View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Dan Rader is a Professor at the Perelman School of Medicine at the University of Pennsylvania, where he conducts translational research on lipoprotein metabolism and atherosclerosis with a particular focus on the function of high-density lipoproteins (HDLs). In this episode, Dan goes in-depth on HDL biology, including the genesis of HDL, its metabolism, function, and how this relates to atherosclerotic cardiovascular disease (ASCVD). He explains why having high HDL-C levels does not directly translate to a low risk of cardiovascular disease and reveals research pointing to a better way to measure the functionality of HDL and predict disease risk. He also goes into detail on the role of HDL in reverse cholesterol transport and the benefits this has for reducing ASCVD. Additionally, Dan discusses the latest thinking around the association between HDL cholesterol and neurodegenerative diseases and ends the conversation with a discussion of how the latest research on HDL provides a promising outlook for ongoing trials and future therapeutic interventions. We discuss: The lipidology of apoB and apoA [4:00]; A primer on the high-density lipoprotein (HDL): genesis, structure, and more [9:30]; How the lipoprotein system differs in humans compared to other mammals [20:00]; Clarifying the terminology around HDL and apoA [25:30]; HDL metabolism [31:45]; CETP inhibitors for raising HDL-C: does it reduce CVD risk? [34:45]; Why it's so important to have hard outcome trials in the field of cardiovascular medicine [42:30]; SR-B1: an HDL receptor important for cholesterol efflux [48:00]; The association between HDL levels and atherosclerosis: are they causally linked? [53:15]; How insulin resistance is impacting HDL, and how HDL-C provides insights into triglyceride metabolism [58:00]; Disappointing results from the studies of niacin—a drug that raises HDL-C and lowers apoB [1:08:15]; HDL lipidation, dilapidation, and reverse cholesterol transport [1:12:00]; Measuring the cholesterol efflux capacity of HDL: a better predictor of ASCVD risk than HDL-C? [1:22:00]; A promising new intervention that may promote cholesterol efflux and reverse cholesterol transport [1:32:45]; The association between HDL cholesterol and neurodegenerative diseases [1:34:00]; Challenges ahead, a promising outlook, and the next frontier in lipidology [1:44:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
Veganism is a dangerous game for anyone with or at risk of an eating disorder such as binge eating disorder. Here I offer my expert insight and give 3 alternatives to veganuary which are less likely to exacerbate disordered eating symptoms.30 SECOND CEREAL BOX BOOK REVIEW: BDA RESOURCE ON NUTRITIONAL ADEQUACY OF PLANT-BASED DIETS: Plant-based diet (bda.uk.com)ONE BLUE DOT: A DIETITIANS GUIDE TO SUSTAINABLE DIETS: one blue dot reference guide.pdf (bda.uk.com)ASSOCIATION BETWEEN PLANT-BASED DIETS AND TYPE 2 DIABETES: Association Between Plant-Based Dietary Patterns and Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis | Lifestyle Behaviors | JAMA Internal Medicine | JAMA NetworkFRUIT & VEG CONSUMPTION & CVD RISK, CANCER AND ALL CAUSE MORTALITY: Fruit and vegetable consumption and all-cause, cancer and CVD mortality: analysis of Health Survey for England data | Journal of Epidemiology & Community Health (bmj.com)THE HEALTH BENEFITS OF STRONG RELATIONSHIPS: The health benefits of strong relationships - Harvard HealthGOOD FISH GUIDE 2020: 784-2020 Pocket Good Fish Guide 2020 Inners WEB.indd (mcsuk.org)
Please join authors Loren Field and Sean Reuter, as well as Associate Editor Thomas Eschenhagen as they discuss the article "Cardiac Troponin I-Interacting Kinase Affects Cardiomyocyte S-Phase Activity But Not Cardiomyocyte Proliferation." Dr. Greg Hundley: Welcome listeners, to this January 10th issue of Circulation on the Run, and I am Dr. Greg Hundley, associate editor, director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Dr. Peder Myhre: I am Dr. Peder Myhre from Akershus University Hospital and University of Oslo in Norway. Dr. Greg Hundley: Well, listeners, this week's feature discussion delves into the world of preclinical science and evaluates cardiac troponin I and its impact on S phase activity in cardiomyocytes, and does that relate to cardiomyocyte proliferation. But before we get to that, how about we grab a cup of coffee and Peder and I will work through some of the other articles in the issue. Peder, how about this week I go first? Dr. Peder Myhre: Go ahead, Greg. Dr. Greg Hundley: Right. So Peder, this first study evaluated whether the burden of positive coronary artery calcification on cardiovascular disease differed by multidimensional individual characteristics, and so the investigators led by Dr. Kosuke Inoue from Kyoto University sought to investigate the heterogeneity in the association between positive coronary artery calcium and incident cardiovascular disease. And so Peder, to examine this question, the authors implemented a cohort study design that included adults aged greater than 45 years, free of cardiovascular disease, from the Multi-Ethnic Study of Atherosclerosis, or MESA, and after propensity score matching in a one-to-one ratio, they applied a machine learning causal forest model to, first, evaluate the heterogeneity in the association between positive coronary artery calcium and incident cardiovascular disease and then, second, to predict the increase in cardiovascular disease risk at 10 years when the coronary artery calcium score was greater than zero, so versus is it zero at all at the individual level? Dr. Peder Myhre: Oh, Greg, that is so cool, so using machine learning for coronary artery calcium and risk prediction, I'm very excited. What did they find? Dr. Greg Hundley: Right, Peder, so the expected increases in cardiovascular disease risk when the coronary artery calcium score was greater than zero were heterogeneous across individuals. Moreover, nearly 70% of people with low atherosclerotic cardiovascular disease risk showed a large increase in cardiovascular disease risk when the coronary calcium score was greater than zero, highlighting the need for coronary artery calcium screening among such low-risk individuals. And Peder, future studies are really needed to assess whether targeting individuals for coronary artery calcium measurements based on not only the absolute ASCVD risk, but also the expected increase in CVD risk when a CAC score is greater than zero and whether that improves overall assessment of cardiovascular outcomes. Dr. Peder Myhre: Wow, that is so clinically relevant and very interesting. And we're actually going to stay clinically relevant with the next paper which is about anti-platelet therapy after PCI. And this paper describes the long-term results of the HOST-EXAM trial. To remind you, Greg, the HOST-EXAM trial was an investigator-initiated prospective, randomized, open label, multicenter trial done at 37 sites in Korea. They enrolled patients who had undergone PCI with DES and maintained dual anti-platelet therapy without any clinical event for a mean 12 months and then they were randomized one to-one to either clopidogrel, 75 milligrams once daily, or aspirin, 100 milligram once daily. The primary results of this trial was published in Lancet in 2021 and showed superiority of clopidogrel over aspirin in prevention of the composite of MACE and major bleeding during 24 months of followup. And then, through the current paper, this describes the results of the post trial extended followup of about five years. Dr. Greg Hundley: Very nice, Peder, so aspirin versus clopidogrel and looking at the maintenance of that monotherapy and cardiovascular outcomes. Wow, so what did they find? Dr. Peder Myhre: Yeah, Greg. They, in this extended followup study, had a total of 5.8 years median followup, and the primary endpoint occurred in 12.8% in the clopidogrel group versus 16.9% in the aspirin group, and that has a range of 0.74 with a 95% conference interval ranging from 0.63 to 0.86. So also the clopidogrel group had lower risk of the secondary thrombotic endpoint and the secondary bleeding endpoint while there was no significant difference in the incident on all caused death. So Greg, to conclude, these very interesting results from the primary analysis of the HOST-EXAM trial was consistent through the longer followup, and this support the use of clopidogrel over aspirin monotherapy from 12 months onwards after PCI. Dr. Greg Hundley: Very nice Peder, beautiful description and sounds like long-term clopidogrel use over aspirin was quite beneficial. Well, the next study comes to us from the world of preclinical science, and it is from the investigative group led by Dr. Yunzeng Zou from Shanghai Institute of Cardiovascular Diseases and the Zhongshan Hospital and Fudan University. Peder, the study pertains to diabetes. So diabetic heart dysfunction is a common complication of diabetes mellitus and cell death is a core event that leads to diabetic heart dysfunction. However, the time sequence of cell death pathways and the precise intervening time of particular cell death type remained largely unknown in diabetic hearts. And so, Peder, this study aimed to identify the particular cell death type that is responsible for diabetic heart dysfunction and propose a promising therapeutic strategy by intervening in this cell death pathway. Dr. Peder Myhre: Wow, Greg, that is really interesting. Heart dysfunction in diabetes is something that we really have to learn more about and I'm so excited to hear what these authors found, Greg. Dr. Greg Hundley: Right. So first, Peder, the authors identified necroptosis as the predominant cell death type at later stages in the diabetic heart. And then second, Peder, the CB2 receptor, and we'll call that CB2-R, recruits transcription factor Bach2 to repress necroptosis and protects against diabetic heart injury while hyperglycemia and MLKL in turn phosphorylates CB2-R to promote ubiquitous dependent degradation of CB2-R, thus forming a CB2-R centric feedback loop of necroptosis. And finally, Peder, cardiac CB2-R or Bach2 expression negatively correlates with both MLKL 10 expression and the extent of diabetic heart injuries in humans. And so the clinical implications of these findings, Peder, are that the CB2-R centric necrotic loop represents a promising target for the clinical treatment of diabetic heart injuries. Dr. Peder Myhre: So Greg, this paper that comes to us from corresponding author Amanda Paluch from University of Massachusetts Amherst, is a meta-analysis of eight prospective studies with device measured steps including more than 20,000 adults who were followed for CVD events. And the mean age of participants in this study was 63 years and 52% were women. And the participants were followed for a median of 6.2 years and 1,523 cardiovascular events occurred. So first, Greg, there was a significant difference in the association of steps per day in cardiovascular disease between older, that is greater or equal to 60 years, and younger, that is less than 60 years adults. So for older adults that has the ratio for cardiovascular disease using Q1 as reference was 0.80 for Q2, 0.62 for Q3, and 0.51 for Q4. And for younger adults that has ratio for cardiovascular disease using Q1 as reference was 0.79 for Q2, 0.90 for Q3, and 0.95 for Q4. And in the paper, Greg, there are some beautiful, restricted cubic lines that really illustrate the association between daily steps and the risk of cardiovascular disease among older adults and in younger adults. So the authors conclude that for older adults taking more daily steps is associated with a progressively lower risk of cardiovascular disease. And monitoring and promoting steps per day is a simple metric for clinician patient communication and population health to reduce the risk of cardiovascular disease. Dr. Greg Hundley: Well, Peder, we've got some other very interesting articles in this issue and how about we dive into that mail bag and discuss a few of those. So I'll go first. The first is a Perspective piece by Professor Powell-Wiley entitled “Centering Patient Voices through Community Engagement in Cardiovascular Research.” A very important topic where can those in the community actually help us design meaningful outcomes for our research initiatives? And next Peder, there is a Research Letter from Professor Evans entitled “Increasing Mononuclear deployed Cardiomyocytes by Loss of E2F7/8, and does that fail to improve cardiac regeneration post myocardial infarction?” Dr. Peder Myhre: Thanks, Greg. We also have an ECG Challenge by Dr. Li entitled, “What Is The Truth Behind Abnormal ECG Changes?” And this is describing a very rare and interesting cause of ST segment elevation. I recommend everyone to read that case. We also have our own Nick Murphy who gives us the Highlights from the Circulation Family of Journals where he summarizes five papers from the Circulation subspecialty journals. First, the experience with a novel visually assisted ablation catheter is reported in circulation A and E. The impact of various exercise training approaches on skeletal muscle in heart failure with preserved the F is presented in circulation heart failure. Gaps in heart failure treatment over a decade are reported in circulation cardiovascular quality and outcomes, and the associations of machine learning approaches to plaque morphology from coronary CTA with ischemia are reported in circulation cardiovascular imaging. And finally, Greg, an observational study of left main PCI at sites with and without surgical backup is reported in circulation cardiovascular interventions. Let's go on to the feature paper today describing the cardiac troponin I interacting kinase and the impact on cardiomyocyte S phase activity. Dr. Greg Hundley: Great, let's go. Welcome listeners to this January 10th feature discussion. Very interesting today as we are going to delve into the world of preclinical science. And we have with us today Dr. Loren Field and Dr. Sean Reuter from University of Indiana in Indianapolis, Indiana. And our own associate editor, Dr. Thomas Eschenhagen from University Medical Center of Hamburg in Hamburg, Germany. Welcome gentlemen. Well, Loren, we're going to start with you. Can you describe for us some of the background information that went into the preparation of your study, and what was the hypothesis that you wanted to address? Dr. Loren Field: Sure. This study actually came about in a rather roundabout fashion. We were doing a study with Kai Wollert in Hanover, Germany, where we were looking at the impact of a CXCR4 antagonist, which is used to mobilize stem cells from the bone marrow. And we had sent our mice over to Kai's lab and we have a mouse model that allows us to track S phase activity in cardiac myocytes, so these are cells are starting to replicate. And Kai crossed them into a different genetic background. And when he sent the mice back to us to analyze the hearts, we observed that we saw things that we never saw before in our experiments here. His injury model was different than ours and now the mouse also had a genetic background, so we had to spend about a year to figure out if it was the injury model or the background. It turned out to be the genetic background, and the phenotype was these mice had about a 15-fold elevated level of cell cycle reentry. So then it became a relatively simple genetics game where we took the progenitor mice, made F1 animals, looked for the phenotype, did backcross animals, and basically identified the gene responsible for the phenotype. Dr. Greg Hundley: Very nice. And so in this study moving forward, what hypothesis did you want to address? Dr. Loren Field: Well, the main hypothesis was to figure out what the gene was and then secondarily to figure out the degree of cell cycle progression. When the cell is proliferating, the first task is to replicate its genome, which is S phase activity that's followed by the nuclei dividing and then finally by the cell itself becoming two cells. So our task was to identify, first, the gene and secondly, how far through the cell cycles the cells progressed. Dr. Greg Hundley: Very nice. And how did you construct your experiment? Dr. Loren Field: It was, again, very straightforward. It was simply setting up the appropriate genetic crosses to produce the animals. For the past 10, 15 years, we've been developing a computer assisted assay that allows us to identify the anatomical position of S phase positive cardiac myocytes in sections of the