.”     Vitamin D levels higher in exercisers   Johns Hopkins University The Journal of Clinical Endocrinology & Metabolism published the finding of researchers at Johns Hopkins University of a correlation between increased physical activity and higher levels of vitamin D. Higher levels of vitamin D and exercise was also associated with a lower risk of cardiovascular disease. The study included 10,342 men and women who were free of coronary heart disease and heart failure upon enrollment in the Atherosclerosis Risk in Communities study between 1987 to 1989. Physical activity levels were assessed during follow-up visits that took place over a 19.3-year period. Stored serum samples obtained at the second visit were analyzed for 25-hydroxyvitamin D3. Following adjustment for lifestyle and other factors, those who met the recommended levels had a 31% lower risk of being deficient in vitamin D than those with poor activity levels. Subjects in the recommended activity group with levels of vitamin D of 30 ng/mL or more had a 24% lower risk of cardiovascular disease.   Gingko biloba helps protect against the toxic cognitive effects of aluminium chloride Atomic Energy Authority (Egypt) Ginkgo biloba extract helped protect the brain from the toxic effects of aluminium chloride, exposure to which has been linked to diseases such as Alzheimer's. Researchers found its antioxidant properties were key in protecting the brain neurons of rats from oxidative stress caused by aluminium chloride (AlClʒ) intake. “The toxic effect of AlClʒ caused significant histologic changes in brain and testis tissues which is in agreement with other data that found accumulation of Al metal in neurons which cause ultra-structural changes,” wrote researchers from the Atomic Energy Authority in Egypt wrote in Nutrition Journal. “Administration of Ginkgo biloba extract (GbE) with aluminium chloride improved some biochemical and histologic changes observed in the brain and testis of male rats.” Overexposure to aluminium, a potent neurotoxin, could be a possible factor in several neurodegenerative disorders including Alzheimer's disease, say researchers. GbE on the other hand, has antioxidant and free radical scavenging properties. It has been used to help treating cerebral disorders that result from ageing and hypoxia. Previous studies also highlighted its ability to regulate neurotransmitters and exert neuprotective effects.   New data shows avocado consumers have improved nutrient intakes USDA and Haas Avocado Board A new analysis of the National Health and Nutrition Examination Survey (NHANES) data, compared avocado consumers to non-consumers and found that consuming avocados may be associated with an overall better diet, higher intake of essential nutrients, lower body weight, lower Body Mass Index (BMI) and smaller waist circumference. Insulin and homocysteine levels were lower in the avocado group, as well as a significantly reduced incidence of metabolic syndrome. Homocysteine, when elevated, has been associated with an increased risk of cardiovascular disease.i Metabolic syndrome is the name for a group of risk factors that raises the risk for heart disease and other health problems, such as diabetes and stroke.ii The analysis, "Avocado consumption by adults is associated with better nutrient Intake, diet quality, and some measures of adipositywas published in the journal Internal Medicine Review. SUMMARY OF KEY FINDINGS: * Compared to non-consumers, avocado consumers have:   Higher intakes of dietary fiber, total fat, good fats (monounsaturated fatty acids and polyunsaturated fatty acids), vitamins E and C, folate, magnesium, copper and potassium.   Lower intakes of total carbohydrates, added sugars and sodium. * Improved physiologic measures include:   On average, avocado consumers weighed 7.5 lbs less, had a mean BMI of 1 unit less and 1.2 in. smaller waist circumference compared to non-consumers.   Avocado consumers were 33% less likely to be overweight or obese and 32% less likely to have an elevated waist circumference compared to non-consumers.   Incidence of metabolic syndrome was significantly reduced for avocado consumers.       Better quality relationships associated with reduced dementia risk University of East Anglia (UK) Positive social support from adult children is associated with reduced risk of developing dementia, according to a new research published today. Conversely, negative social support is linked with increased risk, according to the 10-year follow-up study carried out by a team of researchers from the University of East Anglia (UEA), University College London (UCL), London Metropolitan University and the University of Nottingham. The researchers analysed a decade of data that followed 10,055 core participants from ELSA who were dementia-free at the start of the study. Participants were interviewed every two years and incidence of dementia was identified from self-reports by participants or information given by nominated informants. Positive support was characterised by having a reliable, approachable and understanding relationship with spouses or partners, children and other immediate family. But negative support scores showed stronger effects - an increase of one point in the negative support score led to up to 31 per cent rise in the risk. Negative support was characterised by experiences of critical, unreliable and annoying behaviours from spouses or partners, children and other immediate family.   After spouse passes, death risk from ‘broken heart' rises Rice University In the three-month period following a spouse's death, widows and widowers are more likely to exhibit risk factors linked to cardiovascular illness and death, according to a new study This could make a bereaved spouse more likely to “die of a broken heart,” the researchers say. The study, which appears in Psychoneuroendocrinology, found that individuals who have lost a spouse within the last three months have higher levels of pro-inflammatory cytokines (immune markers that indicate inflammation in the bloodstream) and lower heart rate variability (HRV) compared with non-bereaved individuals who share the sex, age, body mass index, and educational level. Both are factors that increase an individual's risk for cardiac events, including death. The study is the first to demonstrate that bereavement is associated with elevated levels of ex vivo cytokines and lower HRV. “In the first six months after the loss of a spouse, widows/widowers are at a 41 percent increased risk of mortality,” says lead author Chris Fagundes, an assistant professor of psychology in Rice University's School of Social Sciences. “Importantly, 53 percent of this increased risk is due to cardiovascular disease. This study is an important step toward understanding why this is the case by identifying how bereavement gets under the skin to promote morbidity and mortality.” Finally, the bereaved spouses reported 20 percent higher levels of depressive symptoms than the control group. Participants ranged in age from 51 to 80 (average 67.87) and included 22 percent men and 78 percent women. The sex and age of the control group was comparable, and the results were the same when accounting for slight differences in weight and health behaviors.

Secondo un nuovo studio pubblicato sul Journal of Clinical Endocrinology & Metabolism gli uomini con livelli elevati di grasso corporeo hanno una densità ossea inferiore e potrebbero avere maggiori probabilità di fratture ossee.Gli studi sin qui disponibili, oltre all'esperienza clinica, hanno in realtà sempre affermato il contrario, cioè che il peso corporeo, a prescindere dalla sua composizione in termini di massa grassa, si associa ad un'elevata densità ossea e quindi basso rischio di frattura, le nuove ricerche hanno invece dimostrato che un peso corporeo elevato, ma determinato da una maggiore massa grassa, è correlato a una minore densità ossea e questa tendenza riguarda prevalentemente gli uomini rispetto alle donne.

I livelli a digiuno della grelina "ormone della fame" possono aiutare a ridurre il grasso addominale e migliorare la sensibilità del corpo all'insulina, secondo uno studio pubblicato sul Journal of Clinical Endocrinology & Metabolism della Endocrine Society .

You don't need to lose weight to get out of pain. And the idea that some amount of pain is something we have to just “live with” because of our age or body type is nonsense. A majority of the messages in my inbox include some version of “I have pain and I know I need to lose weight but...” which honestly breaks my heart because I believe that life without pain is possible for everyone. I truly do. Researchers really want to make a connection between obesity, BMI, and pain but haven't been able to - but that doesn't stop them from trying. In this episode, you'll learn: Why you don't need to lose weight to get out of pain How science really wants to make a connection but can't And why focusing on BMI is a waste of time (and missing the point) All the links: Okifuji A, Hare BD. The association between chronic pain and obesity. J Pain Res. 2015;8:399-408. Published 2015 Jul 14. doi:10.2147/JPR.S55598 Evers Larsson, U. Influence of weight loss on pain, perceived disability and observed functional limitations in obese women. Int J Obes 28, 269–277 (2004). https://doi.org/10.1038/sj.ijo.0802534 McGoey BV, Deitel M, Saplys RJ, and Kliman ME. Effect of weight loss on musculoskeletal pain in the morbidly obese. The Journal of Bone and Joint Surgery. British volume 1990 72-B:2, 322-323 Paul Welsh, Eliana Polisecki, Michele Robertson, Sabine Jahn, Brendan M. Buckley, Anton J. M. de Craen, Ian Ford, J. Wouter Jukema, Peter W. Macfarlane, Chris J. Packard, David J. Stott, Rudi G. J. Westendorp, James Shepherd, Aroon D. Hingorani, George Davey Smith, Ernst Schaefer, Naveed Sattar, Unraveling the Directional Link between Adiposity and Inflammation: A Bidirectional Mendelian Randomization Approach, The Journal of Clinical Endocrinology & Metabolism, Volume 95, Issue 1, 1 January 2010, Pages 93–99, https://doi.org/10.1210/jc.2009-1064 30 days to more strength + flexibility with the Mobility Mastery Toolkit Movement Mavens has the tools and strategy to support you on your path to enjoying life without pain - www.aewellness.com/mavens www.aewellness.com/podcast - Show notes, links and more. Join the free Body Nerds FB community: https://www.facebook.com/groups/aewbodynerds/ Come hang out with me on Instagram @hollaformala : https://instagram.com/hollaformala/ TikTok @ aewellness Bodywork Starter Guide - learn the 6 places you need to roll right now for quick-relief, plus the reason why what you've tried so far has only given you a temporary fix. Download the guide for free now at www.aewellness.com/bodywork 818-396-6501 is the Body Nerd Hotline - how do you build consistency and/or where are you getting stuck? Drop me a line and let me know your body nerd hacks - you might just hear your voice on a future episode! Today's episode was brought to you by The Amino Co. Their essential amino acid blends are 100% backed by science to help you perform at your best, heal from within, and live life to the fullest. Whether your goal is to reduce inflammation, maintain muscle mass or improve focus - the Amino Co has you covered! Save 30% off your entire order when you use the code BODYNERD at www.AEwellness.com/amino.

INGREDIENTS OF THE DAY:  None A rare, genetic disorder called Laron Syndrome may hold the key to the development of new therapies and dietary treatments for the prevention of some cancers and Type-2 diabetes.  In this episode, the trail to these discoveries is explored in the fascinating story of the connection between dwarfism, disease, and longevity.  Show Notes: To Contact Show:  foodlabelsrevealed@gmail.com Facebook Page:  https://www.facebook.com/prophetofprocessedfood/?ref=bookmarks The podcast can be subscribed to at the iTunes store, or Google Play, or using most of the podcast apps available for smart phones or tablets.  Just search under Food Labels Revealed. References: Fight Aging.org:  “On Laron Syndrome in Ecuador” https://tinyurl.com/dndu2b4c The New York Times:  “Ecuadorian Villagers May Hold Secret to Longevity” https://tinyurl.com/25uhvyt9 Rare Diseases Website:  “Laron Syndrome” https://tinyurl.com/3fpuswa8 Medical Daily:  “… Ecuadorian Dwarfs Have Genetic Mutation That Protects From Disease …” https://tinyurl.com/a3bhzx8 Online Mendelian Inheritance in Man:  “Laron Syndrome” https://www.omim.org/entry/262500 YouTube Video:  “Dwarfism May Provide Cancer Cure Clue” https://www.youtube.com/watch?v=NzUZi3F7d0Y Wikipedia:  “Insulin-like Growth Factor 1” https://tinyurl.com/yx5b6zhc National Institutes of Health:  “Hormones in Dairy Foods and … Impact on Public Health” https://tinyurl.com/3a2m28bx The Journal of Clinical Endocrinology & Metabolism:  “Laron Syndrome … 1958–2003” https://tinyurl.com/32b5sjhx Music: Intro music is the "Peter Gunn Theme" by Henri Mancini. Outro music is “Dark Science” courtesy of David Hilowitz.

Raphael e João recebem mais uma vez a dra. Nathalie Santana, dessa vez para discutir o tratamento farmacológico da obesidade! Quais as indicações de tratamento farmacológico? Quais as opções on-label? Quais as diferenças de preço e potência das medicações? Isso e muito mais nesse episódio! Referências: Obesity in adults: Drug therapy Author:Leigh Perreault, MDSection Editor:F Xavier Pi-Sunyer, MD, MPHDeputy Editor:Lisa Kunins, MD - ABESO - Diretrizes brasileiras de Obesidade 2016 - SCHUTZ, Dominique Durrer et al. European practical and patient-centred guidelines for adult obesity management in primary care. Obesity facts, v. 12, n. 1, p. 40-66, 2019. - VA/DoD Clinical Practice Guideline for the Management of Adult Overweight and Obesity - AMERICAN DIABETES ASSOCIATION et al. 2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes—2021. Diabetes Care, v. 44, n. Supplement 1, p. S15-S33, 2021. - APOVIAN, Caroline M. et al. Pharmacological management of obesity: an Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, v. 100, n. 2, p. 342-362, 2015.

