Podcasts about dxa

En lo último en salud y fitness edición de abril 2025, damos un paseo por las últimas tendencias, investigaciones y noticias en el mundo de la salud y el fitness.En este episodio hablaremos de temas desde cómo la cafeína afecta tu rendimiento (y por qué a veces parece que ya no funciona), hasta la última información sobre los suplementos de omega-3 para el cuidado de tus ojos. También veremos datos nuevos sobre los monitores de glucosa que te harán repensar algunas cosas, y pondremos sobre la mesa la verdad sobre los medicamentos GLP-1 y su efecto en tu músculo.Atajos del episodio: 02:56 - ¿Tomar cafeína todos los días te vuelve inmune a sus efectos para el ejercicio?106:47 - ¿Usas lágrimas artificiales? Mejor dale a tus ojos lo que realmente necesitan211:50 - La glucosa no es tan predecible como pensabas318:16 - GLP-1 y pérdida de peso: ¿también estás perdiendo músculo?423:19 - Más omega-3 y omega-6, menos grasa corporal (sí, leíste bien: omega-6 también)5Referencias: 1.      Khodadadi, D., Azimi, F. & Moghanlou…, A. E. Habitual Caffeine Consumption and Training Status Affect the Ergogenicity of Acute Caffeine Intake on Exercise Performance. Sports … (2025).2.      Hong, S., Woo, M., Eom, Y., Kim, H. K. & Yoon…, K. C. A Multicenter, Randomized, Clinical Trial Assessing the Effect of rTG-Omega 3 Supplementation on Meibomian Gland Dysfunction Patients after Cataract Surgery rTG …. Journal of Ocular … (2025).3.      Hengist, A., Ong, J. A., McNeel, K., Guo, J. & Hall, K. D. Imprecision nutrition? Intraindividual variability of glucose responses to duplicate presented meals in adults without diabetes. The American Journal of … (2025).4.      Beavers, K. M., Cortes, T. M., Foy, C. M. & Dinkla…, L. G LP1Ra‐based therapies and DXA‐acquired musculoskeletal health outcomes: a focused meta‐analysis of placebo‐controlled trials. … (2025).5.      Yang, Z. et al. Omega-3 and omega-6 fatty acids: Inverse association with body fat percentage and obesity risk. Nutrition Research (2025).

In drug development, the right biomarker can mean the difference between success and a missed opportunity. In this episode of SNiPs, Bracken Senior Partner David Raunig, PhD explores how imaging biomarkers—like DXA and the fracture risk score—are being used in new ways to assess efficacy in clinical trials, especially for rare and complex diseases. David breaks down the evolving landscape of FDA qualification, highlighting a flexible path that allows sponsors to leverage novel endpoints without requiring tens of thousands of patients. From muscle mass in aging populations to trial-specific biomarker strategies, he shares valuable insight into what's possible today—and what's coming next.

BUFFALO, NY- January 29, 2025 – A new #editorial was #published in Volume 16, Issue 22 of Aging (Aging-US) on December 11, 2024, titled “ISarcoPRM algorithm for global operationalization of sarcopenia diagnosis.” In this editorial, Pelin Analay, Murat Kara and Levent Özçakar from Hacettepe University Medical School discuss the importance of establishing a standardized global approach to diagnosing sarcopenia, an age-related condition that leads to muscle loss and reduced strength. The authors highlight the ISarcoPRM algorithm, which suggests measuring quadriceps muscle mass instead of the commonly used appendicular lean mass (ALM) measurement. They believe this improved method could help clinicians identify sarcopenia earlier and provide better treatment options. Sarcopenia is a major health problem for older adults, making daily activities such as walking, climbing stairs, and standing up more difficult. As muscle strength declines, individuals with sarcopenia are at greater risk of falls and serious injuries, such as fractures. Early detection of sarcopenia is crucial to help older adults maintain their mobility and independence. The editorial points out that current diagnostic tools, such as dual-energy X-ray absorptiometry (DXA), may not effectively measure age-related muscle loss. Sarcopenia primarily affects fast-twitch muscle fibers, which are essential for strength and quick movements. However, DXA scans measure overall muscle mass and fail to assess these specific fibers, potentially leading to inaccurate or delayed diagnoses. The authors propose that measuring the quadriceps muscle mass—the large muscle in the thigh—is a more accurate way to diagnose sarcopenia. This muscle plays a critical role in mobility and strength, and its size and function are strongly linked to a person's overall physical performance. The editorial recommends using ultrasound (US) imaging as a practical and cost-effective solution for diagnosing sarcopenia in clinical settings. Compared to other imaging techniques, US is affordable, widely available, and well-suited for elderly patients, including those with mobility limitations or medical implants. Ultrasound is also non-invasive, making it an ideal choice for routine sarcopenia screening in hospitals, clinics, and long-term care facilities. If widely adopted, this new way of diagnosing sarcopenia could help clinicians detect it more accurately and at an earlier stage. Finding sarcopenia early allows people to start helpful treatments, like exercise, better nutrition, and healthy lifestyle changes. These steps can slow down muscle loss and help older adults stay strong and active. Finally, the authors encourage a global consensus on how to diagnose sarcopenia and suggest the ISarcoPRM method as a great option. “In conclusion, quadriceps muscle mass measurements, preferably by US and as recommended by the ISarcoPRM algorithm, holds great promise in the diagnosis of sarcopenia.” DOI - https://doi.org/10.18632/aging.206174 Corresponding author - Pelin Analay - pelinanalay@yahoo.com Video short - https://www.youtube.com/watch?v=gDcQ9w6mHyE About Aging-US The mission of the journal is to understand the mechanisms surrounding aging and age-related diseases, including cancer as the main cause of death in the modern aged population. Please visit our website at https://www.Aging-US.com​​ and connect with us: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc MEDIA@IMPACTJOURNALS.COM

Get 20% off the Tone LUX Crystal Red Light Therapy Face Mask with the code VANESSA Hi friends! In this episode we're diving deep into the world of DXA body scans and why they're a game-changer for assessing your health. A DXA scan provides a detailed breakdown of your body composition, including bone density, muscle mass, body fat percentage, and Resting Metabolic Rate (RMR). More importantly, we explore why these insights are essential for understanding metabolic health, muscle and bone health, and even longevity. We also discuss my latest DXA scan results—what's improved, what I'm working on, and how regular assessments have helped me stay on track with my health goals. You'll hear firsthand how body composition tracking offers actionable insights to optimize your health and fitness journey. Key Takeaways from the Episode: • What a DXA body scan is and how it works. • The importance of assessing body composition beyond just tracking weight or BMI. Optimal body fat percentages for women and men. • How monitoring muscle mass, bone density, and visceral fat impacts metabolic health and longevity. • Why regular DXA scans are vital for tracking progress and catching early warning signs. • My personal DXA results and how they're helping me adjust my approach to health and fitness. Whether you're focused on fat loss, muscle gain, or healthy aging, this episode provides the science and practical advice you need to understand and optimize your body composition. Get 20% off the New 2nd Generation Tone Device HERE with the code VANESSA Join the Community! Follow Vanessa on instagram to see her meals, recipes, informative posts and much more! Click here @ketogenicgirl Follow @optimalproteinpodcast on Instagram to see visuals and posts mentioned on this podcast. Link to join the facebook group for the podcast: https://www.facebook.com/groups/2017506024952802/   Thank you to our sponsor:   Bioptimizers Magnesium Breakthrough is one of the only supplements I take with me when I travel as it is so important to me! Save 10% OFF with the code VANESSA at bioptimizers.com/vanessa - This podcast content does not constitute an attempt to practice medicine and does not establish a doctor-patient relationship. Please consult a qualified healthcare provider for medical advice and personal health questions. Prior to beginning a new diet you should undergo a health screening with your physician to confirm that a new diet is suitable for you and to out any conditions and contraindications that may pose risks or are incompatible with a new diet, including by way of example: conditions affecting the kidneys, liver or pancreas; muscular dystrophy; pregnancy; breast-feeding; being underweight; eating disorders; any health condition that requires a special diet [other conditions or contraindications]; hypoglycemia; or type 1 diabetes. A new diet may or may not be appropriate if you have type 2 diabetes, so you must consult with your physician if you have this condition. Anyone under the age of 18 should consult with their physician and their parents or legal guardian before beginning such a diet. Use of Ketogenic Girl podcasts & videos are subject to the Ketogenicgirl.com Terms of Use and Medical Disclaimer. All rights reserved. If you do not agree with these terms, do not listen to, or view any Ketogenic Girl podcasts or videos.

Knoxville Hospital and Clinics Radiologist Tech Taylor VanDenberg discusses DXA and bone density scans.