heart. And basically, we apply that program to the different genetic backgrounds and after that it's a ball of mapping studies, QTL mapping. Dr. Greg Hundley: So really mechanistic understanding. Well listeners, we're next going to turn to Sean, and Sean, can you describe for us your study results? Dr. Sean Reuter: Yes, as Loren stated, we saw a 15-fold increase in the S phase activity within the remote zone. Now we partition the heart in three different zones after injury, so the scar, the border zone, and then the remote zone or injury. And as Loren stated, we saw a 15-fold increase in the S phase activity, cell cycle activity, in the remote zone. And it's only because we have this system in hand that we can anatomically map the S phase activity within the heart that we were able to detect and also quantify this. And I think that's the reason we discovered this particular phenotype. But in addition to that, we performed RNA-seq or Exome sequencing and discovered that TNNI3K was the responsible gene for elevated S phase activity within the remote zone and border zone, but interestingly not in the scar. Dr. Greg Hundley: Very interesting, Sean, and so describe for us the importance of the TNNI3K and its relationship to this S phase. Dr. Sean Reuter: Sure. This particular gene was first discovered around 2000, and it's been studied for a while now, but the targets of this kinase specifically expressed in the heart, and it does get elevated after injury, but the actual targets are not well described or well known. It's believed that it phosphorylates some mild filament fibers and structural proteins, but the actual mechanism and the consequence of this is not known. So when we saw this in the remote zone, the elevated S phase, our current theory is that we believe that it's probably increasing oxidative stress that would basically further out from the at-risk zone or the border zone and then it now is in the remote zone. So we think it's just causing the heart, a pathological area of the heart, basically to expand. And so that's our current theory. Other groups have published on the oxidative stress in over expression of TNNI3K as well. Dr. Greg Hundley: Very nice. Well listeners, next we are going to turn to our associate editor, Thomas many articles come your way and come across your desk. What attracted you to this particular article, and how do we put its results really in the context of cardiac regeneration? Dr. Thomas Eschenhagen: Indeed, there were several arguments. It's a cool paper and the whole field is still very important. As probably most of you know, the field have a rough ride over the last 20 years, went up and down, lots of bad findings. And in the end it turns out that we are there where we have been 20 years ago, the mammalian heart essentially doesn't regenerate. So anything which would improve that would be of very major importance. Why is it a good paper? Because it starts from a very clear finding, one mouse, which looks like strongly regenerating after MI, another mouse line, which doesn't. And so by applying, let's say, classical genetic, very stringent methodology, Loren Field and his group identified this troponin I kinase to be the culprit. And they also proved it, because putting it back in the strain with a low, so-called, regeneration brought it back to the other level. So it's a very clear, nice methodology. And finally, it's also a bit provocative because others in a very prominent paper, actually, have shown that this kinase... Or they concluded more or less just the opposite. The reason for the discrepancy is not quite clear and I was very happy to learn that the two groups actually discussed about it. So it's not just a bad controversy, but something which brings forward science. And finally, I think something we didn't talk about yet today, what I particularly liked, maybe the most, on this paper is that this group didn't stop at the point of DNA synthesis. Everybody else would've probably said, "Okay, here we are, one regenerate the other doesn't." But in the very important extra finding of this paper is that this is just increased DNA synthesis and not more myocytes. And this distinction is so critical to the field because people forget that adult mammalian cardiomyocytes often have several nuclei and individual nuclei have more than one set of chromosomes, so this polyploid. And so if you see DNA synthesis like in this paper, it doesn't necessarily mean more myocytes. And actually here it was shown that it is not more myocytes but more polyploidization and making this difference so clear, I think it's a very important contribution to the field. Dr. Greg Hundley: Very nice. Well, listeners, we're going to turn back to each of our guests today and we'll start with you Loren. Based on your results, what do you see as the next study moving forward in this sphere of research? Dr. Loren Field: I think these results made me appreciate for the first time that the intrinsic level of cell cycle reentry, that's just the S phase, not the cell division, is actually much higher than I had thought previously. And this was because we just fortuitously, or I guess anti-fortuitously, we're using a strain that had low levels of S phase induction. If you calculate the turnover, if every nucleus that it synthesized DNA actually went on to have that cell divide, you could replace a 50% loss of myocytes over the course of about 550 days, give or take. And to me, that's actually telling me that if we could push those cells from just being polypoid, as Thomas was saying, to actually go through cytokinesis, there would be enough intrinsic activity to go forward. So this really tells me that what we should be focusing on is now not trying to induce cell cycle, but to allow the cells that are entering the cell cycle to actually progress through it. Dr. Greg Hundley: Very nice. And Sean? Dr. Sean Reuter: Yes, well, echoing Loren's point there, it's really not necessarily cell cycle induction, it's cell cycle completion to the cytokinetic fate. And that's the key. If we can get to that point, if we can figure out the mechanism to get to that point, then we have a wonderful discovery. However, we're not quite there yet, but we hope to be. Dr. Greg Hundley: And Thomas. Dr. Thomas Eschenhagen: Well, nothing to add really from my side, except that I would like to know what this Troponin I kinase does, because that is somehow still a missing link. How does this kinase lead to more DNA synthesis or the initiation of cell cycling? That would be an important finding and I'm sure there will be more research going on. Particularly also, to solve this discrepancy, I mean, there must be something in it and we don't quite yet know how, but I think we are in a good way. I'm sure there will be papers showing that soon. So I think that's, again, a very good start for this discussion. Dr. Greg Hundley: Well, listeners, we want to thank Dr. Loren Field, Dr. Sean Reuter and Dr. Thomas Eschenhagen for bringing us this really informative study in mammalian myocellular regeneration, highlighting that the level of cardiomyocyte cell cycle reentry in hearts expressing TNNI3 kinase would lead to significant regenerative growth if each cardiomyocyte exhibiting S phase activity was able to progress through cytokinesis. And this in turn suggests that identification of factors which facilitate cardiomyocyte cell cycle progression beyond S phase will be key to unlocking the intrinsic regenerative capacity of the heart. Well, on behalf of Carolyn, Peder and myself, we want to wish you a great week and we will catch you next week on the run. This program is copyright of the American Heart Association 2023. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.
A Maine Mountain Monster is abducted by his old friends and must integrate himself back into society to fight a war against an incense-fueled town of hate. On Episode 545 of Trick or Treat Radio we welcome our brother MonsterZero back to the show as a regular host! MZ was gone for an entire year and we'll find out all the exciting things he's been up to. We also discuss the Swissploitation film, Mad Heidi from director Johannes Hartmann! So grab your finest aged cheeses, dust off your old collectors edition Rufus and Ronaldo mug, and strap on for the world's most dangerous podcast!Stuff we talk about: MZ returns!, incest running wild, Bull Moose, MZ stealing cats, tuck dance, Zombie Grrlz, Septic, catching MZ up on the events of the last year, Evil Dead Rise, Smile, Ash talking raw, digital vs shot on film, motivational speakers, young up and coming hungry young monster hunters, Bat Pussy, Kung Fu From Beyond the Grave, Terrifier 2, I Spit On Your Grave: Deja Vu, Swiss Miss, chocolate pudding, your doctor lying to you, nunsploitation, the different subgenres of exploitation, Mad Heidi, Trent Haaga, Johannes Hartmann, Astron 6, Grindhouse, 42nd St. sleaze, nazis with cheese, Sleepy Horror, Casper van Dien, Cam Newton with Lederhosen, CGI gore meets practical gore, Black Dynamite, Vanishing Point, Dirty Mary Crazy Larry, Russ Meyer, Chesty Morgan, revenge films, the definition of exploitation films, The Hero's Journey, The Swiss Luke Skywalker, the Barbarian Sisters, bratwurst with cheez, Ilsa: She Wolf of the SS, Ravenshadow's definition of an important film, ball gore, Time Bandits, Werner Herzog, Even Dwarves Started Small, Batman: Dying Is Easy, CVD, Hobo With a Shotgun, Fresh, Candy Land, who is it ok to lie to?, and an abundance of balls.Support us on Patreon: https://www.patreon.com/trickortreatradioJoin our Discord Community: discord.trickortreatradio.comSend Email/Voicemail: mailto:email@example.comVisit our website: http://trickortreatradio.comStart your own podcast: https://www.buzzsprout.com/?referrer_id=386Use our Amazon link: http://amzn.to/2CTdZzKFB Group: http://www.facebook.com/groups/trickortreatradioTwitter: http://twitter.com/TrickTreatRadioFacebook: http://facebook.com/TrickOrTreatRadioYouTube: http://youtube.com/TrickOrTreatRadioInstagram: http://instagram.com/TrickorTreatRadioSupport the show
Join Jenny for this super insightful pep talk about how to show up in bigger and better ways for yourself as a holiday visit from a close family friend helped shine a spotlight on Jenny's own routine and how her cardiovascular activity reduction was negatively impacting her energy levels. (Yes, even fitness professionals experience a lull in their workouts!) We're all familiar with the tried and true saying: A body in motion stays in motion. Being sedentary wastes valuable and positive energy! Movement = momentum, and momentum = motivation. Listen in on why scheduling your fitness will carry success into all the areas of your life. Save $100 off Your MAXPRO Fitness here JOIN The YOUR BEST BODY PRIVATE COMMUNITY and for the Password say "Jenny invited me"JOIN The YOUR BEST BODY PROGRAM If you enjoyed this episode, make sure and give us a five star rating and leave us a review on iTunes, Podcast Addict, Podchaser and Castbox. STRONG Fitness Magazine Subscription Use discount code STRONGGIRL ResourcesSTRONG Fitness MagazineSTRONG Fitness Magazine on IGTeam Strong GirlsCoach JVB Follow Jenny on social mediaInstagramFacebookYouTube
To bring in the new year I thought it would be good to take a moment and consolidate some of the memorable moments, and key takeaways, from 2022. In Episode #241, part 1 of a 2 part year in review, we traverse how to think about nutrition, so we can better make sense of claims online, diet, and cardiometabolic health, how you can flip the switch on your microbiome so the trillions of gut bugs in your large intestine reward you with better health, and the benefits up for grabs through consuming our food over less hours - otherwise known as time restricted eating or fasting. Guests featured include Dr Gil Carvhalo, Dr Richard Johnson, Dr Alan Flanagan, Danny Lennon, Dr David Jenkins, Dr Justin Sonnenburg, Dr Erica Sonnenburg, Dr Christopher Gardner, Dr Tim Spector, Dr Don Layman, Dr Valter Longo, Dr Stuart Phillips, Dr Satchin Panda and Dr Courtney Peterson. Specifically, we cover: Intro (00:00) Circadian Disruption is a Problem with Dr. Satchin Panda (01:59) Fasting & weight loss with Dr. Courtney Peterson (08:26) Optimal fasting window with Dr. Satchin Panda (15:49) Nutrition science claims with Dr Gil Carvalho (36:49) Diet & metabolic health with Dr. Richard Johnson (51:32) Cholesterol & CVD with Dr Alan Flanagan and Danny Lennon (57:22) Lowering cholesterol with Dr. David Jenkins (1:14:06) Gut microbiome with Drs. Erica and Justin Sonnenburg (1:24:44) Fibre & inflammation with Dr. Sonnenburg and Dr. Gardner (1:32:43) Fermented foods (1:49:35) Building microbiome diversity with Drs. Erica and Justin Sonnenburg (1:50:26) Simple dietary advice with Dr Tim Spector (1:55:57) Muscle & metabolic health with Dr. Donald Layman (1:58:34) Aging pathways with Dr. Valter Longo (2:07:24) Muscle & aging with Drs. Stuart Phillips and Christopher Gardner (2:14:48) Outro (2:20:11) Episodes featured: Episode #221 with Dr Satchin Panda Episode #232 with Dr Courtney Peterson Episode #207 with Dr Gil Carvhalo Episode #233 with Dr Richard Johhson Episode #231 with Dr Alan Flanagan & Danny Lennon Episode #216 with Dr David Jenkins Episode #202 with Dr Erica Sonnenburg & Dr Justin Sonnenburg Episode #191 with Dr Justin Sonnenburg & Dr Christopher Gardner Episode #224 with Dr Tim Spector Episode #236 with Dr Don Layman Episode #237 with Dr Valter Longo Episode #228 with Dr Stuart Phillips & Dr Christopher Gardner I hope you find this episode helpful for consolidating some of the key learnings from 2022. Part 2 of the year in review will be released next week with a focus on exercise, planetary health and more. Happy new year. Enjoy, friends. Simon Want to support the show? The best way to support the show is to use the products and services offered by our sponsors. To check them out, and enjoy great savings, visit theproof.com/friends. You can also show your support by leaving a review on the Apple Podcast app and/or sharing your favourite episodes with your friends and family. Simon Hill, MSc, BSc (Hons) Creator of theproof.com and host of The Proof with Simon Hill Author of The Proof is in the Plants Watch the episodes on YouTube or listen on Apple/Spotify Connect with me on Instagram, Twitter, and Facebook Nourish your gut with my Plant-Based Ferments Guide Download my complimentary two-week meal plan and high protein Plant Performance recipe book
Download the cheat: https://bit.ly/50-meds View the lesson: Generic Name propofol Trade Name Diprivan Indication anesthesia, induction, sedation, Action hypnotic, produces amnesia with no analgesic properties Therapeutic Class general anesthetic Pharmacologic Class none Nursing Considerations • use cautiously with CVD, lipid disorder, increased ICP • can cause apnea, bradycardia, hypotension • burning and pain at insertion site • can turn urine green • assess respiratory status and hemodynamics • maintain patent airway • assess level of sedation
In this episode, Paul is joined by Deborah Aroshas and Talchaim Damri to discuss how their company Capsoul is “presenting the new era of diamond.” The conversation begins with Deborah discussing Capsoul's collaboration with TAG Heuer to produce the Carrera Plasma watch –a first of its kind timepiece that includes over 10-carats of single-crystal and polycrystalline lab diamond. The group then discusses if novel diamond jewelry is driven more by artistic vision or engineering capability. Next, Talchaim explains the technical difference between single-crystal and polycrystalline diamond and how both materials can be used in jewelry. Paul and Talchaim then talk about the HPHT versus CVD diamond growing methods and what other technologies exist for producing diamond. The conversation closes with a discussion about using man-made diamond in high-tech applications and how the product positioning of lab-diamond jewelry versus traditional natural diamond jewelry is likely to veer further in the future. Hosted by: Paul Zimnisky Guest: Deborah Aroshas & Talchaim Damri Guest plug: www.capsouldiamond.com More information on PZDA's State of the Diamond Market report: www.paulzimnisky.com/products Show contact: firstname.lastname@example.org or visit www.paulzimnisky.com. Please note that the contents of this podcast includes anecdotes, observations and opinions. The information should not be considered investment or financial advice. Consult your investment professional before making any investment decisions. Please read full disclosure at: www.paulzimnisky.com.