Today's podcast is all about how to eat for Hypothalamic Amenorrhea recovery and specific foods to include that can boost your recovery. In this episode I'm going to go over: 10 foods to incorporate that can boost your Hypothalamic Amenorrhea recovery What nutrients these foods contain and how they can boost your fertility, energy availability and recovery When and how much to add each of these foods into your diet during hypothalamic amenorrhea recovery Smart swaps if you're allergic or intolerant to any of the foods listed Meal and snack ideas for your hypothalamic amenorrhea recovery journey that incorporate these specific fertility and energy boosting foods   ❤️ Join my newsletter list for weekly motivation and inspiration and you'll also receive a FREE copy of my eBook "31 Ways to Boost Your Body Image" ❤️ Ready to get your period back? Join the next round of Healing Hypothalamic Amenorrhea! This 8-week, hybrid group and 1:1 coaching program is designed to help you recover your period while improving your relationship with food, exercise and your body. Find out details and sign up here: https://sarahlizking.com/healing-ha/ ❤️ Work with me to improve your relationship with food and exercise by heading to www.sarahlizking.com or sending me a DM on Instagram @sarahlizking ❤️ If you enjoyed this episode please leave a 5⭐️ review and share a screenshot on Instagram by tagging myself @sarahlizking and I'll be sure to reshare.   References for studies listed in this podcast: Audrey J Gaskins, Rajeshwari Sundaram, Germaine M Buck Louis, Jorge E Chavarro, Seafood Intake, Sexual Activity, and Time to Pregnancy, The Journal of Clinical Endocrinology & Metabolism, Volume 103, Issue 7, July 2018, Pages 2680–2688, https://doi.org/10.1210/jc.2018-00385 Chavarro, J. E., Rich-Edwards, J. W., Rosner, B., & Willett, W. C. (2007). A prospective study of dairy foods intake and anovulatory infertility. Human reproduction (Oxford, England), 22(5), 1340–1347. https://doi.org/10.1093/humrep/dem019 Comerford KB, Ayoob KT, Murray RD, Atkinson SA. The Role of Avocados in Maternal Diets during the Periconceptional Period, Pregnancy, and Lactation. Nutrients. 2016; 8(5):313. https://doi.org/10.3390/nu8050313 Poretsky L, Kalin MF. The gonadotropic function of insulin. Endocr Rev. 1987;8(2):132-141. doi:10.1210/edrv-8-2-132 Zhang C, Bosch MA, Levine JE, Rønnekleiv OK, Kelly MJ. Gonadotropin-releasing hormone neurons express K(ATP) channels that are regulated by estrogen and responsive to glucose and metabolic inhibition. J Neurosci. 2007;27(38):10153-10164. doi:10.1523/JNEUROSCI.1657-07.2007

Elevated blood glucose is one of the earliest and most common indicators of worsening metabolic health, insulin resistance and cardiovascular disease. For our clients, fasting blood glucose and triglycerides are amongst the first things we test to get a snapshot view of metabolic health. We've now added HbA1C - a marker that offers a broader look at glycemic history - to our baseline blood panel, to better evaluate our clients. On this podcast, NBT Scientific Director Megan Hall talks about the HbA1C blood test: what it is, who needs it, and why you should care. Megan talks about the optimal reference range for this test, and when to become concerned about your result (hint: it's sooner than your doctor would have you believe). She also talks about exactly what to do if your A1C is out of range, and how a continuous glucose monitor can help you evaluate your body's response to different foods and other environmental factors. Here's the outline of this interview with Megan Hall: [00:00:48] HbA1C (aka glycated haemoglobin): a marker of your glycemic history. [00:02:27] Glucose to A1C conversion chart. [00:02:52] Megan's outline for this podcast. [00:03:04] Why you should care about HbA1C. [00:03:48] Optimal ranges for HbA1C: 5.0% to 5.4%. [00:04:33] Studies supporting optimal reference range: 1. Zhong, Guo-Chao, et al. "HbA 1c and Risks of All-Cause and Cause-Specific Death in Subjects without Known Diabetes: A Dose-Response Meta-Analysis of Prospective Cohort Studies." Scientific reports 6.1 (2016): 1-11; 2. Schöttker, Ben, et al. "HbA 1c levels in non-diabetic older adults–No J-shaped associations with primary cardiovascular events, cardiovascular and all-cause mortality after adjustment for confounders in a meta-analysis of individual participant data from six cohort studies." BMC medicine 14.1 (2016): 1-17; 3. Li, Fu-Rong, et al. "Glycated hemoglobin and all-cause and cause-specific mortality among adults with and without diabetes." The Journal of Clinical Endocrinology & Metabolism 104.8 (2019): 3345-3354; 4. Pai, Jennifer K., et al. "Hemoglobin a1c is associated with increased risk of incident coronary heart disease among apparently healthy, nondiabetic men and women." Journal of the American Heart Association 2.2 (2013): e000077. [00:06:12] Prediabetes range: 5.7% to 6.4% (above 6.4% is diabetes). [00:07:06] Only 12% of the population is metabolically healthy; Study: Araújo, Joana, Jianwen Cai, and June Stevens. "Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016." Metabolic syndrome and related disorders 17.1 (2019): 46-52. [00:07:31] Limitations and caveats of the A1C blood marker. [00:08:05] Partial marker of mean glycemic exposure; Article: Bloomgarden, Zachary. "Beyond HbA1c." Journal of diabetes 9.12 (2017): 1052-1053. [00:08:53] Things that cause HbA1C to be falsely low or high. [00:10:14] Study: Virtue, Mark A., et al. "Relationship between GHb concentration and erythrocyte survival determined from breath carbon monoxide concentration." Diabetes Care 27.4 (2004): 931-935. [00:12:36] Racial and ethnic differences: Herman, William H., and Robert M. Cohen. "Racial and ethnic differences in the relationship between HbA1c and blood glucose: implications for the diagnosis of diabetes." The Journal of Clinical Endocrinology & Metabolism 97.4 (2012): 1067-1072. [00:12:42] Other markers of glycemic regulation. [00:12:55] Drawbacks of Glycomark. [00:14:08] Reticulocytes - helpful to calculate RBC lifespan. [00:14:40] Equation: RBC survival (days) = ~ 100 / [Retics (%) / RLS (days)] [00:15:44] Sign up for our group program to get a blood test + bloodsmart.ai report + 4 group coaching sessions + help videos. [00:16:44] Continuous Glucose Monitor (CGM). [00:17:26] Podcast: Continuous Glucose Monitoring to Prevent Disease and Increase Healthspan, with Kara Collier, RDN. [00:17:46] Get $50 off your Nutrisense membership when you support NBT on Patreon. [00:18:26] Studies demonstrating that HbA1C is not the perfect marker: 1. Cohen, Robert M., et al. "Red cell life span heterogeneity in hematologically normal people is sufficient to alter HbA1c." Blood, The Journal of the American Society of Hematology 112.10 (2008): 4284-4291; 2. Wright, Lorena Alarcon-Casas, and Irl B. Hirsch. "The challenge of the use of glycemic biomarkers in diabetes: reflecting on hemoglobin A1C, 1, 5-Anhydroglucitol, and the glycated proteins fructosamine and glycated albumin." Diabetes spectrum 25.3 (2012): 141-148; 3. Dubowitz, N., et al. "Aging is associated with increased HbA1c levels, independently of glucose levels and insulin resistance, and also with decreased HbA1c diagnostic specificity." Diabetic Medicine 31.8 (2014): 927-935. [00:18:58] What to do if your A1C is out of range: Diet, lifestyle, measure other markers, monitor blood glucose. [00:19:35] Cellular vs. acellular carbs. [00:22:25] Simon Marshall, PhD. on stress management: How to Manage Stress. [00:24:19] 4-quadrant model. [00:26:07] Retest after 2-3 months. [00:27:58] Join our group program.