Ah, so it's the 4th July as I record this so Happy Independence Day to all my US friends and colleagues!    In this episode, I do my regular round-up of things I've heard during judging - I was chairing the Click Expo Print Competition (the standard was incredible!) and I made a few notes from this and a few other things I've been involved in.   I mention a couple of products and here are the links: EVOTO AI - https://go.evoto.ai/PaulWilkinson (if you use this link, you'll get 30 free credits!) ACDSee https://www.acdsee.com/en/index/  DXO - https://www.dxo.com/   Enjoy!   Cheers P. If you enjoy this podcast, please head over to Mastering Portrait Photography, for more articles and videos about this beautiful industry. You can also read a full transcript of this episode. PLEASE also subscribe and leave us a review - we'd love to hear what you think! If there are any topics, you would like to hear, have questions we could answer or would like to come and be interviewed on the podcast, please contact me at paul@paulwilkinsonphotography.co.uk.    Transcript EP154 - A Bit More Different (And Other Thoughts On Judging) [00:00:00] Introduction and Warm (Water) Review [00:00:00] So, let me read this out to you. I'm loving this podcast. It's like sitting in a bath of warm water in that the subject matter is gently flowing over you in a warm, friendly, soothing way. When I get to the end of the series, I'm going to start again. I think Sarah sends it to me, so I'm assuming it's on iTunes. So thank you to Skinny Latte via Apple Podcasts. Yes, it is. It's Apple Podcast. Who left that review. It made me laugh. I've never, ever. I don't think been compared to a bath of warm water, but Hey. It certainly, it certainly made me smile. And I will take a review worded like that. Poetry in its finest, in its finest watery form. [00:00:43] Podcasting Challenges and Episode 154 [00:00:43] I'm Paul, and this is the Mastering Portrait Photography Podcast. [00:00:49] Well, I blew that ambition out of the water. Didn't I, the let's do one podcast every week for the rest of the year. Uh, I've barely managed three or four, I think. It has been just one of those. years, this is episode 154. And really it's just been busy. [00:01:23] As I record this, it's the 4th of July. So, happy 4th of July, to all of our American. Listen is in so many ways. The 4th of July might be something of an independence day for us too certainly with a little luck, a day of change. [00:01:37] Busy Year and Listener Feedback [00:01:37] Um, it's just been really busy in a year like this everything's working really well, but we're having to work that little bit harder to get there. Everything's a little bit more expensive. Clients have a little less to spend and somebody wrote in the other day. And said that they were waiting for episode 154. And partly because having the podcast, this podcast out there, from someone who is living and breathing the same industry that you are. It's feeling the same things that you are going through the same processes, the same client experiences that you are is comforting. [00:02:11] And just knowing that they're not alone. So here is episode 154. In that sense, I think we really are. Um, a market, we're a collective of individuals. We're all going through the same thing, but on our own. It's useful to know. Uh, that there's other people out there going through the same thing. So I don't sleep very much. Uh, we're working flat-out I love every second of it. [00:02:35] Don't get me wrong. Having having a camera in my hands is just the most natural thing in the world. So, and taking pictures for a living. Well, I couldn't ask for a better way to put food on the table, but that's not to say it isn't really hard work. And in fitting in all of the other things that seem to have crept up into my world. Um, it just takes a little bit of time. [00:02:58] So apologies that the podcast has been a little bit more sporadic then I would have liked. Uh, before I get any further, I would just like to say thank you to everybody that filled in the questionnaire that Sarah has sent out. Um, It's really, really, really interesting. The data in it is incredibly insightful. [00:03:18] And what we're trying to understand is what do we do with Mastering Portrait Photography? How do I push it and prod it and coax it forward? Um, we're due to give a really big kick this year? That's what we're trying to do, but at this stage we weren't entirely certain where to focus. So we now have an awful lot of really insightful, useful data. And the biggest thing that's come up is that it's well-worth. I know that sounds really bizarre. You know, I know people read our articles. [00:03:48] I know people like the diagrams, our stuff is out there in Professional Photo Magazine. And this month also, In Digital Photography Magazine, you want to pick up a copy of that. On the news stand of a Professional Photo. Uh, it has gone all Digital, but Digital Photographer. Is there a paradox there that professional photo magazine is now all digital, but Digital Photography magazine, you can pick that up on it. I can't. I think there must be a paradox in there somewhere or an irony. Maybe it's an irony. I never entirely certain. The difference between an irony and a paradox. Anyway, anyway. Um, thank you to everybody who filled that in. Uh, I was due to record his podcast. This podcast was meant to be. It was meant to be a podcast from the land Rover. Uh, but it's been a very hot day. [00:04:33] I was working. A two hour drive away. So two hour drive, half hour shoot, two hour drive back, and I was going to record one, maybe two podcasts. Um, weirdly the Landrover was more rattling than usual because, and I don't know why there is a toaster in the foot well. You know, when you get into a car and you, you, you drive away and you can either clanking rattling. There's a little Chrome toaster in my foot. [00:04:56] Well, I need to pick that up with my son. Uh, anyway. [00:04:59] Family Pride and Personal Updates [00:04:59] On the topic of kids. Both my kids. I know. It's got nothing to do with photography, right. But I'm a dad and you can't help, but be proud of your children and this couple of weeks. I am beyond proud. Uh, today. Jake got his degree. Uh, Sport Technology from Loughborough University. [00:05:18] So you got a two, one. Uh, degree in BEng. In it's literally engineering with balls, there's no other way to describe it. That's what it is. They study balls and things with which to hit balls. Cricket bats, baseball, bats, golf clubs, football boots. And then they also, uh, research things like, uh, helmets. [00:05:37] So when the ball hits you, it stops you being an unconscious cricket player or backstop or whatever. Uh, so truly, truly a magnificent result for him really, really proud of him. [00:05:49] And just as proud of our daughter who has for the past few weeks just started her new job, working in London for one of the biggest creative agencies, creative marketing agencies. In the UK. Um, as a creative account manager. Uh, she's just going to tear the world apart. She's super organized, super creative, super lovely to work with. [00:06:10] She's a grafter and I could not be prouder of both of them. So forgive me for saying that and giving a shout out to my children, but Hey, my podcast. You don't have to listen to it. Uh, so where are we? Right, it has been a very busy. Uh, I think it's about six weeks since I've done an episode. [00:06:28] Workshops and Masterclasses [00:06:28] Um, so I cannot I've lost count. I usually I'll give you a quick count up of everything we've done. Numerous hearing dogs shoots a load of workshops and one-on-one master classes them. I just. Do you know what? I never thought. I honestly never thought I'd enjoy running workshops and masterclasses as much as I do. There's something. And I don't know why, but there's something really thrilling about being in a room with a few people who genuinely want to, uh, take ideas and create ideas and push boundaries and try things and discuss things. Um, and that's turning into actually a really, really, for me, a really rewarding part of our business. [00:07:10] And I never, I don't know if I ever really expected that. It's, I'm certainly not one of those people. That I want, you know what, I really love doing training because it's giving something back. It's none of that. It's not that at all. There's just an incredible buzz. Of a group of people working towards creating an image and explaining. And understanding and learning how things work and why more importantly, why we do things, why it's always, everyone tells you what. You know, when you look at things online, everything's about the what and the how, but why, why do we do things? [00:07:42] Why do we approach. Light the way we do why'd we approach the camera settings the way we do. Why, why, why, why, why? I just find the Y. So much more interesting than the what and the, how. And I think probably more valuable because if I understand why then I'll do it. If I understand the what I won't necessarily do it, it might be a useful tool or it might be a useful technique. But if I don't really get why I'm doing something, I will bin that off as just not useful. [00:08:12] But if I understand why there's a rationale to why. And so all of our workshops and masterclasses now are premised on why. Anyway, that's a slight aside we'd last week we had a couple of students work placement students that are. Uh, 15 year old and a 17 year old. Two brilliant. Uh, young students who had approached us to come and spend. A few days with us in the studio. [00:08:36] Military Photoshoot and Student Experiences [00:08:36] Uh, they came with us to the hearing dogs for shoot. And then we did, um, a shoot here, uh, with, um, a guy in military uniform. Um, it's one of those, the shots. Uh, this was the perfect sheet for me. Um, a guy said, I want to do something. Really sort of vintage modern cameras, modern lighting, all the rest of it. But he sent me a couple of pictures that must've been taken. [00:08:57] I'm going to guess in the 1940s at, I don't know the exact date, but I'm guessing around there from the style, my grandfather. Both my grandfathers had pictures like these in their military uniform. There's something about the way it's lit. Something about the way it's styled something about the way it's posed and finished. [00:09:13] And of course it's on film, black, white film. And he said, I want to, we create these, but you know, he's a, he's a soldier. He's at the very top of what you can be if you're a noncommissioned officer. Um, and he wanted to celebrate that moment. And so we photographed these incredible images and there was a moment in the shoot, where literally the hair stood up on the back of my neck and I realized what I was looking at with the same pictures that I would have seen of my grandfather's the same styling, the same vibe, same feel. [00:09:47] And it's a sort of, it's an almost indescribable styling that makes all of that hang together. Anyway, it was absolutely wonderful. And I would love to share them. But I can't because he works for one of the top secret, um, units in the military. So I've got these beautiful pictures. It's of a guy that I can never tell you about and never show the pictures. I can tell you I did the shoot because it's of course nobody knows. Uh, but it's a real shame, but I really, really, really enjoyed it. [00:10:14] So now looking around for anyone with a military uniform of the similar style, That we could do something that we could do something with I can share. So if there's any of you out there who have, uh, retired from the military, but still have your number two uniform. I'd love to. Uh, love to take some pictures just for the sheer joy of doing exactly the same thing, but then I can share them. Uh, I think the students really enjoyed it too. [00:10:38] And then the day after that, a brilliant magician . I've worked with Sam strange. Probably for 12 years, I think now. Um, incredible magician. Part of the Champions Of Magic him. Uh, Young and Strange, he works as part of a duo with Richard Young. Uh, but this was a shoot just for him. Sam Strange, wonderful guy just playing. I'm so lucky in the studio that the human beings that come in here. Uh, I think some of the nicest people in the world, I mean, I have only met a tiny proportion of the people in the world. [00:11:08] I'm sure there are other nice people. But my client base is genuinely. Uh, just a never ending stream of people who I love to spend time with a, Sam Strange. Is right up there. So he spent ages taking pictures of him. And as, as a kind of, we wanted to get some shots where he was genuine, genuinely performing. [00:11:25] So the two work placement students became instantaneously his audience, uh, some card tricks. He did these card tricks. One of the students looked quite confused. I'm not entirely certain that she understood what had just happened while she was holding the card with her name on it and a knife hole in it. Anyway. [00:11:43] It was very funny and absolutely. Uh, wonderful. We've done a load of portrait shoots. The weather has been kind for a couple of weeks. Which is a pleasure. Uh, so we've been out in the sunshine, um, And just. It's just, it's. What I came into photography to do was to laugh in the sunshine, taking beautiful pictures. Uh, so that's really, really, really lovely. Um, we've been judging the monthly's the BIPP. The BIPP the British Institute of Professional Photography. [00:12:11] Monthly's over the past couple of months. I think we've done two. Monthly since I last spoke with you, sorry. That's my bad, just busy. That's all it is. We're just busy. Um, I love doing, I love chairing the judging. [00:12:23] And then on top of that, Um, I was asked to chair the print judging for the click expo. [00:12:28] Judging Competitions and Photography Tips [00:12:28] That was up in the Midlands a couple of weeks ago, some big names there, Lindsay Adler, and a few others. Uh, with some of the photographers presenting, it was. Um, it wasn't the biggest expo in the world, but we had a really good entry into the foot print competition. And the standard is out of this. World. [00:12:45] And when you see a panel of judges, we had judges on rotation. So five judges at any one time and me chairing it. And when you see the excitement, you see the judge's eyes just light up. When they are appreciating the very best of the craft of photography, I think, you know, there's, I don't know how to explain some of this stuff. [00:13:05] Why that, you know, that feeling when you take a picture right. And you hit the button and you just know, you just know you can feel it. That's the same sensation that I think we still get when we're assessing images at the highest standard, there's something really exhilarating about it in explicable. Uh, but exhilarating. [00:13:26] I see on the flip side of that, I was laughing with our two work placement students of the other side of the line, which is when you see somebody else take a beautiful photo and they're in the same session as you. Sometimes when I'm training people, this happens to me. And, you know, with talking through staff were doing ideas and then somebody hit the button and they'll create a picture. That I wish. I'd taken and then I have to suppress. I have to suppress that kind of. I'm really jealous about that. [00:13:54] Why didn't I take that picture? I cause you call and of course you have to celebrate. The absolute, the excitement. I still get the same excitement from the picture. I just wish I'd taken it. Um, Which is quite a weird sensation. I'm getting used to that sensation because if I'm doing my job well in a workshop, I won't do. My job well in a masterclass, if I'm genuinely. Um, passing on ideas and information, then. Really people in those workshops should be creating beautiful images that I'm jealous of. It is still quite hard though. [00:14:26] Anyway, we were judging it. Click. Um, and I'm going to come back, uh, to, to that in a moment as the topic of this particular podcast. Uh, but a few bits and pieces. Uh, one of the things that occurred to me this morning, and I'm going to drop this into this podcast because it's a useful thing to remember. Um, is always remember to pack your bag so that at a single glance, you know, what's. In it. And will more importantly, what isn't. I was driving along and I do this thing. [00:14:56] If you. I don't know if you're the same as me. I'll get halfway down the road and I'll be like, did I pack my passport? And I literally, I don't know how many times I've done it. I've pulled into a lay-by and gone and checked. I still do the same with my camera kit. But this morning I was driving away and I did that thing. Have I, I packed everything I need. [00:15:14] And then actually I remembered I'd looked over the top of my bag. Um, while it was open and I know everything was there because I pack it in a way that if something is missing, I can see the gap. And it's like, oh, okay. So, um, you could do it with checklists. Of course you can be much more methodical than that, but just as a simple trick, pack your bag in a way where you can visibly see if something is missing. Right. [00:15:39] So where are we in our warm bath water? I still think that's a great review. Thank you, skinny latte. That's just like the skinny lattes. They use it named by the way. That's not just me being random. Uh, that is like the best review. I'm going to put that on a, if I ever have a poster. You know, Paul Wilkinson appearing somewhere. , it's like sitting in a bath of warm water. I don't know what to do with it, but it's, uh, please feel free everybody. To write us poetic reviews like this, and I promise you they will get read out because it's absolute genius. [00:16:10] Um, I just love that I'm going to have that printed as a poster. I'm loving this podcast is like sitting in a bath of warm water. Anyway. Um, I thought I do these regularly, um, quick updates on things that I heard or saw during um, the judging. Um, So, let me just go over some incidentally as an aside one of the reasons we use, sorry, there's lots of asides with me. You get used to that or you don't. That was funny. The night I met someone for the first time and she laughed at me and said, you're always after the punchline aren't you. And I was like, yeah, that was really. Is very astute, but it did somewhat stop me in my tracks. Um, I don't mean to be like that. I just am a. [00:16:54] One of the reasons we use a panel of judges are more than one judge. Is so that we get a more reliable score, but I was judging in the monthly's this month round. I. So I wouldn't say who the judge was, but they were very worried that their score was out of kilter with the other judge. And they had no reason to be. [00:17:14] I, I can export the judges scores and I can see exactly what's going on. Um, I'm a big data, nut, I love data. I love the data behind scoring. So I've had a look at the data and their scoring is exactly where I would hope it would be, but you don't always agree. And that's really important. If every judge for every image gave the same score, we'd only ever need one judge. That's not how it works. That is so not how it works. [00:17:43] It's not supposed to work like that. A panel of judges are all supposed to bring different experiences. Different backgrounds, different hotspots that they look for different passions, different prejudices, different biases by using a panel of judges. You will always get a different score or you should always get a different score from every judge or you haven't picked your panel of judges very well. [00:18:09] And we pick up panels of judges incredibly carefully so that they are different. They bring different ideas to the table. We pick the panel of judges so that they're going to get on, they're going to work as a team. So if there's a challenge, if there's a discussion or they're not going to get into an argument, they're going to develop. Uh, thought process, and come to a considered view. [00:18:28] That's why we use a panel of judges. It's important that the judges are reliable and they are experienced and they're top of their game. Of course. But they will give different scores. Anyway in the, from a Click. At this time and a little bit from the monthly's I thought I very quickly go through one or two things I heard. [00:18:45] It's just useful stuff. You know, there's nothing major in that. [00:18:48] Um, so paper choice. Paper choice comes up in every single printer competition I am involved in. Just does. Um, the big one, this time was be careful, where. Um, If you've got a textured paper and you print something like a baby on it with smooth skin, it can look like the baby's skin is wrinkled, particularly when the baby or the face of the baby is quite small in the frame, newborns. [00:19:12] This was typically a criticism. What's your paper choice. If you're going to. Print things that would have a smooth texture in the real world, smooth skin, that kind of thing. Use a smooth. Paper. Uh, that said if you're using fine art matte, papers, go and figure out how to get your blacks to map correctly because typically fine art matte papers. [00:19:33] Don't give you much. Uh, changed between the grades of black. It suddenly goes, it goes. Sort of dark. So you get blocked up areas that aren't quite black and then suddenly when it gets to a slightly lighter. Like a lighter tone. You'll start to see texture again. There are ways of printing for that. Go look them up. Uh, Sanjay Jogia, I'm going to give Sanjay quick shout is a brilliant printer. Brilliant technician. Uh, he does, uh, workshops and seminars on printing. You can do a lot worse and go talk to Sanjay. And he's a super lovely guy, too. [00:20:06] Uh, stray hairs. We had one assay. This was in a digital file, um, in the competition. Uh, this month there's a stray hair in the print in a file. And that's clearly on the sensor. With print and competition judging. The judges are gonna zoom these things in. They're going to look at them under a light on a light box. If it's a print, they're going to zoom it to a hundred percent on a big Eizo monitor if it's a digital competition. If there's a stray hair or a dust spot, they are going to see it. So go find your files, go, go over them and over them and over them. [00:20:35] If you want to do one in competitions, get the little details, right. Uh, because that score that dropped, I mean, so many points. It was a great image. Great idea, creatively. Brilliant. But if you're letting things like dust spots and stray hairs go through, that's not going to be regarded as competition standard. [00:20:53] Mounts. We saw some incredible mounts. [00:20:55] We saw circular mounts and oval mounts and, uh, one photographer. I don't know if it's the same author, but I've seen this technique a couple of times where they cut out the edges of the mounts of the landscape picture goes all the way across and breaks out the sides of the frame. [00:21:09] Mounting and Presentation Tips [00:21:09] Um, they're brilliant. Um, you remember that with a print competition? [00:21:12] Typically the mount is part of the puzzle. So make sure your mounts are complimentary. Make sure they are adding to the image. They're not distracting from the image. Um, make sure that your everything is super accurate, super, just square. It needs to be lined up. We had one. Uh, image where the horizon wasn't horizontal. Uh, it was a seascape. And it wasn't horizontal and it may have slipped in the mound or maybe that the author just didn't notice. [00:21:40] I don't know which of those two things is true, but of course it's not going to do that. Well, So mounting is really, really important and we do zoom in to make sure the quality. Um, is there. [00:21:50] Uh, a few dead come up with banding issues, JPEG issues. In this day and age where computers are pretty powerful and you know, the sensors and cameras are at least 14 bit these days. Um, if not 16, Um, then please do just get your techniques down. [00:22:06] So if you got a big blue sky, make sure it's a big blue sky without banding in it. Um, it's just one of those things. [00:22:12] The Debate on Titling Images [00:22:12] Uh, titling. I don't. This comes up every single time. I don't like titling. I don't think it should be necessarily part of an image competition. Um, but I'm out there as I'm in the minority. I think. Um, but I just don't like it. I think we should judge what we see in front of us. But, uh, if the competition asks for a title, enter one, create one, invent one, stick your image in an AI generator and get a title. I don't care how you do it, but put a title in on average. Now I've only heard this anecdotally and I've no idea what the research was, but anecdotally, a couple of judges told me that titles typically give you one additional mark on average, if it's a sensible title. It certainly can add poetry to it. It can add a meaning to it. So if you put a picture. I have no idea. Uh, of, uh, a sad looking child. I don't know, making this up a sad looking child with no title. Well, it's a sad looking child. Put up a sad looking child and give it the title, Daddy's Gone Again. Suddenly, you've got a very different tone to how the view is and the judges. Our assessing an image. [00:23:23] Now this is why I don't agree with it because I don't think that's how it should work. I think we should judge the image. But given it's an opportunity to get a mark or two. And given you're entering a competition, which is a game. Then play the game. And put titles in. [00:23:37] Attention to Detail in Photography [00:23:37] Uh, where are we? Um, a couple of images came up this time round, which I wrote down all details and reading this and we notebook. I carry a note book almost all of the time. [00:23:46] It's a throwback to my PhD days. I think always had a notebook. Uh, title, sorry. All details. Some so EEG cushions, this was a, an image that came in where the hole that the room had been styled to perfection. But when you looked at the sofa, It looks like. Somebody had just sat on it. So the cushions were fine. Like the back cushions, the throws and all of those, but the actual seated part of the sofa. Had been left as if somebody just sat on it, perhaps sat on it to plump up the cushions. I don't know, but it just, it drew our eye to X. Everything else in the image was so pristine. What's your details, particularly with architectural and commercial. [00:24:25] Uh, confusion. [00:24:26] Understanding Image Composition [00:24:26] This came up. Where we weren't certain or the judges, weren't certain what to make of an image. I've talked about this a few times. It's not the judges, job to decode your story. [00:24:40] It's your job as the author to tell your story in a way that the judges can get it. It's got to be approachable. Um, you can be as clever as you, like, you can be as subtle as you like, but in the end, if you're not telling the story in a way that the judges can understand decode it, that's not the judge's fault. Um, so just, you know, make sure, maybe test it on other people and see what they think at image before submitting it. [00:25:04] Uh, we saw a few of these. Uh, what have I written down? Uh, They've written down. Uh, the only image here. Okay. I wrote down if only if only is one of those things. Have you ever done that with your images where you look at an image in Lightroom and you're just like, oh, if only. If only the background was clean. If only I hadn't blown a highlight, if only the eyes were sharp. You know what I mean? [00:25:29] You have these if only moments where the image you'd done everything. Right. But then you've missed a bit. Well, don't enter those into a competition for a star. Um, There was one image that came up and. It felt to me like. It felt like a grab shot. It was a beautiful shot, but a grab shot. Now the construction of the image was one we see all the time dog in a basket, nothing particularly clever about that. Um, or, you know, rare in that, I suppose. [00:25:56] But the particular angle, the way it was framed, felt like they grabbed the shot. Now, if you said to a fine oil artist or pencil artist, or a cartoonist or a commercial air brusher, create me a picture of a dog in a basket. They would have a real angle on it. There'd be something about the way they place the objects relative to each other and relative to the frame. There'll be a way of doing it. That would have a certain aesthetic, a style, a cleanliness for me, my particular thing is I love when the lens is absolutely horizontal. Low down in the frame, preferably on the floor. If it's a subject that is on the floor so that everything for me, I feel like it climbs into that world. [00:26:42] That's just my particular aesthetic. It doesn't have to be anybody else's. I mean, please. Everybody. I'm a Muppet. I don't know what I might have out, but I liked the idea that I've done something that has a, it has a statement to it. It has a shape to it. I love the work of E.H. Shephard who drew A.A. Milne's books, um, Winnie the Pooh and house at Pooh. The corner and when we were young and all of these beautiful Christopher Robin stuff. The drawings always feel like you're in the small characters world. You're not an adult looking down at it. [00:27:13] And I think that's the point I'm trying to make is have a view. Think about it. Think as if you're drawing it, don't think of it as a photograph thing. Okay. Take a step back. If you've got time. Sometimes you don't right. If you're a news photographer, you haven't got time, but step back from your image in your head. Say, okay, these are all of the bits of the puzzle. This is, I've got one of those, two of them, three of them. I've got these colors and this shape, this light. If I was drawing this, if I slowed down and somebody said, draw those on a piece of paper. So that made sense. How would I do it? Uh, you know, there's an, there's another picture. [00:27:49] It was a picture. Um, it was a newborn picture. And there were objects in the foreground. So it was, it made it feel like the baby was amongst objects and then objects behind the baby. But what's happened is they've. Thought that because we mutter a lot, and I'll come on to this one later. don't crop things at the edges of a frame. They pulled the objects. [00:28:11] That baby is surrounded by, away from the edge of the frame, but that meant, it felt like there was only a few objects. In this instance, using the objects and cutting them at the edge of the frame as if there was millions of them receding into the distance that would have made sense. And visually it would have had an expansive feel to it, rather than I only have four of those objects, so I've placed them where I have. And it's that sense of thinking about your layer? And if you look at the very best of these types of images, The guys really do know their way round it. [00:28:41] Uh, comping compositing. Combining images. It must be invisible. We actually, as photographers, don't have a problem on the whole, unless the category says you can't use composite images. We don't have a problem with it. Judges don't worry about it. [00:28:55] We just don't want to see it. So the compositing, the bringing different images and elements together has to be invisible. Uh, there are skills to this. Practice them. Because if you, the minute a judge spots that it's a composite, it's failed in its job. I mean, obviously there are obvious composites, you know, if you're doing a. King Kong thing of a gorilla climbing, a skyscraper. Fair enough. We're going to know straight away. That's not real. But it still has to look real, has to be believable. Uh, okay. What else have we got? [00:29:26] Um, baby skin. This has come up a few times. Be careful of. Using blue and dark green style filters, filter effects in your monochrome conversions. Uh, blue filter typically turns the lips dark, which is fine. If you have, um, You've got a model and smooth skin like ultra smooth skin and makeup that's flawless because you've got red lipstick and you punch them on a Chrome with a bluish or green filter. It drops the lips to a very dark color and that could look incredible. But with babies would it also does. If there's any red in the cheeks, it makes those go blotchy too. So you have dark lips and bruised looking cheeks, and that's not really, how probably you want to have. A baby photograph, by the way, if you can hear stuff going on in the background, I've got all the windows open because it's a really warm day. Um, and I'm sitting just recording. Uh, where are we? [00:30:23] On the converse side of that. So we've got blue filters, making skin look kind of grungy and textured and blotchy. Equally, we are still seeing way too much over smoothing. Um, on the skin work. Um, it just. It doesn't look, if it doesn't look quite right, you know, and it's really subtle. I don't know how to describe it, but we know as judges, when we look at I I'm a big one for, when someone applies makeup to a face really well, really beautifully. It smooths out the lumps and bumps, but what it doesn't do is remove the texture. [00:30:59] There's still pores, there's still skin pores there're still fine hairs. There are still little tiny ripples created by blemishes underneath the makeup. So, if you want to make it look real, when you're doing digital makeup or digital smoothing. You have to remember to leave details in that show reality, even when you're doing really fine art kind of work. [00:31:21] So just what's that. Um, incidentally, a shout again to EVOTO.AI. Um, I've just had a new release of that this week. Um, incredible bit of software. Uh, in that you can control how much you do. So it's not, it's not all the bells and whistles that make these things good. What make these things good is when you can turn it down, so it's imperceptible. Uh, EVOTO.AI is actually very, very good. Please do go and have a play with that. I will drop a link down in. Uh, further down in the show notes. [00:31:54] The Importance of Image Sharpening [00:31:54] Over sharpening. Uh, this came up as a bit of a debate actually, me and Sanjay don't entirely agree on this. I don't think. My view is that you don't need to sharpen images anymore. Um, I've never heard, not once have I heard. Uh, judge say this image needed more sharpening. Not once I've heard images get critiqued, cause they're soft by the which, I mean they're blurred. And the minute you try to rescue a blurred image using, um, Topaz or, you know, any one of the sharpening tools. Unless you're really on top of it and really, really, really careful, it looks like it's sharpened. However, I've heard many times. That an image looks over sharpened over, over you see halos, you see this kind of slightly, really weird edge effect. Um, I took the decision a couple of years ago to stop sharpening my images, because it removes one or two problems when you. Because for us, we don't, uh, we produce the same file to be printed at different sizes. [00:32:49] I don't worry too much. Um, about, uh, scaling at 300 DPI for A4, 300 DPI for seven by five, three to DPI. I just give the guys one file. Um, and our sensors now is so sharp that they reproduce and they give a, for me, they give a slightly smoother finish. Um, And I've only ever been pulled upon over sharpening when I did it. [00:33:11] No one's ever pulled me up on under sharpening. So I would say don't sharpen Sanjay. Doesn't say that he says you should do sharpening, but know exactly at which point in the workflow to do it. And that's fine. Um, Sanjay is a master at this stuff. So he does sharpen. Uh, I'm using Sanjay as an example because he's one of my judges, uh, this time round. Uh, so is there an interesting thing. My, if you're not absolutely a hundred percent certain of what sharpening to do, don't do any, you'll be fine. [00:33:40] Uh, where are we? [00:33:42] Final Thoughts and Recommendations [00:33:42] Um, oh yeah, one of the things. It has come up this come up in conversation a little bit is why we as judges get so picky about which images get over the line to be a merit or a bronze. So typically with all of the associations all slightly different. But around about the 80 mark for most associations is the break point for bronze or merit. Now. The thing about a bronze or a merit is that is something that's likely to end up being used on a website or being used in social media for the association. Um, maybe with the societies, it's going to end up on their display boards at the convention. [00:34:23] And that's why we're picky. That break point between professional standard is a lot, the associations call it and a merit or bronze. That break point defines what will be displayed to the public and to the rest of the photography industry. And as such the message we're sending is that this image is what you should be trying to attain. So when I go round, if I'm, uh, if I've entered a competition, I go round and look at all of the things that have. Uh, they're being displayed in the convention or they're in the magazine or in a book. [00:34:55] I look at those images from bronze to gold. As the things I should be aiming for. And that's why as judges, we're very careful what goes over that line. And if we find a defect that we think, do you know what the photographer should have spotted that. You're going to dump marks really quickly because the judges don't want to have that out there as something that becomes an exemplar for what a successful image should be. [00:35:16] That's why. That's why that break point is so tough. Uh, so just what you, it was quite funny, this in the competition this time round. Uh, and the monthly's is, uh, one of the images looked like the horizon. Wasn't quite level, it's a digital file. So it clearly wasn't anything to do the mounting. And by the way, it was a degree or two out, which is. I don't know. I don't know why people do that. Why would you do that? Given you just put into Lightroom or Photoshop and align with the ruler to it anyway, my two judges, I'm watching both of them on, uh, our Squadcast screen. So we record these sessions. Um, One of the judges went to his EITZO monitor took the file, put it into Photoshop and checked the horizontal alignment. [00:35:57] My other judge went to a cupboard. I watched them do it, went to a cupboard behind them, opened the cupboard door, got a ruler. And started measuring her screen, which is quite weird when you're watching it on the webcam that's on her screen. She's measuring the screen. It was quite old school, but it did make me laugh. [00:36:13] Anyway, things like horizons, check them. [00:36:16] Uh, Great. Well, so if we got, oh yeah, when you're, there's a lot of actions around and even I've written a few where you're going to soften or blur the edges. Um, So there was a particular file. Where I think a baby skin had been softened. You could see that it had been, and it was fine. [00:36:36] It looked very good actually it looked like they got a good technique on it. But what they hadn't done is lift all of the skin onto a new layer, just cut it out and drag it onto a new layer and softened it there, what they done is soften it on the original layer with all of the. Um, blankets and clothing around it. And what that did is, it dragged color from the blankets into the soften skin. So you could see a slight coloration around the edges where the softening had been done. And you expect that if you're using a blur. It blurs across the boundary. So what you have to do is cut out the skin onto a new layer. So it's transparent all the way around except for the skin, soften it there, and then you can drop it back in and you'll get no color contamination. Um, but we spotted it and of course it's a real shame. [00:37:19] Uh, With babies and with faces, the light, the light source should always be above the nose. [00:37:25] I heard this said a few times by different, uh, I think I was working with Elli Cassidy who is just like one of the best judges to work with, she's lovely. Super lovely, super nice person. Um, great newborn photographer and she raised the same point as did lots of others. The light source should be above the nose, nine times out of 10. It's very rare. Do you want the light coming up from underneath? [00:37:44] Um, I love this quote. This is one of my judges. He just, he liked a particular image because it was a bit more different. If ever I have another podcast in this industry, I'm going to call it The Bit More Different Podcast because I know it's a great title. [00:37:57] It's not English, but it's a great title. [00:37:59] Um, final bit on this bit. Is cropping at the edges. We can't, I kind of talked about it a minute ago with the baby and the objects. Just look around the edges of the frame. There's an amazing news image, this time round. Loved it. I'm not going to say what it was cause I'm not gonna draw attention for the author. But there was a scene in the middle of his action in the middle. [00:38:23] And on the right-hand side of the frame, there was nothing contaminating. Everything was kind of contained, but on the left. They were knuckles and elbows poking in onto the edge of the file when just moving the crop edge in by. I dunno, a couple of hundred pixels on a six megapixel file would have removed all of that, and focused, directly on the story in the middle. And it's such a silly thing. [00:38:47] We see it all the time. Is we get sidetracked by what's going on in the middle of our picture, the bit we want people to look at it and we forget to look. All the way around the edges of the frame. I look around the edges of your frame carefully. And if there's anything there that's distracting and pulling your eye away. Just change your crop or clone them out, whichever is easy for you. [00:39:08] Um, So that's it. Those are the notes. I mean, there's loads, of course there's loads of things. I carry copious notes, but I thought those are the most interesting. Um, to talk about, uh, particularly as we're, heading towards, uh, at this time of year, when people start to hive images away ready for the competitions, uh, for the BIPP print competition. Um, and eventually, you know, the doors will open for the society's convention as well. [00:39:30] So I thought there'd be useful. Um, The other thing, a couple of updates. Where are we with things that I've been asked? Uh, to look at. Uh, where are we? DXE DXE. CXO asked me to play with. DXA labs. Uh, the DXA labs for, I think it is an, a DX oh, film pack seven. Now the XO labs. It's not really the photo lab is not really for me because it, Lightroom is at the heart of my workflow. Um, we used the XO pure raw anyway, which is brilliant, pure, or for, by the way. Brilliant. [00:40:03] Absolutely love it. Uh, so don't, for me, that's not necessarily something I'm going to put into my workflow. I'm sure it's very good. I've used it a little bit, but however, the DSO film pack, film pack seven. It's an absolute blast. Loving it just for the moment. [00:40:17] I use effects quite a lot, but I like it if I can for it not to look effected. If you see what I mean that of course, the minute you really easily apply a film preset, of course he looks effected, I'm not an idiot. Um, but I love those kinds of tones. They feel very analog to me. Uh, it's really, uh, really, really, really good. [00:40:34] So, uh, highly recommends if you get a chance to have a play with that. I'm sure they do a trial. I haven't looked. Uh, DXO Filmpack 7. And the other thing I thought I'd give a quick shout about today. Um, his ACDSee, which I've continued to use again, they approached me and asked me to have a look at it and say what I thought it's really, really good. [00:40:55] Um, it's not good at high volumes of face recognition. I discovered that as it. just crashed my computer basically. Um, but that not withstanding. It's blindingly quick is great to have it there . Lightroom for us is our management tool for all of our raw files. Um, but the RAW files get archived away, and we then have all of the JPEGs that I've generated for print. Hi res. Uh, low compression JPEGs. [00:41:21] So having ACDSee that looks over all of my Dropbox folders and keeps that as an active catalog. Is great because I can get to any image. I like, in a heartbeat. Absolutely brilliant. So I absolutely, I would highly recommend that. Um, again, I will put a link to, um, I'll put a link to ACDSee in the show notes. And then finally just a more pop-up it's our beer festival on Saturday. [00:41:45] Now. I know none of you are local, but nonetheless, um, I will be at the beer festival if anyone fancies a beer and a chat we're in, but it had them in Buckingham share. Uh, I'd love to catch up if there is anybody around, because it's, I'm hoping that there's going to be good. Um, it's like the best place to listen to music. [00:42:02] Have a nice beer. And have a great conversation. And on that happy note, I'm going to go home now and we're going to open. I hope a bottle of champagne to celebrate Jake's success and Harriet's success in her new job. Uh, the sun is shining. And then we're going to try and stay up and see the results. Of this particular, general election. [00:42:21] Again, to all our American friends have a wonderful . Uh, July 4th. [00:42:25] And I'm going to go away and be more like sitting in a bath of warm water. I remember whatever else. Be kind to yourself. Take care.

Dive into the multifaceted world of healthy weight assessment. Moving beyond the simplicity of the scale, there are various metrics such as BMI, body composition, and body fat percentage. This episode covers the strengths and limitations of different methods, from skinfold measurements to advanced techniques like hydrostatic weighing and DXA scans. Tune in to discover a personalized approach to understanding and achieving a healthy weight, empowering you to embrace a holistic wellness journey. Read More: Beyond the Scale: Reassessing Healthy Weight Metrics     Read More: Why Fitness Matters More Than the Number on the Scale Listen: Episode 135: Why Fitness Matters More Than the Number on the Scale InBody - learn more (NOT an affiliate) Learn about the Real World Nutrition Membership More blog posts: Real World Nutrition News You Can Use Schedule a free 30-minute introductory call today to learn how I can help you reach your health and wellness goals. Enroll in the Mini Course: 6 Tips for the Busy Person to Have Sustainable Energy: All-Day Energy Through Food AND Companion Workbook

Doctors Lisa and Sara talk to Dr Saadat Ahmed, ST5 in Geriatrics for a deep dive into Osteoporosis. We cover what it is, why it matters, what the risks factors are, who and how to assess for it, and what to do with results from FRAX and DXA scans. After a discussion on lifestyle options to help improve bone health, we ask advice on counselling patients around the pros and cons of taking Bisphosphonates including his advice on talking about the rarer side effects. We talk through a case and ask advice on how to reassess bone health after these initial conversations, and medications might have been started, including when to consider drug holidays.   Lots of excellent CPD here we feel. Enjoy and please share with any interested clinicians/trainees as you see fit.   Useful resources:  Osteoporosis - Prevention of Fragility Fractures NICE CKS Guidelines (updated Apr 2023): https://cks.nice.org.uk/topics/osteoporosis-prevention-of-fragility-fractures/ FRAX Calculator UK (Link from National Osteoporosis Guideline Group UK: https://frax.shef.ac.uk/FRAX/tool.aspx?country=1 WHO Falls Management: https://www.who.int/news-room/fact-sheets/detail/falls National Osteoporosis Guideline Group UK: https://www.nogg.org.uk/full-guideline/section-4-intervention-thresholds-and-strategy https://www.nogg.org.uk/full-guideline/section-7-strategies-management-osteoporosis-and-fracture-risk SIGN Scottish Osteoporosis Guidelines (discussion of evidence for links between PPIs and Osteoporosis on page 27): https://www.sign.ac.uk/media/1812/sign-142-osteoporosis-v3.pdf Osteonecrosis of the Jaw relative risk discussed on page 37 of National Osteoporosis Guideline Group UK: https://www.nogg.org.uk/sites/nogg/download/NOGG-Guideline-2021-g.pdf Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus, Journal of Bone and Mineral Research. Khan A et al 2015: https://pubmed.ncbi.nlm.nih.gov/25414052/ Flow Chart for Oral Bisphosphonates long term treatment and monitoring NOGG Guidelines: Page 35: https://www.nogg.org.uk/sites/nogg/download/NOGG-Guideline-2021-g.pdf Rubin KH, Rothmann MJ, Holmberg T, et al. Effectiveness of a two-step population-based osteoporosis screening program using FRAX: the randomized Risk-stratified Osteoporosis Strategy Evaluation (ROSE) study. Osteoporosis Int 2018; 29(3): 567-78. https://pubmed.ncbi.nlm.nih.gov/29218381/ Merlijn T, Swart KM, van Schoor NM, et al. The Effect of a Screening and Treatment Program for the Prevention of Fractures in Older Women: A Randomized Pragmatic Trial. J Bone Miner Res 2019; 34(11): 1993-2000. https://pubmed.ncbi.nlm.nih.gov/31220365/ Merlijn T, Swart KMA, van der Horst HE, Netelenbos JC, Elders PJM. Fracture prevention by screening for high fracture risk: a systematic review and meta-analysis. Osteoporosis Int 2020; 31(2): 251-7. https://pubmed.ncbi.nlm.nih.gov/31838551/ _____ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com _____ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions.  The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it's release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.

How do you uncover the root cause of bone loss? Doctors usually diagnose Osteoporosis during routine screening for the disease. The most common test for measuring bone mineral density is dual-energy x-ray absorptiometry (DXA or DEXA). Today's guest recommends the best lab tests to help you determine your bone health.    Dr. Kim Millman is an integrated medical doctor and the founder of The Millman Clinic. She is an expert in Functional Medicine and Nutrition Response Testing, two holistic techniques she integrates into her medical practice. Her passion is to help people live the rich, full lives they deserve without the burden of chronic illness.    Dr. Millman does not prescribe a pill for every ill. Instead, she sees the person as a complicated interconnected web integrating the effects of emotions and stress with the biochemical aspects of the disease. She excels at embracing the complexities, which allows her to see the root of the problem. As a result, her patients see long-lasting solutions to their problems.   The first step to addressing bone health issues, specifically Osteoporosis, is determining the root cause, and the best way to do this is to take the essential lab tests discussed by Dr. Millman.   Thank you for listening to another informative episode of the Happy Bones, Happy Life podcast! “Analyzing and addressing the root cause of your bone disease can help you become the healthiest version of yourself.” - Dr. Kim Millman   In this episode: - [02:31] - How and why Dr. Millman decided to focus on helping people with Osteoporosis  -[06:00] - Valuable resources from Dr. Millman - [09:53] - What are the bone turnover markers? - [16:23] - Hyperparathyroid and renal leak test - [19:48] - Essential bone nutrients test - [23:33] - Why do you need a GI-MAP test? - [33:41] - Food sensitivities and intestinal permeability test - [46:59] - Blood sugar and insulin resistance test  - [50:44] - Continuous blood glucose monitor (CBGM) - [54:14] - Why is it important to test for inflammation in the body? - [55:20] - How to use Dr. Kim's interactive lab testing tool  - [57:37] - What's inside the Restore & Rebuild - 100 Days to Healthier Bones program?   Resources mentioned - Wait list for Dr. Millman's next course - themillmanclinic.com/randr. Use coupon code FallMargie for a significant discount  - Interactive Lab Testing Tool Kit (free) - https://themillmanclinic.com/bonestesting  - Essential Lab Testing for Bone Health Guide ($27) - https://themillmanclinic.thrivecart.com/essential-lab-testing-guide/   - Exercise and Osteoporosis Handout - https://www.happyboneshappylife.com/osteoporosis-exercises-to-strengthen-your-bones-and-prevent-fractures  - Discounted supplements through Fullscript - https://us.fullscript.com/welcome/mbissinger - Myers Detox Podcast - https://podcasts.apple.com/us/podcast/myers-detox-podcast/id1021418457   More about Margie - Website - https://margiebissinger.com/  - Facebook - https://www.facebook.com/p/Margie-Bissinger-MS-PT-CHC-100063542905332/  - Instagram - https://www.instagram.com/margiebissinger/?hl=en    DISCLAIMER – The information presented on this podcast should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider. The ideas shared on this podcast are the expressed opinions of the guests and do not always reflect those of Margie Bissinger and Happy Bones, Happy Life Podcast.   *In compliance with the FTC guidelines, please assume the following about links on this site: Some of the links going to products are affiliate links of which I receive a small commission from sales of certain items, but the price is the same for you (sometimes, I even get to share a unique discount with you). If I post an affiliate link to a product, it is something that I personally use, support, and would recommend. I personally vet each and every product. My first priority is providing valuable information and resources to help you create positive changes in your health and bring more happiness into your life. I will only ever link to products or resources (affiliate or otherwise) that fit within this purpose.