In episode 528, James and Mike go through the logic and math around CVD risk estimates with regard to repeat cholesterol measurements. We discuss the impact remeasuring cholesterol has on CVD risk estimates and show that re-measuring every 5-10 years provides minimal if any value when it comes to making treatment decisions. All you need […]
In this exclusive interview, Hannes Hagström joins Jörn Schattenberg, Louise Campbell and Roger Green to explore papers emerging from Scandinavia which offer fascinating insights to the field at large.Hannes opens the conversation with his idea that 2022 was an encouraging year for research, specifically in that the mechanisms of drugs in development “feel more realistic.” When asked what he means by realistic, Hannes explains his interpretation of NAFLD to be a public health problem by which the metabolic system is overloaded with nutrients. He suggests a general pathway would aim to reduce this burden, citing examples like GLP-1s and possibilities surrounding an imminent announcement on resmetirom. From here Hannes describes developing a population-based cohort of liver disease patients using relatively accurate registers in Sweden. He highlights that this system enables studies to navigate issues around selection bias and capture the whole of a population with any diagnosed liver disease dating back to the sixties - roughly 350,000 unique patients in Sweden. The data available in this cohort can be linked back to the general population and used to examine several important research considerations. Long-term outcomes of chronic liver diseases, risk factors for disease progression, impact of dispensed drugs, disease panorama and time trends are among examples.Segueing to several studies utilizing this cohort, Hannes first introduces a paper which examines cardiovascular disease (CVD) risk and life expectancy in patients with NAFLD compared with the general population. While NAFLD was associated with a higher risk of nonfatal CVD, it notably did not affect post-CVD mortality risk. Another conclusion: patients diagnosed with NAFLD have a lower life expectancy than the general population. Strikingly, this loss in life expectancy was accentuated depending on the age of patient at time of diagnosis. The younger in age one has a diagnosis of NAFLD, the more one can expect to have a drop in life expectancy. Hannes suggests this may summon an urgency in screening younger populations. A caveat of this cohort is noted to be the reality of true incidence rates could be higher than what has been captured in diagnosis in specialty care. At this point, Jörn and Louise ask a series of thought-provoking questions which spur Hannnes to describe additional compelling facets of working with this rich data set. Studies can link research cohorts examining biopsies of patients with NAFLD to these registers, allowing for long-term follow-up. Hannes also mentions collaboration with the Swedish Diabetes Register which captures at least 90% of patients with type 2 diabetes. Such granularity enables investigation into the influence of comorbidities on the risk of liver disease. Roger notes a theme of recent guidelines is to assume that diabetic patients have NAFLD, therefore the recommendation is to immediately search for NASH in the evidence of fibrosis. As these databases are pooled, NAFLD can be examined through a diabetes lens or vice versa. The group goes on to briefly discuss elements of screening, guidelines and the influence of NITs on interpreting prevalence. Hannes bridges this discussion to a just-accepted paper whereby his team looked at developing FIB-4 in a more meaningful way through stratifying subgroups within the overarching risk categories. Simply, the three parameters used are age, presence of diabetes and a gamma-glutamyl transferase test. The latter is noted to be useful in linking cardiac outcomes and an imperfect marker for alcohol use. As the session winds down, the panelists explore speculative questions around genetics and the microbiome, and any foresight into how these factors could be filtered through the aforementioned registers and databases. In closing, Hannes provides a glimpse at what awaits for his research in 2023. Surf on to find out.
This week, Kate, Gary, Henry and Mark discuss a new guideline for managing jaundice in babies, treating painful diabetic peripheral neuropathy, acetazolamide for patients hospitalized with CHF, and screening for CVD in older men.
This week on Pharm5: Tamiflu backorder ADHD medications & CVD risk Paxlovid dispensing guidance EUA pulled for last remaining COVID-19 monoclonal antibody ASHP Midyear Meeting Connect with us! Listen to our podcast: Pharm5 Follow us on Twitter: @LizHearnPharmD References: Current drug shortages. ASHP. https://bit.ly/3Fk0Keo. Accessed December 1, 2022. Center for Drug Evaluation and Research. Drug shortages. U.S. Food and Drug Administration. https://bit.ly/3B2DGhC. Accessed December 1, 2022. Weekly U.S. Influenza Surveillance Report. Centers for Disease Control and Prevention. https://bit.ly/3gQ77MW. Published November 28, 2022. Accessed December 1, 2022. Zhang L, Yao H, Li L, et al. Risk of cardiovascular diseases associated with medications used in attention-deficit/hyperactivity disorder. JAMA Network Open. 2022;5(11). doi:10.1001/jamanetworkopen.2022.43597 HQ APhA. APhA has created a pharmacist decision-making support tool for paxlovid. use it in your practices to help assess whether a prescription for Paxlovid is appropriate. Twitter. https://bit.ly/3H6F3Q7. Published November 30, 2022. Accessed December 1, 2022. FDA pulls U.S. authorization for Eli Lilly's Covid Drug Bebtelovimab. Reuters. https://bit.ly/3UiQyHa. Published November 30, 2022. Accessed December 1, 2022. Midyear clinical meeting 2022 - ASHP. MCM22. https://bit.ly/3B1dunI. Accessed December 1, 2022.
Video: Nothing is more anti-woman than this. Gen Z Refuses to Grow Up | With Dr. Jean Twenge Tomato extract shows blood thinning potential versus aspirin: Study University of Aberdeen (Scotland), November 23, 2022 A proprietary tomato extract has been shown to thin blood in healthy people – but less severely than aspirin and without typical side-effects. The research – published in the European Journal of Clinical Nutrition concluded the lycopene-free extract “may be appropriate for use as a dietary antiplatelet.” Lead researcher Dr Niamh O'Kennedy working at the Rowett Institute of Nutrition & Health at the University of Aberdeen in Scotland told us the research showed tomato extracts could be used as alternatives to drugs like aspirin for blood thinning. This was especially the case for groups like the elderly who frequently were intolerant of drugs like aspirin typically prescribed for that purpose. “Platelet function is very tricky,” Dr O'Kennedy told us. “If you knock out the platelets it can have a bad effect on the body. And many treatments knock out too much. Some people respond strongly so bad they bleed. ” She added: “Results like this show that people and the medical world should start looking at dietary interventions like these that can have a big impact.” Platelet plugs usually form within 50-100 seconds. The researchers found platelet plugs were formed within 100-150 seconds among tomato extract users, compared to 300-600 seconds for aspirin users. Because of this more gentle effect, Dr Kennedy and her team suggested tomato extract could be a suitable dietary intervention to control platelet hyperactivity which increases with age, the onset of type II diabetes, mellitus, atherosclerosis and other conditions in subjects with low cardiovascular disease (CVD) risk. (Next) Use of penicillin early in life, even in low doses, affects the gut microbiome, contributing to brain inflammation and changes in behavior McMaster University (Ontario), November 18, 2022 It is truly unavoidable to catch a cold or contract a disease, especially with today's lifestyle trends and medical misinformation. A lot of the medicine we use to treat our health conditions may actually cause more harm than good. A St. Joseph's Healthcare Hamilton and McMaster University joint study found that low doses of penicillin administered to pregnant mice and their young results in behavioral changes that have long-term effects. The study, which was published in Nature Communications, reports that the behavioral changes noted in the mice included elevated levels of aggression, characteristic neurochemical changes in the brain, and imbalance in the gut microbiome of the mice. On the bright side, giving the mice a lactobacillus strain of bacteria managed to prevent the effects of the administered penicillin. Low-dose penicillin taken in late pregnancy and early life of mice offspring results in behavioral changes and imbalances in the microbes of the gut. While the tests were done on mice, there are increasing concerns about the long-term effects of antiobiotics in humans, according to Dr. John Bienenstock, director of the Brain-Body Institute at St. Joseph's Healthcare Hamilton and distinguished professor at McMaster University. Large doses of multipurpose antibiotics in adult animals have been shown to affect behavior, but none have been able to test the effects of clinical doses of commonly used antibiotics, such as penicillin, on the bacteria in the gut and in behavior. Almost all babies in North America have received some dose of antibiotics during their first year of life. Researchers are looking into analyzing the effects of the drug on the offspring of the mice if given only to the pregnant mothers (teratogenesis). Penicillin is the first type of medication that is effective against bacterial infections caused by staphylococci and streptococci, but is however, easy to build resistance against. Almost 10 percent of all people around the world are allergic to penicillin. (Next) High-dose vitamin C reduces inflammation in cancer patients, study shows Riordan Clinic (Wichita KS), November 22, 2022 The value and impact of a daily vitamin C supplement as well as high, concentrated doses for acute illnesses is becoming increasingly clear. Studies have already shown the efficacy of liposomal vitamin C in treating infections and as an anti-cancer therapy. Now, another study is confirming its effectiveness against inflammation in cancer patients, one of the primary markers. High levels of inflammation seem to indicate a higher risk of cancer as well as a less hopeful prognosis for healing and recovery. Inflammation impairs the immune system, plays a role in cachexia, lowers toleration of numerous cancer treatments, and generally decreases health and quality of life. This study made use of high-dose intravenous vitamin C (IVC) treatments and analyzed their effects. The results found indicate great promise for the use of high-dose intravenous vitamin C treatments to help reduce inflammation in cancer patients, which is one of the major factors of cancer and its progression. Markers of inflammation such as pro-inflammatory cytokines and C-reactive protein tumor markers showed a positive response to vitamin C treatments, with inflammation reduced significantly. This improvement correlated with reduced tumor size and the hindrance of the cancer's ability to metastasize. Vitamin C is especially valuable in extremely high doses taken either orally or intravenously. A range of cancers have been proven to benefit from vitamin C treatments, including cancers of the prostate, breast, skin, bladder, lung, pancreas, thyroid, and B-cell lymphoma. This research was conducted by Riordan Clinic scientists and published in the Journal of Translational Medicine. When supplementing with liposomal vitamin C orally for major health issues, 10,000 to 12,000 mg per day should be taken. This dose can be taken in 2,000 to 4,000 mg doses gradually throughout the day to aid absorption. (Next) Having trouble sleeping? Try exercise! Norwegian University of Science and Technology, December 1, 2022 The vast majority of people have trouble sleeping from time to time. However, 10 to 20 per cent of the population struggle more than the rest of us and have serious long-term sleep problems. Many people who struggle with insomnia sooner or later resort to some form of sleeping aid. However, one study of more than 34 000 adults would suggest that some of them should exercise instead. “We've observed that people who are in better physical condition have a lower risk of taking prescription sleeping pills,” says Linda Ernstsen, an associate professor at the Norwegian University of Science and Technology's (NTNU) Department of Public Health and Nursing. The researchers reviewed participant data in Norway's large Trøndelag Health Survey (The HUNT study). A total of 240 000 people from Trondheim have taken part in the survey since it began in 1984. Four survey rounds have been carried out to date. “Almost 5800 of the participants received their first prescription sleep medication during the study period,” says Ernstsen. This means that approximately 17 percent of the participants' sleep issues were serious enough to warrant a prescription from their doctor. But the participants who were in the best condition used fewer of these prescription drugs. “These findings suggest that being physically fit can also help you sleep better,” Ernstsen says. Unfortunately, the beneficial effect of exercise is stronger for men than for women. The findings show that the fittest men had a 15 per cent lower risk of needing drugs for troublesome sleep issues. “The corresponding percentage risk for the fittest women was much lower. But women who struggle with sleep can still benefit from getting in better shape,” says Ernstsen. (Next) New study puts gut microbiome at the center of Parkinson's disease pathogenesis University of Alabama at Birmingham, December 1, 2022 New research from the University of Alabama at Birmingham says the gut microbiome is involved in multiple pathways in the pathogenesis of Parkinson's disease (PD). The findings, published in Nature Communications, show a wide imbalance in microbiome composition in persons with Parkinson's disease. The study is the largest microbiome study conducted at the highest resolution. The investigators employed metagenomics, the study of genetic material recovered directly from the stool microbiome of persons with PD and neurologically healthy control subjects. “The primary aim of this study was to generate a full, unaltered view of the imbalance in PD gut microbiome,” said Haydeh Payami, Ph.D., professor in the Marnix E. Heersink School of Medicine Department of Neurology and senior author on the study. The study reports Parkinson's disease metagenome is indicative of a disease-promoting microbiome. “We found evidence for multiple mechanisms that we know are linked to PD, but we didn't know they were happening in the gut also and are orchestrated by the microbiome,” Payami said. Investigators found an overabundance of opportunistic pathogens and immunogenic components, which suggest infection and inflammation at play, overproduction of toxic molecules, and overabundance of the bacterial product curli. This induces PD pathology and dysregulation of neurotransmitters, including L-dopa. At the same time, there was a shortage of neuroprotective molecules and anti-inflammatory components, which makes recovery difficult. The researchers studied 257 species of organisms in the microbiome, and of these, analysis indicated 84, more than 30%, were associated with Parkinson's disease. “Of the 84 PD-associated species, 55 had abnormally high abundance in persons with PD, and 29 were depleted,” Payami said. “We found that over 30% of the micro-organisms and bacterial genes and pathways tested have altered abundances in Parkinson's disease, which indicates a widespread imbalance.” At one end of the spectrum, Bifidobacterium dentium was elevated by sevenfold, Actinomyces oris by 6.5-fold and Streptococcus mutans by sixfold. At the other end of the spectrum, Roseburia intestinalis was reduced by 7.5-fold and Blautia wexlerae by fivefold. Overall, 36% of PD-associated species had higher than twofold change in abundance, reflecting a 100% to 750% increase or decrease in PD versus the healthy control group. “This is exciting research, as metagenomics is a new, albeit fast-evolving field, and the resources, methods and tools, while state-of-the-art, are still in development,” Payami said. (Next) Five precepts of Buddhism may be linked to lower depression risk Study suggests the moral practice may buffer known links between high stress levels and depression Chiang Mai University (Thailand) & Károli Gáspár University (Hungary), November 30, 2022 A new study suggests that people with high levels of neuroticism and stress may be at greater risk for depressive symptoms, but those links could be buffered for people who observe the five precepts of Buddhism—a fundamental system of ethics for the religion's followers. The five precepts of Buddhism guide followers not to kill, steal, engage in sexual misconduct, tell ill-intentioned lies, or use intoxicants. Previous research suggests that observing the five precepts can boost wellbeing and quality of life for the general public, including nonserious followers. However, it has been less clear whether the five precepts could ease symptoms of depression for those at higher risk. To address this question, Wongpakaran and colleagues focused on known links between neuroticism, stress, and depression. Prior research has shown that greater neuroticism is associated with greater risk of depression, both directly as well as indirectly through perceived stress—how people think and feel after stressful life events. From late 2019 through September 2022, the researchers conducted an online survey of 644 adults in Thailand. The survey included standard questionnaires to measure each participant's levels of perceived stress, neuroticism, and depressive symptoms, as well as their observance of the five precepts of Buddhism. Statistical analysis of the survey results showed that observing the five precepts to a high degree appeared to buffer the influence of perceived stress on depression. These results suggests that people with high levels of neuroticism and stress may be less likely to develop depressive symptoms if they follow the five precepts closely. The researchers note that, while their study suggests potential benefits for the five precepts in the context of depression, it does not confirm a cause-effect relationship. A large proportion of participants were female and people who lived alone, and participants' religious involvement was unknown, although 93.3% reported that they were Buddhist. More research will be needed to determine whether these findings might extend to the general population of Thailand and beyond, as well as to non-Buddhists. The authors add: “The five precepts practice makes other people feel safe, as all these behaviors are harmless, and it potentially provides the stressful practitioner with a buffer against depression.”