Treatment with Rhodiola mimics exercise to resist high-fat diet-induced muscle dysfunction Central South University (China), April 30, 2021   According to news reporting out of Changsha, People’s Republic of China, research stated, “Muscle dysfunction is a complication of high-fat diet (HFD)-induced obesity that could be prevented by exercise, but patients did not get enough therapeutic efficacy from exercise due to multiple reasons.” The news reporters obtained a quote from the research from Xiangya Hospital of Central South University: “To explore alternative or supplementary approaches to prevent or treat muscle dysfunction in individuals with obesity, we investigated the effects of Rhodiola on muscle dysfunction as exercise pills. SIRT1 might suppress atrogenes expression and improve mitochondrial quality control, which could be a therapeutic target stimulated by exercise and Rhodiola, but further mechanisms remain unclear. We verified the lipid metabolism disorders and skeletal muscle dysfunction in HFD feeding mice. Moreover, exercise and Rhodiola were used to intervene mice with a HFD. Our results showed that exercise and Rhodiola prevented muscle atrophy and dysfunction in obese mice and activating the SIRT1 pathway, while atrogenes were suppressed and mitochondrial quality control was improved. EX-527, SIRT1 inhibitor, was used to validate the essential role of SIRT1 in salidroside benefit.” According to the news editors, the research concluded: “Results of cell culture experiment showed that salidroside alleviated high palmitate-induced atrophy and mitochondrial quality control impairments, but these improvements of salidroside were inhibited by EX-527 in C2C12 myotubes. Overall, Rhodiola mimics exercise that activates SIRT1 signaling leading to improvement of HFD-induced muscle dysfunction.”     Prenatal exposure to pesticides increases the risk of obesity in adolescence First study to analyse the long-term effects of persistent organic pollutants on cardiometabolic risk in adolescents Barcelona Institute for Global Health (Spain), May 3, 2021 Exposure before birth to persistent organic pollutants (POPs)-- organochlorine pesticides, industrial chemicals, etc.--may increase the risk in adolescence of metabolic disorders, such as obesity and high blood pressure. This was the main conclusion of a study by the Barcelona Institute for Global Health (ISGlobal), a research centre supported by the "la Caixa" Foundation. The study was based on data from nearly 400 children living in Menorca, who were followed from before birth until they reached 18 years of age.  POPs are toxic, degradation-resistant chemicals that persist in the environment. Examples of such compounds are pesticides and organochlorine insecticides (DDT, etc.). POPs have adverse effects on both human health and the environment and their use is regulated globally. Prenatal exposure to these substances has been associated with cardiometabolic risk factors in childhood, but there were previously no studies assessing whether such associations continue into adolescence, a developmental stage characterised by significant changes in the endocrine system and rapid increases in body mass. The aim of this investigation, carried out within the framework of the INMA Project-Environment and Childhood, was to study the associations between prenatal exposure to POPs and body mass index (BMI) as well as other markers of cardiovascular risk in adolescence. Data from 379 children in Menorca was analysed. POP levels were measured in umbilical cord blood samples and the children were then seen periodically between the ages of 4 and 18 years. At these visits, BMI, body fat percentage and blood pressure were recorded as they grew. When the child reached 14 years of age, the scientists measured blood biomarkers of cardiometabolic risk (cholesterol, triglycerides, glucose, etc.). The results of this study, published in the journal Environment International, suggest an association between prenatal POP exposure and a higher BMI in adolescence, particularly in the case of the fungicide hexachlorobenzene (HCB) and the insecticide compound dichloro-diphenyl-trichloroethane (DDT).  Exposure to these two organochlorides--HCB and DDT¬--was also associated with higher blood pressure in childhood and adolescence and increased cardiometabolic risk at 14 years of age.  ISGlobal researcher Núria Güil-Oumrait, the first author of the study, explains that "this is the first longitudinal study to analyse the relationship between persistent organic pollutants and cardiometabolic risk throughout childhood and adolescence. Our findings show that the association between these substances and infant BMI does persist into adolescence and that prenatal exposures are associated with the main risk factors for metabolic syndrome in adults, a condition that today affects one in four people worldwide. With respect to the mechanisms that might explain this association, Güil-Oumrait points out that "it is thought that POPs may interact with hormone receptors or with the generation of free radicals, and the chief problem is that these pollutants accumulate in the fatty tissues of living organisms, where they can persist for years, even decades".  Martine Vrijheid, study coordinator and head of the Childhood and Environment Programme at ISGlobal, highlights the fact that "some of these substances could be considered endocrine disruptors, that is, chemicals that interfere with hormonal regulation". In her view "more studies are needed in this field, especially focussing on childhood and adolescence, which are critical developmental stages characterised by particular vulnerability".     One cup of leafy green vegetables a day lowers risk of heart disease Research has found that by eating just one cup of nitrate-rich vegetables each day people can significantly reduce their risk of heart disease. Edith Cowan University (Australia), May 4, 2021 New Edith Cowan University (ECU) research has found that by eating just one cup of nitrate-rich vegetables each day people can significantly reduce their risk of heart disease. The study investigated whether people who regularly ate higher quantities of nitrate-rich vegetables, such as leafy greens and beetroot, had lower blood pressure, and it also examined whether these same people were less likely to be diagnosed with heart disease many years later. Cardiovascular diseases are the number one cause of death globally, taking around 17.9 million lives each year. Researchers examined data from over 50,000 people residing in Denmark taking part in the Danish Diet, Cancer, and Health Study over a 23-year period. They found that people who consumed the most nitrate-rich vegetables had about a 2.5 mmHg lower systolic blood pressure and between 12 to 26 percent lower risk of heart disease. Lead researcher Dr Catherine Bondonno from ECU's Institute for Nutrition Research said identifying diets to prevent heart disease was a priority. "Our results have shown that by simply eating one cup of raw (or half a cup of cooked) nitrate-rich vegetables each day, people may be able to significantly reduce their risk of cardiovascular disease," Dr Bondonno said. "The greatest reduction in risk was for peripheral artery disease (26 percent), a type of heart disease characterised by the narrowing of blood vessels of the legs, however we also found people had a lower risk of heart attacks, strokes and heart failure."  Forget the supplements The study found that the optimum amount of nitrate-rich vegetables was one cup a day and eating more than that didn't seem to give any additional benefits. "People don't need to be taking supplements to boost their nitrate levels because the study showed that one cup of leafy green vegetables each day is enough to reap the benefits for heart disease," Dr Bondonno said. "We did not see further benefits in people who ate higher levels of nitrate rich vegetables." Smoothies are ok Dr Bondonno said hacks such as including a cup of spinach in a banana or berry smoothie might be an easy way to top up our daily leafy greens. "Blending leafy greens is fine, but don't juice them. Juicing vegetables removes the pulp and fibre," Dr Bondonno said. The paper "Vegetable nitrate intake, blood pressure and incident cardiovascular disease: Danish Diet, Cancer, and Health Study" is published in the European Journal of Epidemiology. It is a collaboration between Edith Cowan University, the Danish Cancer Society and The University of Western Australia. The research adds to growing evidence linking vegetables generally and leafy greens specifically with improved cardiovascular health and muscle strength. This evidence includes two recent ECU studies exploring cruciferous vegetables and blood vessel health and green leafy vegetables and muscle strength.     Mindfulness programs can boost children's mental health   University of Derby (UK), May 4, 2021 Mindfulness programs can improve the mental health of school-age children and help them to feel more optimistic, according to new research from the University of Derby and Derbyshire Educational Psychology Service. More than 1,000 pupils aged between 9-12 years old across 25 schools in Derbyshire, received one 45-minute mindfulness session per week for nine weeks during the year-long project, which involved a collaboration between Dr. William Van Gordon, Associate Professor in Contemplative Psychology at the University, and Derbyshire Educational Psychology Service. Mindfulness is an ancient meditation technique that involves focussing awareness on the present moment, as a means of fostering calm, wellbeing and insight. The weekly sessions involved activities such as practicing mindful breathing and paying attention to bodily sensations, as well as exercises intended to help cultivate attention skills and a greater awareness of emotions. The impact of the sessions, which were delivered by teachers in a traditional classroom environment, was evaluated by comparing psychological assessments that the children completed before the classes began, with assessments undertaken after the program had concluded. Part of the evaluation measured children's emotional resiliency using The Resiliency Scale for Children, while wellbeing was rated using the Stirling Children's Wellbeing Scale. Overall, the study found a significant improvement in positive emotional state, outlook and resiliency. There was also an increase in the different dimensions of resilience: optimism increased by 10%, tolerance was improved by 8% and self-efficacy, how a child feels they can cope with a situation based on the skills they have and the circumstances they face, improved by 11%. Professor Van Gordon said: "Findings from the study indicate that mindfulness delivered by school teachers can improve wellbeing and resiliency in children and young people. "This is consistent with wider evidence demonstrating the positive impact of mindfulness on school children's levels of emotional resiliency, emotional stability, wellbeing and stress. "These findings are also in line with the view that preventative interventions given at a young age can help to reduce the incidence of mental health problems in young people."   Vitamin D levels higher in exercisers Johns Hopkins University, May 01 2021  The issue of the Journal of Clinical Endocrinology & Metabolism published the finding of researchers at Johns Hopkins University of a correlation between increased physical activity and higher levels of vitamin D. Higher levels of vitamin D and exercise was also associated with a lower risk of cardiovascular disease. The study included 10,342 men and women who were free of coronary heart disease and heart failure upon enrollment in the Atherosclerosis Risk in Communities study. Physical activity levels were assessed during follow-up visits that took place over a 19.3-year period. Stored serum samples obtained at the second visit were analyzed for 25-hydroxyvitamin D3. Subjects who achieved American Heart Association recommended physical activity levels had average levels of vitamin D that were higher than those who had intermediate and poor levels of activity. Following adjustment for lifestyle and other factors, those who met the recommended levels had a 31% lower risk of being deficient in vitamin D than those with poor activity levels. Subjects in the recommended activity group with levels of vitamin D of 30 ng/mL or more had a 24% lower risk of cardiovascular disease. The association between exercise and vitamin D was stronger in subjects of European ethnicity than among African Americans. The authors noted that European-Americans as well as those who engage in exercise are likelier to be supplement users. “We did find that vitamin D supplement use was higher among those with increased physical activity,” they observed. "In our study, both failure to meet the recommended physical activity levels and having vitamin D deficiency were very common" stated coauthor Erin Michos, MD, MS, of Johns Hopkins University School of Medicine. "The bottom line is we need to encourage people to move more in the name of heart health."     One teaspoon daily of trehalose can help maintain glucose homeostasis: a double-blind, randomized controlled trial  Hayashibara Co. Ltd (Japan), April 24, 2021 Background Trehalose is a natural disaccharide that is widely distributed. A previous study has shown that daily consumption of 10 g of trehalose improves glucose tolerance in individuals with signs of metabolic syndrome. In the present study, we determined whether a lower dose (3.3 g/day) of trehalose improves glucose tolerance in healthy Japanese volunteers. Methods This was a randomized, double-blind, placebo-controlled study of healthy Japanese participants (n = 50). Each consumed 3.3 g of trehalose (n = 25) or sucrose (n = 25) daily for 78 days. Their body compositions were assessed following 0, 4, 8, and 12 weeks; and serum biochemical parameters were assayed and oral 75-g glucose tolerance tests were performed at baseline and after 12 weeks. Results There were similar changes in body composition and serum biochemistry consistent with established seasonal variations in both groups, but there were no differences in any of these parameters between the two groups. However, whereas after 12 weeks of sucrose consumption, the plasma glucose concentration 2 h after a 75-g glucose load was significantly higher than the fasting concentration, after 12 weeks of trehalose consumption the fasting and 2-h plasma glucose concentrations were similar. Furthermore, an analysis of the participants with relatively high postprandial blood glucose showed that the plasma glucose concentration 2 h after a 75-g glucose load was significantly lower in the trehalose group than in the sucrose group. Conclusions Our findings suggest that trehalose helps lower postprandial blood glucose in healthy humans with higher postprandial glucose levels within the normal range, and may therefore contribute to the prevention of pathologies that are predisposed to by postprandial hyperglycemia,, even if the daily intake of trehalose is only 3.3 g, an amount that is easily incorporated into a meal.     Coffee compound enhances autophagy to protect against cell injury Chengdu University of Traditional Chinese Medicine (China), April 30, 2021 According to news reporting originating from Sichuan, People’s Republic of China, research stated, “Autophagy serves an important role in amyloid-beta (A beta) metabolism and tau processing and clearance in Alzheimer’s disease. The progression of A beta plaque accumulation and hyperphosphorylation of tau proteins are enhanced by oxidative stress.” Our news editors obtained a quote from the research from the Chengdu University of Traditional Chinese Medicine, “A hydrogen peroxide (H2O2) injury cell model was established using SH-SY5Y cells. Cells were randomly divided into normal, H2O2 and chlorogenic acid (5-caffeoylquinic acid; CGA) groups. The influence of CGA on cell viability was evaluated using a Cell Counting Kit-8 assay and cell death was assessed using Hoechst 33342 nuclear staining. Autophagy induction and fusion of autophagic vacuoles assays were performed using monodansylcadaverine staining. Additionally, SH-SY5Y cells expressing Ad-mCherry-green fluorescent protein-LC3B were established to detect autophagic flow. LysoTracker Red staining was used to evaluate lysosome function and LysoSensor ™ Green staining assays were used to assess lysosomal acidification. The results demonstrated that CGA decreased the apoptosis rate, increased cell viability and improved cell morphology in H2O2-treated SH-SY5Y cells. Furthermore, CGA alleviated the accumulation of autophagic vacuoles, reduced the LC3BII/I ratio and decreased P62 levels, resulting in increased autophagic flux. Additionally, CGA upregulated lysosome acidity and increased the expression levels of cathepsin D. Importantly, these effects of CGA on H2O2-treated SH-SY5Y cells were mediated via the mTOR-transcription factor EB signaling pathway.” According to the news editors, the research concluded: “These results indicated that CGA protected cells against H2O2-induced oxidative damage via the upregulation of autophagosomes, which promoted autophagocytic degradation and increased autophagic flux.” This research has been peer-reviewed.