Normalt diagnosticeres knoglesygdom ved enten et knoglebrud efter et let fald eller med en knoglescanning, der kaldes DXA. Men denne type scanning har vist sig ikke at være så god til at vise, hvor stor risiko personer med type 1-diabetes har for at udvikle knoglesygdom. Derfor har forskere udviklet ny metode, som er mere finmasket. Den viser, at type 1-diabetes påvirker brudstyrken i knoglerne.ForskerInge Gerlach Brandt, læge og ph.d.-studerende hos Steno Diabetes Center Nordjylland VærtSimon BrixDiabetesforskerne er udgivet af de 7 Steno Diabetescentre og produceret af Podcastbureauet

There are many ways to measure body fat percentage. However, the most accurate measurements aren't available at home.While it's natural to want objective feedback on your progress, body weight shouldn't be your main focus.Some “overweight” people are healthy, while others with “normal weight” are unhealthy.However, your body fat percentage tells you what your weight is comprised of.Specifically, it tells you the percent of your total body weight that is fat. The lower your body fat percentage, the higher percentage of lean muscle mass you have on your frame.1. Skinfold CalipersSkinfold calipers measure the thickness of your subcutaneous fat — the fat underneath the skin — at certain body locations.Measurements are taken at either 3 or 7 different sites on the body. The specific sites used vary in men and women.2. Bioelectrical Impedance Analysis (BIA)BIA devices detect how your body responds to small electrical currents. This is done by placing electrodes on your skin.Some electrodes send currents into your body, while others receive the signal after it has passed through your body tissues.Electrical currents move through muscle easier than fat due to the higher water content of muscle.The BIA device automatically enters your body's response to the electrical currents into an equation that predicts your body composition.There are many different BIA devices that vary widely in cost, complexity and accuracy.3. Dual-Energy X-ray Absorptiometry (DXA)As the name implies, DXA uses X-rays of two different energies to estimate your body fat percentage.During a DXA scan, you lie on your back for approximately 10 minutes while an X-ray scans over you.The amount of radiation from a DXA scan is very low. It's about the same amount you receive during three hours of your normal life.DXA is also used to assess bone density and provides detailed information about the bone, lean mass and fat in separate body regions (arms, legs and torso).Singh Snapshot:Whichever method you use, it's important to use the same method consistently.For almost all methods, it's best to perform your measurements in the morning after an overnight fast, after you go to the bathroom and before you eat anything or begin your daily activities.Ideally, you should do the test before you have anything to drink, especially for methods that rely on electrical signals like BIA, BIS and EIM.Assessing yourself the same way each time will reduce error rates and make it easier to tell if you are making progress.However, you should always interpret your results from any method with caution. Even the best methods are not perfect and only give you an estimate of your true body fat.Fit, Healthy & Happy Podcast Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...Listen on: Apple Podcasts SpotifySupport the show

If you're a midlife woman, then your bone health should be at the top of your list to check. As we age and transition from peri-menopause, to menopause, to post-menopause, our bone health is at risk, for some more than others. Here's a stat from the Bone Health & Osteoporosis Foundation: Of the estimated 10 million Americans with osteoporosis, about eight million or 80% are women. Approximately one in two women over age 50 will break a bone because of osteoporosis. A woman's risk of breaking a hip is equal to her combined risk of breast, uterine, and ovarian cancer. Our healthcare system isn't about preventive medicine but waiting until the fire is burning to come in for the rescue. Perimenopause can start for women in their 30's, the average age of menopause is 51. There's a possible 15-20 years that your bone health could be declining, in conjunction with declining and fluctuating hormones, let alone years of a sub-optimal lifestyle and diet choices. One of the tests I recommend for all my midlife women clients to take is a DEXA scan, which is the gold standard for assessing your bone mineral density, and risk of osteoporosis. Unfortunately, most health insurance companies will not pay for this test as a preventive measure until you are 65 years old, 70 for men unless you have prior risk factors. You will want to be working with a doctor, practitioner, or health coach who is trained to properly read the results and help you navigate any bone health issues that you may have with lifestyle/diet, supplements, and possibly medications. You do not need a doctor's prescription to go ahead and get a DXA scan, but if you want to try and have your health insurance cover it, then you do. Dr. Kristi DeSapri is back for a second time to go over what a DXA scan is, how it works, how to read the report, and then what the next steps are to take if needed. We will use my very recent DXA as an example. Dr. Kristi DeSapri is a board-certified internist specializing in midlife women's health. After fellowship training at the Cleveland Clinic, she has worked in private practice and academic medicine for over 13 years, including as the director of the Northwestern Women's Bone Health program at the Center for Sexual Medicine and Menopause at Northwestern Medicine in Chicago. She is currently opening Bone and Body Women's Health, a concierge midlife women's health practice in the Chicago area, focused on consultation and management of perimenopause, menopause, osteoporosis, and sexual health. Medical Disclaimer: By listening to this podcast, you agree not to use this podcast as medical advice or for making any lifestyle changes to treat any medical condition in either yourself or others. Consult your physician for any medical issues that you may be having. This entire disclaimer also applies to any of my guests on my podcast. Resources: Website: www.boneandbodywh.com IG: https://www.instagram.com/boneandbodywh/ Calcium Calculator: https://www.osteoporosis.foundation/educational-hub/topic/calcium-calculator Fracture Risk Assessment Tool: https://frax.shef.ac.uk/FRAX/tool.aspx?country=9 Stay connected with me! Follow me on IG: https://www.instagram.com/jillfooswellness/ Watch on my YouTube channel: https://www.youtube.com/@jillfooswellness/videosFacebook: https://www.facebook.com/jillfooswellness Grab discounts on my favorite biohacking products: https://www.jillfooswellness.com/health-products And, try some of my nutrient-dense recipes: https://www.jillfooswellness.com/recipes Schedule a free 30-minute consultation with me and start to discover your unique longevity plan: https://www.jillfooswellness.com/contact

Découvrez en 20 minutes avec Dr Didier Poivret, rhumatologue, l'essentiel à savoir concernant l'ostéoporose en MG. ✅ Quels sont les facteurs de risque à connaître ? ✅ Quand demander une ostéodensitométrie (DXA) ? ✅ Comment interpréter T score; Z score et Trabecular Bone Score ? ✅ Quand est remboursée une DXA ? ✅ Quand et comment débuter un traitement par biphosphonate et pour combien de temps ? ✅ Comment surveiller ce traitement ? ✅ Quelle est la place de Dénosumab et de Romosozumab ? Abonnez-vous ici

L'esame DEXA (Dual-Energy X-ray Absorptiometry), noto anche come DXA, rappresenta un baluardo nella valutazione della composizione corporea e della salute dello scheletro. Inizialmente concepito come strumento diagnostico per l'osteoporosi grazie alla sua capacità di quantificare la densità minerale ossea (BMD), il DEXA si è evoluto diventando uno strumento di valutazione multidisciplinare.In pratica il DEXA si configura come una tecnologia di frontiera nella valutazione complessiva della salute del paziente. Oltre al suo ruolo consolidato nella diagnosi e nel monitoraggio dell'osteoporosi, il suo impiego nell'analisi della composizione corporea apre scenari promettenti per l'identificazione e la gestione di condizioni patologiche legate all'accumulo di grasso viscerale e per la promozione di strategie mirate al raggiungimento di una salute ottimale e di una maggiore longevità.Per saperne di più, su questo e su molti altri argomenti, resta in contatto con il Dr. Valerio Rosso:(1) Ottieni subito gratuitamente “Lifestyle Principles”, un eBook che ti permetterà di scoprire i principi della Lifestyle Medicine e migliorare drasticamente la tua vita: https://psiq.it/lifestyle-principles/(2) Disponibile adesso “psiq: Salute Mentale: Istruzioni per l'uso”, il nuovo libro del Dr. Valerio Rosso: https://bit.ly/psiqVR oppure anche https://www.psiq.it

Did you know that there are more tools to measure your health progress than just a scale? Today, Jessica Kuchnia, from DexaFit Madison is here to explain to us what a DEXA scan is and what all it measures. We first met Jess when we walked into her business for our own scans. We all share the same passion for all things health, fitness, nutrition, and longevity.It can be so hard not to compare ourselves to other women. Especially in this social media era we are living in. Jess explains why it is important to focus on progress on ourselves and how focusing inward can be our best bet when it comes to living our healthiest lives. We also know that progress can be slow. Especially as we age and after we have babies. Jess explains what can help with this and why playing the long game when it comes to your health is best.One of our favorite pieces of advice that Jess shares is to beware of the “BLTs” of life - and they aren't what you think they are!Sponsor: 10% off at BETTERHELP: http://betterhelp.com/herselfSponsor: Sponsor: LMNT; drinkLMNT.com/HERSELFLinks & Resources:Enroll in the HERself Self-Care CourseFollow DexaFit Madison on InstagramFollow DexaFit Madison on FacebookDexaFit Madison WebsiteEmail: madison.wi@dexafit.comDexaFit Madison Fall Challenge Info: The challenge starts on October 16th, 2023 and ends on January 6th, 2024. It includes two DXA scans (baseline and follow up) and then 6, 3D scans to help stay on track throughout. Participants can also include an optional RMR for a discounted rate. Let's connect!HERSELF SHOP: https://herself-podcast-favorites.myshopify.comHERSELF PATREON: https://www.patreon.com/herselfpodcastHERSELF INSTAGRAM: http://instagram.com/herselfpodcastMEET AMY: http://instagram.com/ameskieferMEET ABBY: http://instagram.com/abbyrosegreenThis episode was produced and edited by @pivotballchange.

No episódio 85 do Ypocast, embarcamos em uma jornada de descoberta e inspiração com Oscar Decotelli, uma força inovadora no mundo dos negócios. Suas raízes contam uma história que se estende de tradições judaicas sefarditas da Espanha e Itália até histórias emocionantes de escravizados negros oriundos da França e Angola. Neste episódio, Oscar nos conduz por sua vida, detalhando a influência de seus pais educadores: uma mãe professora de hebraico e um pai que, vindo da comunidade em Piedade, trilhou seu caminho até se tornar professor e economista. Relembramos sua infância, quando, aos 10 anos, Oscar e sua família tomaram a decisão audaciosa de se mudar para Long Island, Nova York, para uma experiência que o transformaria para sempre. Em seu retorno, uma escola alemã se tornou sua casa acadêmica, culminando em uma jornada estudantil na PUC. Oscar descreve sua transição para o mundo corporativo com detalhes ricos, desde seus dias de estagiário no Banco Primus até sua rápida ascensão como gerente de riscos com apenas 19 anos. Mas sua paixão e perspicácia não pararam por aí. Ainda jovem, ele assumiu desafios na GAP Asset e na gestora Opus, antes de finalmente realizar seu sonho empreendedor ao lançar a DxA, uma renomada plataforma de assessoria de investimentos de negócios privados (Private Equity), onde continua a liderar como CEO. Cada passo, cada escolha, cada desafio que Oscar enfrentou é um testemunho de determinação, resiliência e paixão. Este é um episódio repleto de insights, histórias de vida e, acima de tudo, uma celebração da capacidade humana de sonhar grande e realizar ainda mais. Não perca! ----------------------------------------------------------------- Disponível nas principais plataformas de streaming ou no YouTube. 

No episódio 85 do Ypocast, embarcamos em uma jornada de descoberta e inspiração com Oscar Decotelli, uma força inovadora no mundo dos negócios. Suas raízes contam uma história que se estende de tradições judaicas sefarditas da Espanha e Itália até histórias emocionantes de escravizados negros oriundos da França e Angola. Neste episódio, Oscar nos conduz por sua vida, detalhando a influência de seus pais educadores: uma mãe professora de hebraico e um pai que, vindo da comunidade em Piedade, trilhou seu caminho até se tornar professor e economista. Relembramos sua infância, quando, aos 10 anos, Oscar e sua família tomaram a decisão audaciosa de se mudar para Long Island, Nova York, para uma experiência que o transformaria para sempre. Em seu retorno, uma escola alemã se tornou sua casa acadêmica, culminando em uma jornada estudantil na PUC. Oscar descreve sua transição para o mundo corporativo com detalhes ricos, desde seus dias de estagiário no Banco Primus até sua rápida ascensão como gerente de riscos com apenas 19 anos. Mas sua paixão e perspicácia não pararam por aí. Ainda jovem, ele assumiu desafios na GAP Asset e na gestora Opus, antes de finalmente realizar seu sonho empreendedor ao lançar a DxA, uma renomada plataforma de assessoria de investimentos de negócios privados (Private Equity), onde continua a liderar como CEO. Cada passo, cada escolha, cada desafio que Oscar enfrentou é um testemunho de determinação, resiliência e paixão. Este é um episódio repleto de insights, histórias de vida e, acima de tudo, uma celebração da capacidade humana de sonhar grande e realizar ainda mais. Não perca! ----------------------------------------------------------------- Disponível nas principais plataformas de streaming ou no YouTube.

Timeline:00:21 About Dr. Bill Campbell – Professor at the University of South Florida02:40 How Bill chose his field of study at USF – sports nutrition versus physique enhancement05:17 Performance versus Looking Pretty – Dr. Campbell opines09:07 What's the ‘real' body fat %? DXA vs Skinfolds vs Pick your method09:32 Two women can have the same % fat and yet one can look “ripped,” and the other looks super smooth13:55 Are there regional differences where body fat is lost? Male vs Female?16:10 Cool sculpting (i.e., cryolipolysis) – does this even work? You'd be surprised18:30 Liposuction 21:23 Lose fat and gain muscle at the same time? – advice from Dr. Campbell24:33 “I just want to lose fat; I don't care if I lose lean body mass!” – why this irks Dr. Campbell30:14 Why women may be “better” at preserving lean tissue31:49 Rate of weight loss – does it matter if you lose it quickly? Slowly? Drs. Campbell and Ricci give us the lowdown34:30 Dr. Campbell – changed his mind as more data came along – he first thought that you must avoid rapid weight loss at all costs. 36:04 Minnesota Starvation Experiment 39:00 Dr. Campbell now thinks rapid weight loss is actually a viable strategy44:10 Make sure that the rapid weight loss duration is very short – that way you can ameliorate hyperphagia (i.e., extreme and insatiable hunger)48:48 Flexible vs Rigid Dieting50:10 A Protein-anchored flexible dieting approach is best50:47 Sometimes the rigid approach is best as you approach a physique competition or even to make weight for a sport (e.g., boxing)51:42 Gain fat on protein? Highly improbableAbout our Guest:Dr. Bill Campbell, Ph.D., FISSN, CSCS, is a Professor of Exercise Science and the Director of the Performance & Physique Enhancement Laboratory at the University of South Florida. His master's and doctoral degrees were earned at Baylor University while serving as the Coordinator of the Exercise and Biochemical Nutrition Laboratory. He joined the faculty at USF in the Fall of 2007.As a researcher and author, Dr. Campbell has published more than 150 scientific papers and abstracts (in academic journals) related to sports nutrition and physique enhancement. His research is focused on improving exercise performance and enhancing physique through the synergism of resistance exercise, nutrition, and dietary supplements. Dr. Campbell is a fellow of the International Society of Sports Nutrition where he also served as a Past President.Social media – Instagram: billcampbellphdhttps://www.usf.edu/education/faculty/faculty-profiles/bill-campbell.aspx About the ShowWe cover all things related to sports science, nutrition, and performance. The Sports Science Dudes represent the opinions of the hosts and guests and are not the official opinions of the International Society of Sports Nutrition (ISSN), the Society for Sports Neuroscience, or Nova Southeastern University. The advice provided on this show should not be construed as medical advice and is purely an educational forum.If you want to be a guest on the show, contact Dr. Jose Antonio at sportssciencedudes@gmail.com 

Welcome to the first episode in the Her Story: Osteoporosis series of the Stronger Bones Lifestyle Podcast. Join us as we dive into the world of bone health with women with a diagnosis of osteoporosis or osteopenia sharing experiences, insights, and strategies for leading a stronger life and taking control of their bone health.Today Debi talks to Sue Edgley, a Therapist & Healer, who worked at the National Health Services in the UK for 12 years about her journey with osteoporosis, her experience with the echolight scan and bone loss.Key  Takeaways:[8:20] Correlation between gut health and bone health[9:35] How do you know whats going on in your gut[10:12} Her journey with osteoporosis[13:18] Echolight [16:10] DXA scan issues [26:19] Why are you loosing bone in the first place[26:40] Bone absorption markers[29:23] Common digestive issues[36:05] Forward folding[39:14] Vitamin D[46:07] Is bone loss reversibleWhere to Find Our Guest:WebsiteMemorable Quotes:"What I'd like everybody to realize is that often it doesn't mean you are going to break because the bones can be strong even though they are thinner than when you were thirty." [40:43]  – SueTo learn more about me and to stay connected, click on the links below:Instagram: @debirobinsonwellnessWebsite: DebiRobinson.comHealthy Gut Healthy Bones ProgramCultural Immersion to Bali 2023

In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about the importance of interventional radiologists stepping up to address the entire picture of osteoporosis and taking the initiative to treat the underlying cause of the disease. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/xVGPFx --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about the importance of interventional radiologists stepping up to address the entire picture of osteoporosis and taking the initiative to treat the underlying cause of the disease. This is the first installment of our 4-part BackTable VI series on osteoporosis treatment. Dr. Beall starts by stating his mission: he not only performs vertebral augmentation; he also offers DXA scans and T-score analysis, prescribes osteoanabolic agents, and follows up with patients over time. Dr. Beall cites data showing that both vertebral augmentation and osteoporosis medications can improve patients' quality of life and significantly reduce mortality. Even with newer osteoanabolic agents like Teriparatide, Abaloparatide, and Romosozumab being approved for treatment, osteoporosis screening rates have dropped in recent years. This is a pressing concern, since osteoporosis is a growing societal burden, given the increasing population of elderly patients. Furthermore, treatment of osteoporosis allows patients to regain mobility, which reduces comorbidities. We finish this episode by discussing how IRs have the potential to learn about osteoanabolic medications, counsel patients, and take ownership of this disease process. --- RESOURCES Dr. Douglas Beall Twitter: @DougBeall BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall: https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions Number Needed to Treat with Vertebral Augmentation to Save a Life: http://www.ajnr.org/content/early/2019/12/19/ajnr.A6367 Risk of Mortality Following Clinical Fractures: https://pubmed.ncbi.nlm.nih.gov/11069188/ Prospective and Multicenter Evaluation of Outcomes for Quality of Life and Activities of Daily Living for Balloon Kyphoplasty in the Treatment of Vertebral Compression Fractures: The EVOLVE Trial: https://journals.lww.com/neurosurgery/Fulltext/2019/01000/Prospective_and_Multicenter_Evaluation_of_Outcomes.20.aspx

Kristi Tough DeSapri, MD joins us in this CME podcast episode to discuss bone health in midlife women, including fracture risk assessment, what do do with a DXA report, medications and treatments, understanding a woman's risk factors and supplements.After listening to this podcast, please visit menopauselearning.com to claim your free accreditation.Support the showDon't miss another episode, subscribe to our FREE Speaking of Women's Health Podcast!Do you have a women's health question that you want answered by Dr. Thacker? Send us a message on Instagram with your question and you might just hear it on the next Speaking of Women's Health Podcast episode. (And while you're there, follow us!)

Host Melissa Berry has learned so much about bone health as a result of her, "Beautiful To The Bone" podcast series, as well as a special episode produced for the "It's All About The Break" campaign. Tune in to hear Melissa share her favorite "snippets" from some of the past episodes and in just under an hour you'll have enough information to advocate for YOUR bone health and get a DXA scan!

Understanding a person's metabolism – the process in which the body converts food consumed into fuel to expend during all of its functions – is a key component to any successful weight/fat loss program. Resting metabolic rate (RMR) represents roughly 65% of all the calories a person expends during a day - keeping the heart beating, temperature control, breathing, and circulation activities. Some people have a fast metabolism – one that effectively processes and converts the food you eat into energy, versus a slow metabolism that stores more of the energy from daily food intake.RMR, also referred to as basal metabolic rate (BMR) - is the total amount of calories that a human body requires to maintain itself.  Other metabolic components include the thermal effect of eating – the energy cost of chewing, digesting, and absorbing nutrients, which increases the RMR by 5 to 15%; physical activity expenditure – daily exercise - that adds another 15 to 30% to RMR; and non-exercise activity thermogenesis (NEAT), that represents walking, sitting down, getting up, and any restless-type activity.During my thirty years of multiple hospital-affiliated sports performance, fitness, and wellness programs, we measured a person's RMR using a metabolic cart, which was also used to determine their ventilatory threshold and maximum endurance capacity – all factored into a client's macro-nutrient intake and exercise guidelines to reduce excess weight and body fat, while preserving or increasing lean muscle. There are equations that have been used to compare against the RMR measurements.Harris-Benedict (HB):Men: (13.75 x W) + (5 x H) – (6.76 x A) + 66Women: (9.56 x W) + (1.85 x H) – (4.68 x A) + 655Weight (W) is in kilograms Take your weight in pounds / 2.2 = weight in kilogramsHeight (H) is in centimetersTake your height in inches x 2.54 = height in centimetersA = ageThe main issue with the HB calculation is that it does not take into consideration your increase or decrease in lean body mass (muscle).A more accurate formula is the Cunningham equation: RMR = 500 + (22 x LBM in kilograms). This formula requires obtaining a body composition from a DXA scan or the use of body composition devices, like bio-impedance, and skin calipers (less accurate with obese individuals). You divide your LMB in pounds by 2.2 to get kilograms.If you would like to learn more about metabolic rate, check out maxwellnutrition.com. You can also find information on other RMR formulas at https://www.lizino.net/facts-about-resting-metabolic-rate/ 

Host Melissa Berry speaks with Dr. Edward Fox, an orthopedic surgeon specializing in musculoskeletal oncology surgery. He is a professor in the Department of Orthopedics and Rehabilitation, Chief of the Division of Orthopedic Oncology, and a professor in the Department of Medicine at the Penn State Cancer Institute and Penn State Health., to talk about the importance of having a bone health plan and advocating for yourself. Learn about overlapping fracture risk such as menopause and breast cancer, who can get a DXA scan and when the best point of entry is for screening, diagnosis and treatment. Dr. Fox works closely with American Bone Health, so be sure to use their fracture risk calculator right here. Discuss the results with your healthcare provider so you can develop your own bone health plan. Thank you Amgen for making this episode possible!

DescriptionIn this episode Dr. Loh discusses BMI vs body composition and how we can be deceived by the number on the scale.Find out more about Normal Weight Obesity in episode 2 of vlmd rounds.0:55  What's my ideal weight?2:16  What is body composition2:43  BMI4:39  Ethnic differences in BMI6:17  Body composition7:14 % body fat criteria for obesity8:52  de Lorenzo et al study BMI vs % body fat11:26 Inconsistency between DXA and bioimpedance % body fat12:43 CT/MRI to measure body comp14:32 Other devices to measure body comp16:45 DXA vs Bioimpedance devices17:10 radiation levels from DXA19:25 "trick" for converting bioimpedance to DXA % body fat22:46 Health risks of normal weight obesity27:36 Where to get a DXA body comp28:47 Prevalence of obesity in US by % body fat (est)32:15 Stigma of obesity32:50 Aging and body comp34:16 Diseases with accelerated lean mass loss35:01 Wrapup

Joining us today to explore hidden causes of osteoporosis, metabolic syndrome, and more is Dr. Aaron Hartman, MD.Click Here To Discover The 3-Step Blueprint To Stronger Bones --> Stronger Bones MasterclassLIMITED TIME FREE ACCESS --> Click Here For Your FREE 7-Day Osteoporosis Kickstart***Topics Covered0:00 - Episode start2:27 - Introduction to Dr. Aaron Hartman and his work5:15 - Why is study design important and what are some of the flaws in research today?9:36 - Are there nutritional compounds that could be helpful, but are never thoroughly studied?10:58 - Which conditions do you see most frequently in your office? 12:10 - What is metabolic syndrome? What are the factors or related conditions that contribute to developing metabolic syndrome?15:53 - Your experience with conventional medicine versus functional medicine18:15 - How do chemical exposures and hormone disruptors relate to osteoporosis?20:05 - How does early menopause set a woman up for osteoporosis?22:06 - What are the most common overlooked diseases that increase the risk of osteoporosis, and how do you help your patients work through those conditions?26:55 - What is your standard “work-up” or process for your patients?29:50 - Why Dr. Aaron recommends a specific type of collagen to his patients31:18 - How do I test for success in my bone health? Not just DXA scans.37:13 - Where can people connect with Dr. Aaron?***Resources Mentioned**Find all resources mentioned and show notes @ https://bonecoach.com/dr-aaron-hartman-md-richmond-functional-medicine***What can you do to support your bone health and this podcast?1. Hit the “Subscribe” Button. 2. Leave a review. Thank you!

Host Melissa Berry had the unique opportunity to speak with Dr. Michele McDermott, Medical Director of Bone Health for Amgen. Dr. McDermott founded the Menopause and Osteoporosis Center in Austin, Texas which she directed until she joined Amgen in 2018.  This episode is packed with tons of information about bone health as it relates to breast cancer. How often should you get a DXA scan? What happens if you don't monitor your bone density during treatment? What are the signs and symptoms of osteoporosis? Tune in to find out her answers to these questions and many more!

Claire Gill, Chief Executive Officer at the Bone Health & Osteoporosis Foundation, returns to the show to give us a refresher about bone health, but also brings us all up to speed on the current legislation surrounding the medical reimbursement rate for the DXA scan. From bone health tips to prevent fracture to ways that you can help get this bill passed,  Claire shares everything that you need to know about bone health AND how to advocate for it!    PLUS - Enter To Win A Cancer Fashionista VIP Gift Bag filled with all of my favorite things! Simply complete this survey  and a winner will be drawn at random on Wednesday, August 31 2022. Winner to be notified via email on September 1, 2022.    If the prize is not redeemed within 5 business days, another contestant will be selected.  Thanks so much for completing this survey and good luck! It's so helpful for me to know what will help you with YOUR bone health, so this is totally a win-win!

Reto Brändli is a Swiss triathlon and cycling coach working with professional (including e.g. Imogen Simmonds) and amateur athletes. He also runs a performance lab, so is very well versed in all sorts of testing, including classic gas exchange and lactate tests, DXA body composition measurements and more. IN THIS EPISODE YOU'LL LEARN ABOUT: -Reto's perspectives on training and coaching for professional and amateur athletes, respectively -How time-crunched amateurs should prepare for longer races like half and full distance triathlons -Main principles and specific tips for swim, bike and run development -What kind of lab testing to do (in an ideal world), how to apply the results in your training, and mistakes to avoid when it comes to lab testing SHOWNOTES: https://scientifictriathlon.com/tts342/ SCIENTIFIC TRIATHLON AND THAT TRIATHLON SHOW WEBPAGE: www.scientifictriathlon.com/podcast/ SPONSORS: Precision Fuel & Hydration - Optimise and individualise your fueling and hydration strategy using the free online Sweat Test and Quick Carb Calculator on precisionfuelandhydration.com. Book a free one-on-one consultation to chat with the team and refine your fueling and hydration even further. Listeners of That Triathlon Show get 15% off their first order of fueling and hydration products. If you didn't catch the discount code in the episode, email Andy and the team at hello@precicionhydration.com and they will be happy to help.  ZEN8 - The ZEN8 Indoor Swim Trainer is a one of a kind swim bench for time-crunched triathletes looking to improve their swim technique, power and propulsion, and consistency of swim training. It is very affordable, about the price of a pair of running shoes, and Zen8 offer free shipping in the US and the UK. Best of all, you can try it risk-free. If you don't love it after two weeks, send it back and get a full refund. Get 20% off your order at zen8swimtrainer.com/tts. LINKS AND RESOURCES: Training and Diagnostics (Reto's business) website and Instagram Blood Flow Restricted Training with Richard Ferguson, PhD | EP#270 Puissance et performance en cyclisme - Frédéric Grappe RATE AND REVIEW: If you enjoy the show, please help me out by subscribing, rating and reviewing: www.scientifictriathlon.com/rate/ CONTACT: Want to send feedback, questions or just chat? Email me at mikael@scientifictriathlon.com or connect on Instagram, Facebook, or Twitter.