Marlisa Brown is a Registered Dietitian, Certified Diabetes Educator Author and Chef. She has been president of Total Wellness Inc., > 20 years, has a BS in Marketing and MS in Nutrition: she specializes in diabetes, obesity, CVD and GI disorders. Some Clients include; NY Jets, Kennedy Space Center, Hofstra and Adelphi Universities, Guardian Life, Brookhaven National Labs, Goldman Sachs Tiffany, Dean Witter Reynolds, Pall Corp, Bank of New York, Sony, Liz Claiborne, Ethicon and more. In addition Marlisa worked for Lackmann Culinary Services as their Wellness Coordinator > ten years. Marlisa has made numerous television appearancesincluding 5 years on “International Healthy Cooking” for AHA. She is author of “Gluten-Free Hassle Free”, and “Easy, Gluten-Free”, other contributions include: Shape, Food Service Management, Newsday, Parenting Magazine, Weight and Training for Dummies. She has developed many programs including, Richard Simmons' Food Mover Program, cookbooks, recipe cards, Kathy Smiths' Project You II for Diabetes, Jorge Cruises' 3-Hour Diet Cookbook, DR Vincent Pedres' Happy Gut & Leslie Sansones' Walk Away the Pounds. Marlisa is an NSA professional member, past president, media representative, PR chair of the New York State Dietetic Association, recipient of the 2011 Diabetes Educator of the Year and Emerging Dietetic LeaderAward from the AND, Dietitian of the year LIDA, Best Of Long Island L.I Press, and Community Service AwardCW.www.marlisaspeaks.net
Videos: 6 minutes ago : Elon Musk Shared Terrifying Message (8:39) You're Not Going To Believe This! | Mark Steyn & Eva Vlaardingerbroek (3:03) Tulsi Gabbard News Live/ Tulsi Shares The True Reason Of Her Exit (3:13) Neil Oliver – ‘…it's a toxic hell…' (START @ 9:00) So THIS is how they plan to screw these companies, from inside out | Redacted with Clayton Morris (2:48) Pomegranate juice found to combat systemic inflammation throughout the body University of Bologna (Italy) & University of Auckland (New Zealand), November 18, 2022 The researchers from the University of Bologna and the University of Auckland looked at the effects of the juice of the pomegranate in particular, which has already been shown to help conditions like diabetes, atherosclerosis and prostate cancer. Chronic inflammation, a response by the body to infection and tissue damage, has been linked to the development of disorders such as inflammatory bowel disease, asthma, rheumatoid arthritis, chronic obstructive pulmonary disease and psoriasis. After analyzing an extensive number of existing studies on pomegranate, they found plenty of evidence that shows pomegranate juice can indeed help inflammation-related diseases, although they pointed out that a definitive relationship has not been officially established. Most of the scientific research on pomegranate's health benefits has been carried out on cell culture or animal models, they point out, and clinical trials with humans are generally lacking. They found that pomegranate seems to show the most promise in fighting cardiovascular diseases, metabolic syndrome and diabetes, but the researchers urge care, calling on further studies to determine its specific effects and explain why the fruit juice seems to help chronic inflammatory diseases. A Case Western study published in the Journal of Inflammation, for example, found that the extract of pomegranate significantly inhibited the buildup of damaging proteins associated with Alzheimer's disease by as much as a half. This effect is being attributed to its ability to protect against the oxidative stress that leads to beta-amyloid deposits. Researchers have also demonstrated its potential to help those with prostate, colon and breast cancer. In studies where tumor cells were treated with pomegranate, cell migration dropped and the cancer was stopped from spreading to other areas of the body. Pomegranate juice came out on top in a study of beverages known for their antioxidant content carried out by the Center for Human Nutrition at the University of California – Los Angeles's David Geffen School of Medicine. While all of the beverages examined – blueberry juice, acai berry juice, green tea, white tea, Concord grape juice, orange juice, pomegranate juice and red wine, had impressive amounts of antioxidants, pomegranate juice outperformed them all when it came to polyphenols and protective benefits. Its antioxidant potency composite index was a full 20 percent higher than any of the other drinks that were put through the rigorous testing. (NEXT) Handful of walnuts daily cuts risk of asthma University of North's Carolina, November 20, 2022 Here's another reason for you to eat more walnuts as a type of vitamin E, found in these nuts, may prevent the risk of asthma attacks by reducing airway inflammation. According to researchers, sufferers of a common breathing condition, taking it as part of the study, were also found to have less sticky mucus in their lungs. Gamma-tocopherol is a major form of vitamin E, which is abundant in nuts like walnuts and pecans and in the legume peanut, as well as seed oils such as corn, soybean and sesame. Senior study author Professor Michelle Hernandez from the University of North's Carolina school of medicine said epidemiologic data suggested that people with high amounts of vitamin E in their diet were less prone to asthma and allergic disease. The team randomly analysed participants into two groups, one that received gamma tocopherol supplement and other that received a placebo for two weeks. After a three-week period break, the findings indicated that when people were taking the vitamin E supplement, they had less eosinophilic inflammation. In addition, those who were taking vitamin E were also found to have lower levels of proteins called mucins, which affect the stickiness of mucus. Mucins are often elevated in asthmatics. (NEXT) Using vapes may set the stage for dental decay Tufts University, November 23, 2022 A vaping habit could end up leading to a tarnished smile, and more frequent visits to the dentist. Research by faculty from Tufts University School of Dental Medicine found patients who said they used vaping devices were more likely to have a higher risk of developing cavities. With CDC surveys reporting that 9.1 million American adults—and 2 million teenagers—use tobacco-based vaping products, that means a lot of vulnerable teeth. The findings of this study on the association between vaping and risk of caries—the dental term for cavities—serve as an alert that this once seemingly harmless habit may be very detrimental, says Karina Irusa, assistant professor of comprehensive care and lead author on the paper. The study was published in The Journal of the American Dental Association. Irusa says that the recent Tufts finding may be just a hint of the damage vaping causes to the mouth. “The extent of the effects on dental health, specifically on dental decay, are still relatively unknown,” she says. “At this point, I'm just trying to raise awareness,” among both dentists and patients. This study, Irusa says, is the first known specifically to investigate the association of vaping and e-cigarettes with the increased risk for getting cavities. She and her colleagues analyzed data from more than 13,000 patients older than 16 who were treated at Tufts dental clinics from 2019-2022. While the vast majority of the patients said they did not use vapes, there was a statistically significant difference in dental caries risk levels between the e-cigarette/vaping group and the control group, Irusa found. Some 79% of the vaping patients were categorized as having high-caries risk, compared to just about 60% of the control group. The vaping patients were not asked whether they used devices that contained nicotine or THC, although nicotine is more common. It's also been observed that vaping seems to encourage decay in areas where it usually doesn't occur—such as the bottom edges of front teeth. “It takes an aesthetic toll,” Irusa says. (NEXT) Study finds link between foods scored higher by new nutrient profiling system and better long-term health outcomes Tufts University, November 22, 2022 The idea that what we eat directly affects our health is ancient; Hippocrates recognized this as far back as 400 B.C. But, identifying healthier foods in the supermarket aisle and on restaurant menus is increasingly challenging. Now, researchers at the Friedman School of Nutrition Science and Policy at Tufts have shown that a holistic food profiling system, Food Compass, identifies better overall health and lower risk for mortality. In a paper published in Nature Communications, researchers assessed whether adults who ate more foods with higher Food Compass scores had better long-term health outcomes and found that they did. Introduced in 2021, Food Compass provides a holistic measure of the overall nutritional value of a food, beverage, or mixed meal. It measures nine domains of each item, such as nutrient ratios, food-based ingredients, vitamins, minerals, extent of processing, and additives. Based on scores of 10,000 commonly consumed products in the U.S., researchers recommend foods with scores of 70 or above as foods to encourage; foods with scores of 31-69 to be eaten in moderation; and anything that scores 30 or below to be consumed sparingly. For this new study, Food Compass was used to score a person's entire diet, based on the Food Compass scores of all the foods and beverages they regularly consume. For this validation study, researchers used nationally representative dietary records and health data from 47,999 U.S. adults aged 20-85 who were enrolled between 1999-2018 in the National Health and Nutrition Examination Survey (NHANES). Deaths were determined through linkage with the National Death Index (NDI). Overall, researchers found that the mean Food Compass score for the diets of the nearly 50,000 subjects was only 35.5 out of 100, well below ideal. “One of the most alarming discoveries was just how poor the national average diet is,” said O'Hearn. “This is a call for actions to improve diet quality in the United States.” A higher Food Compass diet score was associated with lower blood pressure, blood sugar, blood cholesterol, body mass index, and hemoglobin A1c levels; and lower prevalence of metabolic syndrome and cancer. A higher Food Compass diet score was also associated with lower risk of mortality: for each 10-point increase, there was a 7 percent lower risk of death from all causes. Food Compass also boosts scores for ingredients shown to have protective effects on health, like fruits, non-starchy vegetables, beans and legumes, whole grains, nuts and seeds, seafood, yogurt, and plant oils; and lowers scores for less healthful ingredients like refined grains, red and processed meat, and ultra-processed foods and additives. “We know Food Compass is not perfect,” said Mozaffarian. “But, it provides a more comprehensive, holistic rating of a food's nutritional value than existing systems, and these new findings support its validity by showing it predicts better health.” (NEXT) Acupuncture can relieve lower back and pelvic pain often experienced during pregnancy Guangzhou University of Chinese Medicine, November 21, 2022 Acupuncture can significantly relieve the lower back and/or pelvic pain frequently experienced by women during their pregnancy, suggests a pooled data analysis of the available evidence, published in BMJ Open. And there were no observable major side effects for newborns whose moms opted for the therapy, the findings indicate, although only a few of the published studies included in the analysis evaluated outcomes, such as premature birth, note the researchers. To add to the evidence base, the researchers trawled research databases for relevant clinical trials that compared the pain relief afforded to pregnant womengiven acupuncture, alone or when combined with other therapies, with other/no/dummy treatments, as well as the potential impact on their newborns. The final analysis included 10 randomized controlled trials, involving 1,040 women. Every study was published between 2000 and 2020, and carried out variously in Sweden, the UK, the U.S., Spain and Brazil. The moms-to-be were all healthy, 17 to 30 weeks into their pregnancy on average, and had lower back and/or pelvic pain. Pooled data analysis of the trial results for nine studies suggested that acupuncture significantly relieved pain during pregnancy. Four of those studies reported on the potential of acupuncture to restore physical function, and the results showed that this was significantly improved. Quality of life was recorded in five studies. When the results of these were pooled, the findings suggested that acupuncture significantly improved this too. Pooled data analysis of four studies indicated that there was a significant difference in overall effects when acupuncture was compared with other or no interventions. The researchers conclude that acupuncture merits closer attention for its potential to ease pain at a time when it's preferable to avoid drugs because of their potential side effects for mother and baby. (NEXT) 6 Health Benefits Of Rutin, And Where To Find It GreenMedInfo, November 24, 2022 Rutin is an antioxidant and anti-inflammatory powerhouse found in a variety of delicious food that may boost your health via multiple avenues, from promoting healthy circulation to providing pain relief. Rutin is one of about 4,000 types of flavonoids that are found abundantly in plants. Also known as rutoside and vitamin P, rutin is a flavonol that acts as an active constituent in tea leaves, apples, buckwheat, most citrus fruits and passion flower, for example, with nutraceutical effects that have been valued since ancient times. Medicinal plant compounds often have a range of biological activities that are both impressive and varied. Rutin is no exception, with a number of pharmacological activities that include: Six Top Reasons to Try Rutin Rutin is perhaps best known for its ability to ward off oxidative stress via potent antioxidant properties. This makes it valuable in a number of disease conditions and even as a tool for healthy aging. Rutin, for instance, reduces skin aging by strengthening dermal density and elasticity, and is found in more than 130 registered therapeutic medicinal preparations. GreenMedInfo.com has additionally compiled nearly 70 pharmacological actions related to rutin, along with 136 diseases that it may be useful for. Some of its top health benefits follow. Protection From Neurodegenerative Disease Rutin has demonstrated benefits to the central nervous system, including prevention of neuroinflammation, anticonvulsant activity and antidepressant effects. Rutin may be useful for recovery after stroke and also shows promise for Alzheimer's disease. With an ability to cross the blood-brain barrier, rutin may benefit the cognitive and behavioral symptoms of neurodegenerative diseases and helps to remove the inflammatory component of neurodegeneration. Relieve Arthritis Pain Rutin not only has analgesic and antinociceptive effects but also antiarthritic effects, making it an ideal natural option for arthritis.The plant compound has been found to suppress oxidative stress in people with rheumatoid arthritis,while also inhibiting both the acute and chronic phases of inflammation in an arthritis rat model. Antidiabetic Effects Rutin has beneficial effects on the endocrine system, including antidiabetic and anti-hypercholesterolemic effects. Rutin helps fight diabetes by decreasing carbohydrates absorption from the small intestine, increasing the uptake of glucose into tissues and stimulating the secretion of insulin from beta cells, leading to antihyperglycemic effects as well as protection against the development of diabetic complications. Rutin is also useful for protecting against age-related metabolic dysfunction, with research suggesting it inhibits age-related mitochondrial dysfunction and oxidative stress, as well as endoplasmic reticulum, or ER, stress, which is related to proteins that are not properly folded. Promote Healthy Circulation and Reduce Blood Clots Consuming rutin, either from foods or supplements, may be an effective way to block the formation of blood clots. Research by Harvard Medical School researchers suggests that rutin is effective against both platelet-rich clots that form in arteries and fibrin-rich clots that form in veins. Rutin was found to be a “champion compound” for inhibiting protein disulfide isomerase (PDI), which plays a role in the initial stages of clot formation. A nano-formulation of rutin was also found to exert powerful antithrombotic effects by inhibiting PDI,while rutin may also augment the production of nitric oxide in human endothelial cells, which is useful for blood pressure and cardiovascular system health. In terms of improved circulation, rutin is a venoactive compound, which means it may be useful for symptoms of chronic venous diseases (CVD). The compound has been demonstrated to reduce severity of lower leg pain, leg cramps, heaviness and itching, as well as edema (swelling), in people with CVD. Anticancer Effects Rutin's anticancer properties have been extensively studied. In human leukemia cells, rutin led to a significant reduction in tumor size, and it's known to inhibit cancer cell growth by cell cycle arrest and apoptosis. It also inhibits proliferation and metastasis of colorectal cancer cell lines and shows promise for use in ovarian and color cancers, as well as neuroblastoma. Support Gastrointestinal Health Rutin has antiulcer effects, as it inhibits the gastric proton pump that sends acid to your stomach. It also has potential against inflammatory bowel disease, not only due to its antioxidant effects but also by suppressing the release of proinflammatory mediators and the expression of inflammatory proteins. Top Sources of Rutin As noted in the Saudi Pharmaceutical Journal, “An ancient saying ‘an apple a day, keeps doctor away' seems to be true as rutin, one of the important constituents of apples, has a wide array of biological activities.”