Lion’s mane mushroom helps reduce depression and anxiety Tohoku University (Japan), March 21, 2021 Several studies have shown the potential of lion’s mane mushroom to help address several health problems including those that are related to brain function. Lion’s mane mushroom (Hericium erinaceus), also known as hedgehog mushroom, is a mushroom native to North America, Asia and Europe. Its fruiting bodies are said to contain polysaccharides that are beneficial to the human body. This mushroom has a long history of medical uses, especially in Traditional Chinese Medicine (TCM) where it was used to help support brain health. In recent years, its value in supporting cognitive health has been supported by a number of studies. The mushroom helps Reduce depression and anxiety In a study published in the journal Biomedical Research, the mushroom was tested on female participants in order to tests its effects on mental health. After taking lion’s mane mushroom cookies for four weeks, the participants reported reduced depression and anxiety. According to the researchers, this was due to two chemical constituents isolated from lion’s mane’s fruiting body called hericenones and erinacines. These two chemicals stimulate nerve growth factor (NGF) biosynthesis. NGF takes part in a number of activities in the body that are essential in maintaining and organizing neurons. By stimulating NGF biosynthesis, lion’s mane is able to help improve mental health. Meanwhile, in a study on mice, researchers from Tohoku University  in Japan discovered that lion’s mane mushroom may be used to prevent cognitive dysfunction. The Japanese researchers administered 10 micrograms of amyloid-beta peptide to the mice on days seven and 14 in their 23-day experimental period. Also, the mice subjects were fed with food containing lion’s mane mushroom over the course of the experimental period. To measure the results of their study, the team used Y-maze and the novel object recognition tests on the subjects. They discovered that the mushroom prevented the negative effects of amyloid-beta peptide on the spatial short-term and visual recognition memory of the mice. The study suggests that the mushroom might reverse even the effects of amyloid-beta peptide – a protein believed to cause Alzheimer’s disease. Lion’s mane for cognitive impairment Moreover, in another study conducted by Japanese scientists, lion’s mane mushroom showed potential in improving symptoms of mild cognitive impairment. This is the stage between aging-related cognitive decline and the development of dementia. Its symptoms include problems with memory, language, thinking or judgment. The team took 30 patients with mild cognitive impairment and gave them 250mg tablets with 96 percent lion’s mane extract to be taken in four pieces for three times a day for 16 weeks. During weeks eight, 12 and 16, the patients underwent observation wherein they showed improvement in their cognitive function as displayed by the increase of their scores on the cognitive function scale. Moreover, the researchers conducted laboratory tests on the patients and saw that the intake of lion’s mane did not result in any side effect. In addition, the patients’ scores in the cognitive function scale decreased by the time their intake of lion’s mane mushroom tablets stopped.       Quercetin-3-o-glucuronide alleviates cognitive deficit in mouse model of Alzheimer disease Hua-zhong University of Science & Technology (China), March 22, 2021   According to news reporting from Wuhan, People’s Republic of China, research stated, “Scope Alzheimer’s disease (AD) is characterized by amyloid-beta (A beta) related imbalance, Tau-hyperphosphorylation, and neuroinflammation, in which A beta and neuroinflammation can induce brain insulin resistance (IR). Gut microbiome disorder is correlated with inflammation in AD.” The news correspondents obtained a quote from the research from the Huazhong University of Science and Technology, “As of yet, there are no effective treatments clinically. Thus, it is focused on the potential benefit of quercetin-3-O-glucuronide (Q3G), a pharmacologically active flavonol glucuronide, on AD treatment by regulating brain IR and the gut microbiome. AD mice model built through intracerebroventricular injection of A beta(1-42) and AD cell model developed through the SH-SY5Y cell line and A beta(1-42) are used to explore the protective effects of Q3G on AD. Neurobehavioral test, brain insulin signaling pathway, and high-throughput pyrosequencing of 16S rRNA are assessed. Data show that Q3G attenuates neuroinflammation and brain IR in A beta(1-42)-injected mice and relieves apoptosis in A beta(1-42)-treated SH-SY5Y cells by interrupting the downstream insulin signaling. Q3G ameliorates A beta accumulation and Tau phosphorylation, restores CREB and BDNF levels in the hippocampus , and reverses A beta(1-42)-induced cognitive impairment. Besides, Q3G restores A beta(1-42)-induced reduction of short-chain fatty acids (SCFAs) and gut microbiota dysbiosis.” According to the news reporters, the research concluded: “Q3G can alleviate brain IR through directly acting on the brain or modulating the gut-brain axis, ultimately to relieve A beta(1-42)-induced cognitive dysfunction.” This research has been peer-reviewed.     Research shows possible link between number of fast-food outlets and heart attacks Hunter Medical Research Institute & University of Newcastle (UK), March 17, 2021  Researchers from the Hunter Medical Research Institute (HMRI), the University of Newcastle and Hunter New England Health (HNE Health) have found that for each new fast-food outlet the number of heart attacks per 100,000 people went up by four. Published in the latest edition of the Internal Medicine Journal the study aimed to determine whether the number of fast-foodoutlets in an area could be considered an environmental risk factor for Myocardial Infarction (heart attack). The team led by Dr. Tarunpreet Saluja from the University of Newcastle, compared all cases of Myocardial Infarction within the Hunter-New England Health District with the Fast-Food Outlet Density (FFD) of each Local Government Area within the district.  "Heart attack is one of the leading causes of death worldwide" said Dr. Saluja, "However, recent data suggests that an increasing number of heart attacks cannot be explained by known risk factors." "There is a well-established link between fast food consumption and cardiovascular diseases such as heart attack. This highlights the need to explore the role of food availability in the probability of having a heart attack." The team found that FFD was positively correlated with an increase of myocardial infarction, even after accounting for other factors such as age, obesity, hyperlipidaemia (high cholesterol), hypertension (high blood pressure), smoking status, diabetes, and socioeconomic status.  Study co-author and cardiologist at John Hunter Hospital, Professor Andrew Boyle said that while it has been known for some time that consuming fast food was bad for the heart no one had determined whether the number of stores was itself a predicting factor.  "Until now there has been very little data on the link between fast-food outlet density and heart attacks, so these results should provide an important consideration for future public‐health policy and community development," said Professor Boyle.  Study co-author and Associate Director of HMRI's Data Science Group, Dr. Christopher Oldmeadow, said that developing a new metric to calculate fast-food outlet density was key to the study and there was scope to expand the data to look at more outlets in the future.  "For this study, we focused on the 10 most popular fast-food outlets in Australia and used census data to determine the density per 100,000 people in each local government area," Dr. Oldmeadow said. "This worked for the majority of the LGAs, but there is scope to investigate the relationship between smaller, locally operated fast‐food outlets and heart attacks."   Vitamin B6 may help calm cytokine storms in COVID-19 University of Hiroshima (Japan), March 14, 2021 Vitamin B6 may help calm cytokine storms and unclog blood clots linked to novel coronavirus (COVID-19) lethality, according to a new study published in the journal Frontiers in Nutrition. In the paper, researchers from Hiroshima University pointed out growing evidence showing that vitamin B6 exerts a protective effect against chronic illnesses such as cardiovascular diseases and diabetes by suppressing inflammation, inflammasomes, oxidative stress, and carbonyl stress. Coronaviruses and influenza are among the viruses that can cause lethal lung injuries and death from acute respiratory distress syndrome worldwide. Viral infections evoke a “cytokine storm,” leading to lung capillary endothelial cell inflammation, neutrophil infiltration, and increased oxidative stress, the researchers said. The researchers said thrombosis or blood clotting and cytokine storm or hyper-inflammation might be closely linked to the graveness of COVID-19. Cytokine storms happen when the immune system dangerously goes into overdrive and starts attacking even the healthy cells. Meanwhile, blood clots linked to COVID-19 can block capillaries, damaging vital organs like the heart, lungs, liver, and kidneys, according to the study. Vitamin B6 is a known anti-thrombosis and anti-inflammation nutrient. Deficiency in this vitamin is also associated with lower immune function and higher susceptibility to viral infections. Studies have so far explored the benefits of vitamins D and C and minerals like zinc and magnesium in fortifying immune response against COVID-19. Research on vitamin B6 has been limited, the researchers said. The researchers said they hope the paper will show vitamin B6's potential in lowering the odds of patients becoming seriously ill with the coronavirus, and prompt further research. "It is of great interest to examine if vitamin B6 exerts protection against novel types of virus infection and pneumonia which will be encountered in the future,” said Thanutchaporn Kumrungsee, PhD, lead author of the paper, in a statement. “At present, there is few information regarding the protective role of nutrients against pneumonia and lung diseases.” Vitamin B6 has a close relationship with the immune system, she said. Its levels always drop in people under chronic inflammation such as obesity, diabetes, and heart diseases. “We can see from the news that obese and diabetic people are at high risk for COVID-19, said Kumrungsee. “Thus, our attempt in this paper is to shed light on the possible involvement of vitamin B6 in decreasing the severity of COVID-19.     Green space or light at night: How we can improve health University of Adelaide (Australia), March 18, 2021 There is a growing body of evidence that exposure to green space is good for our health but a new study from the University of Adelaide has found that this may equally be due to how much light we are exposed to at night. Spending time in green space can improve depressive symptoms, obesity, and sleep problems, and reduce the risk of breast and prostate cancer. Conversely, exposure to light at night, particularly urban light pollution, increases the risk of breast and prostate cancer, and can worsen depression, obesity and sleep problems.  Researchers identified a negative correlation between green space diversity and outdoor artificial light at night for Australian major cities—in other words, the greener your environment, the less the light pollution, and vice versa.  This makes intuitive sense, because the more developed an area is, the fewer trees there will be and the more lights there will be.  Published in Environmental Research, the study questions whether the health benefits of green space exposure may in part be a result of avoiding light at night.  "There seems to be a pattern here—yet, amazingly, no one has put these two things together—until now,"' said lead author Dr. Jessica Stanhope from the University of Adelaide's School of Allied Health Science and Practice.  "It is possible that these factors have been confounding each other in epidemiological studies of the associations between residential green spaces and improved health, and urban outdoor artificial light at night exposure and poor health.  "We have shown that green space is inversely associated with outdoor artificial light at night, making it unclear whether health outcomes result from the green space, the light at night, or possibly in an interaction of the two."  Researchers recommend that epidemiological studies focus on resolving this problem as a priority, so that recommendations can be made for interventions that would improve the public health. For example, to improve population health, is it more important to plant green space in urban areas to give people in cities better green space exposure, or is it better to invest that effort in reducing urban light pollution, or both?  "Some great studies have been done on the association between green space and health, which is a rapidly growing research area; and there are also very neat epidemiological studies of the adverse health effects of exposure to light at night," said Dr. Stanhope.  "It is now really important that future studies include both factors so that we can better understand their association—only then can we make better public health recommendations about planning health-giving sustainable urban landscapes."   Supplements may protect those with low vitamin D levels from severe COVID-19 Albert Einstein College of Medicine, March 20, 2021 Patients with low vitamin D levels who are hospitalized for COVID-19 may have a lower risk of dying or requiring mechanical ventilation if they receive vitamin D supplementation of at least 1,000 units weekly, according to a study presented virtually at ENDO 2021, the Endocrine Society's annual meeting. "Given how common vitamin D deficiency is in the world and the United States, we believe that this research is highly relevant right now," said co-author Sweta Chekuri, M.D., of Montefiore Health System and Albert Einstein College of Medicine in the Bronx, New York.  Research has shown that vitamin D supplementation can prevent inflammation in other respiratory diseases, but there have been limited studies examining the role of vitamin D supplementation in COVID-19. The purpose of the study was to determine whether being supplemented with vitamin D before being admitted to the hospital with COVID-19 resulted in less severe COVID-19 disease in patients with a low vitamin D level. The researchers studied 124 adult patients with low vitamin D that was measured up to 90 days before their admission for COVID-19. They compared the patients who were supplemented with at least 1,000 units of vitamin D weekly to those who had not received vitamin D supplements in terms of whether they were mechanically ventilated or died during admission. They found that patients who were supplemented were less likely to be mechanically ventilated or to die following admission, though the finding wasn't statistically significant (37.5 percent of patients who were not supplemented vs. 33.3 percent of those who were) They also found that more than half of those who should have been supplemented were not.  "Though we weren't able to show a definitive link to severe COVID-19, it is clear that patients with low vitamin D should receive supplementation not only for bone health, but also for stronger protection against severe COVID-19," said co-author Corinne Levitus, D.O., of Montefiore Health System and Albert Einstein College of Medicine. "We hope this research will encourage clinicians to discuss adding this supplement with their patients who have low vitamin D, as this may reduce the odds of people developing severe COVID-19." A study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism last fall found over 80 percent of 200 COVID-19 patients in a hospital in Spain had vitamin D deficiency.     Study finds changes in gut microbiome connected to Alzheimer-like behavior Oregon Health & Science University, March 19, 2021 New research in mice published in the journal Scientific Reports strengthens the growing scientific consensus regarding the role of the gut microbiome in neurodegenerative disorders including Alzheimer’s disease. The study, led by researchers at Oregon Health & Science University, found a correlation between the composition of the gut microbiome and the behavioral and cognitive performance of mice carrying genes associated with Alzheimer’s. The mice carried the human amyloid precursor protein gene with dominant Alzheimer’s mutations generated by scientists in Japan. The study further suggests a relationship between microbes in the digestive tract and the expression of genes that trigger Alzheimer-like symptoms in mice. “You know the expression, ‘You are what you eat?’” said senior author Jacob Raber, Ph.D., professor of behavioral neuroscience in the OHSU School of Medicine. “This may be part of that. While all mice were fed the same diet, the gut microbiome is affected in a genotype-dependent fashion and this in turn might affect your brain.” The findings are the first to demonstrate a direct connection between the gut microbiome and cognitive and behavioral changes in an Alzheimer’s disease animal model, and they are consistent with a recently published observational study in people newly diagnosed with Alzheimer’s. In fact, a U.S. clinical trial for the treatment of mild to moderate Alzheimer’s disease is currently underway involving a compound that targets microbes in the gut. The research published breaks new ground. In addition to the cognitive and behavioral changes that were measured, the study is the first to demonstrate a relationship between changes in the gut microbiome and epigenetic changes in neural tissue in the hippocampus, an area of the brain affected in Alzheimer’s. This type of research is not possible in people. The microbiome is a complex assemblage of microorganisms such as bacteria that play a critical role in a wide range of functions in the body. In this case, researchers wanted to see if the gut microbiome affected cognitive and behavioral measures in specially bred mice at 6 months of age. So they compared wild-type mice with those genetically engineered to carry the human amyloid precursor protein gene with dominant Alzheimer’s mutations. They found changes in the gut microbiome - measured in fecal pellets - corresponded with epigenetic regulation of the apolipoprotein E and Tomm40 genes, both associated with Alzheimer’s. They found a clear correlation, but they still can’t say whether one causes the other. “Microbes may elicit an impact on behavioral and cognitive measures relevant to Alzheimer’s disease via epigenetic changes in the hippocampus,” Raber said. “Or, alternatively, it might be that the epigenetic changes in the hippocampus affect changes in the gut microbiome.” The next phase of research will determine whether it’s possible to reduce Alzheimer’s-like symptoms in genetically predisposed mice by altering their diet. “The exciting part of this is that you can manipulate the gut microbiome,” Raber said. “We can use probiotics and see what the effect is.”

In hoeverre speelt aanleg een rol in de kans op overgewicht? Coach Erik en Jeroen behandelen de meest bekende theorieën en gaan in de de rol van de omgeving en het biopsychosociaal model.Besproken bronnen:https://www.fit.nl/afvallen/aanleg-overgewichtDemerath, E. W. (2012). The genetics of obesity in transition. Collegium antropologicum, 36(4), 1161-1168.Llewellyn, C., & Wardle, J. (2015). Behavioral susceptibility to obesity: gene–environment interplay in the development of weight. Physiology & behavior, 152, 494-501.Konttinen, H., Llewellyn, C., Wardle, J., Silventoinen, K., Joensuu, A., Männistö, S., … & Haukkala, A. (2015). Appetitive traits as behavioural pathways in genetic susceptibility to obesity: a population-based cross-sectional study. Scientific reports, 5, 14726.Vanderpump, M. P. (2011). The epidemiology of thyroid disease. British medical bulletin, 99(1).Savas, M., Wester, V. L., Staufenbiel, S. M., Koper, J. W., Van Den Akker, E. L., Visser, J. A., … & Van Rossum, E. F. (2017). Systematic evaluation of corticosteroid use in obese and non-obese individuals: a multi-cohort study. International journal of medical sciences, 14(7), 615.Vinales, K. L., Schlögl, M., Piaggi, P., Hohenadel, M., Graham, A., Bonfiglio, S., … & Thearle, M. S. (2017). The consistency in macronutrient oxidation and the role for epinephrine in the response to fasting and overfeeding. The Journal of Clinical Endocrinology & Metabolism, 102(1), 279-289.Schlögl, M., Piaggi, P., Pannacciuli, N., Bonfiglio, S. M., Krakoff, J., & Thearle, M. S. (2015). Energy expenditure responses to fasting and overfeeding identify phenotypes associated with weight change. Diabetes, 64(11), 3680-3689.Müller, M. J., Enderle, J., Pourhassan, M., Braun, W., Eggeling, B., Lagerpusch, M., … & Bosy-Westphal, A. (2015). Metabolic adaptation to caloric restriction and subsequent refeeding: the Minnesota Starvation Experiment revisited. The American journal of clinical nutrition, 102(4), 807-819.Piaggi, P., Vinales, K. L., Basolo, A., Santini, F., & Krakoff, J. (2018). Energy expenditure in the etiology of human obesity: spendthrift and thrifty metabolic phenotypes and energy-sensing mechanisms. Journal of endocrinological investigation, 41(1), 83-89.Weyer, C., Vozarova, B., Ravussin, E., & Tataranni, P. A. (2001). Changes in energy metabolism in response to 48 h of overfeeding and fasting in Caucasians and Pima Indians. International journal of obesity, 25(5), 593-600.Norgan, N.G. & Durnin, J.V. (1980). The effect of 6 weeks of overfeeding on the body weight, body composition, and energy metabolism of young men.The American journal of clinical nutrition. ;33:978–88. Bray, G. A., Smith, S. R., de Jonge, L., Xie, H., Rood, J., Martin, C. K., … & Redman, L. M. (2012). Effect of dietary protein content on weight gain, energy expenditure, and body composition during overeating: a randomized controlled trial. Jama, 307(1), 47-55.Reinhardt, M., Thearle, M. S., Ibrahim, M., Hohenadel, M. G., Bogardus, C., Krakoff, J., & Votruba, S. B. (2015). A human thrifty phenotype associated with less weight loss during caloric restriction. Diabetes, 64(8), 2859-2867.Piaggi, P. (2019). Metabolic determinants of weight gain in humans. Obesity, 27(5), 691-699.Hollstein, T., Ando, T., Basolo, A., Krakoff, J., Votruba, S. B., & Piaggi, P. (2019). Metabolic response to fasting predicts weight gain during low-protein overfeeding in lean men: further evidence for spendthrift and thrifty metabolic phenotypes. The American journal of clinical nutrition, 110(3), 593-604.Koepp, G. A., Moore, G. K., & Levine, J. A. (2016). Chair-based fidgeting and energy expenditure. BMJ open sport & exercise medicine, 2(1), e000152.Montague, C. T., Farooqi, I. S., Whitehead, J. P., Soos, M. A., Rau, H., Wareham, N. J., … & Cheetham, C. H. (1997). Congenital leptin deficiency is associated with severe early-onset obesity in humans. Nature, 387(6636), 903-908.Levine, J. A. (2002). Non-exercise activity thermogenesis (NEAT). Best Practice & Research Clinical Endocrinology & Metabolism, 16(4), 679-702.

We look at sugars and appetite with Kathleen Page, MD, associate professor of medicine at the University of Southern California Keck School of Medicine. Dr. Page is the corresponding author of a new article published in The Journal of Clinical Endocrinology & Metabolism, "Appetite-Regulating Hormones Are Reduced After Oral Sucrose vs Glucose: Influence of Obesity, Insulin Resistance, and Sex." For more information, including helpful links and other episodes, visit our website at https://www.endocrine.org/podcast.