In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about the importance of interventional radiologists stepping up to address the entire picture of osteoporosis and taking the initiative to treat the underlying cause of the disease. --- CHECK OUT OUR SPONSOR Laurel Road for Doctors https://www.laurelroad.com/healthcare-banking/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/xVGPFx --- SHOW NOTES In this episode, host Dr. Jacob Fleming interviews Dr. Douglas Beall about the importance of interventional radiologists stepping up to address the entire picture of osteoporosis and taking the initiative to treat the underlying cause of the disease. This is the first installment of our 4-part BackTable VI series on osteoporosis treatment. Dr. Beall starts by stating his mission: he not only performs vertebral augmentation; he also offers DXA scans and T-score analysis, prescribes osteoanabolic agents, and follows up with patients over time. Dr. Beall cites data showing that both vertebral augmentation and osteoporosis medications can improve patients' quality of life and significantly reduce mortality. Even with newer osteoanabolic agents like Teriparatide, Abaloparatide, and Romosozumab being approved for treatment, osteoporosis screening rates have dropped in recent years. This is a pressing concern, since osteoporosis is a growing societal burden, given the increasing population of elderly patients. Furthermore, treatment of osteoporosis allows patients to regain mobility, which reduces comorbidities. We finish this episode by discussing how IRs have the potential to learn about osteoanabolic medications, counsel patients, and take ownership of this disease process. --- RESOURCES Dr. Douglas Beall Twitter: @DougBeall BackTable VI Episode 94, Innovation in Spine Interventions with Dr. Douglas Beall: https://www.backtable.com/shows/vi/podcasts/94/innovation-in-spine-interventions Number Needed to Treat with Vertebral Augmentation to Save a Life: http://www.ajnr.org/content/early/2019/12/19/ajnr.A6367 Risk of Mortality Following Clinical Fractures: https://pubmed.ncbi.nlm.nih.gov/11069188/ Prospective and Multicenter Evaluation of Outcomes for Quality of Life and Activities of Daily Living for Balloon Kyphoplasty in the Treatment of Vertebral Compression Fractures: The EVOLVE Trial: https://journals.lww.com/neurosurgery/Fulltext/2019/01000/Prospective_and_Multicenter_Evaluation_of_Outcomes.20.aspx

Ni veliko področij, na katerih smo Slovenci prvi na svetu. Zdaj pa so podatki pokazali, da med vsemi državami prav v Sloveniji največ uporabljamo poseben medicinski kalkulator FRAX. S pomočjo vprašalnika lahko hitro in enostavno izračunamo, ali nam grozi zlom zaradi osteoporoze, ali ne. Osteoporoza – drugič. O zgodnjem odkrivanju, o meritvi DXA in mineralni kostni gostoti ter o FRAXu. Sprašuje Iztok Konc, odgovarja dr. Tomaž Kocjan z UKC Ljubljana. Dr. Tomaž Kocjan: Slovenci smo svetovni prvaki pri uporabi kalkulatorja FRAX za odkrivanje osteoporozeNi veliko področij, na katerih smo Slovenci prvi na svetu. Zdaj pa so podatki pokazali, da med vsemi državami prav v Sloveniji največ uporabljamo poseben medicinski kalkulator FRAX. Ob pomoči vprašalnika lahko hitro in enostavno izračunamo, ali nam grozi zlom zaradi osteoporoze ali ne. Osteoporoza – drugič. O zgodnjem odkrivanju, o meritvi DXA in mineralni kostni gostoti ter o FRAX-u. Sprašuje Iztok Konc, odgovarja prof. dr. Tomaž Kocjan z UKC Ljubljana. Kalkulator FRAX Zdravilo, ki zgradi novo zdravo kost

Cheryl joins Melissa once again to chat about all of the great work that American Bone Health has done to keep the breast cancer community informed. Learn how to advocate for your bone health, the importance of the DXA scan and so much more!

This week we have a spectacular (pun intended

Effects of Curcumin Supplementation on Inflammatory Markers, Muscle Damage, and Sports Performance during Acute Physical Exercise in Sedentary Individuals Universidade Federal de Viçosa (Brazil), December 14, 2021 Exhaustive and acute unusual physical exercise leads to muscle damage. Curcumin has been widely studied due to the variety of its biological activities, attributed to its antioxidant and anti-inflammatory properties. Furthermore, it has shown positive effects on physical exercise practitioners. However, there is no literature consensus on the beneficial effects of curcumin in acute physical activities performed by sedentary individuals. Therefore, we systematically reviewed evidence from clinical trials on the main effects of curcumin supplementation on inflammatory markers, sports performance, and muscle damage during acute physical exercises in these individuals. Most studies have shown positive effects of curcumin supplementation in sedentary individuals undergoing acute physical exercise. Overall, participants supplemented with curcumin showed less muscle damage, reduced inflammation, and better muscle performance. (NEXT) Long Term Study Alludes to Artificial Sweeteners and Cognitive Decline Link University of Barcelona, December 10. 2021 Diet is considered an important modulator of cognitive decline and dementia, but the available evidence is, however, still fragmented and often inconsistent. Methods and Results In conclusion, our prospective and validated data suggest that food-related and microbiota-derived metabolites may play an important role in the later development of CD. Our results support a protective association between metabolites reflecting the consumption of polyphenol-rich foods (i.e., fruits and vegetables), cocoa, coffee, mushrooms and red wine with CD, whereas other food components related to unhealthy dietary components (i.e., alcohol, artificial sweeteners) may have deleterious effects on cognition. (NEXT) Key role in brain health for vitamin E University of Newcastle (Australia), December 18, 2021 Vitamin E has a key role to play in reducing the onset of Alzheimer's disease, fatty liver diseases and other health risks, experts at a recent symposium on vitamin E have said. Eggersdorfersaid that more than 90% of the US's population did not meet their recommended daily allowance of vitamin E, which was a worry. Consumers were expected to take in enough vitamin E through their diets, but “they are characterised by an increasing intake of processed foods”, said Lisa Wood, associate professor at the Centre for Asthma and Respiratory Diseases at Australia's University of Newcastle. (NEXT) Childhood obesity linked with mother's unhealthy diet before pregnancy University of Southampton, December 22, 2021 New research led by the University of Southampton shows supporting women to eat a healthy diet pre-pregnancy could reduce risk of obesity for their children. New research, at the University of Southampton, has found children aged eight or nine were more likely to be obese if their mother had a poor diet during—and before—pregnancy. The research identifies these as critical times, when initiatives to reduce childhood obesity may be more effective. The results, published in the International Journal of Obesity, showed that if a mother-child pair was in a lower diet quality group, this was associated with child having a higher DXA percentage body fat and BMI at age eight or nine. This research shows the importance of intervening at the earliest possible stage in a child's life, in pregnancy or even before conception, to enable us to tackle it." (NEXT) Can Oily Fish, Cherries Or Milk Help You Sleep? Here's What The Evidence Shows Aston University (UK), December 20, 2021 Almost one-in-five British people report they don't get enough sleep each night. The problem is so bad that in total the UK public are losing around a night's worth of shut-eye each week. Our diet has an influence upon sleep patterns by affecting the sleep hormone melatonin. For example, foods rich in the essential amino acid tryptophan are commonly cited as helping sleep, as tryptophan helps produce melatonin. Additionally, some vitamins and minerals may help sleep, such as vitamin D, magnesium and zinc. Oily fish: Evidence suggests the more oily fish, such as salmon or herring, you eat the better you sleep. Oily fish contain healthy fats such as omega-3 oils which have been shown to improve sleep in children and are involved in serotonin release. Tart cherries: Evidence suggests that tart cherries improves sleep in older adults, probably due to their ability to increase melatonin levels. And tart cherries are also rich in nutrients, including magnesium, which also may improve your sleep. Warm milk: Research conducted in the 1970s suggested that a glass of warm milk before bed could improve sleep quality. This research was performed in a very small group however, and little research has been done since. Drinking milk does increase melatonin levels which could help. But there isn't enough evidence to support the claim that a glass of warm milk definitely makes you nod off. Herbal teas: Evidence for valerian, a common ingredient, to aid sleep is inconclusive. Decaffeinated green tea has been reported to improve sleep quality, which might be linked to the relaxing qualities of L-theanine, an amino acid it contains (NEXT) War metaphors for cancer hurt certain prevention behaviors University of Michigan, December 15, 2021 It's not unusual for people to use war metaphors such as "fight" and "battle" when trying to motivate patients with cancer. But a new University of Michigan study indicates that using those words can have an unintended negative effect. David Hauser, a U-M doctoral student in psychology, and colleague Norbert Schwarz of the University of Southern California, found in three studies that exposure to metaphoric language relating cancer to an enemy significantly lessens the extent to which people consider cancer-prevention behaviors.

Após divulgação dos resultados trimestrais, CVCB3 e CSAN3 caem na B3, enquanto VBBR3 sobe. Confira no Flash! A Vibra (antiga BR distribuidora), CVC e Cosan divulgaram seus balanços na última sexta-feira. A Vibra (BRDT3), antiga BR Distribuidora, teve lucro líquido de R$ 598 milhões, crescimento de 78,5% na comparação com o mesmo período do ano passado. Já a CVC contabilizou prejuízo de R$ 83,81 milhões, uma queda de 61,1% antes as perdas de R$ 215,55 milhões registradas no ano passado. O lucro líquido ajustado da Cosan (CSAN3) alcançou R$ 531 milhões, uma alta de 7% na comparação com o mesmo período de 2020. O programa destaca ainda que o Banco Central informou nesta terça que seu Índice de Atividade (IBC-Br), que é a prévia do PIB, caiu 0,27% em setembro ante agosto. E mais: A plataforma para investidores TC (TRAD3), Traders Club, comprou uma participação de 20% na gestora de private equity DXA por R$ 20 milhões, enquanto a XP (XPBR31) informou a compra de participação minoritária na Vista Capital, que tem mais de R$ 4 bilhões em ativos sob gestão em fundos de investimentos multimercado e de ações. As principais notícias para quem acompanha o mercado financeiro, no Flash InvestNews, com Erica Martin. Os destaques da bolsa nesta manhã, a cotação do Ibovespa e dólar, além de outras informações da economia brasileira que podem influenciar seus investimentos e rentabilidade.

In this Part II of our Bone Health and Echolight interview with Dr. Kimberly Zambito, we explore the clinical use of R.E.M.S. technology (Radiofrequency Echographic Multi Spectrometry) technology and Echolight, an emerging technology for the diagnosis and monitoring of osteoporosis.LIMITED TIME FREE ACCESS-->Click Here For Your FREE 7-Day Osteoporosis Kickstart***Episode Timeline3:40: What is the Echolight? How do you describe Echolight to patients?4:30: Is it the same as a DXA scan?5:53: Is it better than a DXA scan?10:25: How long does an Echolight REMS evaluation take?12:15: Why do I have to have a separate appointment for the Echolight and the review/consultation?13:31: What do I do to prepare for the Echolight scan?14:41: Is it uncomfortable?15:39: Do I need to bring my DXA?16:14: Do you scan the wrist?16:41: What if I have a total hip joint?17:10: What if I have a spine fracture?17:44: How do you use the information?28:04: Take home message to patients?31:27: Where can people find you Dr. Zambito?***Resources Mentioned**Show notes @ https://bonecoach.com/osteoporosis-testing-echolight-rems-dr-kimberly-zambito**Part 1 Youtube Video: BONE DENSITY Not Enough? New Osteoporosis Tech To Understand Bone Strength w/ BoneCoach™ + Echolight Medical>>Watch On Youtube NowWhere to find Dr. Zambito >> https://www.mbortho.com/***What can you do to support your bone health and this podcast?1. Hit the “Subscribe” Button. 2. Leave a review. Thank you!

I denne episoden snakker vi med doktorgradsstipendiat Marie Wasmuth Lundblad. Marie jobber ved Norges Arktiske Universitet og forsker en del på helse i form av fettprosent- og kroppssammensetningsmålinger. Hun ser blant annet på fettprosenten til Tromsøs befolkning og prøver å etablere en fornuftig ratio mellom innvendig og utvending fett rundt buken/magen. Hvor mye fett kan man ha innvendig i forhold til utvendig? Er BMI fortsatt et godt mål på fedme? Burde det kombineres med flere mål som midjelmål (cm) og en DXA skann (% fett og muskel)? Alt dette med mer får du svar på i denne podcastepisoden. God lytting! Kontaktinformasjon: Sjekk hennes Researchgate Sjekk hennes Twitter Jobbsiden hennes Referanser: Lundblad, M. W., Jacobsen, B. K., Grimsgaard, S., Andersen, L. F., Carlsen, M. H., & Hopstock, L. A. (2018). Energy and macronutrient intake and associations with body mass index and fat mass index: The seventh Tromsø Study 2015-16. Norsk Epidemiologi, 28. Lundblad, M. W., Andersen, L. F., Jacobsen, B. K., Carlsen, M. H., Hjartåker, A., Grimsgaard, S., & Hopstock, L. A. (2019). Energy and nutrient intakes in relation to National Nutrition Recommendations in a Norwegian population-based sample: the Tromsø Study 2015–16. Food & nutrition research, 63. Lundblad, M. W., Jacobsen, B. K., Johansson, J., De Lucia Rolfe, E., Grimsgaard, S., & Hopstock, L. A. (2021). Reference Values for DXA-Derived Visceral Adipose Tissue in Adults 40 Years and Older from a European Population: The Tromsø Study 2015–2016. Journal of obesity, 2021. Lundblad, M. W., Jacobsen, B. K., Johansson, J., Grimsgaard, S., Andersen, L. F., & Hopstock, L. A. (2021). Anthropometric measures are satisfactory substitutes for the DXA‐derived visceral adipose tissue in the association with cardiometabolic risk—The Tromsø Study 2015–2016. Obesity Science & Practice. Menns magefett er farligere enn kvinners - NRK artikkel

Episode 163 of the Institute of Performance Nutrition's "We Do Science" podcast! In this episode, I (Laurent Bannock) discuss "Body Composition Methods in Applied Sport Practice" with Professor Graeme Close (Liverpool John Moores University, UK) and Professor Kevin Tipton (The Institute of Performance Nutrition, UK).Discussion Topics Include:Overview of Body Composition and its Importance to Athlete Health and PerformanceAn Overview of Measurement Methodologies That Can Be Used in Applied Sport for the Assessment of Body CompositionPractical Considerations When Using DXA and Skinfolds as Measures of BodyComposition in Applied Sport PracticeConclusions and Recommendations for the FieldPodcast Episode Transcript: Download PDF CopyKey Paper(s) Discussed / Referred to:Come Back Skinfolds, All Is Forgiven: A Narrative Review ofthe Efficacy of Common Body Composition Methods in AppliedSports PracticeRelated Podcast Episodes:#113 - "DXA and Body Composition Assessment: Gold Standard or Gold Plated?" with Dr Julia Bone#100 - 'Diets and Body Composition' with Alan Aragon MS and Brad Schoenfeld PhD#77 - 'Body Composition & Assessment' with Shawn Arent PhDCheck out our other podcasts, publications, events, and professional education programs for current and aspiring sports nutritionists at www.TheIOPN.com and follow our social media outputs via @TheIOPN

Host/Producer: Rhonda Feiman Co-Producer: Petra Hall Technical assistance: Joel Mann & Amy Browne Osteoporosis: The myths and facts in diagnosis, new developments in screening technology, and the pros & cons of current treatment options Key Discussion Points: 1. What are some ideas and strategies to keep your bones strong and healthy? 2. What are some ways to be safe in your house and with your everyday activities to try to prevent debilitating falls? 3. What is osteoporosis? 4. Why is bone density difficult to measure? 5. What is a DXA scan? How are DXA scans interpreted? 6. What is a Trabecular Bone Score (TBS)? 7. Why should Trabecular Bone Score software be used to interpret the results of your DXA scan? 8. What is osteopenia, and why is this a controversial diagnosis? 9. What are the pros and cons of current medicines being prescribed for osteoporosis, including biophosphonates such as alendronate (Fosamax), etidronate (Didronel) & zoledronic acid (Zometa), and monoclonal antibodies, such as denosumab (Prolia)? 10. How has pharmaceutical company research & marketing impacted and influenced medical diagnosis and treatment of bone density and osteoporosis? Guest: Cindy Pearson, the former Executive Director of the National Women's Health Network of Washington, D.C. She is one of the nation's best-known advocates for women's health, and is well known for her leadership in bringing grassroots organizations together to press for accountability from the government and other powerful entities. Cindy Pearson often testified before Congress, the National Institutes of Health and the FDA, and was frequently featured in the news as a consumer expert on women's health issues. Website of Interest: National Women's Health Network About the host: Rhonda Feiman is a nationally-certified, licensed acupuncturist practicing in Belfast, Maine since 1993. She primarily practices Toyohari Japanese acupuncture, using gentle and powerful non-insertion needle techniques, and also utilizes Chinese acupuncture and herbology. In addition, Rhonda is a practitioner of Qi Gong and an instructor of Tai Chi Chuan in the Yang Family tradition. The post Healthy Options 8/4/21: Osteoporosis: Myths and Facts first appeared on WERU 89.9 FM Blue Hill, Maine Local News and Public Affairs Archives.

In this interview with Alex Exposito & Echolight Medical, we're going to explore why R.E.M.S. technology (Radiofrequency Echographic Multi Spectrometry) technology may very well be the future of prevention, diagnosis, and short and long term monitoring of osteoporosis.LIMITED TIME FREE ACCESS-->Click Here For Your FREE 7-Day Osteoporosis KickstartEpisode Timeline3:51: Alex's background and the story of Echolight Medical5:01: What is REMS technology?7:07: The need for REMS and improving on current DXA scans9:05: TBS versus the REMS Fragility score9:55: REMS and how it compares to the FRAX tool10:42: What areas of the body are assessed using REMS11:58: What patients experience using REMS technology13:25: What to expect from REMS exam results14:15: How REMS results are affected by previous surgeries, vertebroplasty, kyphoplasty etc.15:41: How REMS results are affected by scoliosis and varying spinal anatomy17:48: Studies on EchoS and REMS technology19:12: DXA scans' “least significant change” or margin of error23:45: Technician error in DXA versus REMS25:54: How REMS results are affected by being small-boned or petite26:54: REMS limitations27:45: Frequency of REMS testing28:33: Insurance coverage and out-of-pocket costs 31:00: What physicians can be doing to increase adoption of REMS31:46: What patients can do to learn more about Echolight Medical and REMS technology***Resources Mentioned:--->Claim your FREE 7-Day Osteoporosis Kickstart here! (the exact information you need to accelerate your path to stronger bones now)Show notes @ https://bonecoach.com/osteoporosis-testing-echolight-medicalPhysician Takeway linkWebsite:  www.echolightmedical.comYoutube version of this interview: https://www.youtube.com/watch?v=G_ePNntuNA8 ***What can you do to support your bone health and this podcast?1. Hit the “Subscribe” Button. 2. Leave a review. Thank you!

Architects Jordan Rogove and Wayne Norbeck, co-founders of DXA studio, join Mansion Global reporter Leslie Hendrickson in a discussion of the rising costs of home construction and how to navigate ongoing supply chain issues.

In this episode, Ayesha discusses the results of a recent study that show Amazon's Halo app can accurately estimate body fat percentage with results comparable to traditional DXA testing. The app has built-in AI algorithms that analyze images taken from a user's smartphone, which are used to build a 3D model of the body and generate an estimate of body fat percentage within seconds. The app is easy to use and offers users the convenience of assessing their body fat composition from the comfort of their homes, instead of having to go to a clinic and wait for several days or weeks for results. The team also talked about Regeneron's monoclonal antibody treatment for COVID-19 that has been shown to reduce the risk of deaths by 20 percent among hospitalized COVID-19 patients in results from the UK RECOVERY trial. The treatment consists of two monoclonal antibodies that target the spike protein of SARS-CoV-2. The team discussed how it is still important to research effective treatments for COVID-19 despite having vaccines because of circulating variants, and the potential for new ones, as well as continuing high case numbers in some countries. Moreover, continuing to develop new technologies and treatments will be beneficial for other current and future infectious diseases.Read the full articles here:Study Shows Amazon's AI-Powered Halo App Can Accurately Assess Body Fat PercentageRegeneron's COVID-19 Monoclonal Antibody Treatment First to Reduce Risk of Death in Hospitalized PatientsFor more life science and medical device content, visit the Xtalks Vitals homepage.Follow Us on Social MediaTwitter: @Xtalks Instagram: @Xtalks Facebook: https://www.facebook.com/Xtalks.Webinars/ LinkedIn: https://www.linkedin.com/company/xtalks-webconferences YouTube: https://www.youtube.com/c/XtalksWebinars/featured

Practice Bulletin #129 - Published September 2012 (Reaffirmed 2016) 1. In any hypoestrogenic state, resorption begins to overwhelm building, leading to decreased bone density. 2. Treatment is warranted if T-score ≤ 2.5 on DXA scan or if patient has history of vertebral facture or other type of fragility fracture 3. FRAX tool can be helpful in determining usefulness of treating patients in the osteopenic range (T-score < - 1 to ≥ -2.5). It predicts risk of osteoporotic fracture over next 10 years . 4. Bisphosphonates are first-line therapy for all-comers, though raloxifene is also reasonable first-line in younger postmenopausal women. 5. HRT is a great alternative to bisphosphonates in younger women at risk for osteoporotic fracture: ~35% decreased risk of hip fracture (estrogen alone or estrogen + progestin) Show Notes Wine pairing: 2017 Tempranillo from Baron de Ley Varietales Theme music by Evan Handyside Logo design by JD Dotson (jddotson1@gmail.com)