How can you help reduce healthcare inequities in your patients with cardiovascular disease (CVD)? Drs Watson and Ogunniyi discuss. Credit available for this activity expires: 11/21/2023 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/984175?ecd=bdc_podcast_libsyn_mscpedu
Cardiovascular disease continues to be the #1 cause of mortality in the US and around the world. In this episode of The Health Edge, Mark and John review a paper that begins to address why it is that as we age, our risk for cardiovascular disease (CVD) and all other "age-related diseases" goes up dramatically. In this 2021 paper from the Journal of The American College of Cardiology, inhabitants of the Ikaria Island in Greece, a Blue Zone culture demonstrate lower levels of age-related changes e.g. inflammation, high insulin, short telomeres and offers many reasons for lower CVD risk, mortality and expanded healthspan.https://www.jacc.org/doi/epdf/10.1016...https://www.thehealthedgepodcast.com
How Obstructive Sleep Apnea (OSA) is common and causes QOL issues, increases morbidity and risks for CVD, heart failure, CKD and accidents How the pathways to diagnosis and treatment are complex and muddied by commercial interests Well-informed GPs playing a bigger role in managing patients with OSA How the recently launched online Sleep Health Primary Care Resources has been thoughtfully designed to offer GPs practical and comprehensive help Host: Dr David Lim | Total Time: 32 mins Guests: Prof Nick Zwar, Primary Health Care Teacher and Researcher andA/Prof Ching Li Chai-Coetzer, Sleep and Respiratory Physician Register for our fortnightly FREE WEBCASTSEvery second Tuesday | 7:00pm-9:00pm AEDT Click here to register for the next oneSee omnystudio.com/listener for privacy information.
Audience called in and asked questions of our experts on how to cope with life's added stress of having diabetes. Register for our next LIVE Q&A event at diabetes.org/experts or by calling 1-800-DIABETES.
This week, Tom and Nan have TONS of natural products news and research to share, including the return of Our Favorite Things! But first, this packed edition of Naturals in the News has some terrific insights, including:-Find out if weight lifting really does help seniors with muscle wasting and bone strength.-How beetroot juice provides phytochemicals that reduce blood pressure and support cardiovascular health.-Following a Mediterranean diet is linked with improved brain activity.-How CBD helps postmenopausal health issues such as bone, CVD markers and mood.-And more on amazing research on Vitamin E! Our Favorite Things shares traditional secrets and modern research on Elderberry and Shankahpushpi.Show LinksCheck out the Supplement Super Sleuth & Herbal Storyteller on Facebook: https://www.facebook.com/watch/thesupplementsupersleuthpodcast/Learn more about our work at https://watersedgewellness.com/
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Erin Michos is an internationally-known leader in preventive cardiology and women's cardiovascular health. In this episode, Erin discusses current trends in cardiovascular disease (CVD) through the lens of female biology and the observation that major adverse cardiac events in both sexes are on the rise. She walks through risk factors including LDL-cholesterol, apoB, and Lp(a) and makes the case for the importance of early preventative measures. She explains various interventions for reducing risk including a discussion of statins, GLP-1 agonists, PCSK9-inhibitors, and drugs that lower Lp(a). She goes in-depth on female-specific factors that contribute to CVD risk such as pregnancy, grand multiparity (having five or more children), oral contraceptives, menopause, and polycystic ovary syndrome (PCOS). Additionally, she explains her approach with patients as it relates to the use of hormone replacement therapy and provides advice for people wanting to lower risk both through lifestyle changes and medications. We discuss: Erin's background in preventive cardiology and women's health [2:30]; Recent trends in cardiovascular disease in women, mortality data, and how it compares to cancer [5:15]; Why early preventative measures are critical for cardiovascular disease risk [13:15]; ApoB as a causal agent of CVD, and why high apoB levels are not being aggressively treated in most cases [19:45]; The rising trend of metabolic syndrome and other factors contributing to the regression in progress of reducing cardiac events [27:00]; GLP-1 agonists—Promising drugs for treating diabetes and obesity [33:30]; Female-specific risk factors for ASCVD (pre- and post-menopause) [37:15]; Polycystic ovary syndrome (PCOS): prevalence, etiology, and impact on metabolic health, lipids and fertility [47:00]; The effect of grand multiparity (having 5+ children) on cardiovascular disease risk for women [52:30]; The impact of oral contraceptives on cardiovascular disease risk [55:00]; The effect of pregnancy on lipids and other metabolic parameters [58:45]; The undertreatment of women with familial hypercholesterolemia (FH) and how it increases lifetime risk of ASCVD [1:02:00]; How concerns around statins have contributed to undertreatment, and whether women should stop statins during pregnancy [1:09:45]; How Erin approaches the prescription of statins to patients [1:16:00]; PCSK9 inhibitors and other non-statin drugs [1:21:15]; Advice for the low- and high-risk individual [1:28:30]; The impact of nutrition, stress, and lifestyle on lipids and CVD risk [1:31:00]; Lp(a) as a risk enhancer for cardiovascular disease [1:41:15]; The effect of menopause on cardiovascular disease risk [1:50:30]; How Erin approaches decisions regarding hormone replacement therapy (HRT) for her patients [1:55:30]; The urgent need for more data on women's health [2:03:30]; Erin's goal of running a marathon in every state [2:09:45]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
VIDEOS: Mark Dolan: Covid has been the biggest “I told you so” in history (4:41) Society is going to COLLAPSE (5:24) Fear Psychosis and the Cult of Safety – Why are People so Afraid? (13:25) MSNBC Midterm PANIC꞉ ‘It's Going To Be a BLOODBATH'!!! (0:18 – 3:32) Pycnogenol, gotu kola supplementation associated with decreased progression of atherosclerosis D'Annunzio University (Italy), October 23, 2022 The results of studies published in Minerva Cardioangiologica suggest a benefit for supplementation with extracts of pine bark and the herb gotu kola in atherosclerosis. In one study, participants with arterial wall atherosclerotic lesions and intima-media thickening (thickening of the artery walls' innermost layers) received standard management, standard management plus aspirin, or standard management, aspirin and Pycnogenol® pine bark extract plus gotu kola extract daily for three years, after which atherosclerotic lesion progression, carotid artery intima-media thickness and oxidative stress were assessed. At the end of the trial, 5.3% of those who received Pycnogenol and gotu kola had experienced atherosclerotic lesion progression in comparison with over 20% of the remainder of the participants. Cardiovascular events that required hospital admission were less than 4% in the supplemented group compared to over 12% in the rest of the subjects. Carotid artery intima thickness and oxidative stress were also lower in association with supplementation. In the second study, 90 men with coronary artery calcifications received standard management alone, standard management and daily Pycnogenol, or standard management with daily Pycnogenol plus gotu kola. All participants received daily aspirin. Calcification was assessed at the beginning of the study and after one year. While Pycnogenol plus standard management was more effective than standard management alone, men who received Pycnogenol plus gotu kola experienced a 10% decline in the number of calcifications by the end of the study, in contrast with a 34.9% increase in the standard management group. “This indicates that supplementation with the combined supplements blocks the increase in calcified areas and, possibly, in time may decrease the number of calcified spots,” Shu Hu and colleagues write. Effects of pistachios on cardiovascular disease risk factors and potential mechanisms of action: a dose-response study. Pennsylvania State University, October 22, 2022 Nut consumption lowers cardiovascular disease (CVD) risk. Studies are lacking about the effects of pistachios, a nutrient-dense nut, on CVD risk factors, dose-response relations, and lipid-lowering mechanisms. We evaluated the effects of 2 doses of pistachios, added to a lower-fat diet, on lipids and lipoproteins, apolipoprotein (apo)-defined lipoprotein subclasses, and plasma fatty acids. To investigate the mechanisms of action, we measured cholesteryl ester transfer protein and indexes of plasma stearoyl-CoA desaturase activity (SCD). In a randomized crossover controlled-feeding study, 28 individuals with LDL cholesterol > or = 2.86 mmol/L consumed 3 isoenergetic diets for 4 wk each. Baseline measures were assessed after 2 wk of a typical Western diet. The experimental diets included a lower-fat control diet with no pistachios [25% total fat; 8% saturated fatty acids (SFAs), 9% monounsaturated fatty acids (MUFAs), and 5% polyunsaturated fatty acids (PUFAs)], 1 serving/d of a pistachio diet (1 PD; 10% of energy from pistachios; 30% total fat; 8% SFAs, 12% MUFAs, and 6% PUFAs), and 2 servings/d of a pistachio diet (2 PD; 20% of energy from pistachios; 34% total fat; 8% SFAs, 15% MUFAs, and 8% PUFAs). Inclusion of pistachios in a healthy diet beneficially affects CVD risk factors in a dose-dependent manner, which may reflect effects on SCD. Poor quality sleep may be linked to heightened risk of glaucoma, irreversible sight loss Sichuan University (China), November 1, 2022 Poor quality sleep, including too much or too little shuteye, daytime sleepiness, and snoring, may be linked to a heightened risk of developing irreversible sight loss (glaucoma), suggests a large UK Biobank study published in the open access journal BMJ Open. The findings underscore the need for sleep therapy in people at high risk of the disease as well as eye checks among those with chronic sleep disorders to check for early signs of glaucoma, conclude the researchers. While population screening may not be cost-effective, targeted screening of high-risk groups might be, suggest the researchers. And previously published research suggests that sleep disorders may be an important risk factor. To explore these issues further, the researchers set out to ascertain the risk of glaucoma among people with different sleep behaviors: insomnia; too much or too little sleep; night or morning chronotypes (“owls” or “larks”); daytime sleepiness; and snoring. They drew on 409,053 participants in the UK Biobank, all of whom were aged between 40 and 69, and who had provided details of their sleep behaviors. Sleep duration of 7 to less than 9 hours per day was defined as normal, and as too little or too much outside this range. Chronotype was defined according to whether the person described themselves as more of a morning lark or night owl. During an average monitoring period of just over 10.5 years, 8690 cases of glaucoma were identified. Those with glaucoma tended to be older and were more likely to be male, chronic smokers, and to have high blood pressure or diabetes than those who weren't diagnosed with the disease. Short or long sleep duration was associated with a heightened risk of 8%; insomnia, 12%; snoring, 4%; and frequent daytime sleepiness, 20%. Compared to those with a healthy sleep pattern, snorers and those who experienced daytime sleepiness were 10% more likely to have glaucoma, while insomniacs and those with a short/long sleep duration pattern were 13% more likely to have it. Could a Japanese mushroom extract eradicate HPV? University of Texas Health Science Center October 29, 2022 A study by researchers from The University of Texas Health Science Center suggests that an extract from a Japanese mushroom has potential to eradicate human papillomavirus – the leading cause of cervical cancer. HPV is also accountable for around 95% of anal cancers, 65% of vaginal cancers, 60% of oropharyngeal cancers, 50% of vulvar cancers and 35% of penile cancers. . As such, the team set out to assess the effects of active hexose correlated compound (AHCC) against HPV. AHCC is a substance produced by the shiitake mushroom, also called the Japanese mushroom, native to Asia. AHCC is already available as a nutritional supplement, hailed for its immune-boosting properties. Previous studies, however, have suggested that the compound may improve the growth and function of cells that ward off infections and prevent tumor growth. To reach their findings, Smith and colleagues enrolled 10 women to their study who had tested positive for HPV infection. Once a day for up to 6 months, each woman took an oral formulation of AHCC. Five of these women tested negative for HPV infection after 3 months of AHCC use. Among three of the participants, it was confirmed that HPV had been completely eradicated after AHCC use had ceased. The remaining two women needed to take AHCC for the full 6 months to see results. The team's findings are “very encouraging,” according to Smith. “We were able to determine that at least 3 months of treatment is necessary, but some need to extend that to 6 months,” she says, adding: “Since AHCC is a nutritional supplement with no side effects and other immune-modulating benefits, we will be planning on using 6 months of treatment in our phase 2 clinical study to have a consistent study treatment plan. This confirms our earlier preclinical research.” Research suggests higher testosterone reference range for young men University of Michigan, October 31 2022. In an article appearing in the Journal of Urology, Alex Zhu , of University of Michigan and his associates asserted that the standard cutoff for testosterone deficiency of 300 nanograms per deciliter (ng/dL) is too low for men younger than 45 years of age. The study is “the first evaluation of normative, population-based testosterone levels for young men in the United States,” according to Dr Zhu and colleagues. “There is an age-related decline in male testosterone production,” they wrote. “It is therefore surprising that young men are evaluated for testosterone deficiency with the same cutoff of 300 ng/dL that was developed from samples of older men.” The investigation included 1,486 men between the ages of 20 to 44 years who participated in the National Health and Nutrition Examination Surveys (NHANES) of United States residents. Men who were receiving hormone replacement therapy were excluded from the study. The men's testosterone levels were evaluated according to 5-year age groups. Testosterone levels that fell in the middle one-third of each group were categorized as normal. For every 1-year increase in age, a 4.3 ng/dL decline in testosterone was observed. Normal levels of testosterone for men aged 20 to 24 years were categorized as 409-558 ng/dL, for those 25-29 as 413-575 ng/dL, for men 30 to 34 as 359-498 ng/dL, for 35-39-year-olds as 352-478 ng/dL and for 40 to 44-year-olds as 350-473 ng/dL. This resulted in age-specific cutoffs for low testosterone levels of 409, 413, 359, 352 and 350 ng/dL for each age group. “Young men have different testosterone reference ranges than older men,” Dr Zhu, remarked. “Our findings suggest we should be using age-specific cutoffs when assessing testosterone levels in younger men.” Why 80% of Us Are Deficient In Magnesium Dr Mark Sircus, October 31st 2022 Magnesium deficiency is often misdiagnosed because it does not show up in blood tests – only 1% of the body's magnesium is stored in the blood Most doctors and laboratories don't even include magnesium status in routine blood tests. Thus, most doctors don't know when their patients are deficient in magnesium, even though studies show that the majority of Americans are deficient in magnesium. Consider Dr. Norman Shealy's statements, “Every known illness is associated with a magnesium deficiency” and that, “magnesium is the most critical mineral required for electrical stability of every cell in the body. A magnesium deficiency may be responsible for more diseases than any other nutrient.” Few people are aware of the enormous role magnesium plays in our bodies. Magnesium is by far the most important mineral in the body. After oxygen, water, and basic food, magnesium may be the most important element needed by our bodies; vitally important, yet hardly known. It is more important than calcium, potassium or sodium and regulates all three of them. Millions suffer daily from magnesium deficiency without even knowing it Symptoms of Magnesium Deficiency The first symptoms of deficiency can be subtle – as most magnesium is stored in the tissues, leg cramps, foot pain, or muscle ‘twitches' can be the first sign. Other early signs of deficiency include loss of appetite, nausea, vomiting, fatigue, and weakness. As magnesium deficiency worsens, numbness, tingling, seizures, personality changes, abnormal heart rhythms, and coronary spasms can occur. Symptoms involving impaired contraction of smooth muscles include constipation; urinary spasms; menstrual cramps; difficulty swallowing or a lump in the throat-especially provoked by eating sugar; photophobia, especially difficulty adjusting to oncoming bright headlights in the absence of eye disease; and loud noise sensitivity from stapedius muscle tension in the ear. Continuing with the symptoms of magnesium deficiency, the central nervous system is markedly affected. Symptoms include insomnia, anxiety, hyperactivity and restlessness with constant movement, panic attacks, agoraphobia, and premenstrual irritability. “Symptoms or signs of the cardiovascular system include palpitations, heart arrhythmias, and angina due to spasms of the coronary arteries, high blood pressure and mitral valve prolapse. Be aware that not all of the symptoms need to be present to presume magnesium deficiency; but, many of them often occur together. One of the principle reason doctors write millions of prescriptions for tranquilizers each year is the nervousness, irritability, and jitters largely brought on by inadequate diets lacking magnesium. Persons only slightly deficient in magnesium become irritable, highly-strung, and sensitive to noise, hyper-excitable, apprehensive and belligerent. If magnesium is severely deficient, the brain is particularly affected. Clouded thinking, confusion, disorientation, marked depression and even the terrifying hallucinations of delirium tremens are largely brought on by a lack of this nutrient and remedied when magnesium is given. Another good list of early warning symptoms suggestive of magnesium insufficiency: Physical and mental fatigue Persistent under-eye twitch Tension in the upper back, shoulders and neck Headaches Pre-menstrual fluid retention and/or breast tenderness Possible manifestations of magnesium deficiency include: Low energy Fatigue Weakness Confusion Nervousness Anxiousness Irritability Seizures (and tantrums) Poor digestion PMS and hormonal imbalances Inability to sleep Muscle tension, spasm and cramps Calcification of organs Weakening of the bones Abnormal heart rhythm Signs of severe magnesium deficiency include: Extreme thirst Extreme hunger Frequent urination Sores or bruises that heal slowly Dry, itchy skin Unexplained weight loss Blurry vision that changes from day to day Unusual tiredness or drowsiness Tingling or numbness in the hands or feet Frequent or recurring skin, gum, bladder or vaginal yeast infections Magnesium deficiency is a predictor of diabetes and heart disease both; diabetics both need more magnesium and lose more magnesium than most people. In two new studies, in both men and women, those who consumed the most magnesium in their diet were least likely to develop type 2 diabetes
The Journal of the American College of Cardiology reported on the results of a modeling study in August 2022 that concluded, “the association of CRF (cardiorespiratory fitness) and mortality risk across the age spectrum (including septuagenarians and octogenarians), men, women, and all races was inverse, independent, and graded. No increased risk was observed with extreme fitness.”The study – "Cardiorespiratory Fitness and Mortality Risk Across the Spectra of Age, Race, and Sex" – further concluded that, “being unfit carried a greater risk than any of the cardiac risk factors examined.”The study group included a diverse group – age, gender, and race – of 750,302 U.S. veterans aged 30 to 95, who were followed for a median of 10.2 years. Age and gender-specific CFR categories were created based on peak MET (metabolic equivalent) achieved on a standardized treadmill test – one MET equal to 3.5 ml/kg/min. According to the study investigators, “the lowest mortality risk was observed at approximately 14.0 METs for men and women, with no evidence of an increase in risk with extremely high CRF. The risk for least fit individuals (20th percentile) was 4-fold higher compared with extremely fit individuals.”In a related editorial, my friend, Cardiologist, Carl (Chip) J. Lavie, MD, whom I worked closely with during my tenure as Director of Health and Fitness for the Ochsner Heart and Vascular Institute, commented, “indeed, "improving CRF should be considered a target in CVD prevention, similar to improving lipids, blood sugar, blood pressure, and weight.”If you would like to read the abstract from this study, here's the link.https://www.jacc.org/doi/abs/10.1016/j.jacc.2022.05.031For more detailed information on similar studies, go to maxwellnutrition.com.