It's the worst!  Watching your hair slide down the shower drain or clumping up on your brush is a horrible feeling, especially for women!Our hair is connected to our identity, our youth, and our health.While it’s natural for some women to experience hair loss at certain times in their menstrual cycles or times of the year, hair loss is also caused by specific health conditions including a thyroid imbalance.So the question here is....Why does a thyroid imbalance cause thinning hair?Your hair normally grows in a healthy cyclical pattern with most of the hair follicles growing while only a small number are “resting.”With a thyroid imbalance, this cycle can be thrown off, resulting in more hair follicles “resting” than growing — and more hair falling out.Hair loss is a very common symptom of a thyroid imbalance.But thyroid imbalances often arise slowly and remain unnoticed by women and their doctors in the early phases.Even with a lab test, your doctor may say everything is fine with your thyroid, even though you strongly suspect that something is wrong.This is because standard labs have a very wide range for what is “normal” in terms of thyroid test results.So how do you know if your hair loss is connected to a thyroid disorder?So here are 5 signs and symptoms your hair loss is connected to a thyroid disorder1. Thinning eyebrowsHypothyroidism - which is an underactive thyroid  often causes general hair loss as well as thinning of the outer third of the eyebrows.We don’t know exactly why the eyebrow is targeted in thyroid disorders, but this is a good indicator that your thyroid hormones may be low.2. Hair that is brittle, dry, and breaking easily.Dry, brittle hair is also connected to low thyroid function. And research published in the Journal of Clinical Endocrinology & Metabolism finds that thyroid hormones increase growth and color in hair.Low thyroid hormone can lead to the early release of the hair shaft and root, as well as premature gray or white hair.3. Feeling exhausted all the time, even after 8 hours of sleep.The thyroid is the master of our metabolism, so it affects the way we use and store energy.With low thyroid hormone, metabolism slows down. This can often lead to persistent fatigue as well as weight gain4. Puffiness in the faceMany people with hypothyroidism have an excess of a compound called mucin.Mucin is part of our connective tissue and is present in blood vessels and cells all over the body. It absorbs water and may cause excess water retention in an individual with an underactive thyroid imbalance.5. Yellowing of the palms of your hands. Yellowing of the skin on your hands can happen with a thyroid imbalance due a build-up of carotene in your blood. Hypothyroidism can slow the conversion of carotene to vitamin A.If you think your hair loss might be connected to a thyroid imbalance, begin supporting your thyroid — and your hair — naturally.Adaptogens are the safest and best way to help the body cope with stress.  Other products like CBD can also help.Shop our Evoq Beauty Root Revival Hair Growth System (2x's more powerful than Minoxidil) and CBD @evoqbeauty  and www.evoqbeauty.coLove and light!Share the Love:If you like The Awakened Beauty Podcast….Subscribe, Rate & Review via iTunesVisit us at awakenedbeautyhq.com for updates.Businesses: www.evoqbeauty.com | www.beautyecology.comInstagram @awakenbeautyhqInstagram @evoqbeautyWatch on Youtube at my channel: Awaken Beauty PodcastShop natural health and beauty products with EVOQHere’s how!Go to awakenbeauty-hq on ITunes and write your biggest takeaway in the rate and review section. Just pretend it says “ah ha” here!! Don’t just review the episode, I would love your ah-ha moment from this episode that is more specific so you can confirm your takeaway as you write, but also help others capture your brilliance. It’ll take 3 minutes from your day. What you declare will be life to others. So remember, go to I tunes to rate and review.Comment or question you’d like to ask Kassandra.P.S! Your review is not only paramount in helping others discover the show, but we also read each and every submission personally…and they mean the world to us.Love and Light! - KassandraIn the Meantime, STAY IN THE CONVERSATION! @awakenbeautyhq | #awakenbeauty#hairlosts #hairgrowth #naturalhaircare #organicbeauty #organicsalon #thyroidimbalance #thyroid #hormones

We get a lot of questions from our clients about postprandial fatigue. Never heard of it? Well you’ve certainly familiar with the term “food coma” - and perhaps with the experience of being in one. What causes this phenomenon and why does it affect some people more than others? Is it normal to need a nap after lunch?  On this podcast I’m joined by NBT Scientific Director Megan Hall to talk about postprandial fatigue - the sleepiness, difficulty focusing, and even dizziness or nausea that strikes after consuming a meal. Megan talks about some of the biological processes behind the need for a post-meal snooze, and when to suspect a deeper pathology. She also offers practical tips to help you resolve your own postprandial fatigue. Thank you everyone who so generously supports this podcast on Patreon - without your support, we wouldn’t be able to keep this podcast independent and free of ads. So thank you. And just a reminder - as a Patreon supporter - not only do you have our eternal gratitude, but also... You get some awesome gifts - including 20-35% discounts on all supplements we recommend when working with clients, which saves many of our supporters $50-$100 a month over what they were previously paying on Amazon. So by supporting the podcast, they’re actually spending LESS money each month. In addition to that, you can also get access to our Office Hours, where Megan answers questions twice a week. You can submit all your own questions, as well as listen to all the replays, covering everything from krill oil to mitochondrial support. We’ve worked really hard to make sure that the bonuses you get are actually way more valuable than what you pay whatever level you choose to support us at. So if you’d like to support the podcast and get access to the discounts and Office Hours, just head over to NBT.link and sign up there. Here’s the outline of this interview with Megan Hall: [00:04:25] Common symptoms of postprandial fatigue. [00:05:46] Reactive hypoglycemia; Study: Johnson, Debra D., Kay E. Dorr, and Wendell M. Swenson. "Reactive hypoglycemia." JAMA 243.11 (1980): 1151-1155.  [00:06:35] Diagnosing reactive hypoglycemia; Study: CHALEW, STUART, et al. "Diagnosis of reactive hypoglycemia: pitfalls in the use of the oral glucose tolerance test." Southern Medical Journal 79.3 (1986): 285-287. [00:09:00] Symptoms and causes of hypoglycemia. [00:09:37] Increased insulin sensitivity; Studies: 1. Brun, J. F., et al. "Increased insulin sensitivity and basal insulin effectiveness in postprandial reactive hypoglycaemia." Acta Diabetologica 33.1 (1996): 1-6; 2. Vexiau, P., B. Legoff, and G. Cathelineau. "Insulin and cortisol secretion during OGTT in patients with reactive hypoglycaemia with or without clinical symptoms." Hormone and metabolic research 15.09 (1983): 419-421. [00:09:47] Hypocortisolism; Studies: 1. Meyer, Gesine, et al. "Nocturnal hypoglycemia identified by a continuous glucose monitoring system in patients with primary adrenal insufficiency (Addison's disease)." Diabetes Technology & Therapeutics 14.5 (2012): 386-388; 2. Christiansen, Jens Juel, et al. "Effects of cortisol on carbohydrate, lipid, and protein metabolism: studies of acute cortisol withdrawal in adrenocortical failure." The Journal of Clinical Endocrinology & Metabolism 92.9 (2007): 3553-3559. [00:10:05] Hypothyroidism; Studies: 1. Kalra, Sanjay, Ambika Gopalakrishnan Unnikrishnan, and Rakesh Sahay. "The hypoglycemic side of hypothyroidism." Indian Journal of Endocrinology and Metabolism 18.1 (2014): 1; 2. Yadav, Tek Chand, et al. "Recurrent hypoglycemia: An unusual finding of hypothyroidism." Thyroid Research and Practice 14.3 (2017): 127. [00:10:53] What to do about hypoglycemia. [00:13:09] Accelerated gastric emptying. [00:16:20] Reactive hypoglycemia after exercise. [00:18:51] Postprandial hyperglycemia; Study: Gerich, John E. "Clinical significance, pathogenesis, and management of postprandial hyperglycemia." Archives of internal medicine 163.11 (2003): 1306-1316. [00:20:38] Problems associated with hyperglycemia; Studies: 1. Ceriello, Antonio, et al. "Meal-induced oxidative stress and low-density lipoprotein oxidation in diabetes: the possible role of hyperglycemia." Metabolism 48.12 (1999): 1503-1508; 2. Ceriello, Antonio, et al. "Meal-generated oxidative stress in type 2 diabetic patients." Diabetes care 21.9 (1998): 1529-1533; 3. Cavalot, F. "Do data in the literature indicate that glycaemic variability is a clinical problem? Glycaemic variability and vascular complications of diabetes." Diabetes, Obesity and Metabolism 15.s2 (2013): 3-8; 4. Ceriello, Antonio, et al. "Evidence for an independent and cumulative effect of postprandial hypertriglyceridemia and hyperglycemia on endothelial dysfunction and oxidative stress generation: effects of short-and long-term simvastatin treatment." Circulation 106.10 (2002): 1211-1218; 5. Tibaldi, Joseph. "Importance of postprandial glucose levels as a target for glycemic control in type 2 diabetes." Southern medical journal 102.1 (2009): 60-66. [00:21:24] Insulin resistance. [00:21:39] Video: PAH 2016 - A systems analysis approach to insulin resistance, with Dr. Tommy Wood. [00:23:02] What to do: Look at diet; 1. Krebs, Jeremy D., et al. "Improvements in glucose metabolism and insulin sensitivity with a low-carbohydrate diet in obese patients with type 2 diabetes." Journal of the American College of Nutrition 32.1 (2013): 11-17; 2. Lin, Po-Ju, and Katarina T. Borer. "Third exposure to a reduced carbohydrate meal lowers evening postprandial insulin and GIP responses and HOMA-IR estimate of insulin resistance." PloS one 11.10 (2016): e0165378; 3. MacDonald, Ian A. "A review of recent evidence relating to sugars, insulin resistance and diabetes." European journal of nutrition 55.2 (2016): 17-23; 4. Bradley, Una, et al. "Low-fat versus low-carbohydrate weight reduction diets: effects on weight loss, insulin resistance, and cardiovascular risk: a randomized control trial." Diabetes 58.12 (2009): 2741-2748. [00:28:46] Mediterranean diet; Study: Guasch-Ferré, Marta, et al. "Dietary polyphenols, Mediterranean diet, prediabetes, and type 2 diabetes: a narrative review of the evidence." Oxidative Medicine and Cellular Longevity 2017 (2017). [00:29:56] Endotoxemia and insulin resistance 1. Moreira, AP Boroni, and R. de Cássia Gonçalves Alfenas. "The influence of endotoxemia on the molecular mechanisms of insulin resistance." Nutrición hospitalaria 27.2 (2012): 382-390; 2. Cani, Patrice D., et al. "Metabolic endotoxemia initiates obesity and insulin resistance." Diabetes 56.7 (2007): 1761-1772. [00:30:24] Megan's outline for this podcast.  [00:31:19] When fatigue after a meal might be normal. [00:33:08] Article: Why a pandemic flu shot caused narcolepsy. [00:33:49] Both high fat and high carb meals can cause sleepiness; Study: Wells, Anita S., et al. "Effects of meals on objective and subjective measures of daytime sleepiness." Journal of applied physiology 84.2 (1998): 507-515. [00:33:56] Intestinal stimulation can cause sleepiness; Kukorelli, Tibor, and Gábor Juhász. "Electroencephalographic synchronization induced by stimulation of small intestine and splanchnic nerve in cats." Electroencephalography and clinical neurophysiology 41.5 (1976): 491-500. [00:34:20] Sleepiness after eating vs. just chewing; Study: MJ Harnish, SR Greenleaf, WC Orr, “A comparison of feeding to cephalic stimulation on postprandial sleepiness.” Physiology & behavior 64.1 (1998):93-96. [00:34:38] Cholecystokinin (CCK) may affect the alert centers in the brain; Study: Wells, Anita S., et al. "Influences of fat and carbohydrate on postprandial sleepiness, mood, and hormones." Physiology & behavior 61.5 (1997): 679-686. [00:37:13] Thermogenesis; Study: Zammit, Gary K., et al. "Postprandial sleep and thermogenesis in normal men." Physiology & behavior 52.2 (1992): 251-259. [00:37:40] Summary: How to fix the problem. [00:38:43] Nutrisense for continuous glucose monitoring (CGM). [00:46:29] Timing your walk with glucose peak; Study: Reynolds, Andrew N., and Bernard J. Venn. "The timing of activity after eating affects the glycaemic response of healthy adults: a randomised controlled trial." nutrients 10.11 (2018): 1743. [00:51:01] Support NBT on Patreon to access the forum.  