In this week’s podcast, articles “The Cardiac Late Sodium Channel Current is a Molecular Target for the Sodium-Glucose Co-Transporter 2 Inhibitor Empagliflozin” by Light et al (www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.053350) and “Metabolic effects of empagliflozin in heart failure: A randomized, double-blind, and placebo-controlled trial (Empire HF Metabolic) by Jensen et al (www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.053463) are discussed. Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast, summary and backstage pass to the journal and its editors. We're your co-hosts, I'm Dr. Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, associate editor, director of the Pauley Heart Center at VCU Health in Richmond, Virginia, Dr. Carolyn Lam: Greg, it's double feature day. And guess what? Both papers that we're going to talk about are regarding the SGLT2 inhibitors, and really look at the mechanism of action of these amazing compounds, from both a pre-clinical and clinic point of view. That's all I want to say, because we've got to tune in, a very interesting discussion coming right up. Dr. Carolyn Lam: But first I'd like to ask you a question. What do you think is the association between health-related quality of life and mortality in heart failure around the world? Dr. Greg Hundley: Well, Carolyn, I would think that, actually, they might be linked. Dr. Carolyn Lam: That's a really clever answer. Thanks Greg. Well, the authors are actually going to tell you with this next paper. It's from Dr. Salim Yusuf from Population Health Research Institute and McMaster University in Hamilton, Canada, and colleagues, who looked at the global congestive heart failure, or GCHF study, which is the largest study that has systematically examined health-related quality of life, measured by the Kansas City Cardiomyopathy Questionnaire, which is the largest study that has systematically examined health-related quality of life and its association with outcomes in heart failure, across eight major geographic regions, spanning five continents. Dr. Greg Hundley: Wow, Carolyn. So what did they find here? Dr. Carolyn Lam: Health-related quality of life, as measured by the Kansas City Cardiomyopathy Questionnaire, or KCCQ, really differs considerably between geographic regions, with markedly lower quality of life related to heart failure in Africa compared to elsewhere. Health-related quality of life was also a strong predictor of death and heart failure hospitalization in all regions, irrespective of symptoms class, and with both preserved and reduced ejection fraction. Dr. Carolyn Lam: Indeed, this paper really highlighted a great need to address disparities that impact health-related quality of life in patients with heart failure in different regions of the world. Dr. Greg Hundley: Fantastic, Carolyn. Well, I have two studies to discuss, Carolyn, and they're kind of similar, so we're going to do them back to back. The first study reports the results of the Sort Out X Trial, a large scale randomized multi-center, single-blind, two-arm, non-inferiority trial, with registry based follow-up designed to evaluate the Dual Therapy Sirolimus-Eluting, and CD34 positive antibody coated combo stent or DTS versus the Sirolimus-Eluting Orsiro Stent or SES. Dr. Greg Hundley: And the study comes to us from Dr. Lars Jakobson, from Arhus University Hospital. The primary endpoint target lesion failure, or TLF was a composite of cardiac death, myocardial infarction, or target lesion revascularization within 12 months, all analyzed using intention to treat. Dr. Carolyn Lam: All right, Greg. So the DTS compared to the SES, what did they find? Dr. Greg Hundley: Thanks, Carolyn. So the DTS did not confirm non-inferiority to the SES stent for target lesion failure at 12 months. The SES was superior to the DTS, mainly because the DTS was associated with an increased risk of target lesion revascularization. However, rates of death, cardiac death, and myocardial infarction at 12 months did not differ significantly between the two stent groups. Dr. Greg Hundley: Now Carolyn, in this same issue, we have another study evaluating endothelial function and implantation of intercoronary stents. And this second study comes to us from Professor Alexandra Lansky, from the Yale University School of Medicine and Yale Cardiovascular Research Group. And Carolyn, the study evaluated whether implantation of an intercoronary stent that facilitated endothelialization after the four to six weeks smooth muscle anti-proliferative effects post-stent implantation would be non-inferior to traditional drug-eluting stents. Dr. Carolyn Lam: Okay, another interesting study. And so, how did they do that? What did they find? Dr. Greg Hundley: Yeah, so Carolyn, a total of 1,629 patients were randomly assigned in a two to one fashion to the supreme DES stent, so 1,086 patients, or the DPDES stent, which was 543 patients. And there were no significant differences in rates of device success, clinically driven, target lesion revascularization, or stent thrombosis at 12 months. Dr. Greg Hundley: And the safety composite of cardiovascular death and target vessel revascularization or myocardial infarction was 3.5 versus 4.6% with the supreme DES stent compared to the DPDES stent. But target revascularization for this new stent was two and a half fold higher. Dr. Greg Hundley: So Carolyn looking at these two papers, what have we learned? So first, the Jakobsen, et al, tested whether the stainless steel COMBO Sirolimus-Eluting Stent coated luminally with CD34 positive antibody could theoretically capture endothelial progenitor cells and regrow endothelium. Dr. Greg Hundley: And the investigators observed that this stent had higher, not lower or equivalent, target lesion revascularization relative to the current generation Cobalt-Chrome Stent that only eluted sirolimus. Dr. Greg Hundley: In the second study, Lansky and associates examined an approach which was touted as enhancing endothelial recovery, where the early erosion of material and release of drug was thought to allow earlier endothelial recovery enhancing vascular response. Non-inferiority of the rapid release was demonstrated, but rather than hints of superiority, there were signs of inferiority. Hereto, target lesion revascularization was problematic and was two and a half fold higher. Dr. Greg Hundley: And so, Carolyn, there's a wonderful editorial from Professor Elazer Edelman from the Massachusetts Institute of Technology entitled, “Karnovsky's Dictum that Endothelium is Good Looking and Smart,” where Dr. Edelman emphasizes that while some endothelial cells may have been present after deployment of these devices, perhaps a fully constituted functioning endothelium may not have been achieved. Dr. Greg Hundley: And as we know, it is a fully functioning endothelium with nitric oxide release, buried platelet adhesion that is most protective. It is a really provocative read that reflects on previous thoughts from Morris Karnovsky, who suggests preservation of endothelial function is optimized by minimizing injury to it. And so, Carolyn, these combined articles really highlight the current state of new developments within interventional cardiology to thwart re-stenosis and highly recommend them to our readers. Dr. Carolyn Lam: Wow, thank you, Greg. That was amazing. But you know what, so's this next paper, because it really provides novel insights into that enigma of the role that the epicardium plays in the pathogenesis of arrhythmogenic cardiomyopathy. Dr. Carolyn Lam: Now, to delineate the contributions of the epicardium to the pathogenesis of arrhythmogenic cardiomyopathy, doctors Marian from University of Texas Health Science Center at Houston, Texas and colleagues performed a series of elegant mouse experiments using conditional deletion of the gene encoding desmoplakin in the epicardial cells of mice. Mutations in genes and coding desmosome proteins, including desmoplakin are known to be major causes of arrhythmogenic cardiomyopathy. Dr. Greg Hundley: Wow, Carolyn, very interesting. So what did they find here? Dr. Carolyn Lam: Epicardial derived cardiac fibroblasts and epithelial cells expressed paracrine factors, including TGF-β1 and fibroblasts growth factors, which mediated epithelial mesenchymal transition and contributed to the pathogenesis of myocardial fibrosis, apoptosis, arrhythmias, and cardiac dysfunction in a mouse model of arrhythmogenic cardiomyopathy. These findings really uncover contributions of the epicardial derived cells to the pathogenesis of arrhythmogenic cardiomyopathy. Dr. Carolyn Lam: Greg, there's a whole lot of other interesting stuff in today's series, as well. There's an exchange of letters among doctors Mehmood, doctors Moayedi and Dr. Birks regarding the article “Prospective Multicenter Study of Myocardial Recovery Using Left Ventricular Assist Device.” There's an ECG challenge by Dr. Ezekowitz on a silent arrhythmia. How would you treat this patient? Go quiz yourself. Dr. Carolyn Lam: There is an AHA Update by Dr. Churchwell on how federal policy changes can advance the AHAs mission to achieve health equity. And finally, a Perspective by Dr. Talbert on rheumatic fever and the American Heart Association, The Nearly 100 hundred-Year War. Well, that wraps it up for the summaries. Let's go to the double feature, shall we? Dr. Greg Hundley: You bet. Dr. Carolyn Lam: Wow, today's feature discussion is really all about SGLT2 inhibitors, and that question that we're still asking, how do they work? And today, we are discussing two papers, very interestingly, looking at it from different aspects, one from a preclinical lens, finding a very novel target for SGLT2 inhibitors, and the other from a clinical lens, and really looking at the metabolic effects of the SGLT2 inhibitors in a way you've not seen before. Dr. Carolyn Lam: I'm very pleased to have with us the authors of these very exciting papers. We have Dr. Jesper Jensen from Herlev and Gentofte University Hospital in Denmark. We have Dr. Peter Light from University of Alberta, in Canada, and we have our associate editors, Dr. Thomas Eschenhagen from University Medical Center, Hamburg, and Dr. Justin Ezekowitz from University Alberta. Dr. Carolyn Lam: So, welcome gentlemen, thank you so much for joining us today. I suggest, let's start from the mice before we go to the men, and Peter, if you don't mind by starting us in, please tell us about this novel target you found, why you looked at it, how you found it, what it means. Dr. Peter Light: Hi, Carolyn, yeah, happy to discuss that. So, we all know that through numerous clinical trials, there's a very unexpected and exciting cardioprotective effect against heart failure with the SGLT2 inhibitors. And we decided to investigate some of the molecular mechanisms, which may underlie that protection. And in looking at the literature previously, and from my own lab's work, we're very interested in control of electrical excitability and ionic homeostasis in cells. Dr. Peter Light: So we investigated a known target or a known iron channel, which is involved in the etiology of heart failure as well as cardiac arrhythmias. And that would be the cardiac sodium channel. So, we investigated the effects specifically on a component of the cardiac sodium channel called the late sodium current, which is only induced in disease states, and they could be that during heart failure or ischemia, or can actually be in congenital conditions such as Long QT Syndrome Three, which involves certain mutations in this sodium channel. Dr. Peter Light: So we basically investigate the effects of empagliflozin, dapagliflozin and canagliflozin, in several different models of a sodium channel dysfunction, including mice with heart failure. And really what we've found is that this class of drug, and this is a class effect, it's not specific to just one of these SGLT2 inhibitors, what we found, they are very good inhibitors of this late current of the sodium channel. And in fact, they don't even affect the peak current at all. Dr. Peter Light: And when we did this and we analyzed the data, we found the IC 50s were in the low micromolar or even sub micromolar range for these drugs, which is exciting. And we extended those studies into cardiac myocytes and looked at calcium handling in those cardiac myocytes and saw that we get a very nice reduction in abnormal calcium handling in cardiac myocytes. Dr. Peter Light: We also used in silico molecular docking of these drugs to the cryo-EM structure of the NaV1.5, which is the cardiac sodium channel and identified that these drugs bind to a known region of that channel, which also binds the local anesthetics or anti-arrhythmic drug, Lidocaine, as well as the anti-anginal drug, Ranolazine. Dr. Peter Light: And finally, we showed that these drugs also reduce inflammation through the NLRP3 inflammasome in an isolated beating heart model. So collectively, we provide evidence that the late component of the sodium channel is a really important, or maybe a really important target for the molecular actions of this drug, and may underlie those observations received from the clinical trials relating both to heart failure, as well as sudden cardiac death. Dr. Carolyn Lam: Thomas, could you put this in context for us? Dr. Thomas Eschenhagen: Thanks, Carolyn. I mean, we immediately liked the story because as you said, and Peter as well, these drugs have amazing effects and every clinical paper and indeed some new ones, but it's really unclear how they do that. And what is, besides the established target, the SGL2 in the kidney, what could be the reason for all of this or some of this?   Dr. Thomas Eschenhagen: And then, of course, other examples proposed, like the sodium hydrogen exchanger, but this story didn't go so far. So we saw now this data from Peter showing that, and this is, of course, for a pharmacologist, just like me, very important, it's very potent binding. It's not a binding which happens in a millimolar or high micromolar, but as Peter said in low micromolar range. So that makes it a very realistic effect, for example, much more potent than ranolazine. Dr. Thomas Eschenhagen: And, of course, now the question is, to which extent could this, now I would say, establish the effect on the late sodium current, explain some of the findings which came out of the clinical studies, and actually, a question I would have to Peter, now that I think most of you know, the late sodium current is a reason for the increased sodium for LQT3 syndrome, very rare. Dr. Thomas Eschenhagen: But, of course it would be tempting to say, okay, maybe that would be a very good drug, particularly for people with LQT3. Did you think about that, Peter? Is it something on your list, mexiletine has been tried. Dr. Peter Light: Yeah, so I think that it's a certainly intriguing possibility. In fact, in our study, we did test out several different Long QT3 mutations and saw a reduction in the late component as also sodium channel. It's tempting to speculate that, indeed, these could actually be a rather effective anti-arrhythmic drug in patients with these LQT3 mutations or specific ones. I would love to be able to test that in at least some of the genetic mouse models of Long QT3 and to see whether this concept holds water or not. Dr. Carolyn Lam: Wow, this is incredible. SGLT2 inhibitors from anti-diabetic to now anti failure, and now anti-arrhythmic drugs? That's just amazing. Thank you, Peter. We should move on to this next paper, and this one all the way on the other spectrum, a clinical paper called Empire Heart Failure, Empire Heart Failure Metabolic, actually. Jesper, could you tell us about your trial and what you found? Dr. Jesper Jensen: Sure, thanks for the invitation to take part in the podcast, first of all. I'll tell you a little bit, we designed this study to try to get behind mechanisms, so the clinical benefits of the SGLT2 inhibitors in order to try to make a clinical outcome trial. But as you know, the DAPA-HF and the EMPEROR-Reduced were competed very fast, demonstrating the clinical benefits in HFrEF patients. Dr. Jesper Jensen: So, the data of our study provides some detailed mechanistic insights to these findings. And from the literature, we know that SGLT2 inhibitors improve glucose metabolism in patients with diabetes, and these changes might not be surprising in the diabetes population, but moreover, alterations in glucose metabolism may not be the main mechanism for the early occurring clinical benefits. Dr. Jesper Jensen: However, we know that many of our heart failure patients without diabetes are insulin resistant as a metabolic feature of the heart failure, and the insulin resistance is associated with an increased risk of developing future diabetes, which in turn reduces the long-term survival and quality of life. So, the targeting insulin resistance in HFrEF patients is, therefore, of clinical relevance to our patients. Dr. Jesper Jensen: So, the population of the Empire HF Metabolic consisted of patients with chronic HFrEF, with or without type two diabetes, who are on a stable guideline directed heart failure therapy, and have also indicated on anti-diabetic therapy. And we randomized patients to receive empagliflozin 10 milligrams once daily, or matching placebo as an-add on for 12 weeks. Dr. Jesper Jensen: And this was a modest sized randomized control trial, including 120 patients. A very large proportion of patients received guideline directed heart failure therapy, and they generally consisted of the best one third of atypical HFrEF population, and only 10% had concomitant history of type two diabetes. Dr. Jesper Jensen: We then, at baseline and after 12 weeks, we formed an oral glucose tolerance test to assess the hepatic and a peripheral insulin sensitivity and performed a whole body DXA scan to investigate alterations in body composition. We know that patients lose weight when they get an SGLT2 inhibitor with and without diabetes, but we don't know what it consists of in a HFrEF population. Dr. Carolyn Lam: Tell us what you found after 12 weeks. Dr. Jesper Jensen: Yeah, so a large proportion, actually half of the patients without a history of diabetes, had a new onset diabetes, or impact glucose tolerance at baseline. So even though few have no diabetes, this population were at very high risk of developing future diabetes. And the main finding was that empagliflozin improved insulin sensitivity. So the hepatic insulin sensitivity was improved by 13% and the peripheral insulin resistance was improved by 20% compared to placebo. Dr. Jesper Jensen: And moreover, both fasting and postprandial glucose were significantly reduced. And regarding the body composition, patients in a mean lost at 1.2 kilos, or 2.6 pounds, which mainly consisted of a loss in lean mass and no significant changes were observed in fatness, and this is from the DXA scan. Dr. Carolyn Lam: Hmm. Justin, could you shed some light on what the editors thought about this, and there's lots of questions still, huh? Dr. Justin Ezekowitz: Yeah, absolutely, Carolyn, and thanks Jesper for sharing this paper with Circulation. Thanks for summarizing it so well. I think the questions that come up and the reason why we liked it so much was we're all trying to understand mechanism of how these medications work so profoundly for our patients. Dr. Justin Ezekowitz: Now, in this predominantly non-diabetic population, the fact that the liver and the peripheral insulin sensitivity improves, how does that bear out for the fact that there is no fat loss in the early stages, yet that's all been linked to later improved exercise capacity and increased fat loss later on in life. Dr. Justin Ezekowitz: So, do you think those two are going to be linked if you went to say from 12 weeks beyond the 52 or two years down the road? Dr. Jesper Jensen: Yes, that is what we've seen from diabetes populations, at least. So you could imagine that the same would be the case also in the HFrEF primarily non-diabetic population, but again, we don't know. But early loss is the mass loss. Dr. Justin Ezekowitz: So Jesper, when you think about the peripheral insulin sensitivity improvement, is that largely indicating mostly muscle based insulin sensitivity improvement, and that would indicate that the muscles, perhaps, are functioning better in the short term with just a simple change in therapy. Dr. Jesper Jensen: Yeah, that could be a way to put it. I would agree upon that. Dr. Justin Ezekowitz: So thanks, Jesper, I think that may indicate the quality of life improvement that we may be seeing in the functional status there, Carolyn. Dr. Carolyn Lam: Yeah, but as you said, Justin, there just seems so many other questions. To Jesper, I want to know, what further might you want to do to find out what's happening with this? The loss of lean mass surprised me, frankly. I thought it would have been fat mass. So, what are you doing to look at that? And then to Peter, I want to go the other direction. What are you planning next that might bring this closer to humans and a clinical study? So maybe I'll ask Jesper to go first. Dr. Jesper Jensen: So, I definitely agree with you, Carolyn. We would also have to put our money on the fat from the beginning, before the study. So with respect to the weight loss, then a loss in lean mass is not preferable if it represents muscle. So however, the weight loss works to mediate the observed change in insulin resistance. And additionally, a significant loss in muscle would result in reduced insulin sensitivity. And we observed the opposite. Therefore, the observed loss in lean mass may be speculated to represent water and pointing towards the early diuretic effect SGLT2 inhibitors. So, the DXA scan is good at looking at body composition, but it has difficulties in separating lean mass from whether it's muscle or water, but combined with the findings on the insulin resistance, we speculate that the lean mass loss is more. Dr. Carolyn Lam: Thank you. And Peter, could you very quickly tell us what are next steps, in your view? Dr. Peter Light: Yeah, obviously we were studying mouse model of heart failure. We'd like to make a more of a translational step in the next experiments we do by studying human tissues. So getting access to ventricular tissue from ex-planted hearts, human hearts, too, and then measure electrical activity as well as some calcium imaging. Dr. Peter Light: Looking at some of these Long QT3 animal models would be another thing that we're going to do. And also start looking at to see whether we can get access to any electrophysiological data from electronic medical records to start looking for DCGs and measuring QT interval, for example, would be another nice step to that. Dr. Peter Light: And then, more of a drug development side of things, we are actively synthesizing new derivatives of these drugs and seeing whether we can enhance the cardio-protective effects on the late sodium current, but actually remove the ability to inhibit SGLT2. So we would no longer have a glucose-lowering drug, but we'd have a cardioprotective drug. So, it's all very exciting work going on right now. Dr. Carolyn Lam: You've been listening to Circulation on the Run. From Greg and I, don't forget to tune in again next week. Dr. Greg Hundley: This program is copyright of the American Heart Association, 2021. 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, visit ahajournals.org.  

On this week's show we will examine the intersection of architectural design and buildings that have Landmark protection, specifically how architects work with landmark restrictions in their construction and design projects.My guests will be Wayne Norbeck and Jordan Rogove, co-founders and partners in the architectural firm DXA Studio. And co-hosting this special episode with me will be Rediscovering New York regular and the program's Special Consultant, David Griffin of Landmark Branding.Tune in for this fascinating conversation at TalkRadio.nyc or watch the Facebook Livestream by clicking here..Show NotesSegment 1To start the show, the topic of New York landmarks was introduced and what goes into designing them. Two of the guests being featured on today's show are the co-founders and partners of the architectural firm DXA Studio. Their names are Wayne Norbeck and Jordan Rogove who both have years of experience. Today's co-host is David Griffin who is a New York historian working with Landmark Branding. Next, the background of the guests is questioned along with how they got into their career field. Both of them explain how becoming an architect was a natural choice.They have wanted to become architects since they were young. There are some challenges that go into working with landmark protected places. Wayne explains how a client can be in for quite a learning experience when working on a project if they are not educated about what is permitted and what is not. In the past, clients have wanted to put a 20 story edition on a building which was not allowed. Also, Jordan discusses the importance of making a project authentic and one way of doing that is to take note of the design and style of architecture that matches the others in the area.Segment 2After the break, 7 Harrison Street in Tribeca, New York was brought up because that is the first place with landmark protection that was worked on by DXA Studio. When a building has landmark status, it is very challenging to change the appearance of it from the street. At times, Jordan and Wayne have to be careful to ensure that whatever they're building is a contribution instead of a hindrance. When adding additions to buildings, they must make sure no one's windows are being blocked for example. One Hundred Barclay is another project that was worked on by DXA. The building is located near the new World Trade Center. They are responsible for the design of the exterior as well as the interior lobby. The two architects explain how a lot of the process was working with designers in order to illuminate a space in the best way possible.Segment 3Next, 827 & 831 Broadway is asked about which used to be a place for artists to produce their work. Many great painters were natives of that location. These buildings are very important to the state culturally. Jordan and Wayne eventually developed a project to create a vertical extension. They wanted to expand on a place that contains so much history, however, the project is currently delayed. Some people are making the case that the project is not appropriate and unnecessary but the two are confident that it will get built in the future.Segment 4Landmark branding is a company that provides branding and marketing support for real estate, architecture and design professionals. David works there and ensures that New York is backed. When Jordan and Wayne are assigned a project that involves religious landmarks they do their best to preserve what they find. In the past, they have preserved stained glass windows among others that are still around today. When they were working on the Brooklyn Bridge, they attempted to bring it back to its original look and feel. The project was received well by the public. They were given some great feedback and many people liked the design.

Live interview on 7th April with Dr Lani Simpson Dr. Simpson is a chiropractic doctor and a Certified Clinical (bone) Densitometrist (CCD). The International Society of Bone Densitometry awards the CCD certification to those who have demonstrated (through an exam) a mastery of an approved body of knowledge in osteoporosis diagnosis though DXA and CT […]

Hvordan er livet som kvindelig fitness atlet? Hvor hårdt er det? og hvordan vil det påvirke dig som person? Det og meget mere diskuterer vores vært træningsfysiolog Henrik Duer med Michelle Lindop, der selv har været fitnessatlet og skrevet speciale om emnet på Københavns Universitet. Derudover inddrager Henrik også data fra et forsøg (ikke publiceret data), hvor Fitness Institute i samarbejde med Københavns Universitet fulgte udviklingen 24 kvindelige fitness atleters fedt og muskelmasse (DXA-scanning) fra 10 mdr ude og helt frem til en uge før konkurrencen. God fornøjelse

Can you measure muscle and body fat from a single picture right from your smartphone?

This week we discuss Jason's DXA scan results, general health and fitness as well as which lense we are using to view the past through.

The US department of Health and Human Services says the most common way to determine, if a person is overweight or obese is to calculate body mass index (BMI), which is an estimate of body fat, based on comparing a person’s weight to his or her height. However, BMI can be flawed with more lean muscle weight, such as the case with a fit person or athlete.The Centers for Disease Control and Prevention (CDC) comments that, “BMI does not measure body fat directly, but research has shown that BMI is moderately correlated with more direct measures of body fat obtained from skinfold thickness measurements, bioelectrical impedance, underwater weighing, dual energy x-ray absorptiometry (DXA) and other methods.” When BMI is added to a person’s potential health comorbidities (high blood pressure, cardiovascular, liver, or kidney disease), there can be a higher risk to complications associated with viral-associated diseases, such as Covid-19. “BMI appears to be strongly correlated with various adverse health outcomes consistent with these more direct measures of body fatness,” notes the CDC.For adults, a BMI of 18.5 to 24.9 is considered normal weight; 25.0 to 29.9 is considered overweight; 30.0 to 39.9 is considered obese, and 40.0 and higher is considered extremely obese.The World Health Organization (WHO) states that the number of obese people has tripled worldwide in the last twenty years – reaching the status of a global epidemic – mainly associated with improper dietary habits and a sedentary lifestyle.According to April 2020 research – Obesity, Bioactive Lipids, and Adipose Tissue in Insulin Resistance – published in the online, peer reviewed journal Nutrients, “obesity is a state of pathological increase in the amount of adipose tissue, which boosts the risk of numerous diseases, such as cardiovascular disease, some types of cancer, and type 2 diabetes.” The study authors from the Department of Hygiene, Epidemiology and Metabolic Disorders, Medical University of Bialystok, Poland, stress that “there are a number of causes leading to the development of obesity, including genetic and environmental factors. The contribution of genetic factors to obesity is very important and is thought to be responsible for 40–70% of obesity cases.”However, note the Polish researchers, “it appears that non-genetic factors, especially environmental factors such as unhealthy eating habits and lack of physical activity, also play a substantial role in generating obesity.” Let’s add sleep duration and daytime sleepiness to the list of complications that may affect being overweight and obese.When insulin resistant – a precursor to type 2 diabetes and obesity – insulin stimulates fat storage and inhibits fat breakdown for energy. Under normal conditions, insulin is an anabolic (building) hormone that increases the uptake of amino acids by muscle tissue and enhances protein synthesis (making muscle).The American Diabetes Association (ADA) defines insulin resistance as, “a condition in which the response of cells to insulin is impaired with respect to carbohydrates, lipids, and proteins, resulting in elevated blood glucose levels.”The ADA further states that, “insulin has a wide spectrum of effects on metabolic processes in adipocytes (fat cells); therefore, it is considered the most important hormone regulating anti-lipolytic processes, and deterioration of cell sensitivity to this hormone or impairment of the insulin pathway may affect the metabolism of adipose (fat) tissue.” The central accumulation of fat tissue – known as an android visceral fat - is consistent with a male fat pattern. Female fat accumulation – known as a gynoid fat pattern – is the increase of subcutaneous (under the skin) fat in the hip and thigh regions. Read the rest at MackieShilstone.com

  DXA studio is an award-winning design practice that provides a rare balance of expertly crafted design with technical proficiency. Believing in the power of architecture to positively influence the lives of all that engage it, DXA focuses on authenticity, sustainability, and innovation in all their projects.  Established in 2011, DXA’s expertise spans the full spectrum of design services and project categories including multi-family and single-family residential, commercial, institutional, and hotel design. In-depth research and analysis happen prior to design, identifying opportunities to push boundaries and integrate technological advances in building materials, construction, and sustainable strategies. By capitalizing on these discoveries, the site, program, and unique opportunities of each project, DXA produces creative solutions and distinctive design work that consistently outperforms expectations. Jordan is a Co-Founder with his partner Wayne Norbeck and he leads the creative design process, managing the studio, and guiding projects through complex municipal approval processes; including Landmarks, Community Board and BSA. Over the course of Jordan’s 20-year career, he has completed a tower that straddles Manhattan’s High Line, won design competitions for health-focused housing in Haiti, an arena for the New Jersey Devils and a pedestrian bridge and park in midtown Manhattan, designed and fabricated scenic sets for television and stage, helped realize the Louis Sullivan Award-winning historic Carbide & Carbon Building renovation and the AN Best Renovation Project 100 Barclay, and designed and oversaw over twenty high-end residential and commercial projects in New York City. This background has helped him form a unique approach to design and a thorough understanding of how to create and realize a successful project. Jordan is currently a visiting Professor of Practice at Virginia Polytechnic Institute, Director of Architecture & Design at LiV Connected, and proud father of three children with his wife Laura. In today's episode, we discuss how modern-day technology can be integrated into properties that support the health and wellbeing of the occupants.  In this episode, you'll learn.. Power of architecture to influence health and well being Modular health-focused multi-family housing- LiV Connected Platform Smart home becomes a partner in health- new technologies help keep us healthy and cared for Namibia & Haiti projects, inexpensive building solutions to fight disease Midtown Viaduct project- Winner Metals in Construction Grand Prize and NYC x Design Best on the Boards awards Links and resources mentioned in this episode. dxastudio.com https://www.instagram.com/dxastudio/ To subscribe and rate & review visit one of the platforms below: Follow Real Estate Success Rocks on:  

This Podcast highlights my DXA scan experience with Peter at Body Comp Imaging Vancouver. 