We don't want you to worry. But if you're going to worry about something, let's at least let it be the number one health risk women face in their lifetime. It's not breast cancer. It's heart disease. In this episode, I'm joined by my good friend and brilliant colleague Dr. Alex Verge, a Naturopathic Doctor who is changing the conversation about heart health for women. In this episode, Alex and I cover Why it's common to miss the conversation about heart health with women in a medical setting. How Estrogen impacts heart health and why risk changes after 50 What women can do in their 30s and 40s to prevent heart disease Why testing and screening needs to be more often than you're probably doing it. I love all aspects of women's health, but hold a special place in my heart for preventive cardiovascular care. If you have a heart. This episode is for you. It's never too early to talk about cardiovascular health in women. We're definitely not immune, and the culture of ignoring this conversation is putting women at risk. Alex shared her research and wisdom at our recent Menopause Advanced Training for integrative health practitioners and is running a Lipidology course for The Confident Clinician this December. If you're an integrative health practitioner working with midlife women, these courses will support your understanding and treatment of women in midlife with cardiovascular risk. Naturopathic doctor Alexandra Verge has been in private practice for over 20 years and has a particular interest in cardiovascular health owing in part to a significant family history of heart disease and a personal tendency to whitecoat hypertension. You can follow her on Instagram and Facebook here @alexvergend as well as at her clinic www.kuraclinic.ca. Be sure to check out Dr. Alex's free resource on Blood pressure and the Mediterranian Diet here
Are you optimizing the management of cardiovascular disease (CVD) in your female patients? Drs Johnson and Bond discuss. Credit available for this activity expires: 10/24/2023 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/982789?src=mkm_podcast_series_982789
Video: 1.Putin just EXPOSED the NATO nuclear plan and they are P*SSED | Redacted w Natali and Clayton Morris 2.Reaction To PayPal Threatening To Fine Users $2,500 Over ‘Misinformation' (4:20) 3.The Genius Behind PayPal's Bad Idea (7:36) 4.Clare Daly Latest Top 7 Contributions in the EU. (First 2 of 7 ) (start @ 1:56) 5. Tulsi Gabbard Speech LIVE | Tulsi Gabbard Accuses Joe Biden | US News Latest | English News LIVE Polyphenol consumption in adolescents is associated with better cardiovascular health University of Barcelona (Spain), October 24, 2022 The consumption of polyphenols in adolescents is associated with a better cardiovascular health, according to a collaborative research study which includes the University of Barcelona. The study has been published in Scientific Reports. As part of the study, the researchers analyzed the amount of polyphenols in the urine of 1,326 adolescents that took part in the SI! Program (Integral Health) of 24 secondary education schools in Madrid and Barcelona. Polyphenols are bioactive compounds with antioxidant and anti-inflammatory properties found in several plant-based foods, mainly in fruit, vegetables, nuts and olive oil. To date, there were few studies on the intake of polyphenols in children and adolescents. “With the results of this study, we observed that a higher urinary polyphenol excretion is linearly associated with a higher cardiovascular health index in adolescents aged 11-14, specially in children. This cardiovascular health index is defined by the criteria established by the American Heart Association (AHA), which considers seven variables: body mass index, physical activity, smoking, diet, blood pressure, total cholesterol and blood glucose,” says Professor Rosa M Lamuela, director of the Institute for Research in Nutrition and Food Safety of the University of Barcelona NAC supplements may benefit cardiovascular health: Human data University of Marburg (Germany), October 16, 2022 Four weeks of supplementation with N-acetylcysteine (NAC) may reduce levels of homocysteine and improve blood pressure, says a new analysis of two randomized, double-blind, placebo-controlled trials. A daily dose of 1.8 grams of NAC could lower homocysteine levels by about 12%, and may improve systolic and diastolic blood pressure, according to findings published in the American Journal of Clinical Nutrition . Elevated levels of the amino acid homocysteine have been reported to increase the risk of cardiovascular disease. This has led some to point to the potential of the B-vitamins to reduce homocysteine levels and reduce the risk of CVD. B vitamins are cofactors for enzymes involved in homocysteine metabolism and therefore giving people vitamin B supplements is hypothesized to reduce homocysteine levels and therefore reduce cognitive impairment. However, clinical trials including participants at risk of, or already suffering from, cardiovascular disease have produced null results, with some experts arguing that short term B vitamin supplementation should not be expected to reverse the long-term development of heart disease. “Because recent analyses that controlled for confounders such as statins or folate fortification detected a benefit of folate/B-vitamins for stroke (22–24), homocysteine may conditionally be a therapeutic target,” wrote the authors of the new study, led by Prof Wulf Hildebrandt, formerly with the German Cancer Research Center and now at the University of Marburg (Germany). “Therefore, an alternative agent for (more) effective homocysteine lowering may be desirable, especially for conditions in which B-vitamins are ineffective [e.g., in renal disease] or if a reduction in homocysteine of >25% is intended.” There is a known link between homocysteine and NAC, and some studies have shown that NAC may reduce levels of the amino acid, but the data is somewhat mixed. Results showed that NAC supplementation significant decreased homocysteine levels by an average of 11.7% (versus 4.1% in the placebo groups), which cysteine levels increased by an average of 28.1% (versus 4% in the placebo groups). There were no significant differences between the hyperlipidemic and normolipidemic men, and the smoking status also did not affect the results. The researchers also found that NAC significantly decreased blood pressure in all the men. However, significant decreases in diastolic BP were observed only for the hyperlipidemic men, and not for the normolipidemic men. Study: Late afternoon exercise helps control blood sugar, cholesterol and triglyceride levels Huazhong University of Science and Technology (China), October 22, 2022 Results of a study published in the journal Front Endocrinol show that exercising at around 4 to 6 p.m. helps to control blood sugar, cholesterol and triglyceride levels better than exercising in the morning, or around 9 to 11 a.m. For the study, researchers observed 12 healthy young men. The volunteers were told to walk on a treadmill for one hour at 60 percent of their maximal oxygen uptake (VO2max) on Monday, Wednesday and Friday. The volunteers were all tested during and after a week of exercising only in the morning or just in the afternoon. After continuous 24-hour monitoring of their blood sugar levels, the total blood sugar levels of the men were lower when they exercised in the afternoon. Their blood sugar levels after meals were also lower following afternoon exercise. Most cell damage from high blood sugar is linked to a high rise in blood sugar at least one to two hours after eating a meal. The volunteers' triglyceride levels were also lower after afternoon exercise. This is crucial since your blood sugar level rises after you eat. If it rises too high, sugar sticks to cell membranes and damages them. That's why diabetes can damage every cell in your body. When your blood sugar level increases, your pancreas releases insulin to keep blood sugar levels from rising too high. Insulin lowers blood sugar by then driving sugar from the bloodstream into the liver. But if your liver is full of sugar, the liver does not accept more sugar and all the extra sugar is converted to fatty triglycerides. Having a blood triglyceride level greater than 150 indicates that your blood sugar rises too high after meals and that you are already diabetic or prediabetic. Blood levels of the good high-density lipoprotein (HDL) cholesterol were also higher after afternoon exercise. When triglycerides rise too high, you are at increased risk for clots. To protect your body from a high rise in triglycerides, your HDL cholesterol carries the triglycerides from your bloodstream into your liver and a high rise in triglycerides causes a drop in blood levels of the HDL cholesterol. So the lower your HDL, the more likely you are to suffer a heart attack. Scientists reveal the relationship between sugar and cancer Flanders Institute for Biotechnology, October 16, 2022 A nine-year joint research project has led to a crucial breakthrough in cancer research. Scientists have clarified how the Warburg effect, a phenomenon in which cancer cells rapidly break down sugars, stimulates tumor growth. This discovery provides evidence for a positive correlation between sugar and cancer, which may have far-reaching impacts on tailor-made diets for cancer patients. The research has been published in the leading academic journal Nature Communications. This project main focus was the Warburg effect, or the observation that tumors convert significantly higher amounts of sugar into lactate compared to healthy tissues. As one of the most prominent features of cancer cells, this phenomenon has been extensively studied and even used to detect brain tumors, among other applications. But thus far, it has been unclear whether the effect is merely a symptom of cancer, or a cause. Prof. Johan Thevelein (VIB-KU Leuven): “Our research reveals how the hyperactive sugar consumption of cancerous cells leads to a vicious cycle of continued stimulation of cancer development and growth. Thus, it is able to explain the correlation between the strength of the Warburg effect and tumor aggressiveness. This link between sugar and cancer has sweeping consequences. Our results provide a foundation for future research in this domain, which can now be performed with a much more precise and relevant focus.” Living with others and community engagement are keys to reduced dementia risk University of New South Wales (Australia), October 24, 2022 Research published in The Lancet Healthy Longevity provides evidence to support that living with others, community group engagement and never feeling lonely are associated with slower cognitive decline. It is widely recognized that poor social connections such as small networks, infrequent interactions, and loneliness are modifiable risk factors for cognitive decline, with the 2020 Lancet Commission on dementia prevention estimating that tackling social isolation could prevent 4% of dementia cases worldwide. This research, led by UNSW Sydney's Centre for Healthy Brain Aging (CHeBA), investigated a range of measures of social connectedness to discover which had the most robust findings in relation to risk reduction of cognitive decline—and dementia. “We looked at a range of measures of social connections, in approximately 40,000 people across 13 international studies,” says lead author Dr. Suraj Samtani, Postdoctoral Fellow and social health expert at CHeBA. “Previous analyses of multiple international studies have many limitations. Co-author and CHeBA Co-Director Professor Henry Brodaty said that the findings have socio-economic significance. “We found that sharing a home with one or more person[s] and weekly community group engagement had the most robust results across studies, indicating these factors are fundamental components in the link with less cognitive decline,” says Professor Brodaty. “We also identified an association between never feeling lonely and a slower rate of cognitive decline.” Carrots Do Help Aging Eyes, Study Shows University of Utah School of Medicine, October 21, 2022 Your parents may have told you, “Eat your carrots, they're good for your eyes,” and a new study suggests they were on to something. Pigments called carotenoids — which give red or orange hues to carrots, sweet potatoes and orange peppers, or deep greens to produce like spinach, broccoli and kale — may help ward off the age-linked vision ailment known as macular degeneration, researchers said. “I tell my patients that fruit and vegetable consumption are very important for eye health — this study validates that notion,” said Dr. Paul Bernstein, a professor of ophthalmology and visual sciences at the University of Utah School of Medicine in Salt Lake City. Age-related macular degeneration (AMD) is one of the most common causes of vision loss, especially in the elderly. It affects the macula, the center part of the retina, and can lead to declines in sharp central vision and even blindness, experts say. Scientists have already linked a variety of factors to the condition including genetics, smoking and nutrition, said Bernstein, who was not involved in the new study. However, treatment for AMD may be limited depending on the type of macular degeneration that a person develops, he said. In the new study, Wu's team looked at data from health surveys that tracked people aged 50 and older — more than 63,000 women and almost 39,000 men -over a 25 year period. Participants were all nurses and other health professionals. Overall, about 2.5 percent of study participants developed either intermediate or advanced forms of the eye condition during the years of the study. Wu's team found that people who consumed the very highest levels of carotenoids known as lutein and zeaxanthin had a 40 percent lower risk of the advanced form of AMD compared to those who ate the very least. “Other carotenoids, including beta cryptoxanthin, alpha carotene and beta carotene, may also play protective roles,” Wu added. People who consumed the very highest amount of these carotenoids — found in foods such as carrots and sweet potato — had a 25 to 35 percent lower risk of the advanced form of the illness, the findings showed. Researchers did not find any link between the carotenoids and the intermediate form of macular degeneration, however. Lutein is found in eggs and dark leafy vegetables including broccoli, kale and spinach, Bernstein said. Zeaxanthin is harder to find in the diet, he said, but you can get it from corn, orange peppers and goji berries. Wu noted that both lutein and zeaxanthin concentrate in the macula, where they are thought to protect it from damage from oxygen and light.