In this episode Dr. Donohoe and Dr. Panno discuss digestion, post-prandial (post-meal) glucose, and how they each affect one another.  We go over several studies that assess gastric emptying time (rate of digestion) and its impact on post-prandial glucose spikes and stability. We cover the various things that can change gastric emptying time and how you can use this information to better control your blood sugar. PLEASE SUBSCRIBE TO THE PODCAST For more Diabuddies content follow us on The Diabuddies Podcast Facebook page. Twitter: @TheDiabuddies Instagram: @thediabuddiespodcast You can email us at TheDiabuddiesPodcast@gmail.com   Time Stamps 2:11 - Why Carbs are not the only factor for dosing a meal? 4:20 - Defining Post-Prandial Glucose and Gastric Emptying (GE) 6:05 - Common Symptoms for Digestive Issues for Non-Diabetics, Type 1's and Type 2's 9:52 - The 3 Main Factors that affect the Postprandial response 14:40 - You can get Neuropathy on your stomach? Autonomic Neuropathy and Digestion 22:25 - More Accurate (Nerdy) Definition of Gastric Emptying  23:45 - The 3 Main Factors of Macronutrients and their Impact on Gastric Emptying 27:00 - Blood Sugar's Impact on the Motility of Food in Non Diabetics and Diabetics  34:51 - Meal Characteristics with the macronutrients (Carb/Protein/Fat) 43:16 - Cholecystectomy (Removal of Gallbladder), and its impact on Digestion and therefore Blood Sugar 50:03 - Different Insulin Dosage Strategies for different macronutrients  57:56 - SO WHAT? How can we use GE in the future to manage blood sugar? 1:10:41 - Applying GE to specific diets (Keto/Vegan/Low Carb, etc) and other health conditions  1:14:39 - Bursts My Beta cells   Resources/Links Discussed in the episode: Lupoli, Roberta, et al. “Gastric Emptying Impacts the Timing of Meal Glucose Peak in Subjects With Uncomplicated Type 1 Diabetes.” The Journal of Clinical Endocrinology & Metabolism, vol. 103, no. 6, 2018, pp. 2269–2276., doi:10.1210/jc.2017-02811. Lupoli, Roberta, et al. “Postprandial Glucose Control in Type 1 Diabetes: Importance of the Gastric Emptying Rate.” Nutrients, vol. 11, no. 7, 2019, p. 1559., doi:10.3390/nu11071559. Marathe, Chinmay S., et al. “Hypoglycaemia and Gastric Emptying.” Diabetes, Obesity and Metabolism, vol. 21, no. 3, 2018, pp. 491–498., doi:10.1111/dom.13570. Smart, C. E. M., et al. “Both Dietary Protein and Fat Increase Postprandial Glucose Excursions in Children With Type 1 Diabetes, and the Effect Is Additive.” Diabetes Care, vol. 36, no. 12, 2013, pp. 3897–3902., doi:10.2337/dc13-1195.

In this episode Dr. Grady Donohoe outlines one of the greatest advancements in blood sugar management. With CGMs, both diabetics (type 1 and 2) and non-diabetics can so much data from these little devices that they can use to master the balancing act of staying "in range" and lowering HbA1c. He talks about the difference of CGMs and finger stick glucometers, the 3 available CGM systems, and how to use them to make less guesses and more educated decisions when it comes to managing your blood sugar (whether you are diabetic or not). PLEASE SUBSCRIBE TO THE PODCAST For more Diabuddies content follow us on The Diabuddies Podcast Facebook page. Twitter: @TheDiabuddies Instagram: @thediabuddiespodcast You can email us at TheDiabuddiesPodcast@gmail.com   Resources/Links Discussed in the episode: Beck, Roy W., et al. “Effect of Continuous Glucose Monitoring on Glycemic Control in Adults With Type 1 Diabetes Using Insulin Injections.” Jama, vol. 317, no. 4, 2017, p. 371., doi:10.1001/jama.2016.19975. Lind, Marcus, et al. “Continuous Glucose Monitoring vs Conventional Therapy for Glycemic Control in Adults With Type 1 Diabetes Treated With Multiple Daily Insulin Injections.” Jama, vol. 317, no. 4, 2017, p. 379., doi:10.1001/jama.2016.19976. Shah, Viral N, et al. “Continuous Glucose Monitoring Profiles in Healthy Nondiabetic Participants: A Multicenter Prospective Study.” The Journal of Clinical Endocrinology & Metabolism, vol. 104, no. 10, 2019, pp. 4356–4364., doi:10.1210/jc.2018-02763.

Polycystic Ovarian Syndrome (PCOS) is common, affecting 5 to 15% of women of reproductive age. PCOS can have reproductive, metabolic and psychological implications across the lifespan. This month on COG we talk with Prof Adam Balen about the international evidenced based guideline released in 2018 on the the diagnosis and management of PCOS. Then in journal club we discuss 4 articles: Costello, M. F., et al. "Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility." (2019): hoy021. Smithson, David S., Tannys DR Vause, and Anthony P. Cheung. "No. 362-ovulation induction in polycystic ovary syndrome." Journal of Obstetrics and Gynaecology Canada 40.7 (2018): 978-987. Torres, Pedro J., et al. "Gut microbial diversity in women with polycystic ovary syndrome correlates with hyperandrogenism." The Journal of Clinical Endocrinology & Metabolism 103.4 (2018): 1502-1511. Varanasi, L. Chitra, et al. "Polycystic ovarian syndrome: prevalence and impact on the wellbeing of Australian women aged 16–29 years." Australian and New Zealand Journal of Obstetrics and Gynaecology 58.2 (2018): 222-233. Related papers from the International group: Teede, Helena J., et al. "Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome." Human Reproduction 33.9 (2018): 1602-1618.

→ Join the Brainjo Collective ← Researcher and writer Bill Lagakos, PhD earned his doctorate in Nutritional Biochemistry and Physiology from Rutgers University, with a focus on obesity, insulin resistance, and circadian biology. He went on to post-doctoral research on inflammation and diabetes, which led to an interest and course of study on circadian rhythm with the Mayo clinic. Bill is the author of the book, “The Poor, Misunderstood Calorie,” and maintains an active blog where he explores health-related topics in the scientific literature. On this podcast with Tommy Wood, MD, Bill discusses critical aspects of entraining circadian rhythm, including the importance of early time-restricted eating. They challenge the concept of chronotypes and discuss why your intermittent fasting program may not be giving you the results you want. Bill also shares his impressions on macronutrient requirements, and the effects of ketosis on body composition and athletic performance. Here’s the outline of this interview with Bill Lagakos: [00:00:22] Bill's Patreon page. [00:00:41] Blog: Calories Proper. [00:03:47] Circadian rhythm and metabolism. [00:05:11] Metabolism is gimped at night; Study: Bo, S., et al. "Is the timing of caloric intake associated with variation in diet-induced thermogenesis and in the metabolic pattern? A randomized cross-over study." International Journal of Obesity 39.12 (2015): 1689. [00:05:26] Meal timing and the circadian regulation of nutrient partitioning; Study: Jakubowicz, Daniela, et al. "Influences of breakfast on clock gene expression and postprandial glycemia in healthy individuals and individuals with diabetes: a randomized clinical trial." Diabetes care (2017): dc162753. [00:05:54] Studies: Jacobs, H., Thompson, M., Halberg, E., Halberg, F., Fraeber, C., Levine, H. & Haus, E. (1975) Relative body weight loss on limited free-choice meal consumed as breakfast rather than as dinner. Chronobiologia 2 (suppl 1): 33; and Hirsh, E., Halberg, F., Goetz, F.C., Cressey, D., Wendt, H., Sothern, R., Haus, E., Stoney, P., Minors, D., Rosen, G., Hill, B., Hilleren, M. & Garett, K. (1975) Body weight change during 1 week on a single daily 2000-calorie meal consumed as breakfast (B) or dinner (D). Cronobiologia 2 (suppl 1): 31–32. [00:06:40] Study: Lombardo, Mauro, et al. "Morning meal more efficient for fat loss in a 3-month lifestyle intervention." Journal of the American College of Nutrition 33.3 (2014): 198-205. [00:08:57] Study: Gasmi, Maha, et al. "Time-restricted feeding influences immune responses without compromising muscle performance in older men." Nutrition 51 (2018): 29-37. [00:10:20] Study: Gabel, Kelsey, et al. "Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: A pilot study." Nutrition and Healthy Aging Preprint: 1-9. [00:12:19] Breakfast like a king, lunch like a prince, and dinner like a pauper. [00:12:30] Early Time-Restricted Feeding; Study: Sutton, Elizabeth F., et al. "Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes." Cell metabolism 27.6 (2018): 1212-1221. [00:13:56] Podcast: How to Use Time-Restricted Eating to Reverse Disease and Optimize Health, with Satchin Panda, PhD. [00:14:16] Continuous energy restriction vs. Intermittent Fasting; Study: Sundfør, T. M., M. Svendsen, and S. Tonstad. "Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: A randomized 1-year trial." Nutrition, Metabolism and Cardiovascular Diseases (2018). [00:15:00] Circadian rhythm disruption and disease risk. [00:16:10] Electronics at night as circadian rhythm disruption. [00:16:44] Artificial light at night and cancer; Studies: Yuan, Xia, et al. "Night shift work increases the risks of multiple primary cancers in women: a systematic review and meta-analysis of 61 articles." Cancer Epidemiology and Prevention Biomarkers 27.1 (2018): 25-40; and Kubo, Tatsuhiko, et al. "Prospective cohort study of the risk of prostate cancer among rotating-shift workers: findings from the Japan collaborative cohort study." American journal of epidemiology 164.6 (2006): 549-555. [00:20:27] Chronotypes as a species-level distinction. [00:23:33] Philips goLITE BLU Energy Light. [00:24:17] Best advice for shift workers. [00:25:20] Genetic polymorphisms; MTNR gene. [00:26:38] Sleep deprivation leads to increased calorie consumption. Study: Broussard, Josiane L., et al. "Elevated ghrelin predicts food intake during experimental sleep restriction." Obesity 24.1 (2016): 132-138. [00:27:41] Sleep contributes to the maintenance of lean body mass. Study: Nedeltcheva, Arlet V., et al. "Insufficient sleep undermines dietary efforts to reduce adiposity." Annals of internal medicine 153.7 (2010): 435-441. [00:29:12] Macronutrient composition of diet. [00:29:23] Book: The Poor, Misunderstood Calorie, by William Lagakos, PhD. [00:30:12] Reduced industrial foods resulting in weight loss; Study: Ebbeling, Cara B., et al. "Effects of a low–glycemic load vs low-fat diet in obese young adults: a randomized trial." Jama 297.19 (2007): 2092-2102. [00:30:31] Calories less important when eating processed foods; Monkey study: Kavanagh, Kylie, et al. "Trans fat diet induces abdominal obesity and changes in insulin sensitivity in monkeys." Obesity 15.7 (2007): 1675-1684. [00:32:16] Protein intake recommendations. [00:34:44] The glucose-sparing effect of ketones. [00:35:47] Protein needed to maintain lean-muscle mass during keto. Study: Meckling, Kelly A., Caitriona O’sullivan, and Dayna Saari. "Comparison of a low-fat diet to a low-carbohydrate diet on weight loss, body composition, and risk factors for diabetes and cardiovascular disease in free-living, overweight men and women." The Journal of Clinical Endocrinology & Metabolism 89.6 (2004): 2717-2723. [00:36:43] Ketogenic diets and mental health. [00:37:24] Neuroprotective properties of keto; Study: Maalouf, Marwan, Jong M. Rho, and Mark P. Mattson. "The neuroprotective properties of calorie restriction, the ketogenic diet, and ketone bodies." Brain research reviews 59.2 (2009): 293-315. [00:37:40] Poor adherence to keto in more severe dementia. Study: Taylor, Matthew K., et al. "Feasibility and efficacy data from a ketogenic diet intervention in Alzheimer's disease." Alzheimer's & Dementia: Translational Research & Clinical Interventions 4 (2018): 28-36. [00:38:02] MCT oil used to moderate cognitive decline; Study: Henderson, Samuel T., et al. "Study of the ketogenic agent AC-1202 in mild to moderate Alzheimer's disease: a randomized, double-blind, placebo-controlled, multicenter trial." Nutrition & metabolism 6.1 (2009): 31. [00:38:39] Keto for Bipolar Disorder; Study: Phelps, James R., Susan V. Siemers, and Rif S. El-Mallakh. "The ketogenic diet for type II bipolar disorder." Neurocase 19.5 (2013): 423-426. [00:39:14] Consultation with clients. [00:41:02] Blog post on changing sleep duration: Circadian rhythms, sleep deprivation, and human performance. [00:42:21] Athletics and adaptation to ketosis. [00:43:25] Wingate test. [00:43:46] Olympic weightlifters; Study: Greene, David A., et al. "A Low-Carbohydrate Ketogenic Diet Reduces Body Mass Without Compromising Performance in Powerlifting and Olympic Weightlifting Athletes." The Journal of Strength & Conditioning Research 32.12 (2018): 3373-3382. [00:45:52] Blog; Twitter; Patreon.