In this episode of Quah (Q & A), Sal, Adam & Justin answer Pump Head questions about ways to mimic the action of sled pushes at home, why heels aggravate knees and what to do about it, ways to deal with relationship stress while quarantined, and the topics they can't agree on. How you can still gain followers and not TRY to gain followers. (5:45) New product alert from Magic Spoon, Mind Pump's staple foods as a kid & MORE. (9:47) Coffee and leanness. (14:48) Let the podcast wars begin! Mind Pump speculates on the future of the medium. (18:17) The benefits of full-spectrum hemp oil for feelings of anxiety. (28:39) The first version of Apple and Google's contact tracing app has arrived.  (31:54) What state will woo Tesla over? (33:17) The pros/cons of working from home and its impact on large tech companies. (35:08) (38:35) How diets really don't matter. (40:02) Clever new delivery service from the pizza makers over at Chuck E Cheese. (41:00) Mind Pump on the future of A.I., how creative artists make money & MORE. (43:39) #Quah question #1 – Is there any way to mimic the action of sled pushes at home? (47:44) #Quah question #2 – I wear heels sometimes, but they aggravate my knees. Is there is certain muscle issue or a problem I have right now that would cause such problems? (51:51) #Quah question #3 – What are some ways to deal with relationship stress while quarantined with your partner? (55:00) #Quah question #4 – Are there any discussions or topics you guys had that you each completely disagree on or come to a conclusion on? (1:01:08) Related Links/Products Mentioned May Promotion: MAPS Starter ½ off! **Promo code “STARTER50” at checkout** Special Promotion: MAPS Anywhere ½ off!! **Code “WHITE50” at checkout** Visit Magic Spoon for an exclusive offer for Mind Pump listeners! Regular Coffee Consumption Is Associated with Lower Regional Adiposity Measured by DXA among US Women THE PODCASTING WORLD IS NOW SPOTIFY VERSUS EVERYBODY ELSE Spotify Soars After Signing Rogan to Exclusive Podcast Deal Joe Rogan Takes $100 Million To Move Podcast To Spotify, Drops Apple, YouTube Visit NED for an exclusive offer for Mind Pump listeners! How Apple and Google plan to check the coronavirus spread with contact tracing Remote working takes off for Twitter, Facebook, tech companies Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates Chuck E. Cheese Launched A Delivery-Only Restaurant Under The Name 'Pasqually's Pizza & Wings' The Age of A.I. – YouTube Hit Makers: The Science of Popularity in an Age of Distraction – Book by Derek Thompson How to Use an Ab Wheel- Bear Crawl Core Exercise (Ab Roller Video 3 of 3) Mind Pump Webinar The 5 Love Languages: The Secret to Love that Lasts – Book by Gary Chapman MAPS Prime Webinar Mind Pump Free Resources People Mentioned Joe DeFranco (@defrancosgym)  Instagram Ben Pakulski (@bpakfitness)  Instagram Ben Greenfield Fitness (@bengreenfieldfitness)  Instagram

Is cardio good or bad?   Well, as with all things in life, the devil's in the dose. This especially holds true when we talk about the pro's and con's of cardiovascular training, or if we were to be more specific; the type, frequency, duration, and intensity of the exercise will determine the individual's response.   So what should we know about how to manipulate these variables relative to our long-term health and body composition goals?   Today I bring back Dr. Dan Dodd, Ph.D. Exercise Physiologist and owner of DexaFit in central Illinois - a testing facility specifically looking at Body Composition Analysis using DXA scans, Metabolic Assessments, and Cardiovascular Testing.   In this illuminating conversation, we discuss the numerous applications of cardiovascular training, depending on the individual and their goals, including:   Relationship between cardiovascular exercise for health and for fat loss - is there a difference? Different types of Cardio based on the intensity Ways to create a calorie deficit with nutrition vs. training volume AND metabolic adaptations Downsides of too much cardio Health Benefits of Cardiovascular exercise Stigmas of Cardio based on sex How to measure Aerobic fitness / cardiovascular function   If you've been wondering how to determine the right type and volume of cardiovascular exercise for you, then you're going to want to tune in to this episode.   As always, if you love what you hear on this show, then do me a favor and subscribe, leave a positive rating and review and share this episode with a friend or loved one whom you think could benefit. AND, if you want to talk about working with me personally, I'd love to chat, just schedule your free nutrition strategy call over at www.bslnutrition.com/levelup   http://www.bslnutrition.com/episode104

Known as Sarcopenia—derived from the ancient Greek words sarx (flesh) and penia (poverty)—the progressive decline in muscle mass and strength (dynapenia) after the age of forty, this condition has caught the attention of researchers and public health experts. So much so, that Sarcopenia has its own ICD-10 reimbursement code.Sarcopenia is most pronounced in those sedentary individuals, who may also have other comorbidities such as diabetes and heart disease, after the age of sixty.Consistent with this loss of muscle is the accrual of fat mass—specifically around the mid-section—visceral abdominal fat—while also infiltrating the muscles—intramuscular adipose tissue.With 87% of falls after the age of sixty-five resulting in fractures, the loss of lean, supporting muscle mass just adds insult to injury.Writing—Efficacy of Nutritional Interventions as Stand-Alone or Synergistic Treatments with Exercise for the Management of Sarcopenia—in the September 2019 online journal Nutrients, researchers from Italy comment that, “Sarcopenia represents an important sanitary problem, since it affects 20% of people over 70 and 50% of people over 80”Moreover, the Italians note that, “considering the important function of muscle tissue beyond locomotion (e.g., influence on glucose and protein metabolism and on bone density), it is associated with many adverse clinical outcomes (falls, fractures, functional and cognitive decline, cardiac and respiratory disease, reduced quality of life and independence, hospitalization, and mortality).”Sarcopenia is now defined as, “a muscle disease, which can be considered probable, if reduced muscle strength is detected” - with the hand grip dynamometer and chair stand test, as the primary measures of muscle strength and the dual-energy X-ray absorptiometry (DXA) and bioelectric impedance used to assess muscle mass.Sarcopenia can accelerate under a pro-inflammatory state, malnutrition, hormonal changes, higher muscle protein breakdown, loss of motor neurons, mitochondria dysfunction, and insulin resistance—which, “reduces the (body’s) ability to use the available proteins.”In addition, “insulin resistance in the skeletal muscle results in whole-body metabolic disturbances associated with type 2 diabetes, which are further exacerbated by Sarcopenia. All these alterations are differently responsible for an imbalance between the anabolic (building) and catabolic (breakdown) process at the muscular level.”The Italian researchers describe several nutritional interventions as follows:Essential amino acids (EAAs), in particular leucine, are an important anabolic stimulus. The main dietary sources of EEAs are lean meat, dairy products, soybeans, cowpeas, and lentils. The biological pathways on which leucine act are the activation of the mammalian target of rapamycin (mTOR), and the inhibition of the proteasome.However, supplementation with high doses of EEAs (10–15 g) and leucine (at least 3 g) is necessary to overcome anabolic resistance in older people.ß-hydroxy ß-methylbutyrate (HMB) is one of the metabolites of leucine, which exerts anabolic and anti-catabolic effects through the activation of the mTOR pathway and the stimulation of the growth hormone/IGF-1 axis.It is recommended to dose vitamin D in all sarcopenic patients and to prescribe supplements in those who are deficient. Promotion of an adequate sunshine exposure together with the consumption of foods rich in vitamin D (salmon, mackerel, herring, sun-dried mushrooms) should instead be suggested in all older people.Supplementation with polyunsaturated fatty acids (PUFAs), and in particular with omega-3 fatty acids, improves muscle protein anabolism. PUFAs seem to directly act on mTOR signaling and reduce inflammation.The researchers importantly comment that, “inactivity is one of the main causes of sarcopenia because it determ

Make some gains with Drs. Feigenbaum (@Jordan_theCoach) & Baraki (@AustinBaraki) of Barbell Medicine as we delve into the topic of sarcopenia! Together we’ll learn what exactly is sarcopenia, how it is diagnosed, and explore approaches to both management and counseling including: exercise prescriptions,  recommendations for protein intake, and even how to treat patients with multiple comorbidities. Show Notes | Subscribe | Spotify | Schwag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by:  Cyrus Askin MD Infographic: Cyrus Askin MD, Hannah Abrams Cover Art: Dr. Kate Grant MBChB DipGUMed Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP    Editors: Matthew Watto MD, FACP; Clair Morgan of Nodderly.com Guests: Jordan Feigenbaum MD; Austin Baraki MD Check Out our friends at Barbell Medicine! Learn more about Barbell Medicine through their website at www.barbellmedicine.com or their YouTube channel - Barbell Medicine. They also have their own Podcast, The Barbell Medicine Podcast and can be found on Instagram: @barbell_medicine, Twitter via @BarbellMedicine. Drs. Feigenbaum and Baraki can be found on instagram via Jordan_BarbellMedicine & Austin_BarbellMedicine. They can also be found on Twitter via @AustinBaraki, @Jordan_theCoach. Time Stamps 00:00 Intro, disclaimer, guest bio 03:20 Guest one-liners; Picks of the Week*: Explain Pain (book) and Explain Pain Super Charged; Range Why Generalists Triumph in a Subspecialized World (book) by David Epstein; The Sports Gene: Inside the Science of Extraordinary Athletic Performance (book); The Mind’s Eye (book) by Oliver Sacks; The Predator High Five (Gif); The Bacterionomicon 08:50 How Austin and Jordan got into coaching, fitness and lifestyle medicine 14:30 Case of chronic pain, lack of exercise and loss of muscle mass; Defining sarcopenia, cachexia, frailty 22:30 How to diagnose sarcopenia -measures of physical performance (Repeat Chair Sit to Stand; Timed Get Up and Go Test; Gait Speed); DXA scans; The SARC-F questionnaire; Serum Creatinine 33:30 Anabolic resistance; Sarcopenic obesity and Osteosarcopenic obesity 37:00 How to counsel patients about physical activity 40:00 The 10,000 step thing is based on marketing, not evidence 41:30 How to sell exercise to patients with comorbidities; Barriers to and safety of resistance training 49:39 Finding a physical trainer 53:18 Dietary protein intake recommendations 61:33 What kind of results might patients expect 65:55 Take home points 68:11 Plugs: Barbell Medicine podcast, Instagram, YouTube and Twitter 69:15 Outro and a pun *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on my Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra. Goal By the end of this episode, listeners will be familiar with sarcopenia as an important clinical entity, the risk factors for sarcopenia, how to assess a potential sacropenic patient and how to provide treatment and counsel towards preventing or reversing sarcopenia.  Learning objectives After listening to this episode listeners will…   Appreciate the clinical relevance/importance of sarcopenia Know who is at risk for sarcopenia and how to screen them Master the most recent exercise and nutrition recommendations for adults Be familiar with motivational interviewing techniques to help promote diet and exercise changes to combat sarcopenia Disclosures Dr. Feigenbaum is the owner of Barbell Medicine LLC which provides free, paid and retail content to include strength/nutrition coaching, strength/nutrition seminars, shirts, training gear and protein / pre-work out supplements. Dr. Baraki works part-time for Barbell Medicine LLC as a writer and coach for which he is paid. He does not receive any proceeds from the sale of supplements or other retail goods.  Citation Askin C, Baraki A, Feigenbaum J, Williams PN, Brigham SK, Watto MF. “#186 Sarcopenia: Raising the Bar in Primary Care”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. December 2, 2019.

Prior research has demonstrated that resistance training is effective in reducing both visceral (around abdominal organs) and subcutaneous (under the skin) fat mass, which can be significant risk factors to overall health, when in excess. In elderly subjects who are at risk to sarcopenia – the aging loss of lean muscle – resistance exercise is a stimulus to lean muscle development.Until now, research is sparse, as to how lean muscle development improves cardio-metabolic health in previously healthy, young individuals. Researchers from Finland and Sweden writing – Resistance Training Induces Antiatherogenic Effects on Metabolomic Pathways – in the September issue of Medicine & Science in Sports & Exercise, chose to, “examine changes in blood metabolome profiles in response to chronic resistance exercise training and associated changes in body composition in healthy young adult men.”Metabolomics examines small molecules present in biological material – like blood – in a comprehensive manner. It was hypothesized that, “chronic resistance training has the potential to alter body composition and metabolome profiles in a cardio-metabolically favorable manner.”Eighty-six recreationally active, healthy thirty-three-year old men without a prior, consistent resistance training background participated in the resistance training (RT) group, while eighteen 31year-old non-training men belonged to non-RT group.Prior to and after the16-week resistance training intervention program, body composition was assessed by dual-energy X-ray (DXA), along with fasting blood samples, and nuclear magnetic resonance (NMR) to assess quantification of serum metabolites in order to identify metabolic pathways. Maximum strength was measured at baseline, at 4 and 12-weeks, and post-study. Four-day food diaries were maintained during the second segment of the 12-week resistance period – with verbal and written nutritional recommendations for normal healthy adults.The resistance training began with 4 weeks of whole-body workouts performed twice-a-week – using 8 to 10 exercises within one workout, two to three sets for every exercise, and 10–15 repetitions in every set. A recovery time of 2 minutes was held constant between sets – with training loads between 50% to 80% of one repetition maximum, which increased throughout the preparatory phase.It was concluded that, “a short-term (4 to 16 weeks) period of resistance training leading to increased levels of lean mass and reduced overall adiposity (fatness) also leads to antiatherogenic modulation of serum metabolome in healthy young men.” Their cardio-metabolic risk profile improved.The researchers also comment that, “change in lean mass could be used as a predictor of metabolome profile, especially regarding HDL (good cholesterol) subpopulations. Furthermore, individuals with the poorest baseline body composition and metabolome profile benefit the most from initiating resistance training in terms of positive cardiometabolic health effects.”Check with your physician before you begin your path to better health using any mode of exercise.

Okay, you've had your body fat tested. How much faith should you put in the results? I'll answer this question in today's Simple Truth Fitness minute (STFM).✨See my STFM on why body composition matters http://bit.ly/2pDnUZe -AND- see my other STFM for which body fat test I say is "best." http://bit.ly/34CqTQh✨In no particular order the big five methods are:- Underwater weighing; hydrodensitometry- Skinfold with calipers- Bodpod- DXA; dual energy x-ray absorptiometry- BIA; bioelectrical impedance analysis;✨Regardless of the method all body fat tests are estimates and only as good as the instrument operator, the calibration of the device and whether the recommended testing protocols were followed.✨At the boots on the ground level, if I were you and I wanted to know my body composition for the sake of assessment of health and fitness (a good idea by the way) I'd get a quality home bath scale that also measures body fat. It'll use the BIA method. I'd follow the instructions for getting the most accurate reading (i.e., not right after showering, or right after eating, or right after working out etc). I'd step on it daily at the same time of day in my same condition (nude) for 7 days. I'd see if the numbers are reasonably close and if not I'd eliminate the really high and the really low one. Then I'd average the remaining 5 and call it a day.✨But! If after doing that I was pretty sure something was way off? Like I've got solid six-pack abs and it says I'm 40% body fat? Then I'm going to find a place that offers DXA and get a full scan done. You can search for DXA scan locations here --> http://bit.ly/2Jup8fO✨DXA could still be off depending on a host of factors but it is the research gold standard and it's likely I'll get a relatively accurate reading. Plus, as a bonus, I'll know my bone density and have a more accurate view of my skeletal muscle mass, not just fat-free mass (which includes bone and everything other than fat).✨If I couldn't find a DXA location then I'd probably find an InBody location. Their high-end scales are also BIA based (like the home bath scales) but the sensors are both at the feet AND hands and, at least anecdotally, word-on-the-street, they are more reliable than a home scale. Find an InBody location starting here  --> http://bit.ly/

What are the five methods of checking body fat you should know and which one is best? I'll answer these questions in today's Simple Truth Fitness minute. Here is some more info I couldn't quite fit in my one-minute summary.✨Underwater weighing - Also known as hydrodensitometry. It CAN be very accurate but makes you blow out all your air while under water for 30 seconds. Not fun, easy or cheap and finding a place to do it can be a pain.✨Next, a skinfold test. Using calipers, most often a trainer will measure skinfolds at one or more locations on your body. Skinfold is highly dependent on the skill of the person holding the calipers and also how heavy the test subject is. The more fat you have the less accurate skinfold is likely to be - it's just harder to pull the skin and fat to get an accurate reading.✨Bodpod - with a bodpod you simply sit in an egg-shaped chamber for 5-8 minutes. Using air displacement technology it'll tell you your weight, fat mass, fat-free mass and lung volume.✨DXA - dual energy x-ray absorptiometry is what researchers all use and is considered the gold standard for body composition testing. Dexa is the only method that'll provide fat mass, fat-free mass, and bone density. You do it fully clothed, lying on your back and it takes about 10 minutes. You can search for DXA scan locations here --> http://bit.ly/2Jup8fO✨BIA - or bioelectrical impedance analysis is what most home scales use if they include body fat testing. BIA circulates a small, safe, electric signal throughout the body. BIA is thought to be more accurate when the device provides both sensors in the foot plate and handles you grip. BIA will tell you your water content, fat mass and fat-free mass and it takes just a few minutes. For a good BIA test start with InBody here --> http://bit.ly/2PB4rmz✨Regardless of the method all body fat tests are estimates and only as good as the instrument operator, the calibration of the device and whether the recommended testing protocols were followed.

After 43 years of sports performance management — with over 3,000 pro athletes, such as my eleven years with world champion tennis player Serena Williams, sports teams, and since 2012, volunteer work with special forces, it came as a surprise, when I was contacted in April of 2017, by Hollywood producer, director, and innovator James Cameron.Cameron wanted me to consider taking on a project consistent with my “so called” reputation of extending careers. Cameron said he wanted to change Hollywood’s mantra of, “throwing female actors away, after the age of forty.” Initially, I wasn’t interested in the project, until he made that comment about discarding human beings based on age. The project involved transforming Linda Hamilton from her present state — yet to be determined — to be able to perform the physical demands of Sarah Connor — the role Hamilton created in Terminators 1&2 — over 28 years ago.I was skeptical that Hamilton, 61 when we started, would be able to survive the training long enough to get to the production. That is, until I met her here in New Orleans.I informed Cameron that I would accept the project, if Hamilton passed extensive medical and physiological evaluations. Hamilton would then have to survive three weeks of training with me to see if she could hold up under the training stress — both physical and mental. She did. Hamilton’s biggest concern was that the audience would compare her to what she looked like 28 years ago. The studio budget provided for the creation of a home gym to be built in the annex of Hamilton’s home in New Orleans — used for training and any injury related rehabilitation, should one occur.The first 12 weeks of work encompassed 6 days per week of 1.5 to 2 hours of circuit training exercises — using a cable weight apparatus with arms — permitting functional human movement patterns, core training using a stability ball, steady state and interval cardio training on an elliptical device, power training with a specially-designed medicine ball — along with specialized pre-habilitation (injury prevention) exercises based on her biomechanical analysis. Hamilton had two AM/PM additional, scripted, heart rate monitored sessions on the elliptical lasting 45 minutes. Over the remaining 9 months of the one-year project, our training became more functional to her character’s movement, as the script developed — moving to the Newman School football field to emphasize footwork, short sprints, agilities (cone drills), and combative training.In Terminator 2 twenty-eight years ago, Hamilton was quite ripped by body building standards, especially in her arms — what I would hear from most women. The potential for muscle and strength loss — accelerated with age — was a big concern. Understanding the effects of sarcopenia — loss of muscle with age and dynapenia — the associated loss of strength — technology from wound care and my prior experiences, provided a partial solution — the use of an amino acid blend — arginine, HMB, a metabolite of the anabolic amino acid leucine, and glutamine, among other medically approved nutrients.Research also demonstrated that the standard 0.8 grams per kilogram for protein requirements would not begin to address Hamilton’s needs with the associated intense training. Based on DXA scans every six weeks, the daily protein requirement was determined down to the gram, as with my athletes. In one of his last communications, when Cameron was provided with pictures of Hamilton just prior to the project completion, he emailed me to say in the words of Arnold Schwarzenegger before T2, “Linda, you look ripped and shredded.”

Body composition, what is it and why does it matter when evaluating fitness? I'll answer these questions in today's simple truth fitness minute (STFM).✨Body fat percentage is superior to body mass index (BMI) for assessing your weight health. BMI is a quick-math calculation, based only on height and weight, that determines whether someone is normal-weight, overweight, obese or morbidly obese. It's good to know your BMI but it's even better to know your body-fat percentage.✨You could be at a "normal" weight but still be too fat due to the loss of muscle (sarcopenia), which is another STFM here --> http://bit.ly/2m38f3f Or you could be considered "overweight" by BMI but actually have a very healthy body fat. Ultimately? IT'S YOUR BODY FAT THAT MATTERS.✨In another Simple Truth Fitness minute I discuss BMI here --> http://bit.ly/2lY8Jra✨In a different STFM I'll discuss the best ways to get your body fat tested but I'll at least mention them here: DXA (dual-energy X-ray absorptiometry) scan is THE gold standard. Second best would be BIA (bio-electrical impedance analysis) but only the kind that has you standing barefoot on a scale AND holding onto sensors with your hands - BOTH.✨You can search for DXA scan locations here --> http://bit.ly/2Jup8fO and for a good BIA test start with InBody here --> http://bit.ly/2PB4rmz

Episode 113 of the Guru Performance 'We Do Science' podcast! In this episode, I (Laurent Bannock) discuss "DXA and Body Composition Assessment: Gold Standard or Gold Plated?" with Dr Julia Bone PhD (Sport Institute Northern Ireland, UK). In this session we get into: DXA defined in the context of its design and use as an imaging system Body composition reference methods DXA use in research and practice in sport and exercise science and nutrition Standardisation and measurement errors in body composition assessment using DXA Effects of exercise, nutrition and hydration, menstrual cycle etc on DXA measurements of body composition Best practice protocols for optimise "accuracy and reliability" of DXA assessments for use in research and practice Check out our other podcasts, publications, events, and professional education programs for current and aspiring sports nutritionists at www.GuruPerformance.com

DFC heads out to BodySpec to see how their physique measures up. They discuss their past history with DXA body scans, compare their normal exercise routines & daily health habits, and scrutinize their final scan results.

Improve your DXA skills by learning from an expert on how to position and analyze for Bone Densitometry procedures. Common mistakes and helpful tips are highlighted throughout this lecture.

We chat about Stacy's ankle injury, DXA scans & only posting what you're comfortable with on social media.