Episode 115: Erectile Dysfunction Diagnosis. Discussion about the diagnosis of erectile dysfunction with Andrew, Adriana, and Dr. Arreaza. Causes, labs, and physical exam is briefly discussed. Written by Andrew Kim, MSIV, Western University of Health Sciences, College of Osteopathic Medicine of the Pacific. Comments by Adriana Rodriguez, MS3, Ross University School of Medicine; and Hector Arreaza, MD.September 22, 2022.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.In episode 39 o erectile dysfunction, Dr. Ihejirika gave us an overview, but today we will be more detailed about the diagnosis of ED. Definition.The American Urological Association (AUA) published an erectile dysfunction guideline in May 2018, which is available online at no cost. Based on that guideline, erectile dysfunction can be defined as “the consistent or recurrent inability to attain and/or maintain penile erection sufficient for sexual satisfaction, including satisfactory sexual performance.” Comment: This guideline provides 25 principles for diagnosing and treating ED. Diagnosis.Getting a good history is important when diagnosing erectile dysfunction. The patient should be asked about the onset of symptoms, severity, how much it hinders his sexual performance, whether the patient can get and maintain an erection, psychological factors, social factors, and presence of morning erections. One can use different questionnaires: the five-question International Index of Erectile Function (IIEF-5) or a single-question self-assessment. Single-question self-assessment:Impotence means not being able to get and keep an erection that is rigid enough for satisfactory sexual activity. How would you describe yourself?Not impotent: always able to get and keep an erection good enough for sexual intercourse.Minimally impotent: usually able to get and keep an erection good enough for sexual intercourse.Moderately impotent: sometimes able to get and keep an erection good enough for sexual intercourse.Completely impotent: never able to get and keep an erection good enough for sexual intercourse.Comment: Basically, the single-question self-assessment is a self-diagnosis of erectile dysfunction; the patient is giving you the severity of his condition. This questionnaire seems to be very subjective. International Index of Erectile Function (IIEF-5):IIEF-5 asks five questions, and the patient answers on a scale of 1 to 5 (1 is the worst, 5 is the best)How do you rate your confidence that you could get and keep an erection?When you had erections with sexual stimulation, how often were your erections hard enough for penetration?During sexual intercourse, how often were you able to maintain your erection after you had penetrated your partner?During sexual intercourse, how difficult was it to maintain your erection to completion of intercourse?When you attempted sexual intercourse, how often was it satisfactory for you?Diagnosis can be made based on the total score. 1 to 7: severe ED, 8 to 11: moderate ED, 12 to 16: mild-moderate ED, 17 to 21: mild ED, and 22 to 25: no ED.This is a self-reported questionnaire, and the score should be interpreted in a clinical context. Answers will likely be biased if, for example, the questionnaire is asked by a female medical assistant. Causes of ED:It is important to assess for medical conditions, psychological conditions, and medications because ED can be caused by vascular, neurological, psychological, and hormonal problems. Cardiovascular: Some common conditions related to ED are cardiovascular disease (PAD, CAD) and HTN.Endocrine: DM, HLD, obesity, testosterone deficiency (hypogonadism), hyperprolactinemia, thyroid disorder, metabolic syndrome.Neurologic: Neurologic conditions (multiple sclerosis, stroke, spine injury), trauma, and venous leakage.Lifestyle causes: sedentary lifestyle, tobacco use.Psychological: Performance anxiety, relationship issues, anxiety, depression, and stress are common psychological causes.Medications and substances: Alcohol, illicit drugs, and nicotine are important causes of ED, but some medications also cause or worsen ED: opiates, diuretics (spironolactone), antifungals (azoles), anticonvulsants, antidepressants (SSRIs), antihistamines, H2 blocker (cimetidine) antihypertensives, nasal decongestants, and antipsychotics. Remember to ask about over-the-counter medications and supplements.Physical exam: Measure blood pressure, BMI, and a complete exam, especially a genital exam. A comprehensive genitourinary exam should include the inspection of the testicles (atrophy, varicocele, signs of hypogonadism). The penis should be inspected and palpated (look for scar tissue and Peyronie's plaques) and assessment of penile stretch/flaccid length (it is done by stretching the penis. An elastic penis is a healthy penis). Dr. Winter's expert opinion: consider a prostate exam in older patients presenting with ED.Labs: Following physical examination, some lab tests can be ordered to further evaluate possible causes of ED. -A1C and glucose levels can be ordered to look for diabetes. -Lipid panel for hyperlipidemia.-TSH should be checked for thyroid function and to rule out hypothyroidism. -Testosterone deficiency can be assessed by measuring morning serum total testosterone level, which is defined as total testosterone < 300 with signs and symptoms. -Prolactin (perform pituitary MRI in any degree of hyperprolactinemia. In patients taking medications that cause hyperprolactinemia, get MRI if prolactin is above 100) Why is it important to diagnose ED?ED can be linked to organic causes.- Glucose: ED is linked to increased fasting serum glucose levels (diabetes). People with PMH of DM are 3 times more likely to develop ED. The longer the patient had diabetes, the stronger association with ED. Fasting glucose levels are associated with the highest risk of ED. The probability of having undiagnosed DM is 1/50 in the age group 40 to 59 without ED but increases to 1/10 for those with ED.- Testosterone and obesity: Low serum testosterone levels can contribute to the link between metabolic syndrome and ED. In men with obesity, the adipose tissue enzyme aromatase is more prevalent and can convert testosterone into estradiol to cause hypogonadism. Furthermore, adipocytes can cause inflammation and recruit inflammatory cytokines, leading to impaired endothelial function and ED. - Cardiovascular disease: ED and CVD have some common risk factors: older age, HTN, dyslipidemia, smoking, obesity, and DM. ED is related to an increased risk of CVD, CAD, and stroke. Usually, it is thought that ED arises two to five years prior to CAD. If a patient develops signs and symptoms of ED before CAD, the patient can be counseled and educated to make lifestyle modifications to prevent CAD.Furthermore, men with ED are more likely to experience angina, MI, stroke, TIA, CHF, and cardiac arrhythmias when compared to their counterparts without ED. A study from 2003 suggested that patients with ED have a 75% increased risk of developing peripheral vascular disease. Studies suggest ED can predict silent CAD, and one study concluded that the incidence of CAD in men below 40 years of age with ED was seven times higher than that of the control population without ED. It is important to diagnose ED because it can be used as a marker for assessing cardiovascular risk.ED can be linked to many causes, and we as clinicians should be able to identify those causes to prescribe a more specific treatment. Not all ED will respond to “the blue pill”. We will talk about treatment in another episode. Conclusion: Now we conclude episode number 115, “Erectile Dysfunction Diagnosis.” Male sexual health sometimes can be taboo, and patients may not fully disclose personal issues like erectile dysfunction. Andrew and Adrianna explained that an open discussion about erectile dysfunction can help you diagnose underlying conditions, including cardiovascular disease. Dr. Arreaza reminded us that the diagnosis of erectile dysfunction should prompt a deeper investigation in most cases before you attribute it to psychological factors. This week we thank Hector Arreaza, Andrew Kim, Adriana Rodriguez, and Fiona Axelsson. Audio edition 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:Burnett AL, Nehra A, Breau RH, et al. Erectile Dysfunction: AUA Guideline. Journal of Urology. 2018;200(3):633-641. doi:10.1016/j.juro.2018.05.004. https://www.auajournals.org/doi/epdf/10.1016/j.juro.2018.05.004.Rew KT, Heidelbaugh JJ. Erectile Dysfunction. American Family Physician. 2016;94(10):820-827. Accessed September 19, 2022. https://www.aafp.org/pubs/afp/issues/2016/1115/p820.html.Khera M. Evaluation of male sexual dysfunction. UpToDate. www.uptodate.com. Last updated: April 28, 2020. Accessed September 19, 2022. https://www.uptodate.com/contents/evaluation-of-male-sexual-dysfunction.Abrams H, Winter A, Williams PN, Watto MF. “#317 Erectile Dysfunction”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. January 24, 2022.Royalty-free music used for this episode: Gushito, Burn Flow. by Videvo, downloaded on May 06, 2022, from https://www.videvo.net/royalty-free-music-track/good-vibes-alt-mix/1017292/
We've decided to do a mini-series on peptides and weight loss. Over the next few weeks, we'll cover topics like what semaglutide is, how semaglutide works for weight loss, the side effects of semaglutide, and how semaglutide compares to other peptides for weight loss. But today, we'll cover semaglutide, what it is, how it works for weight loss, and how effective semaglutide is for weight loss. What is semaglutide? Semaglutide is a glucagon-like peptide-1 (GLP-1) agonist. It was originally approved in 2017 to help control blood sugar in people with Type 2 diabetes. You may know semaglutide as Ozempic, the injectable form of the medication or Rybelsus, the oral pill. Both of these dosage forms are used in people with Type 2 diabetes. Wegovy, a higher-dose version, is used to help people lose weight. Why is semaglutide dosed higher for weight loss? It was found that people taking Ozempic to help control blood sugar also lost weight while taking this medication. Because of this, the manufacturer of the medication studied semaglutide in people without Type 2 diabetes, but at a higher dose. Based on their weight loss findings, the FDA-approved semaglutide (under the brand name Wegovy) for weight loss in adults with a body mass index (BMI) great than or equal to 30mg/kg2 alone or a BMI of 27 mg/kg2 with at least one weight-related issue (e.g., high blood pressure, high cholesterol, sleep apnea, CVD). How does semaglutide work for weight loss? Semaglutide should be used with lifestyle changes, including a healthy diet and exercise, to help people lose weight. After you eat a meal, semaglutide helps to lower your blood sugar by mimicking a gut hormone. This causes your pancreas to release insulin and blocks your liver from releasing sugar. It also slows down how quickly food leaves your stomach. This makes you feel full longer and suppress your appetite. All of these things together lead to weight loss. It's important to know that semaglutide is not a type of insulin. Although it stimulates your pancreas to release insulin when sugar is present, it needs your body's insulin to do so. It's also important to know that semaglutide isn't a stimulant. Semaglutide does not work like phentermine, a weight loss medication with stimulating effects that help curb your appetite. How effective is semaglutide for weight loss? One reason there's a lot of buzz around semaglutide is the amount of weight people lost during clinical trials. A 68-week study with almost 2,000 adult participants reported an average weight loss of nearly 15% (approximately 35 pounds). The placebo group lost an average of 2.5% of their body weight. *The average starting weight of the participants was 232 pounds. Thanks again for listening to The Peptide Podcast. You can find more information at pepties.com. We love having you as part of our community. If you love this podcast, please share it with your friends and family on social media. Have a happy, healthy week! Pro Tips We're huge advocates of using daily collagen peptide supplements in your routine to help with skin, nail, bone, and joint health. But what do you know about peptides for health and wellness? Giving yourself a peptide injection can be scary or confusing. But we've got you covered. Check out 6 tips to make peptide injections easier. And, make sure you have the supplies you'll need. This may include syringes, needles, alcohol pads, and a sharps container. They work to kill bacteria (bactericidal) by preventing them from making their own protective coating in your body.
The treatment your patients need but may not be getting! Take a bite out of our latest episode featuring guest expert Dr. Michelle McMacken (@DrMcMacken) and learn how you can help your patients effectively and sustainably reap the health benefits of improved nutrition. Discover the enormous evidence base for nutritional recommendations, develop scripts to engage patients, and update your CVD, T2DM, and hyperlipidemia treatment plans to meaningfully incorporate nutrition. Get your truffle-hunting outfit on, it's time to go foraging for some tasty knowledge food! Show Segments Intro, disclaimer, guest bio Guest one-liner, favorite advice Case from Kashlak; definitions “Evidence-based nutrition” vs plant-based diet Unifying the guidelines for patient care Treating the skeptical patient Tailoring recommendations to patients' needs Treating the motivated patient Host questions Outro Credits Written and Produced by: Deep Shah MD Show Notes: Sarah Phoebe Roberts, Deep Shah MD Infographic and Cover Art: Lyan Chang Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP; Deep Shah MD Reviewers: Emi Okamoto MD Showrunner: Matthew Watto MD, FACP Technical Production: PodPaste Guest: Michelle McMacken MD, FACP, DipABLM Sponsor: BetterHelp Visit BetterHelp.com/curb today to get 10% off your first month. Sponsor: Indeed Visit Indeed.com/internalmedicine to start hiring now. Super foods handout Full transcript HERE
We discuss two major pages in the Left's playbook: accusing true believers of 'Christian Nationalism' in order to silence us, and propagating lies about the Cvd jab even though stats and truth are being exposed; misinformation, and how believers must pray, vote, and speak while we still can! Daily podcast, relevant articles on issues pertaining to Christians and more can be found on Stand Up For The Truth.
This week's topics include eye scans to predict cardiovascular disease (CVD) mortality, preventing stroke in transcatheter aortic valve replacement (TAVR), should the newer diabetic medications be first line? and intensive care units in the ED.