Dr. Leonard Wartofsky is Professor of Medicine, Georgetown University School of Medicine and Chairman Emeritus, Department of Medicine, MedStar Washington Hospital Center.  He trained in internal medicine at Barnes Hospital, Washington University and in endocrinology with Dr. Sidney Ingbar, Harvard University Service, Thorndike Memorial Laboratory, Boston.   Dr. Wartofsky is past President of both the American Thyroid Association and The Endocrine Society.  He is the editor of books on thyroid cancer for both physicians and for patients, and thyroid cancer is his primary clinical focus.   He is the author or coauthor of over 350 articles and book chapters in the medical literature, is recent past Editor-in-Chief of the Journal of Clinical Endocrinology & Metabolism, and is the current Editor-in-Chief of Endocrine Reviews. In this episode, Dr. Wartofsky discusses the following: Bioavailability versus content of a thyroid replacement tablet, and how it is absorbed. Hypothyroidism causes When is replacement thyroid replacement hormone necessary? The history of replacement thyroid hormone going back to 1891 The early treatment included a chopped up sheep thyroid and served as a ‘tartar’, often resulting in vomiting Myxedema coma The danger of taking generic T4; are cheaper, larger profit margin, but the content varies. Synthroid versus generic Manufacturing plants in Italy, India, Puerto Rico are known to produce generics Content versus absorption when taking generic T4 An explanation of TSH 1.39 is a healthy TSH level for women in the U.S. Symptoms of hypothyroidism, such as a slow mind, poor memory, dry skin, brittle hair, slow heart rate, problems with pregnancy, miscarriage, and hypertension. Screening TSH levels if contemplating pregnancy T4 is the most prescribed drug in the U.S. Hypothyroidism is common when there is a family history Auto-immune disease is often associated with hypothyroidism An explanation of T3 An explanation of desiccated thyroid The T3 ‘buzz’ Muhammed Ali’s overdose of T3 Dangers of too much T3 When to take T4 medication, and caution toward taking mediations that interfere with absorption Coffee and thyroid hormone absorption Losing muscle and bone by taking too much thyroid hormone Taking ownership of your disease NOTES Listen to Doctor Thyroid Related Episode : 37: Adding T3 to T4 Will Make You Feel Better? For Some the Answer is ‘Yes’ with Dr. Antonio Bianco from Rush University American Thyroid Association Leonard Wartofsky

Indiegogo campaign: Medical Study on Hashimoto's Disease and AIP Dr. Joseph Mercola is a board-certified physician and best-selling author whose name has become synonymous with natural health. He’s long been a controversial figure in the public eye, thanks to his outspoken opposition to the norms of the medical establishment. He has maintained a popular website over the past 20 years, catering to the growing number of people seeking alternatives for the prevention and treatment of chronic illness. On this podcast, Dr. Mercola talks with Dr. Tommy Wood about the health consequences of electromagnetic fields (EMFs). They review the science that supports the need for greater caution in the age of cell phones and wireless technology. They also discuss the specific biological processes in the human body that are affected by EMFs and the steps you can take in your own home to mitigate the damage. Here’s the outline of this interview with Dr. Mercola: [00:03:30] Research funded by telecoms industry; Study: Huss, Anke, et al. "Source of funding and results of studies of health effects of mobile phone use: systematic review of experimental studies." Epidemiology 17.6 (2006): S439. [00:03:43] Olle Johansson; Talk: Health Effects of Electromagnetic Fields. [00:04:03] Types of EMFs - Electric, Magnetic, and Radio frequencies. [00:05:09] 10^18 (quintillion) times increase in exposure to radio frequencies. [00:06:54] Sam Milham, epidemiologist. [00:08:38] Thomas Levy, cardiologist. [00:09:22] Martin Pall, PhD; Studies evaluating the effect of calcium channel blockers on EMF toxicity: 1, 2, 3, 4. [00:10:14] Voltage-gated calcium channel (VGCG). [00:10:23] Paul Héroux. [00:10:52] Video: Dr. Mercola Interviews Paul Heroux. [00:11:23] Magnesium as a natural calcium channel blocker. [00:12:52] Resveratrol study: Kjær, Thomas Nordstrøm, et al. "No beneficial effects of resveratrol on the metabolic syndrome: a randomized placebo-controlled clinical trial." The Journal of Clinical Endocrinology & Metabolism 102.5 (2017): 1642-1651. [00:14:31] Study: Pacher, Pál, Joseph S. Beckman, and Lucas Liaudet. "Nitric oxide and peroxynitrite in health and disease." Physiological reviews 87.1 (2007): 315-424. [00:15:30] NAD/Diabetes Study: Yoshino, Jun, et al. "Nicotinamide mononucleotide, a key NAD+ intermediate, treats the pathophysiology of diet-and age-induced diabetes in mice." Cell metabolism 14.4 (2011): 528-536. [00:16:00] Richard Veech; NADPH as the true battery of the cell. [00:16:43] Effect of exogenous ketones on NADPH. Study: Veech, Richard L., et al. "Ketone bodies mimic the life span extending properties of caloric restriction." IUBMB life 69.5 (2017): 305-314. [00:17:14] Symptoms of EMF exposures: brain and heart. [00:18:00] Cancer: Glioblastoma increase; Study: Philips, Alasdair, et al. "Brain tumours: rise in Glioblastoma Multiforme incidence in England 1995–2015 suggests an adverse environmental or lifestyle factor." Journal of Environmental and Public Health 2018 (2018). [00:18:02] Tumors on ipsilateral side of head that cell phone is used; Study: Hardell, Lennart, and Michael Carlberg. "Mobile phone and cordless phone use and the risk for glioma–Analysis of pooled case-control studies in Sweden, 1997–2003 and 2007–2009." Pathophysiology 22.1 (2015): 1-13. [00:18:29] Electromagnetic hypersensitivity. [00:19:28] World Health Organization: EMF given 2B classification. [00:20:18] Long-term effects. [00:20:26] Infertility; Study: Sommer, Angela M., et al. "Effects of radiofrequency electromagnetic fields (UMTS) on reproduction and development of mice: a multi-generation study." Radiation research 171.1 (2009): 89-95. [00:21:12] Autism, Alzheimer's, fertility; Study: Adams, Jessica A., et al. "Effect of mobile telephones on sperm quality: a systematic review and meta-analysis." Environment international 70 (2014): 106-112. [00:23:00] Book: The Non-Tinfoil Guide to EMFs: How to Fix Our Stupid Use of Technology, by Nicholas Pineault; Electrosmog Rx online course. [00:23:38] How to mitigate EMF. [00:23:48] Acousticom 2; Magda Havas. [00:25:10] Dr. Dietrich Klinghardt. [00:26:14] Reducing EMF in the home. [00:27:53] Shielding; smart meters, Faraday cage. [00:30:04] Materials that block EMF. [00:32:40] 8-hydroxy-2-deoxyguanosine, Organic Acids Test, DUTCH Test. [00:34:07] DNA damage; Studies: Lai, Henry. "Single-and double-strand DNA breaks in rat brain cells after acute exposure to radiofrequency electromagnetic radiation." International journal of radiation biology 69.4 (1996): 513-521; Replicated by 2004 European REFLEX study. Final REFLEX report here. [00:34:33] Ionizing vs non-ionizing radiation. [00:35:16] REFLEX report: 24 hours of cell phone use equivalent to 1600 chest x-rays. [00:36:02] Reducing ionizing radiation on aeroplanes. [00:36:26] Zach Bush’s Nitric Oxide Dump. [00:36:54] Exogenous ketones; Dr. Veech’s ketone ester. [00:37:10] NRF2 upregulators (e.g., molecular hydrogen), Cannabidiol (CBD). [00:38:10] Hormetea. [00:39:15] Mitigating damage from cell phones. [00:40:11] Magnetic fields; Trifield. [00:40:42] Dirty electricity; Book: Dirty Electricity: Electrification and the Diseases of Civilization, by Samuel Milham. [00:41:43] Grounding. [00:42:27] Stetzerizer Filter; Dave Stetzer, Martin Graham; Greenwave. [00:44:47] EMF Tents. [00:46:10] Hierarchy of treatment interventions. [00:47:33] Book: Overpowered: The Dangers of Electromagnetic Radiation (EMF) and What You Can Do about It, by Martin Blank; Dr. Mercola’s video interviews. [00:48:55] Other interesting papers Tommy has read along the way: 1, 2, 3, 4, 5, 6. [00:48:55] Bioinitiative 2012 Report.

Dr. Ben House, PhD. is a Nutritionist (CN), Functional Diagnostic Nutrition (FDN) practitioner, and Certified Functional Medicine Practitioner (CFMP), as well as a strength coach and the owner of Functional Medicine Costa Rica.  He has a passion for researching, writing, and teaching, and hosts professional and wellness retreats in the Jungle of Uvita, Costa Rica. Today Ben is talking with Dr. Tommy Wood, MD, PhD, about his pragmatic approach to health coaching and training. They discuss testosterone, estrogen, ketosis, and building strength, muscle mass and resilience.  They also share problem-solving strategies for helping clients who aren’t making the progress they want. In the intro, I also mentioned our new Blood Chemistry Calculator that utilizes a machine learning algorithm and blood chemistry data from 36,000 people. This is a powerful tool that can help identify your specific health challenges without directly testing for them, pointing you more squarely in the direction of your health and performance goals. Here’s the outline of this interview with Dr Ben House: [00:00:42] Dr. Ruscio’s Podcast: Adrenal Testing, Mitochondrial Health, Testosterone, Stress, Calories, Body Comp, and Much More with Dr. Ben House. [00:01:35] Background. [00:02:18] Coeliac disease. [00:04:17] Podcast: How to Create Behaviour Change, with Simon Marshall, PhD. [00:05:24] Retreats in Costa Rica. [00:06:17] Study: Trexler, Eric T., et al. "Fat-Free Mass Index in NCAA Division I and II Collegiate American Football Players." The Journal of Strength & Conditioning Research 31.10 (2017): 2719-2727. [00:07:48] Strength in the endurance athlete. [00:09:40] Testosterone. [00:11:26] Exercised induced hypogonadal male. [00:12:23] GNRH. Study: Bergendahl, Matti, and Johannes D. Veldhuis. "Altered pulsatile gonadotropin signaling in nutritional deficiency in the male." Trends in Endocrinology & Metabolism 6.5 (1995): 145-159. [00:12:48] Physicians for Ancestral Health. [00:13:56] Undereating. [00:14:08] Acromegaly. [00:14:39] Optimal foraging theory. [00:15:55] Getting in the calories on a minimally processed diet. [00:18:31] Low WBC. [00:20:45] 100% meat diet. [00:21:41] Scurvy. [00:21:50] Shawn Baker, MD, nequalsmany.com. [00:23:02] Consistency. [00:24:05] Study: Travison, Thomas G., et al. "Temporal trends in testosterone levels and treatment in older men." Current Opinion in Endocrinology, Diabetes and Obesity 16.3 (2009): 211-217. [00:24:39] How testosterone is made. [00:26:19] Heartmath, float tank. [00:26:50] Traumatic Brain Injury. [00:27:13] Varicocele. [00:29:17] Testosterone Replacement Therapy (TRT). [00:30:05] Studies: Finkelstein, Joel S., et al. "Gonadal steroids and body composition, strength, and sexual function in men." New England Journal of Medicine 369.11 (2013): 1011-1022, and Chao, Jing, et al. "Short-Term Estrogen Withdrawal Increases Adiposity in Healthy Men." The Journal of Clinical Endocrinology & Metabolism 101.10 (2016): 3724-3731. [00:31:29] Oestrogen. [00:32:40] Dried Urine Test for Comprehensive Hormones (DUTCH); also see Podcast: How to Get Deep Insights on Hormones and Their Metabolism, with Mark Newman. [00:33:55] Sex Hormone-Binding Globulin (SHBG). [00:34:17] Albumin. [00:34:26] Megalin. [00:36:58] Looking at sleep, training program. [00:38:28] Bryan Walsh. [00:39:29] Mass2 training protocol. [00:40:01] Dopamine. [00:43:23] Finding a training program. [00:45:19] Gut infections: Cryptosporidium, Giardia. [00:46:29] Practitioner training. [00:47:58] Pseudoscience. [00:48:51] Building credibility. [00:50:16] Chris Kresser. [00:51:24] Book: Mindset: The New Psychology of Success, by Carol Dweck. [00:52:45] Ben on Facebook. [00:52:58] Retreats. [00:54:52] Ben’s website. [00:55:13] Study: Brinkworth, Grant D., et al. "Long-term effects of a very-low-carbohydrate weight loss diet compared with an isocaloric low-fat diet after 12 mo." The American journal of clinical nutrition 90.1 (2009): 23-32. [00:56:36] Jeff Volek. [00:57:05] Keto for women. [00:58:15] Fat and CHO PTSD. [00:58:43] Podcast: The Most Reliable Way to Lose Weight, with Dr. Tommy Wood. [01:00:20] Tracking basal body temp. [01:00:35] Study: Pontzer, Herman, et al. "Constrained total energy expenditure and metabolic adaptation to physical activity in adult humans." Current Biology 26.3 (2016): 410-417. [01:02:19] Podcast with Ryan Baxter: How to Fuel For Your Sport (with Obstacle Course Racing as an Example). [01:03:16] How much can you eat?