Edição de 15 de Janeiro 2019

Dr Carolyn Lam:                Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr Carolyn Lam, associate editor from the National Heart Center and Duke National University of Singapore.                                                 In today's feature discussion, we will be doing a deep dive into the LEADER trial results, looking at new results of liraglutide and its effects in patients with type two diabetes, with or without a history of myocardial infarction or stroke. All of that coming right up after these summaries.                                                 In today's issue, five groups of investigators in two original basic research articles and three research letters tackled the same biological question, and all reached the same conclusion that cells in the heart expressing the SCA-1 cell surface antigen do not become cardiomyocytes to any meaningful degree, and instead become endothelial cells. Among the original basic papers, first author Dr Vagnozzi, corresponding author Dr Molkentin from Howard Hughes Medical Institute and Cincinnati Children's Hospital Medical Center, and their colleagues use the inducible recombinase method and generated a constitutive recombinase at the SCA-1 locus. They found that cardiac resident SCA-1 positive cells were not significant contributors to cardiomyocyte renewal in vivo. Instead, SCA-1 positive cells generated cardiac vasculature throughout development, during aging, and following injury with trivial contribution to the cardiomyocyte population.                                                 In the second paper from co-first authors, Drs Zhang and Sultana, with corresponding author Dr Cai from Indiana University School of Medicine and colleagues, these authors engineered a series of genetically altered mice to identify and track SCA-1 positive cells in the heart, and found that SCA-1 positive cells were purely of the endothelial lineage. Together with three research letters, these five papers add to the growing body of evidence that in adult mammals, our new cardiomyocytes arise from preexisting cardiomyocytes and rarely, if at all, from adult cardiac stem cells.                                                 Could metformin be cardioprotective in patients with type one diabetes? Co-first authors Drs Bjornstad and Schafer, corresponding author Dr Nadeau from University of Colorado School of Medicine, and their colleagues hypothesized that adolescents with type one diabetes have impaired vascular function, and that metformin may improve insulin resistance and vascular dysfunction.                                                 To test this hypothesis, they studied 48 adolescents with type one diabetes and 24 non-diabetic controls using MRI of the ascending and descending aorta, as well as assessment of carotid intima-medial thickness by ultrasound, brachial distance ability by DynaPulse, fat and lean mass by DXA, fasting labs following overnight glycemic control, and insulin sensitivity by hyperinsulinemic euglycemic clamp. The adolescents with type one diabetes were randomized one as to one to three months of 2000 milligrams metformin or placebo daily, after which the baseline measures were repeated.                                                 The authors detected early signs of cardiovascular disease with MRI in these adolescents with type one diabetes compared to controls. They further found that three months of metformin therapy improved insulin sensitivity as assessed by gold standard hyperinsulinemic euglycemic clamp, both in normal weight and obese adolescents with type one diabetes. Moreover, metformin improved carotid intima-medial thickness and aortic wall shear stress and stiffness. Thus, metformin may hold promise as a cardioprotective intervention in type one diabetes.                                                 What are the clinical genetic and environmental determinants of varicose vein formation? Co-first authors Drs Fukaya and Flores, corresponding author Dr Leeper from Stanford University, and colleagues applied machine learning to agnostically search for risk factors of varicose veins in nearly half a million individuals in the UK bio bank. They found that greater height appeared as a novel predictor of varicose vein disease in machine learning analyses, and was independently associated in multi-variable adjusted Cox regression. Using Mendelian randomization, they demonstrated that greater height had a causal role in varicose vein development. A genome-wide association study identified 30 new genome-wide significant loci, identifying pathways involved in vascular development, and skeletal/limb biology, and discovering a strong genetic correlation between varicose veins and deep vein thrombosis. The knowledge greatly expands our understanding of disease pathophysiology, and may help future improvements in the management of varicose veins and their associated complications.                                                 The final original paper describes the effect of glucagon-like peptide-1 receptor agonist liraglutide on cardiovascular events, and all-cause mortality in patients with type two diabetes and chronic kidney disease. First and corresponding author Dr Mann from Friedrich Alexander University of Erlangen in Germany and their colleagues performed a post hoc analysis of the LEADER trial comparing the liraglutide's treatment effects in patients with and without kidney disease.                                                 As a reminder, LEADER was designed to recruit a subgroup of at least 660 patients with an estimated glomerular filtration rate, or eGFR, less than 60, approximately 220 patients with severe renal impairment, eGFR less than 30, and at least 440 patients with moderate renal impairment with an eGFR of 30 to 60. The authors found that the liraglutide reduced the risk of major adverse cardiovascular events, and all-cause mortality compared with placebo in patients with chronic kidney disease defined as an eGFR less than 60, and also in patients with albuminuria defined as a urinary albumin to creatinine ratio above 30.                                                 The overall risk of adverse events did not differ between the liraglutide and placebo treated patients either with or without chronic kidney disease in the LEADER trial. In summary, these results show that liraglutide added to standard of care reduced the risk of major cardiovascular events and all-cause mortality in patients with type two diabetes and chronic kidney disease. Furthermore, these results appear to apply across the chronic kidney disease spectrum that was enrolled.                                                 And that brings us to the end of our summaries. Now for this week's feature discussion.                                                 Cardiovascular outcome trials have transformed the world of treating patients with diabetes. And for our feature discussion today, we're going to be talking about a new analysis from a very important trial, the LEADER trial of GLP-1 receptor agonists, and that's the liraglutide. I'm very proud to have the corresponding author of this paper with us, Dr Subodh Verma, and he's from St Michael's Hospital and University of Toronto, and our senior associate editor, Dr Gabriel Steg, from University of Paris. Actually, Gabriel, I'm actually going to start with you for once because I recall perhaps something you may have written about cardiovascular outcome trials. Dr Gabriel Steg:                Yeah, it's really funny. I'll try to take it graciously. You know, I wrote a frame of reference in Circulation a few years ago, wondering whether we were doing good by doing all these large outcome trials for safety with new anti-diabetic drugs, because there had been not one but two, three, four, five, six trials that were essentially neutral, enrolling more than 107 patients and participants at the expense of millions of dollars, and not much came out of it. And this was published in circulation. I was very happy until the next trial comes up, and this is EMPA-REG. And the next one is LEADER. And we have two trials that literally transform our vision of anti-diabetic agents as major agents for cardiovascular prevention. The trial we're going to discuss today, which you wrote about, is one of these trials. And I think I have to revisit my own writings and probably eat my hat. Dr Carolyn Lam:                So indeed, that's a great segue. Thank you, Gabriel. And Subodh, tell us then, what did you look at this time in LEADER? And maybe start by saying a little bit about LEADER, and the rationale for doing this particular sub analysis. Dr Subodh Verma:           Right. So, as Dr Steg mentioned, these were FDA-mandated studies to look at safety and potential efficacy of newer antihyperglycemic agents. The entire premise was that cardiologists and cardiovascular specialists were not really getting that excited about antihyperglycemic therapies in people with diabetes, because there was no data that they did much. And as Dr Steg mentioned, even the data leading up to some of these trials were disappointing, suggesting that they're safe, but they neither reduce nor increase events.                                                 So, I think EMPA-REG and LEADER really changed the calculus in many ways of how we look at cardiovascular risk reduction with antihyperglycemic agents. LEADER was a trial that was 9,340 patients. These are patients that were at high cardiovascular risk, but unlike EMPA-REG that only enrolled people with prior to ischemic cardiovascular events ICAD, PAD, and CVD, LEADER took a position of enriching the population with this spectrum of patients with cardiovascular disease and risk factors.                                                 So, some were in so-called high risk primary prevention who had not had established ASCVD, but had multiple risk factors such as uncontrolled hypertension or chronic kidney disease. Some had evidence of ASCVD, but had not had a prior myocardial infarction. And some, in fact, had had a prior MI stroke or PAD. So, it was a broad population of patients that was enrolled. And the primary result, again, for the primary outcome of MACE, demonstrated a significant reduction in favor of liraglutide versus placebo. And then for the individual components of that primary outcome, they were all statistically significant, or at least went in the right direction. Importantly, CV death was reduced by 22% with liraglutide versus placebo.                                                 I would like to emphasize that in this day and age, and Dr Steg has nicely set the stage, we have started thinking about how do we think about cardiovascular phenotypes of patients. You know, is a drug more likely to reduce heart failure? More likely to reduce ischemic events? And with LEADER, we found that in fact the trial actually reduced mostly ischemic events, and was really not that beneficial on heart failure related outcomes.                                                 So, that was the broad positive outcome from LEADER. They've led to guideline changes worldwide that patients with diabetes should be prioritized to receive an agent that has shown benefit, particularly if they have cardiovascular disease. And one of those agents was empagliflozin. The other was liraglutide. But, secondary prevention is a pretty crowded space, and not everybody can get everything, and not everybody should get everything, and not everybody can afford everything. So, I think leaders like the two of you here are often thinking about, how do you risk-stratify these populations, and how do we start thinking about people who are at greater risk, people who can actually derive benefit? And I think that's the smart and thoughtful way of doing this. And is there a certain threshold at which point the therapy loses its ability to reduce cardiovascular events, at least in the short term?                                                 So, in that theme, in that vein, what we looked at here was an analysis of people in LEADER who truly had a prior ischemic event. And the work that Dr Steg and others have done in REACH registries, etc. clearly establish that that's a population of patients, type two diabetes and a prior ischemic event. You don't really need many more calculators beyond that. That's the highest risk population. And then, the next level is really type two diabetes with a ASCVD. And we know that from REACH as well, that that's the next level of risk. And then, what about people who have type two diabetes just by itself? Which certainly are much higher risk than people who don't have diabetes, but we didn't have a non-diabetic group to compare to.                                                 And what we find is that the higher the baseline risk defined by this, the greater is the absolute risk reduction. The P value is consistent for ... You know, this is non-significant for heterogeneity. but specifically, people with a prior ischemic event derive benefit. People without a prior ischemic event who've had ASCVD derive significant benefit. But, in fact, we found that the curves were almost superimposable for people who did not have prior ASCVD. And that's not to say the GLP-1 receptor agonists should not be used in diabetes in the absence of cardiovascular disease, because they're great glucose lowering agents. They cause hypoglycemia, they cause weight loss. And potentially, within longer exposure times, cardiovascular benefit may actually emerge. And we've heard data from Dr Gerstein's study called Rewind that is positive, that will be presented next year. Harmony Outcomes was a study that was presented recently that also showed a benefit. So, whether in the primary prevention group we see a benefit in the future remains to be seen. Dr Carolyn Lam:                Oh, that's a great, great summary. But Subodh, you know, it's become a bit of what do we define as a primary and secondary prevention anymore, you know? And the patient that already got type two diabetes. Now, in this paper, it's very nice. As you said, has a history of myocardial infarction and stroke. And maybe I could just clarify to the audience, you couldn't just pick up the primary paper and see that because the way the inclusion exclusion criteria were designed in LEADER, you can't just pick up the sub-groups. So, this specific analysis, so carefully and wonderfully done, was absolutely needed. But then you know, what do you think? What's primary and what's secondary prevention anymore? Dr Gabriel Steg:                Well, I want to commend the authors for doing the careful stratification of diabetic patients they've done in the paper, and particularly for pointing out that it's one thing to have had an event where you actually ruptured a plaque and had a traumatic event. And it's very different from merely having plaque in one of your carotids or your arteries, and which is, of course, in turn very different from the majority of diabetic patients who have neither an event, nor diagnosed plaque or established plaque. And when we think about preventing cardiovascular and diabetes, we have to remember that the outer circle, the broader circle of diabetic patients who haven't had disease is the largest component. Dr Subodh Verma:           True. Dr Gabriel Steg:                And these are the patients whom we treat every day with the hope of eventually keeping them from harm, safe from harm, or with therapies that are new and potentially beneficial. And I think your research very clearly shows that there's a gradient of benefit. The sicker the patient, the greater the benefit in preventing MACE. And as long as you get to more healthier phenotypes of diabetes, then there is less of a benefit. Which doesn't mean that we shouldn't use these agents. As you point out, they're very convenient and effective agents for glucose control. But then, their cardiovascular benefits are more uncertain. And I think this is the key message from this analysis, and it's a great analysis. Dr Subodh Verma:           Thank you. I appreciate that. I totally agree that for the doctor in the trenches, particularly the cardiologist who's just trying to get their feet wet with antihyperglycemic therapy, you know? Cardiologists will embrace PCSK9 inhibitors and rivaroxaban at low dose, and maybe a new way of doing surgery or putting an LVAD. But it's very hard to get their attention when it comes to antihyperglycemic therapy. So, defining for them the population that matters the most, where the greatest risk and risk reduction can be achieved, I think is quite important from a clinical standpoint. And I think most cardiologists will agree that type two diabetes and a prior ischemic event is a high-risk population. Type two diabetes in a prior ASCVD is a high-risk population, and the magnitude of CV death reduction here is something meaningful for them to pay attention to. Dr Carolyn Lam:                Yeah, indeed. That's what I love best about this paper. It's actually asking the question the way a cardiologist would, exactly like you had both put. So, what do you think is the next step now? Do you think we need to look at this primary prevention type two diabetics with no established cardiovascular disease? Do we really need to? Is it that we need a method analysis, which you can talk about? Or, is it that we need longer follow up? Or, what next? Dr Subodh Verma:           I think that first of all, we have to get rid of the terminology, and maybe as a heart surgeon, I can be a little bit provocative and just say it. I wrote an editorial to the Declare Study that was just published yesterday in The Lancet called "Pumps, Pipes, and Filter: Do SGLT2 inhibitors cover it all?" Then I made a strong statement there that this nomenclature of primary and secondary really is artificial because it only captures ischemic risk, and does not capture risk of heart failure or renal disease. So, in a patient, as you've asked, Carolyn, who has type two diabetes, whose renal function is 54 or GFR is 55, who's not had a prior MI ... Is that patient primary prevention? Maybe from an ischemic standpoint, but he's clearly secondary prevention from a renal standpoint. Dr Subodh Verma:           So, I think we need to just think about all disease as a spectrum, and not as an artificial cutoff that, if you've had an ischemic event, suddenly the world changes for you there. Because, that gradient I think is probably what we need to somehow appreciate as to where that risk lies. The patient who's 40 who's had no risk factors, you know? The Rashami paper from the New England Journal that looks at risk factor control and diabetes make a very compelling story that if you control your five risk factors, you actually don't have an excess risk of cardiovascular events in diabetes, at least from MACE. The story is whether anybody can have those five risk factors controlled. But, early on in diabetes, with diabetes duration not being that significant, with risk factors not being that significant, I think maybe that's not the population to go after. But certainly, waiting for ASCVD to develop and then start therapy is also not the right way of doing it, so ... Dr Carolyn Lam:                Interesting. I really wonder what new guidelines are gonna show. Gabriel, any other perspective? Dr Gabriel Steg:                Well, first of all, I love the editorial. I thought the title was fantastic, and you summarize here what we need to think about when we think about diabetes; not solely the pipes. As an interventional cardiologist, I'm very interested in the pipes. Dr Subodh Verma:           Me, too. Dr Gabriel Steg:                Not solely the pump, but also the filter. And there's more than the heart and vessels in the complications of diabetes. So I thought it was a great, great title. My view is that we still need to remember that if we take the lifetime perspective, a healthy youngster with type one diabetes, a relatively healthy patient in his fifties with type two diabetes, their probability of dying from cardiovascular disease is enormous. Even though risk calculators will give them a relatively low probability over the 5 year or 10 year term, eventually that's what's gonna get them. And therefore, we still have progress to make. We are fortunate to have lived an incredible period in the past few years where we've had emergence of new risk preventive therapies in diabetes. That's incredible. It's an epiphany. But, it's not over. We need more information, more trials in other populations. We need to look at renal function and heart failure. So, it's a great time to be doing clinical trials in diabetes. Dr Subodh Verma:           Right. Dr Carolyn Lam:                And indeed, a great time to be publishing in circulation. We've been really doing a lot of publications in the cardiovascular outcome trials in diabetes here. Dr Subodh Verma:           And it's being noticed. There's no doubt about it. Dr Carolyn Lam:                I hope so. And, maybe a time for a new frame of reference, because what you just said was diametrically sort of in contrast. Dr Subodh Verma:           I would emphasize one more point, and that is, you know in atherosclerosis, the dominant mechanism has been LDL, right? And Dr Steg here is changing the landscape of that with Odyssey Outcomes and many other strategies. But again, in Circulation, Dr Bhatt, and I, along with the LEADER investigators, recently presented and published a paper showing that liraglutide's benefit is seen independent of LDL cholesterol, and all the way down to people with LDLs of below .5. So, the point is that this mechanism of benefit of GLP-1 seems to be complimentary to LDL lowering. And therefore, I think it offers great hope that you can actually reduce the ischemic burden in diabetes, not just by ultra-low LDL, but by potentially additional mechanisms as well. Dr Carolyn Lam:                Absolutely. And then now, because I have to have the last word here on this show, let's not forget heart failure outcomes in diabetes. I think it's underestimated. I think it's really important. Okay, and with that, thank you gentlemen for joining me today.                                                 You've been listening to Circulation on the Run. Don't forget to tune in again next week.                                                 This program is copyright American Heart Association, 2018.  

A preexperimental cohort study was conducted with 67 overweight cancer survivors. This cohort of participants was screened for baseline body composition and anthropometrics based on a variety of techniques, including body mass index (BMI), dual X-ray absorptiometry–percentage body fat (DXA-android %BF), diagnostic medical sonography (DMS), and waist circumference (WC). The combination of subcutaneous fat layer at the xyphoid and umbilicus compared with BMI, WC, and DXA-android %BF. These variables demonstrated moderately positive association and were statistically significant. A total maximum mean score of DMS measures of subcutaneous and visceral fat was also compared with BMI, WC, and DXA-android %BF. The aforementioned comparison had a moderately positive association and was statistically significant. The sonographic measure of mesentery fat was compared with WC and demonstrated a strongly positive strength of association and was statistically significant. Sonography may be an inexpensive, noninvasive, portable, and valid body composition measure for overweight patients.

Dr Shona Halson is the Senior Recovery Physiologist at the ‪Australian Institute of Sport and an Associate Editor of the International Journal of Sports Physiology and Performance. Her work involves providing athletes with advice and assistance to minimise fatigue and maximise recovery, she is responsible for conducting applied research to evaluate techniques to reduce fatigue and increase recovery. Shona has worked closely with the Australian Dolphins and their specific preparation for the Rio Olympics. Shona has a wealth of experience in the area of fatigue and recovery and she spent a number of years working as the Recovery Centre Director for the Australian Olympic Committee. Topics Covered in this Episode: Periodization of recovery Cold water immersion and contrast water therapy for recovery Do recovery strategies have the potential to negatively impact adaptive responses to training? Athlete perception and “belief” in recovery modalities The importance of hydrostatic pressure: implications for hydrotherapy practice. Effectively monitoring fatigue in athletes to assess training load and recovery. How your DXA results can effect your recovery strategies AND 80/20 key takeaway strategies you can use to leverage the cold.   Resources and Links: Stephens et al., 2017 – Cold-Water Immersion for Athletic Recovery: One Size Does Not Fit All Stephens et al., 2017 – Influence of body composition on physiological responses to post-exercise hydrotherapy Halson, 2014 – Monitoring training load to understand fatigue in athletes Halson, 2014 – Sleep in elite athletes and nutritional interventions to enhance sleep Versey et al., 2013 – Water immersion recovery for athletes: effect on exercise performance and practical recommendations Crowther et al., 2017 – Team sport athletes’ perceptions and use of recovery strategies: a mixed-methods survey study Argus et al., 2016 – Cold Water Immersion and Contrast Water Therapy Do Not Improve Short-Term Recovery Following Resistance Training Dr Shona Halson's – Twitter

Adam and Vanessa sit down to chat with Jason Belvill of BodySpec about DXA scans and a whole lot more.  Jason combines a passion for athletics with singular expertise in engineering to help design and oversee BodySpec's mobile scanning trucks. Originally from Seattle, WA, Jason graduated from the Air Force Academy in 2008 and was the captain of the All-Armed Forces Soccer Team. Jason is a Certified Strength and Conditioning Specialist, and also holds a Master's in Engineering Management from USC Viterbi School of Engineering. Along with Bryce, Jason co-founded and operated Nu Era Fitness, a fitness equipment retailer. In addition to soccer and CrossFit, Jason enjoys world travel, having visited over 20 countries. Check out BodySpec HERE Learn more about BEE - FEST 2018 Authentic Self Life Mastery Personal Paleo Lifestyle Coaching

Episode 58 has arrived!! The huggable, lovable Dave Thuene makes his triumphant return to The Weight Room. In a weird break in format the show opens with Dave and the guys doing riffs on airline food. Then they get down to business and find out what Dave's been up to since his last visit - he made some major health changes and has been consistently eaten vegan for over year. He tells the 'Bells about all the benefits and challenges of his new lifestyle. Then things get really interesting when the group breaks down Dave's most recent DXA scan. Last everyone answers listener questions about cardio with no knee cartilage and what oils to cook with."Ain't Nothin To It But To Do It, WOOOO!!

In today’s episode, we will cover how to use body composition testing ranging from DXA scans to scales, how accurate they actually are, an interesting case where someone was able to massively manipulate the results of their DXA scan and the lessons we can take from that case.

This episode brought to you by Rock Lobster Cycles, beautiful bicycles handbuilt in Santa Cruz, California. In our last interview, scientist and world champion rower Dr Brianna Stubbs had recently successfully defended her PhD in Biochemical Physiology and reached a juncture in her career. Ten months later, Brianna has retired from professional rowing but continues her passion for biochemistry with San Francisco based nootropics company HMVN where she is working to commercialise the D-BHB ketone monoester developed at Oxford University alongside Prof. Kieran Clarke. The big news is the wait is over! After over a decade of research, the ester is finally here. This interview is two rolled into one. In the first part, we talk about Brianna’s transition out of academia and professional sport and into the world of Silicon Valley startups. In the second part, Brianna talks about the benefits of the ketone ester and takes on some of Dr Tommy Wood’s challenging questions given to me by ahead of the interview but unseen by Brianna. If you’re only interested in hearing about the ketone monoester, skip to the 24-minute mark. Here’s the outline of this interview with Brianna Stubbs, PhD: [00:01:23] Retirement from rowing. [00:02:56] Podcast: Off Road Triathlon World Champion Lesley Paterson on FMT and Solving Mental Conundrums. [00:03:19] App: Strava. [00:04:17] The move to San Francisco. [00:05:00] Professor Kieran Clarke, PhD, CEO of TdeltaS. [00:05:24] HVMN. [00:08:27] World Rowing Championships. [00:09:40] Rodent and then human experiments. [00:10:37] Finding purpose and resolving ambivalence. [00:12:09] Journaling. [00:12:55] Mentoring. [00:14:42] Podcast: How to Create Behaviour Change with Simon Marshall. [00:15:08] YouTube: HVMN Enhancement Podcast: Ep. 46: Correcting Nutritional Deficiencies ft. Christopher Kelly. [00:15:38] Tony Hsieh of Zappos.com. [00:16:38] Body composition. [00:17:39] BHRT (Bioidentical Hormone Replacement Therapy). Podcast: The Critical Role of Oestradiol for Women’s Cognition with Dr. Ann Hathaway, MD. [00:17:57] DXA scan. [00:18:09] Intermittent fasting. [00:19:22] We Fast Facebook Community. [00:20:42] Put on 20lb, mostly muscle. [00:24:51] Podcast: World Champion Rower and Ketone Monoester Researcher Brianna Stubbs. [00:25:19] Dr. Richard Veech, Hans Krebs. [00:26:52] Ketone metabolism. [00:28:04] Study: Cox, Pete J., et al. "Nutritional ketosis alters fuel preference and thereby endurance performance in athletes." Cell metabolism 24.2 (2016): 256-268. [00:28:47] Case Report: Newport, Mary T., et al. "A new way to produce hyperketonemia: use of ketone ester in a case of Alzheimer's disease." Alzheimer's & Dementia 11.1 (2015): 99-103. [00:29:20] FDA GRAS (generally recognized as safe). [00:29:32] WADA. [00:30:38] Who is the ester for? [00:31:54] Article and Studies: Reference 1, 2 and 3. [00:33:30] Glycogen sparing or impairing? [00:35:57] WINGATE test. [00:36:08] If you've got ketones, you don't break down as much protein? BCAA. [00:36:32] Study: Vandoorne, Tijs, et al. "Intake of a Ketone Ester Drink during Recovery from Exercise Promotes mTORC1 Signaling but Not Glycogen Resynthesis in Human Muscle." Frontiers in physiology 8 (2017). [00:37:27] Pro cycling. [00:39:00] Study: Youm, Yun-Hee, et al. "The ketone metabolite [beta]-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease." Nature medicine 21.3 (2015): 263-269. [00:40:05] Why is glucose required for an increase in exercise performance? [00:41:12] Anaplaerosis. See Tommy’s letter published recently in the journal Strength and Conditioning. [00:42:19] Should we stop using the salts? [00:42:41] Appetite suppressing effects of ketones. [00:43:02] D and L isomers. [00:44:11] Dominic D'Agostino, PhD. [00:45:14] Are diet and lifestyle still the most important factors? [00:46:36] Caffeine, nitrates, beta-alanine. [00:47:31] Ketone ester 30 min rowing performance. [00:49:21] Podcast: SNR #195: Brendan Egan, PhD – Exogenous Ketone Supplementation. [00:52:25] Study: Volek, Jeff S., et al. "Metabolic characteristics of keto-adapted ultra-endurance runners." Metabolism 65.3 (2016): 100-110. [00:52:41] Intramuscular triglycerides. [00:53:07] Ketones as signaling molecule. [00:53:46] YouTube: HDAC inhibitors and Podcast: A Ketogenic Diet Extends Longevity and Healthspan in Adult Mice with Megan Hall. [00:54:27] Nicotinic acid receptor. [00:55:11] Book: Behave: The Biology of Humans at Our Best and Worst by Robert M. Sapolsky. [00:56:16] General anesthesia. [00:57:11] Two papers, Kieran hyperglycemia and Veech (ask Tommy) [00:59:02] Exogenous ketones lower blood glucose. [00:59:46] Biden pancreatic islet study [01:00:26] Insulin is anti-proteolytic. [01:00:37] George Cahill paper [01:03:03] Who's it for? [01:03:12] Price. [01:04:06] Intestinal Alk Phos. See Why You Should Skip Oxaloacetate Supplementation, Fueling for Your Activity and More with Dr. Tommy Wood. [01:06:12] Product page at HVMN.

Solving a problem requires understanding what caused it, and rarely is it good enough to move straight to remediation. The same applies to weight (fat) loss, and in this podcast, Dr Tommy Wood, MD, PhD and me discuss the underlying causes of over fatness and draw on three specific examples that represent common patterns we’ve seen in the 1,000 athletes we’ve worked with over the past three or four years. Here’s the outline of this interview with Dr Tommy Wood: [00:00:13] Podcast: Mind Pump Simulcast. [00:01:44] Problem solving. [00:03:22] Sustainability. [00:03:38] First Example: Elite female runner. [00:04:23] Relative energy deficit. [00:08:42] Description of NEAT or Non-Exercise Activity Thermogenesis. [00:09:03] Study: Pontzer, Herman, et al. "Constrained total energy expenditure and metabolic adaptation to physical activity in adult humans." Current Biology 26.3 (2016): 410-417. [00:11:33] Greasing the groove. [00:12:44] Counting and cycling calories. [00:14:27] 10% deficit. [00:15:42] Pharmacological interventions. [00:16:34] Second Example: Christopher Kelly. [00:16:48] Gravel grinder events. [00:17:07] Belgian Waffle Ride. [00:18:05] Reintroducing carbs. [00:19:45] Thyroid on keto. [00:20:26] Kiteboarding. [00:20:55] eBook: What We Eat (scroll to bottom of page). [00:22:24] Self regulating. [00:23:42] Visceral and subcutaneous fat. [00:25:25] Visceral fat has a higher fat turnover. [00:26:34] Killing fat cells with cold thermogenesis. [00:26:59] Lipodystrophy. [00:27:34] Gut health. [00:27:57] Blastocystis, Cyclospora. [00:30:47] Gut health and inflammation. [00:30:59] Podcast: Arrhythmias in Endurance Athletes with Peter Backx, PhD. [00:31:50] HsCRP. [00:32:14] Podcast: The Hungry Brain with Stephan Guyenet, PhD. [00:33:56] Study: Jönsson, Tommy, et al. "Digested wheat gluten inhibits binding between leptin and its receptor." BMC biochemistry 16.1 (2015): 3. [00:34:47] Paleo On The Go. [00:35:43] Visceral fat firewalls off the gut. [00:36:10] LPS (endotoxin) translocation across the gut wall. [00:40:22] Getting a dog. [00:41:28] MitoCalc developed by Alessandro Ferretti and Weikko Jaross as discussed in this NBT blog post by Dr. Tommy Wood. [00:43:21] Time restricted eating. [00:44:24] Walking. [00:45:13] Podcast: The Importance of Strength Training for Endurance Athletes with Mike T. Nelson. [00:46:27] Third example: 35 lb to lose. [00:47:44] The under eating thyroid pattern. [00:48:16] Understanding Local Control of Thyroid Hormones:(Deiodinases Function and Activity). [00:50:35] Resistance training. [00:51:13] Muscle is more metabolically active. [00:52:07] Podcast: Breaking Through Plateaus and Sustainable Fat-Loss with Jason Seib. [00:53:02] DXA or DEXA Scan. [00:53:14] Waist-hip ratio. [00:54:08] I'll happy when... [00:54:41] Icelandic Health Symposium 2017 featuring Dr. Satchidananda Panda, Dr. Tommy Wood and others. [00:55:58] Study: Longo, Valter D., and Satchidananda Panda. "Fasting, circadian rhythms, and time-restricted feeding in healthy lifespan." Cell metabolism 23.6 (2016): 1048-1059. [00:56:16] There are over 600 genes regulated by circadian rhythm, reference 1, 2, 3 and 4. [00:56:56] Continuous feeding. [00:57:58] Eat when it's light outside. [00:58:47] Yearly cycles. [00:59:55] Frontloading calories. [01:00:40] The Nourish Balance Thrive 7-Minute Analysis.