Episode 112: Statins in Primary CareDr. Tiwana explains the use of statins for the primary prevention of cardiovascular disease.Written by Ripandeep Tiwana, MD (Post-Doctoral Research Fellow at Cedar Sinai Medical Center – Heart Institute). Edition of text and 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.Definition.Statins commonly referred to as lipid-lowering medications, are important in primary care as they serve multiple long-term benefits than just lipid lowering alone. They are HMG-CoA reductase inhibitors. As a refresher, this is the rate-controlling enzyme of the metabolic pathway that produces cholesterol. This enzyme is more active at night, so statins are recommended to be taken at bedtime instead of during the day. Statins are most effective at lowering LDL cholesterol. However, they also help lower triglycerides and raise HDL cholesterol.Statins are not limited to just patients with hyperlipidemia. They reduce illness and mortality in those who have diabetes, have a history of cardiovascular disease (including heart attack, stroke, peripheral arterial disease), or are simply at high risk for cardiovascular disease. Statins are used for primary and secondary prevention.Types of statins.How do we determine which statin our patients need?First, we need to know that not all statins are created equal. They vary by intensity and potency thus, and they are categorized as either low, moderate, or high intensity.Several statins are available for use in the United States. They include Atorvastatin (Lipitor), Fluvastatin (Lescol XL), Lovastatin (Altoprev), Pitavastatin (Livalo, Zypitamag), Pravastatin (Pravachol), Rosuvastatin (Crestor, Ezallor), Simvastatin (Zocor)Commonly used in clinics: Simvastatin, Atorvastatin, and Rosuvastatin.Statin Dosing and ACC/AHA Classification of Intensity Low-intensity Moderate-intensity High-intensityAtorvastatin NA 1 10 to 20 mg 40 to 80 mgFluvastatin 20 to 40 mg 40 mg 2×/day; XL 80 mg NALovastatin 20 mg 40 mg NAPitavastatin 1 mg 2 to 4 mg NARosuvastatin NA 5 to 10 mg 20 to 40 mgSimvastatin 10 mg 20 to 40 mg NAOf note, atorvastatin and rosuvastatin are only for moderate or high-intensity use, and do not use simvastatin 80 mg.Identifying patients at risk.How do we determine who needs statin therapy?Once we become familiar with the different statins, we must figure out which intensity is advised for our patient. Recommendations for statin therapy are based on guidelines from The U.S. Preventive Services Task Force (USPSTF), American Diabetes Association (ADA), and the American College of Cardiology/American Heart Association (ACC/AHA) which recommend utilizing the ASCVD risk calculator in those patients who do not already have established cardiovascular disease.ASCVD stands for atherosclerotic cardiovascular disease, defined as coronary heart disease, cerebrovascular disease, or peripheral arterial disease presumed to be of atherosclerotic origin. ASCVD remains a leading cause of morbidity and mortality in the United States, especially in individuals with diabetes.The ASCVD risk score determines a patient's 10-year risk of cardiovascular complications, such as a myocardial infarction or stroke. This risk estimate considers age, sex, race, cholesterol levels, use of blood pressure medication, diabetic status, and smoking status. Regarding age, this calculator only applies to the age range of 40-79 as there is insufficient data to predict risk outside this age group.There are several online and mobile applications available to calculate this score. Once calculated it gives a recommendation for which intensity statin to use. However, as this is a recommendation, it is essential to use your own clinical judgment to decide what is best for your individual patient. Please refer to the above table as a reference for which statin and dose you may consider using.Keeping the above calculator in mind, additional statin guidelines are recommended by the ACC:Patients ages 20-75 years and LDL-C ≥190 mg/dl use high-intensity statin without risk assessment. (You do not need the calculator.)People with type 2 diabetes and aged 40-75 years use moderate-intensity statins, and risk estimate to consider high-intensity statins. (It means moderate for all diabetics older than 40, high for some.)Age >75 years, clinical assessment, and risk discussion. Age 40-75 years and LDL-C ≥70 mg/dl and 10%. Grade B recommendation: prescribe a statin for the primary prevention of CVD.Grade C – 40-75 years with >= 1 cardiovascular risk factor AND estimated 10-year ASCVD risk 7.5-10%. Grade C recommendation: selectively offer a statin for the primary prevention of CVD. The likelihood of benefit is smaller in this group than in persons with a 10-year risk of 10% or greater.Grade I - The USPSTF found insufficient evidence to recommend for or against initiating a statin for the primary prevention of CVD events and mortality in adults 76 years or older.The USPSTF is also very clear regarding the intensity of statin therapy. They explained that there is limited data directly comparing the effects of different statin intensities on health outcomes. Most of the trials they reviewed used moderate-intensity statin therapy. They conclude that moderate-intensity statin therapy seems reasonable for most persons' primary prevention of CVD.The USPSTF has a broader recommendation, whereas the ACC guidelines are more detailed and individualized and provide guidance on the recommended intensity of statin therapy.Labs needed.Establish baseline labs for serum creatinine, LFTs, and CK only if there is a myopathy risk. Routine monitoring of LFTs, serum creatinine, and CK is unnecessary; only check if clinically indicated.A lipid panel should be checked in 6-8 weeks, and the patient should monitor themselves for any side effects, including myalgias. If LDL-C reduction is adequate (≥30% reduction with intermediate statins and 50% with high-intensity statins), regular interval monitoring of risk factors and compliance with statin therapy is necessary to sustain long-term benefit.Side effects and contraindications.Some common side effects include URI-like symptoms, headache, UTI, and diarrhea. Some patients are very hesitant to take any medications. Warning about side effects may decrease compliance. Major contraindications for statin therapy include active liver disease, muscle disorders, pregnancy, and breastfeeding.Special considerations.Chronic kidney disease: The preferred statins for CKD with severe renal impairment are atorvastatin and fluvastatin because they do not require dose adjustment. Pravastatin would be a second choice.Chronic liver disease: Statins are contraindicated in patients with decompensated cirrhosis or acute liver failure. Abstinence from alcohol is critical in patients with chronic liver disease who are taking statins. Pravastatin and rosuvastatin are the preferred agents. Check lipid levels to determine if LDL-C reduction is accomplished with no changes in aminotransferases. You may consider stopping, increasing dose, or changing statin as you discuss the risks vs. benefits with your patient.Conclusion: Simply put, if a patient has an LDL of greater than 190, is a diabetic, has an established history of cardiovascular disease, or is at risk for it, then the patient should ideally be taking a statin unless there is a contraindication, allergy, or other special circumstance that limits him/her from doing so. If you have patients that apply to any of the above scenarios and are not already on a statin, determine their risk, and consider starting them on a statin “stat” to reduce morbidity and mortality. On the other hand, be mindful of overprescribing. Do not prescribe statins to patients who do not meet the above criteria.________________________________________Now we conclude our episode number 113, “Statins in Primary Care.” Statins are powerful medications for the prevention of cardiovascular disease. Do not forget to recommend non-pharmacologic measures such as healthy eating and physical activity, but let's also consider adding a statin to patients who are at moderate to high risk for cardiovascular disease.This week we thank Hector Arreaza and Ripandeep Tiwana. Audio 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:1. Statins, U.S. Food & Drug Administration, 2014, December 16, fda.gov, https://www.fda.gov/drugs/information-drug-class/statins, accessed September 14, 2022.2. Chou R, Cantor A, Dana T, et al. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: A Systematic Review for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2022 Aug. (Evidence Synthesis, No. 219.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK583661/3. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2019; March 17. https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2019/03/07/16/00/2019-acc-aha-guideline-on-primary-prevention-gl-prevention. 4. ASCVD Risk Estimator Plus, published by the American College of Cardiology, https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/, accessed September 14, 2022.5. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication, U.S. Preventive Services Task Force, Final Recommendation Statement, 2022, August 23. https://uspreventiveservicestaskforce.org/uspstf/recommendation/statin-use-in-adults-preventive-medication6. Videvo. “Distinction.” Https://Www.videvo.net/Royalty-Free-Music-Track/Distinction/227882/, Https://Www.videvo.net/, https://www.videvo.net/royalty-free-music-track/distinction/227882/. Accessed 26 Sept. 2022.
Dr. Lee Merritt says we are in the 4th stage of a DNA war and they are aiming at the West, they're going after our children, and they're using emergency authority. Medical misinformation is off the charts and the Biden Administration is stepping up censorship efforts. Medicine has been weaponized, media is fear-mongering, and government is pushing propaganda, forcing compliance. How do we respond? Daily podcast, relevant articles on issues pertaining to Christians and more can be found on Stand Up For The Truth.
Diagnosis & prevention of Cardiovascular disease: The objectives for this presentation will be to discuss the various methods available to help diagnose existing CVD and to understand the differences in how they can predict future CV events (heart attacks, heart failure, etc.) And the newest technology called “Cleerly” which is a CT scan of the heart which measures the amount of heart attack causing plaque in the coronary arteries. Dr. Sal is Board Certified in Lifestyle Medicine and is the President of his Concierge Lifestyle Medicine practice in Fort Myers, Florida. He is the Medical Director of the Lifestyle Medicine Institute and clinically supervises the Pivio program, formerly known as the CHIP program (Complete Health Improvement program). He practiced Internal Medicine and was the Medical Director of the Lee Physician Group of Lee Health from 1994 – 2020. He focuses on using the 6 pillars of Lifestyle medicine to help individuals become and stay healthy. He is an avid runner and tennis player and sees himself as a role model for healthy living. He is the author of “Grow Up without Getting Old” which is available on his website https://www.drsallifestylemed.com/ His goal is to live beyond 100 years of age!
We protect your nervous and skeletal systems. We provide storage space for carbs and increase your metabolic rate so you won't get as fat. We are a great indication of your bone density since the same activities that build us build your bones. Those activities are also like all-natural hormone therapy. We help you move, give you strength, so you don't fall as easily, and when you do fall or get in an accident, we tense up, protecting the tissues beneath us. Oh, and we make you look healthier too. Unfortunately, most of the medical community talks little about us. They've forgotten how essential we are for your health. Maybe they never really knew. Sadly, many "fitness professionals" don't even make us a priority in their programming. We are muscles. Make us bigger and stronger as long as you can. When you reach old age, hold onto us as long as possible. If you do, you'll look and feel younger than most people half your age, and according to the research, you'll live longer as well. This systematic review and meta-analysis of cohort studies found that muscle-strengthening activities were inversely associated with the risk of CVD, total cancer, diabetes, lung cancer and all-cause mortality independent of aerobic activities among adults aged ≥18 years without severe health conditions.Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies The Health Benefits of Muscle Mass I've written about the health benefits of muscle mass for years. As I've reached middle age and seen so many men and women my age getting weaker, gaining body fat, and becoming more sedentary, I've become more and more outspoken about building muscle. My recent bike accident only reinforced my drive to push men and women to build muscle. Here's why I believe building muscle is the most important thing you can do for your longevity, health, and quality of life. Building muscle... Adds to your quality of life savings account At some point, you'll likely face a significant injury, illness, other trauma, or age-related muscle loss. At that point, your body will use up a significant portion of your available muscle mass. The more you have when this process begins, the more you'll be able to lose before really bad things start happening. The stressed state, such as that associated with sepsis, advanced cancer, and traumatic injury, imposes greater demands for amino acids from muscle protein breakdown than does fasting.The underappreciated role of muscle in health and disease Stores carbs, keeping blood sugar levels in check The more muscle you have, the more carbs you can eat without dealing with insulin resistance, diabetes, or metabolic syndrome. Muscle-building exercise not only increases the storage space you have for carbs in your diet, it also makes your muscles more sensitive to insulin. You end up secreting less insulin to shuttle carbs, or glucose, into your muscle cells. If you produce less insulin, you can rely on fat more for energy. If you burn more fat during the day, you'll tap into the fat on your arms, legs, and belly. alterations in the metabolic function of muscle are central to the development of insulin resistance and ultimately diabetesThe underappreciated role of muscle in health and disease Protects your joints Muscles move bones around your joints. When they get weak, or you lose muscle mass, you make your joints more vulnerable to injury and the effects of degeneration. I'm all about using nutrition and supplements to support your joint health (for example, I use AgilEase from Young Living regularly), but I'd never expect a supplement to solve all my joint aches and pains without building muscle size and strength around that joint. I believe wholeheartedly that the muscle mass I developed around my neck kept me from experiencing an injury and outcome m...
HEALTH NEWS Low magnesium linked to diabetic retinopathy Exercise Outweighs Genetics When It Comes To Longer Life Guarana found to have higher antioxidant potential than green tea Study links caesareans and cardiovascular risk Black tea drinkers live longer Unhealthy diet during pregnancy could be linked to ADHD Low magnesium linked to diabetic retinopathy Soochow University (China), August 26 2022. A study reported August 22, 2022, in Biological Trace Element Research found an association between low magnesium and a higher risk of diabetic retinopathy, a major visual complication of long-term diabetes. “Low magnesium consumption has been linked to an increased risk of type 2 diabetic mellitus,” authors Yuan Chen of Soochow University in China and colleagues noted. The body's tight regulation of serum magnesium makes it a poor measure of total body magnesium status. Plasma magnesium also poorly reflects the body's true magnesium status because of the kidneys' reabsorption of the mineral. “The magnesium depletion score (MDS) index was recently proposed as a method of measuring magnesium shortage that took into consideration the pathophysiological factors influencing the kidneys' reabsorption capability and was proven to be more sensitive and reliable than other clinical predictors of magnesium,” Chen and associates wrote. The study utilized data obtained from 4,308 men and women enrolled in the National Health and Nutrition Examination Survey (NHANES) 2005–2018. Diabetes was present in 10.7% of the participants. Dietary questionnaire responses were used to estimate the amount of magnesium consumed each day. Greater magnesium intake and lower magnesium depletion scores were associated with a decreased risk of diabetic retinopathy. A high amount of magnesium intake was associated with a reduced risk of diabetic retinopathy when the magnesium depletion score was at a middle level or lower. “Our research indicates that magnesium deficiency predicts a higher risk of diabetic retinopathy in diabetic individuals and that magnesium supplementation may reduce the risk of diabetic retinopathy,” they concluded. Exercise Outweighs Genetics When It Comes To Longer Life University of California at San Diego, August 26, 2022 If living into your 90s seems to run in the family, don't just assume that means you will too. Our genetics make us who we are, but new research from the University of California, San Diego finds exercise trumps genes when it comes to promoting a longer life. You don't need a medical degree to know that forgoing physical activity in favor of stagnation isn't the wisest choice for your health and longevity. But, certain people are genetically predisposed to live longer than others. The research team at UCSD set out to determine if such individuals don't have to move quite as much as the rest of us to live just as long. This research project began a decade ago. In 2012, as part of the Women's Health Initiative Objective Physical Activity and Cardiovascular Health study (OPACH), study authors began keeping track of the physical activity habits among 5,446 older U.S. women (ages 63 or older). Subjects were tracked up until 2020, and wore a research-grade accelerometer for up to seven days. That device measured how much time they spent moving, the intensity of that physical activity, and their usual amount of sedentary time. Sure enough, higher levels of light physical activity and moderate-to-vigorous physical activity were associated with a lower risk of dying during the tracking period. Additionally, more time spent sedentary was associated with a higher risk of mortality. Importantly, this observed connection between exercise and a longer life remained consistent even among women dete