Dr Jeffry N. Gerber, MD, FAAFP is a board-certified family physician and owner of South Suburban Family Medicine in Littleton, Colorado, where he is known as “Denver’s Diet Doctor”. He has been providing personalized healthcare to the local community since 1993 and continues that tradition with an emphasis on longevity, wellness and prevention. In this interview, Dr Gerber describes the major root causes of cardiovascular disease, the most important of which is insulin-resistant Type 2 Diabetes. Worried about your heart disease risk? Get a coronary artery calcium (CAC) score. Your CAC score (and the rate of progression of your CAC score) is probably the best easily-available predictor of cardiac events. A recent paper from the CARDIA study also showed that an elevated CAC score was highly predictive of long-term heart disease risk in younger adults (18-30 year-olds). Here’s the outline of this interview with Dr. Jeffry N. Gerber, MD: [00:01:27] Clinical experience. [00:02:27] Interest in low-carb diets. [00:03:21] Presentation: Ivor Cummins: “Roads to Ruin?” The Pathways and Implications of Insulin Resistance. [00:03:38] Book: Diabetes Epidemic & You by Joseph R. Kraft. [00:04:23] Professor Grant Schofield and Catherine Crofts, PhD. Podcast: Hyperinsulinaemia and Cognitive Decline with Catherine Crofts, PhD. [00:05:08] Hyperinsulinemia and CVD. [00:06:39] The 2 hour insulin test < 30 UI/mL. [00:07:20] Fiorentino, Teresa Vanessa, et al. "One-hour postload hyperglycemia is a stronger predictor of type 2 diabetes than impaired fasting glucose." The Journal of Clinical Endocrinology & Metabolism 100.10 (2015): 3744-3751. [00:07:51] < 5 UI/mL fasting insulin. [00:10:40] What causes CVD? [00:11:49] Carl von Rokitansky. [00:12:02] Rudolf Virchow. [00:12:19] Blog: Dr. Malcolm Kendrick. [00:13:49] Russell Ross. [00:15:40] List of things that cause CVD. [00:16:44] Nitric Oxide. [00:17:43] Jerry Reaven. [00:19:19] Vega, Gloria Lena, et al. "Triglyceride–to–high-density-lipoprotein-cholesterol ratio is an index of heart disease mortality and of incidence of type 2 diabetes mellitus in men." Journal of Investigative Medicine 62.2 (2014): 345-349. [00:20:17] The Framingham study. [00:21:53] LDL-P and advanced testing. [00:22:32] CAC score. [00:23:41] Intimal media thickness. [00:26:11] Ordering a scan. [00:26:41] 64-slice EBCT machine. [00:27:08] Valenti, Valentina, et al. "A 15-year warranty period for asymptomatic individuals without coronary artery calcium: a prospective follow-up of 9,715 individuals." JACC: Cardiovascular Imaging 8.8 (2015): 900-909. [00:28:15] Soft plaque. [00:28:57] CT angiogram. [00:29:44] Don't let perfect be the enemy of very good. [00:30:34] How to get a zero score. [00:31:28] Industrial seed oils. [00:32:02] D3/K2, magnesium, vitamin C. [00:33:29] Statins. [00:33:47] Absolute risk reduction data. [00:34:13] Ridker, Paul M., et al. "Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein." New England Journal of Medicine 359.21 (2008): 2195. [00:34:40] NICE guidelines for prevention of cardiovascular disease. [00:36:45] Studies: Puri, Rishi, et al. "Impact of statins on serial coronary calcification during atheroma progression and regression." Journal of the American College of Cardiology 65.13 (2015): 1273-1282, Sattar, Naveed, et al. "Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials." The Lancet 375.9716 (2010): 735-742, and Preiss, David, et al. "Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis." Jama 305.24 (2011): 2556-2564. [00:37:22] Interview: Calcification and CAC with the Expert: Professor Matthew J. Budoff, MD, FAAC, Part 1 and Professor Matthew J. Budoff Part 2: Primary Care Physicians and CAC. [00:37:41] Book: Eat Rich, Live Long: Mastering the Low-Carb & Keto Spectrum for Weight Loss and Longevity by Ivor Cummins and Dr. Jeffry Gerber – February 6, 2018. [00:38:50] Four body types: Skinny, insulin-resistant type, the overweight, typical T2 diabetic type, the overweight, insulin-sensitive type, and the metabolically healthy type. [00:40:50] Conference: Low-Carb Breckenridge 2018. [00:41:28] Dr Rod Tayler. [00:42:25] Dr Andrew Mentee and the PURE study. [00:42:46] List of speakers at Low-Carb Breckenridge 2018. [00:43:06] IHMC STEM-Talk Episode 41: Dr David Diamond talks about the role of fat, cholesterol, and statin drugs in heart disease.         [00:44:15] Dr Jeffry N. Gerber, MD, FAAFP. [00:45:27] Rebuttal: 9NEWS – Explaining the science behind the keto diet with Dr Jeffrey Gerber.

Whether you have a bad habit or simply like to unwind with a drink on the regular, the science is pretty clear -- Alcohol isn't helping your dad bod. Find out why you should seriously consider limiting your alcohol intake while you are on the journey to be a better parent in mind, body, and spirit. #redefiningdadbod.Citations[i]Francis A. Tayie, Garret L. Beck. . (2016) Alcoholic beverage consumption contributes to caloric and moisture intakes and body weight status. Nutrition 32:7-8, 799-805.CrossRef[ii] Relationships Between Nutrition, Alcohol Use, and Liver Disease.Charles S. Lieber, M.D., M.A.C.P. National Institute on Alcohol Abuse and Alcoholism. September 29, 2004. http://pubs.niaaa.nih.gov/publications/arh27-3/220-231.htm[iii] Heikkonen, E., Ylikahri, R., Roine, R., Välimäki, M., Härkönen, M. and Salaspuro, M. (1996), The Combined Effect of Alcohol and Physical Exercise on Serum Testosterone, Luteinizing Hormone, and Cortisol in Males. Alcoholism: Clinical and Experimental Research, 20: 711–716. doi:10.1111/j.1530-0277.1996.tb01676.x[iv] Alcoholic Beverages as a source of estrogens. Judith S. Gavaler, PhD. Vol 22, No.3. 1998. http://pubs.niaaa.nih.gov/publications/arh22-3/220.pdf[v] Sleep, Sleepiness, and Alcohol Use. Timothy Roehrs, PhD. National Institute on Abuse and Alcoholism. 2002. http://pubs.niaaa.nih.gov/publications/arh25-2/101-109.htm[vi] Alcohol-Induced Testicular Atrophy in the Adult Male RatDAVID H. VAN THIEL, JUDITH S. GAVALER, CHARLES F. COBB, RICHARD J. SHERINS, and ROGER LESTEREndocrinology 1979 105:4, 888-895[vii] The Endocrine Activities of 8-Prenylnaringenin and Related Hop (Humulus lupulus L.) FlavonoidsR. Milligan, J. C. Kalita, V. Pocock, V. Van De Kauter, J. F. Stevens, M. L. Deinzer, H. Rong, and D. De KeukeleireThe Journal of Clinical Endocrinology & Metabolism 2000 85:12, 4912-4915[viii] Alcoholic Beverages as a source of estrogens. Judith S. Gavaler, PhD. Vol 22, No.3. 1998. http://pubs.niaaa.nih.gov/publications/arh22-3/220.pdf[ix] Suzanne Steinbaum, M.D., director of women and heart disease at Lenox Hill Hospital, New York City; Elizabeth Kovacs, Ph.D., director of the alcohol research program, Loyola University Medical Center, Chicago. Interview, May 2012. http://www.medicinenet.com/script/main/art.asp?articlekey=160482[x] Loyola University Health System. “Moderate drinking may protect against Alzheimer's and cognitive impairment, study suggests.” ScienceDaily. ScienceDaily, 19 August 2011.Become a supporter of this podcast: https://www.spreaker.com/podcast/faithful-fitness-by-better-daily--5150768/support.

Whether you have a bad habit or simply like to unwind with a drink on the regular, the science is pretty clear -- Alcohol isn't helping your dad bod. Find out why you should seriously consider limiting your alcohol intake while you are on the journey to be a better parent in mind, body, and spirit. #redefiningdadbod.Citations[i]Francis A. Tayie, Garret L. Beck. . (2016) Alcoholic beverage consumption contributes to caloric and moisture intakes and body weight status. Nutrition 32:7-8, 799-805.CrossRef[ii] Relationships Between Nutrition, Alcohol Use, and Liver Disease.Charles S. Lieber, M.D., M.A.C.P. National Institute on Alcohol Abuse and Alcoholism. September 29, 2004. http://pubs.niaaa.nih.gov/publications/arh27-3/220-231.htm[iii] Heikkonen, E., Ylikahri, R., Roine, R., Välimäki, M., Härkönen, M. and Salaspuro, M. (1996), The Combined Effect of Alcohol and Physical Exercise on Serum Testosterone, Luteinizing Hormone, and Cortisol in Males. Alcoholism: Clinical and Experimental Research, 20: 711–716. doi:10.1111/j.1530-0277.1996.tb01676.x[iv] Alcoholic Beverages as a source of estrogens. Judith S. Gavaler, PhD. Vol 22, No.3. 1998. http://pubs.niaaa.nih.gov/publications/arh22-3/220.pdf[v] Sleep, Sleepiness, and Alcohol Use. Timothy Roehrs, PhD. National Institute on Abuse and Alcoholism. 2002. http://pubs.niaaa.nih.gov/publications/arh25-2/101-109.htm[vi] Alcohol-Induced Testicular Atrophy in the Adult Male RatDAVID H. VAN THIEL, JUDITH S. GAVALER, CHARLES F. COBB, RICHARD J. SHERINS, and ROGER LESTEREndocrinology 1979 105:4, 888-895[vii] The Endocrine Activities of 8-Prenylnaringenin and Related Hop (Humulus lupulus L.) FlavonoidsR. Milligan, J. C. Kalita, V. Pocock, V. Van De Kauter, J. F. Stevens, M. L. Deinzer, H. Rong, and D. De KeukeleireThe Journal of Clinical Endocrinology & Metabolism 2000 85:12, 4912-4915[viii] Alcoholic Beverages as a source of estrogens. Judith S. Gavaler, PhD. Vol 22, No.3. 1998. http://pubs.niaaa.nih.gov/publications/arh22-3/220.pdf[ix] Suzanne Steinbaum, M.D., director of women and heart disease at Lenox Hill Hospital, New York City; Elizabeth Kovacs, Ph.D., director of the alcohol research program, Loyola University Medical Center, Chicago. Interview, May 2012. http://www.medicinenet.com/script/main/art.asp?articlekey=160482[x] Loyola University Health System. “Moderate drinking may protect against Alzheimer’s and cognitive impairment, study suggests.” ScienceDaily. ScienceDaily, 19 August 2011.

Whether you have a bad habit or simply like to unwind with a drink on the regular, the science is pretty clear -- Alcohol isn't helping your dad bod. Find out why you should seriously consider limiting your alcohol intake while you are on the journey to be a better parent in mind, body, and spirit. #redefiningdadbod.Citations[i]Francis A. Tayie, Garret L. Beck. . (2016) Alcoholic beverage consumption contributes to caloric and moisture intakes and body weight status. Nutrition 32:7-8, 799-805.CrossRef[ii] Relationships Between Nutrition, Alcohol Use, and Liver Disease.Charles S. Lieber, M.D., M.A.C.P. National Institute on Alcohol Abuse and Alcoholism. September 29, 2004. http://pubs.niaaa.nih.gov/publications/arh27-3/220-231.htm[iii] Heikkonen, E., Ylikahri, R., Roine, R., Välimäki, M., Härkönen, M. and Salaspuro, M. (1996), The Combined Effect of Alcohol and Physical Exercise on Serum Testosterone, Luteinizing Hormone, and Cortisol in Males. Alcoholism: Clinical and Experimental Research, 20: 711–716. doi:10.1111/j.1530-0277.1996.tb01676.x[iv] Alcoholic Beverages as a source of estrogens. Judith S. Gavaler, PhD. Vol 22, No.3. 1998. http://pubs.niaaa.nih.gov/publications/arh22-3/220.pdf[v] Sleep, Sleepiness, and Alcohol Use. Timothy Roehrs, PhD. National Institute on Abuse and Alcoholism. 2002. http://pubs.niaaa.nih.gov/publications/arh25-2/101-109.htm[vi] Alcohol-Induced Testicular Atrophy in the Adult Male RatDAVID H. VAN THIEL, JUDITH S. GAVALER, CHARLES F. COBB, RICHARD J. SHERINS, and ROGER LESTEREndocrinology 1979 105:4, 888-895[vii] The Endocrine Activities of 8-Prenylnaringenin and Related Hop (Humulus lupulus L.) FlavonoidsR. Milligan, J. C. Kalita, V. Pocock, V. Van De Kauter, J. F. Stevens, M. L. Deinzer, H. Rong, and D. De KeukeleireThe Journal of Clinical Endocrinology & Metabolism 2000 85:12, 4912-4915[viii] Alcoholic Beverages as a source of estrogens. Judith S. Gavaler, PhD. Vol 22, No.3. 1998. http://pubs.niaaa.nih.gov/publications/arh22-3/220.pdf[ix] Suzanne Steinbaum, M.D., director of women and heart disease at Lenox Hill Hospital, New York City; Elizabeth Kovacs, Ph.D., director of the alcohol research program, Loyola University Medical Center, Chicago. Interview, May 2012. http://www.medicinenet.com/script/main/art.asp?articlekey=160482[x] Loyola University Health System. “Moderate drinking may protect against Alzheimer’s and cognitive impairment, study suggests.” ScienceDaily. ScienceDaily, 19 August 2011.

Dr. Wartofsky is Professor of Medicine, Georgetown University School of Medicine and Chairman Emeritus, Department of Medicine, MedStar Washington Hospital Center.  He trained in internal medicine at Barnes Hospital, Washington University and in endocrinology with Dr. Sidney Ingbar, Harvard University Service, Thorndike Memorial Laboratory, Boston.   Dr. Wartofsky is past President of both the American Thyroid Association and The Endocrine Society.  He is the editor of books on thyroid cancer for both physicians and for patients, and thyroid cancer is his primary clinical focus.   He is the author or coauthor of over 350 articles and book chapters in the medical literature, is recent past Editor-in-Chief of the Journal of Clinical Endocrinology & Metabolism, and is the current Editor-in-Chief of Endocrine Reviews. In this episode, Dr. Wartofsky discusses the following: Hypothyroidism causes When is replacement thyroid hormone necessary? The history of replacement thyroid hormone going back to 1891 The early treatment included a chopped up sheep thyroid and served as a ‘tartar’, often resulting in vomiting Myxedema coma The danger of taking generic T4; are cheaper, larger profit margin, but the content varies. Synthroid versus generic Manufacturing plants in Italy, India, Puerto Rico are known to produce generics Content versus absorption when taking generic T4 An explanation of TSH 1.39 is a healthy TSH level for women in the U.S. Symptoms of hypothyroidism, such as a slow mind, poor memory, dry skin, brittle hair, slow heart rate, problems with pregnancy, miscarriage, and hypertension. Screening TSH levels if contemplating pregnancy T4 is the most prescribed drug in the U.S. Hypothyroidism is common when there is a family history Auto-immune disease is often associated with hypothyroidism An explanation of T3 An explanation of desiccated thyroid The T3 ‘buzz’ Muhammed Ali’s overdose of T3 Dangers of too much T3 When to take T4 medication, and caution toward taking mediations that interfere with absorption Coffee and thyroid hormone absorption Losing muscle and bone by taking too much thyroid hormone Taking ownership of your disease Related episodes: 37: Adding T3 to T4 Will Make You Feel Better? For Some the Answer is ‘Yes’ with Dr. Antonio Bianco from Rush University NOTES Leonard Wartofsky American Thyroid Association