In Folge #115 Das Video der aktuellen Folge direkt auf Youtube öffnen Bitte beachten Sie auch immer den aktuellen "Haftungsausschluss (Disclaimer) und allgemeiner Hinweis zu medizinischen Themen" auf https://paleolowcarb.de/haftungsausschluss/ #geNUSS[explosion] von [næhr:sinn] - das low carb knusper nuss müsli [næhr:sinn] geNUSS[explosion] ist ein hochwertiges low-carb* Müsli und besteht zu 100% aus natürlichen Zutaten. Es ist gut als Frühstück und Snack und hat nur 13,7g verwertbaren Kohlenhydraten auf 100g. Es ist getreidefrei und sojafrei. Perfekt für den Start in den Tag. Wir verarbeiten nur hochwertigste, nährstoffreiche Zutaten, die dich länger satt machen und nachhaltig mit Energie versorgen. Wir nutzen ballaststoffreiche Kokosnuss, Erdmandel und heimische Nüsse. Mehr darüber erfährst du auf lowcarbmüsli.at oder auf Amazon.de Und nicht vergessen: Wenn du uns auf Youtube siehst, und wenn du es noch nicht getan hast, dann abonniere unseren Kanal „Evolution Radio Show“ Wenn du das Podcast hörst, dann findest du die Links für Apple iTunes und Android hier auf unserer Homepage Diese Episode wird gesponsert/unterstützt von BRAINEFFECT Suchst du nach einem Weg schneller in Ketose zu kommen? Dann ist ROCKET C8 von BRAINEFFECT genau das Richtige für Dich. Wie der Name schon sagt besteht das ROCKET C8 aus 100% C8 Fettsäuren (also Caprylsäure), welche die optimalste der mittelkettigen Fettsäuren ist. Es ist geschmacksneutral, und daher kann man es wirklich überall einsetzen.Egal ob im Cafe, auf dem Salat oder in Smoothies etc. Der Vorteil daran ist, dass auch Ketonkörper gebildet werden können, wenn du Kohlenhydrate zu dir genommen hast. Mit dem Gutscheincode Evolutionradioshow bekommt ihr 20% auf alle Produkte im BRAINEFFECT Shop unter http://www.brain-effect.com/ Transkript der Folge Der Wunsch nach der Süße ohne Reue ist groß. Im Laufe der letzten Jahrzehnte haben wir einige Substanzen entdeckt, oder im Labor erzeugt, die Süß schmecken, ohne jedoch Kalorien zu liefern. Manche dieser Substanzen haben sich als Gesundheitsschädlich erwiesen, manche scheinen unbedenklich zu sein. Als “neue” Süßstoffe am Markt haben sich in den letzten Jahren, die sogenannten Zuckeralkohole etabliert. Die Ergebnisse einer aktuelleren Studie regen zur Sorge an - könnte Erythrit etwas mit Übergewicht zu tun haben? Bevor wir auf den eigentlichen Artikel eingehen, möchte ich ein paar Worte zu Zucker und Süßstoffen generell loswerden. Generell ist erstrebenswert sich Süßigkeiten und Naschen abzugewöhnen. Egal ob Zucker oder Süßungsmittel, der Griff zum Goodie sollte die Ausnahme bilden. Nun zur aktuellen Studie: [Hootman, Katie C., et al. "Erythritol is a pentose-phosphate pathway metabolite and associated with adiposity gain in young adults." Proceedings of the National Academy of Sciences (2017): 201620079.](http://www.pnas.org/content/114/21/E4233.abstract) Die Arbeit von Katie Hootman und Kollegen hat zu einem großen Aufschrei in der LCHF Gemeinde geführt. Erythrit soll zu Übergewicht führen, oder Übergewicht begünstigen? Kann denn das sein? Die Erythrit-Gegner haben auch nicht lange auf sich warten lassen und in der Studie eine Bestätigung der Grundsätzlichen Skepsis dem Zuckeralkohol mit dem suspekt wirkenden Namen gesehen. Erythrit, kann ja nicht gut sein, ist ja nicht „natürlich“ – oder doch? Aber dazu später. Erst einmal zur eigentlichen Studie. Was wurde gemacht und was waren die Ergebnisse?   Methode Untersucht wurden Collage Studenten (n=172) im Alter zwischen 18-19 Jahren. Die Auswahl der Teilnehmer war Randomisiert und auf gleichmäßige Verteilung der Geschlechter wurde geachtet. Erfasst wurden anthropometrische Daten, Blutplasma (nicht nüchtern) sowie die Körperzusammensetzung via DXA (dual -energy x-ray absorptiometry). Untersucht wurden verschiedene Metabolite (Stoffwechselprodukte) hinsichtlich ihrer möglichen Rolle als Prädiktor für die Entwicklung von Übergewicht. Die Studenten wurden dann hinsichtlich ihrer Fettmasse und dem Hba1c eingeteilt. Daraus ergaben sich 4 Phänotyp Gruppen: Fettmasse Zunahme in der Bauchregion (incident central adiposity gain) Stabiles Fettmasse (stable adiposity) Hba1c in den Top 25% Hba1c in den untersten 10% Ergebnisse der Studie Nach einem Jahr haben 75% der Studenten an Körpergewicht zugelegt. (>0.5kg). Bei 66 Teilnehmern konnten die Forscher eine Fettzunahme in der Bauchregion feststellen. Metabolite als Prädiktor für Fettzunahme in der Bauchregion Die Forscher haben sich verschiedene Metabolite angesehen. Neben Erythritol, auch Fructose, Lactat, Valin und Leucin. Es gab Unterscheide in allen genannten Metaboliten zwischen den Gruppen, allerdings erreicht nur Erythritol das Signifikanzlevel. Interessant ist, dass die höchsten Eryhtritol Konzentrationen in der Gruppe zu finden waren, mit der geringsten Zunahme an Bauchfett. Während die niedrigsten Erythritol Werte in der Gruppe mit den Größten Veränderungen der Bauchfettmasse zu beobachten waren. Eigensynthese von Erythritol Nimmt man Erythrit über die Nahrung auf, dann werden 90 – 95% über den Harn ausgeschieden. 5 – 10% werden zu Eryhtronat oxidiert. Der menschliche Körper ist allerdings auch in der Lage Erythritol selber aus Glucose zu synthetisieren. Diskussion Die Autoren der Studie fanden signifikante Unterschiede zwischen den Gruppen was Fructose und Erythritol Konzentrationen betrifft. Sie sehen eine positive Assoziation zwischen Erythritol im Plasma und dem Auftreten von Fettmassezuwachs in der Bauchregion. Weitere Untersuchungen werden benötigt um diese Ergebnisse verstehen zu können.   Assoziation ist kein ursächlicher Zusammenhang Soweit die Kurzfassung der Studie. Bevor wir die Ergebnisse weiter besprechen und in wie weit sie für uns relevant sind, ein paar Worte zu statistischen Zusammenhängen. Die Forscher sehen eine positive Assoziation. Das bedeutet, dass Wert A und Wert B gemeinsam auftreten, einen ursächlichen Zusammenhang kann man aus dieser Studie noch nicht ableiten. Wir können also nicht sagen: A verursacht B. Endogene Produktion vs. Exogene Exposition Was die Autoren der Studie auch bemerken ist, dass wir noch nicht wissen, was das mit der exogenen Aufnahme von Erythrit zu tun hat, und ob überhaupt. Das Erythrit, das die Autoren in den Blutproben gefunden haben, stammt ja aus endogener Synthese, und zwar aus Glucose. Jetzt kommen wir zu einem interessanten Punkt. Die Autoren schreiben, dass in bisherigen Studien nicht gezeigt werden konnte, dass Menschen Erythritol endogen synthetisieren können. Sie zitieren dazu eine Studie aus dem Jahr 1993 von Hiel et. al.[1] Dies scheint jedoch nicht mehr ganz aktuell zu sein. Bei weiterer Recherche stellt sich heraus, dass Erythrit von Föten diverser Wiederkäuer selbst produziert wird[2], und nicht nur von Wiederkäuern, sondern auch vom Menschen.   Erythrit und andere Polyole im menschlichen Fötus und der Plazenta 2005 im Journal „Pediatric Research“, welches zu Nature Publishing gehört, veröffentlichte Brusati et al. eine Arbeit mit dem Titel: „Fetal and Maternal Non-glucose Carbohydrates and Polyols Concentrations in Normal Human Pregnancies at Term“[3]. Andere Zucker und Zuckeralkohole wie Inositol, Sorbitol und Erythrit, sind wichtige Energielieferanten für das Ungeborene. Diese Zuckeralkohole finden sich in signifikanten Mengen in der Nabelschnur und, in geringeren Mengen, auch im Blut der Mutter. Besonders interessant ist, dass es zwischen Mutter und Fötus einen relativ großen Konzentrationsgradienten gibt. Dies unterstützt die Annahme, dass der Fötus selbst Polyole (Inositol, Sorbito und Erythritol) synthetisiert. […] Finally, that polyol concentrations are elevated sufficiently in fetal blood to lead to the establishment of relatively large fetal–maternal concentration gradients for polyols such as inositol, sorbitol, and erythritol suggests that the trophoblast may be relatively impermeable to these compounds. The presence of large fetal–maternal concentration ratios for the polyols also suggests that the reduction of sugars to their corresponding alcohols is favored. The role of the polyols in developing tissues is currently unknown. […]   Erythrit in Samen und Reproduktionsorganen Die biologische Bedeutung von Polyolen hat zugenommen, da man größere Mengen in Samen und Reproduktionsorganen findet [4] [5].  Erythritol Produktion beim Rind, steigt mit Fortschreiten der Trächtigkeit an und erreicht einen Peak in der Mitte der Trächtigkeit[6]. Die Bedeutung und der Fokus der Forscher auf Erythritol, gerade in der Veterinärmedizin, hat einen etwas mit einem Bakterium namens Brucella zu tun. Brucellen sind kurze, stabförmige Bakterien. Sie kommen in Geschlechtsorganen und Harntrackt von Rindern, Schafen und Schweinen vor. Sie führen, unter anderem, zu Placentitis, Frühgeburten[7] und Vergrößerung der Geschlechtsorgane. Brucellen haben eine besondere Vorliebe für Erythritol entwickelt. Mit steigender Erythritolkonzentration, steigt auch die Anfälligkeit für eine Brucelleninfektion. Das heißt jetzt nicht, dass Erythritaufnahme über die Nahrung zu einer Brucelleninfektion führt. Die metabolische Besonderheit der Geschlechtsorgane, liefern Nährstoffe, die dem Stoffwechsel von Brucella sehr entgegenkommen. So etwas nennt man auch Parasite-Host Co-Evolution. Erythritol im Serum als Indikator für Übergewicht Welche Rolle könnte Erythritol im Serum nun als Marker für Übergewicht spielen? Das ist ja die zentrale Frage. Wir wissen nun, dass die endogene Synthese von Erythritol nicht wirklich etwas Ungewöhnliches ist und sehr wohl im Menschen bereits beschrieben wurde. Erythritol ist besonders hoch konzentriert in Samen, Geschlechtsorganen, Plazenta, Nabelschnurblut und im Fötus selbst. Erythritol, und andere Polyole dürften eine Rolle in sich entwickelnden Geweben spielen. Mannose ist zum Beispiel notwendig für die Synthese von Glycoproteinen und Glycophospholipiden[8]. Die signifikant höheren Plasmalevel von Erythritol in der Gruppe, die eine deutliche Zunahme an Bauchfettmasse hatten, gegenüber der Gruppe mit stabiler Adipositas, sind interessant und könnten ein Hinweis auf Fehlregulation im PPP (Penthosephosphat Pathway) sein. Bei Übergewicht und Fettleibigkeit sehen wir oft, dass Signalwege überexpremiert werden, welche Zellwachstum, Proliferation und generell anabole Prozesse regulieren. Ähnliches könnte auch hier der Fall sein. Endogene Erythritsynthese könnte auch ein Marker für gestörte Energiegewinnung sein. Wird aus Glucose-6-Phospaht nicht Pyruvat, sondern vermehrt Erythritol synthetisiert, könnte das auch ein Hinweis auf eine gestörte Glycolyse sein. Eine andere Hypothese, die ich nicht allzu weit hergeholt finde, wäre die der Dysbiose. Wir wissen, dass Bakterien in unserem Darm eine wichtige Rolle bei der Entstehung von Übergewicht spielen. Erythritolsynthese wurde zuerst bei Bakterien beschrieben. Es wäre durchaus denkbar, dass das Erythritol im Plasma seinen eigentlichen Ursprung in bakterieller Synthese im Darmlumen hat, von dort, über eine gestörte Barrierefunktion der Darmwand, in das Blut übertritt und aus diesem Grund dort auch nachweisbar ist. Ähnliches sehen wir bei Lipopolysacchariden (LPS). LPS sind Bestandteile der Zellmembran von Gram-negativen Bakterien. Sie provozieren eine starke Immunantwort und können im Plasma nachgewiesen werden. Fazit Abschließend bleibt zu sagen, dass wir eigentlich noch nicht wirklich viel wissen. Von der Beobachtung höherer Erythritolwerte im Plasma bei Übergewichtigen, zu der Vermutung, Erythrit fördert Übergewicht – das ist schon ein sehr großer Schritt und höchst spekulativ. Ich denke aber, es ist eine spannende Beobachtung, die definitiv weiterer Forschung bedarf. Vor allem im Hinblick auf meine Alternativhypothesen was die Aktivierung von Wachstumsfaktoren, die Fehlregulation der Energiegewinnung oder sogar die bakterielle Komponente betrifft. Referenzen [1] Hiele, Martin, et al. "Metabolism of erythritol in humans: comparison with glucose and lactitol." British Journal of Nutrition 69.01 (1993): 169-176. [2] Peter D. Constable Kenneth W Hinchcliff Stanley H. Done Walter Gruenberg. Veterinary Medicine - A textbook of the diseases of cattle, horses, sheep, pigs and goats, Edition 11. October 25, 2016 Elsevier Health Sciences [3] Brusati, Valentina, et al. "Fetal and maternal non-glucose carbohydrates and polyols concentrations in normal human pregnancies at term." Pediatric research 58.4 (2005): 700-704. [4] Clark, J. B. K., et al. "D-Mannitol, erythritol and glycerol in bovine semen." Journal of reproduction and fertility 13.2 (1967): 189-197. [5] Lewin LM, Yannai Y, Melmed S, Weiss M 1982 myo-Inositol in the reproductive tract of the female rat. Int J Biochem 14:147–150 [6] Samartino, L. E., Traux, R. E., and Enright, F. M. (1994). Invasion and replication of Brucella abortus in three different trophoblastic cell lines. Zentralblatt Veterinarmedizin Reihe B. 41, 229–236. doi: 10.1111/j.1439-0450.1994.tb00223.x [7] Letesson, Jean-Jacques, et al. "Brucella Genital Tropism: What's on the Menu." Frontiers in Microbiology 8 (2017). [8] Brusati, Valentina, et al. "Fetal and maternal non-glucose carbohydrates and polyols concentrations in normal human pregnancies at term." Pediatric research 58.4 (2005): 700-704. Artikel Macht Erythrit dick? Webseiten Paleo Low Carb - JULIAS BLOG | (auf Facebook folgen) Superhumanoid - PAWELS BLOG Super | (auf Facebook folgen)

Veteran health podcaster, blogger, international speaker, and bestselling author Jimmy Moore from “Livin’ La Vida Low-Carb” teams up with Toronto, Ontario Canada-based nephrologist Dr. Jason Fung from IntensiveDietaryManagement.com and Dr. Fung’s Clinical Director at his Intensive Dietary Management Program clinic Megan Ramos on this podcast dedicated to answering YOUR questions about intermittent, alternate day, and extended fasting. Jimmy and Dr. Fung are the coauthors of the 2016 international bestseller The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting and, along with Megan, are happy to provide this podcast as an additional resource for anyone curious about going on a fast to improve their health. We love hearing from our listeners with new questions–send an email to Jimmy at livinlowcarbman@charter.net. And if you’re not already subscribed to the podcast on iTunes, then you can do that and leave a review HERE. Listen in today as Jimmy and Jason answer your questions about all things fasting in Episode 5. JIMMY AND DR. ADAM NALLY’S KETO LIVING SUPPLEMENTS Jimmy and Jason respond to Dr. Phinney's concerns about fasting in Episode 5: - Labels fasting as a “fad” saying it will produce major pushback from the health authorities when people start dying suddenly - Getting adequate fluid, potassium, and sodium with an intermittent fast up to 24 hours is benign - After 24 hours of no calorie intake, the body starts breaking down protein from lean tissue - By Day 3 of fasting, the rate of lean tissue loss is equivalent to 3/4 pound per day - The data on extended fasting in THE COMPLETE GUIDE TO FASTING is misstated - If someone fasts for three days a week, the amount of lean tissue lost is greater than the amount of lean tissue they can regain in the other four days - Doesn’t believe that my 10-pound lean tissue loss (according to DXA) during my 28 of 31 day fast in January 2016 was water, claims it would take 40 days of eating again to recover this loss (actually a follow-up DXA two weeks later showed all of that 10-pound “lean tissue” loss was back on my body again—so he’s mistaken) - When someone fasts for a prolonged period of time, you’re vulnerable to “refeeding syndrome” (WWII prison camp prisoners suddenly died when they were fed copious amounts of food following extended fasting) - There’s an acute shift in minerals out of the bloodstream into the cells causing an impairment of heart function - The Liquid Protein Diet is used as an example of sudden death from refeeding syndrome that was reported as happening because of ketones…it shut down the science on ketosis for two decades - For some people, a 36-hour fast is fine as long as the other 5 1/2 days of eating have adequate minerals (apparent contradiction of his earlier statement) - We need research that shows long-term, positive, sustainability for people who are fasting to reverse diabetes and reduce body fat that goes 1-2 years - With two-week fasting or longer, the rate of protein breakdown comes down markedly. First day of fasting produces very little protein breakdown, the rate of protein breakdown peaks on the third day of fasting, by two weeks the lean tissue loss is about one-third pound lean tissue loss daily and at 28 days it’s a quarter-pound a day of lean tissue loss (another contradiction of earlier statements) - If you only look at urea, then the lean tissue loss seems to be much less but ammonia, creatinine, and other byproducts all make up the lean tissue loss as well so urea doesn’t give the entire picture. - It’s unethical to write a book telling people to start fasting on their own (and yet we mention to consult with a physician often throughout our book) - I’m not saying fasting is wrong, but we don’t know what the truth is - Getting adequate potassium and magnesium is critically important and you’re not getting these when you are fasting iTunes review:   FREE N=1 TRACKING TOOL AT HEADS UP HEALTH BECOME A NUTRITIONAL THERAPY PRACTITIONER Sign up by February 6, 2017 for the 9-month program NOTICE OF DISCLOSURE: Paid sponsorship LINKS MENTIONED IN EPISODE 5 – SUPPORT OUR SPONSOR: Become a Nutritional Therapy Practitioner through the Nutritional Therapy Association at NutritionalTherapy.com – JIMMY AND DR. ADAM NALLY’S NEW SUPPLEMENT LINE: Try the KetoEssentials Multivitamin and Berberine Plus ketogenic-enhancing supplements – Start tracking your health markers for FREE at HeadsUpHealth.com – Jimmy Moore from “Livin’ La Vida Low-Carb” – Dr. Jason Fung from Intensive Dietary Management – Megan Ramos from Intensive Dietary Management – The Complete Guide to Fasting: Heal Your Body Through Intermittent, Alternate-Day, and Extended Fasting – Get the full audiobook read by Jimmy on Audible – Fung Shweigh Facebook page

This week we will conclude our discussions on making measures for your weight loss and discuss the most accurate ways to measure your body composition. Before we go into the details of the tools and systems that make these measures let talk a bit more about fat.

Topics: Money, Media & Social Justice, Digital Technology, Value Extraction, Human Values, Economic Model, Standing Rock, Terra Firma, Currency, The FED, Conspiracy, Empire, Bazaar, Peer To Peer, Innovation, Central Capital, Pivot, Investors, Hypernormal...

Episode 77 of the Guru Performance 'We Do Science' Podcast! In this episode I (Laurent Bannock) discuss 'Body Composition & Assessment' with Shawn Arent PhD, Rutgers University, USA. In this session we get into: Defining 'Body Composition' Chemical and Anatomical Body Composition Models Reference / Criterian Methods of Assessing Body Composition Laboratory Methods for Assessing Body Composition (i.e. DXA, Densitometry, Hydrometry etc) Field Methods of Assessing Body Composition (i.e. Anthropometry / Skin folds, BIA etc) Limitations & Contexts for Body Composition Testing (Health, Performance, Aesthetic etc) Checkout our other podcasts, video blogs and articles on all things performance nutrition at www.GuruPerformance.com

Welcome, Medicare Nation! My guest today is Dr. Andrea Singer, who is a professor of  Obstetrics and Gynecology at Georgetown University Medical Center. Dr. Singer is the Director of Women’s Primary Care and the Director of the Bone Densitometry program. She is a trustee and clinical director for the National Osteoporosis Foundation and a national lecturer on the subject. Dr. Singer has published extensively on many women’s issues and is active in the education of medical students and residents at Georgetown University Medical Center. Dr. Singer is here to teach us about osteoporosis and how it affects our lives and health. Can you define osteoporosis for Medicare Nation listeners? “Yes—I value this opportunity and hope it can be a call to action for your listeners. Osteoporosis is a disease of the bones in which too much bone is lost or the body simply makes too little bone. The bones become weak and can break from minor falls or simple actions, even like bumping into furniture or sneezing!” How prevalent is osteoporosis in the US? “It’s a very common disease and I’ll give you some statistics: 50% of people age 50 or older (54 million of the 99 million) have either osteoporosis or low bone mass. The number jumps to 65% of people age 65 or older who are at risk for broken bones.” Do these numbers apply to both genders, or just to women? “They apply to both genders, even though it’s commonly thought of as a woman’s disease. Interestingly, men have a harder time recovering after a broken bone incident. Of the population age 50 or older, 1 in 2 women and 1 in 4 men will break a bone due to osteoporosis in their remaining years.” What are the risk factors for osteoporosis? “Risk factors can be broken into two categories: non-modifiable and modifiable factors. Non-modifiable risk factors are those that you can’t control, like age, gender, family history, low body weight/frame, and previous bone fractures. Modifiable risk factors include lack of calcium/vitamin D, inactive lifestyle, smoking, and too much alcohol. Regarding previous fractures, those of the spine, hip, wrist, shoulder, and pelvis are classic osteoporosis fractures. Also, certain medications for other disorders can increase bone loss. If you have these risk factors, you should speak to your health care provider and ask about being evaluated for osteoporosis.” How is osteoporosis diagnosed? “Doctors will look at risk factors and do physical exams and lab tests, but the only real way to find osteoporosis is to do a bone density test. The lower the bone density, the greater the risk will be. The DXA scan is the bone density test, and is covered under the Welcome to Medicare package for women. Men are not covered for this test unless they fall into one of the following categories: on long-term steroid therapy, diagnosed with hyperparathyroidism, already on osteoporosis therapy, or has a vertebral abnormality or deformity found on an x-ray. The National Osteoporosis Foundation recommends that men be screened at age 70, but the bone density test isn’t covered unless one of the four criteria is met.” Why are there not many people being screened for osteoporosis? “Osteoporosis is under diagnosed, under recognized, and under treated. It’s thought of as ‘my grandmother’s disease,’ and many people don’t recognize the risk factors. In addition, there are fewer health providers doing DXA scans. For many, they lack the realization that broken bones over age 50 is a strong indicator of osteoporosis. We need to raise awareness so that people who are candidates for osteoporosis will get tested. I hope that this discussion empowers people to take charge of their bone health, be proactive and advocate for yourself to your doctor.” How is the medical community treating osteoporosis? “People need to get adequate calcium and vitamin D, either through diet or supplements. Weight-bearing, muscle-strengthening exercise can help stimulate the bones to remodel themselves and reduces the risk for falls. Fall prevention is a big part of treatment, and there are medications that can slow the bone breakdown or build new bone.” What are the options for osteoporosis medications? “Prescription pills can be taken daily, weekly, or monthly. These are covered under Medicare Part D. Injections can be given daily, once yearly, or 4x/year; these are covered under Medicare Part B or Part A, depending on where they are administered. The important point is that there is a medication to fit everyone who is at risk.” Where can Medicare Nation listeners go for more information and resources? Visit the website of the National Osteoporosis Foundation: www.nof.org. You can also find the Foundation on Twitter: @osteoporosisnof or on Facebook. There is also a new app available on iTunes or Google Play: Food4Bones. Check out these valuable resources for more information!   Do you have questions or feedback? I’d love to hear it!   email me: support@themedicarenation.com Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here)       Find out more information about Medicare on Diane Daniel’s website!  www.CallSamm.com  

BANG! @southernvangard #radio Ep 057! Friends - STOP EVERYTHING. It’s Tuesday, and we have a doozy for you this week. Outside of bringing you all of the latest and greatest hip-hop joints this week - AGALLAH FARO sits down with us for an interview session and it is NOTHING but that REAL. On top of that, we have EXCLUSIVE joints from Agallah’s new LP that drops Feb 18th AND exclusive beats from COUNT BASS D’s release dropping this week! Feel that heat we’re giving y’all this winter?! There’s literally nothing else to say - hit play, and gear up for this week’s interview that drops on Thursday. Check snippets at the end of this weeks mix, and as always, it’s #smithsonian #grade // #download #stream #listen #enjoy // southernvangard.com // @southernvangard on #itunes #podcast #stitcherradio #soundcloud #mixcloud // #hiphop #rap #underground #DJ #mix #interview #podcasts #ATL #WORLDWIDE Recorded live February 7, 2016 @ Dirty Blanket Studios, Marietta, GA southernvangard.com @southernvangard on #itunes #podcast #stitcherradio #soundcloud #mixcloud twitter/IG: @jondoeatl @southernvangard @cappuccinomeeks *Inst beds by Count Bass D "Monumental" - Agallah Faro feat. Hus Kingpin & Rozewood "EmOsHuNaL GrEeD" - Bumpy Knuckles feat Sy Ari (prod. DJ Premier) "Wonderful" - Bunty Beats & Chox Mak "Birthday Boys" - Birthday Boys (Illmaculate & Marv Won) "Blow Yr Head" - Asher Roth X Nottz X Travis Barker "Gotta Be Classic" - D.I.T.C. Studios feat. A.G. & O.C. (prod. Showbiz) "Return of The Black Man" - Vice Souletric feat. Talib Kweli, G. Huff & Will Blaze "Run Em Back" - Nocando (prod. Eraserfase w/William Thedford IV) "Fundamentals" (Real Live Remix) - K-Def feat. Blu & Quartermaine "Reason Why" - Praverb The Wyse feat. DXA "’50 Inch Zenith" - Westside Gunn feat. Skyzoo (prod. Statik Selektah) "Ag Season" - Agallah Faro "Do What I Want 2" - D.I.T.C. Studios feat David Bars "Let It Be" - Consequence feat. Stalley + Alex Isley "The Curve" - Statik Selektah feat. Westside Gunn, Conway, Your Old Droog, & Termanology "Mansa Musa" - Planet Asia (prod. Dirty Diggs) "My Blessing" - Count Bass D Interview Snippets - Agallah Faro

Roman Shypailo and his colleagues at Baylor College of Medicine have built a 7kg baby out of PVC, nylon and polyethylene. Their plastic baby - or 'phantom' - is a calibration tool. Roman hopes that it will be used to standardize infant scans in DXA machines, which are used to measure bone density. See acast.com/privacy for privacy and opt-out information.

Marci Anne Goolsby, MD, Assistant Attending Physician in the HSS Women's Sports Medicine Center, presents on bone health and stress fractures in runners. Learn the most up-to-date information on avoiding painful fractures and make sure you are taking good care of your bones.

Das Ziel dieser Dissertation war es zu untersuchen, ob es möglich ist, die Körperzusammensetzung von Zuchttieren bei 100 kg Körpergewicht zu einem früheren Termin bzw. bei einem niedrigeren Körpergewicht genau vorherzusagen. Dazu wurden die Tiere bei 80 kg und bei 100 kg mittels Magnetresonanztomographie (MRT) und Dualenergie-Röntgenabsorptiometrie (DXA) analysiert. Insgesamt gingen 117 Zuchttiere, darunter 22 intakte Eber und 95 Sauen in die Untersuchung ein. Jedes Tier wurde zweimal mittels MRT und DXA untersucht. Am ersten Untersuchungstermin wogen die Tiere durchschnittlich 84,5 kg, bei der zweiten Untersuchung im Durchschnitt 102 kg. In dieser Arbeit wurden verschiedene reinrassige Linien und deren Kreuzungen verwendet. Die Rassenverteilung war dabei wie folgt: Deutsche Landrasse (n = 19), Deutsches Edelschwein (n = 7), Large Black (n = 18), Schwäbisch Hällisches Landschwein (n = 3), Piétrain (n = 4), Duroc (n = 3) und ihre verschiedenen Kreuzungen (n = 63). Für die Untersuchungen wurden die Tiere mittels Azaperon (2mg/kg) und Ketamin (40mg/kg) sediert. Anschließend wurden die Tiere mittels MRT untersucht. Verwendet wurde ein Siemens Magnetom Open, mit einer Feldstärke von 0,2 Tesla. Die Lenden- sowie die Oberschenkel- und Glutealregion wurden bei jedem Schwein als Untersuchungsregionen herangezogen. Hierzu wurde eine T1-gewichtete Spinechosequenz verwendet. Die Schichtdicke betrug 15 mm und der Distanzfaktor 3,75 mm (=0,25). Für die Lendenregion wurde eine axiale Schnittrichtung verwendet, für die Oberschenkel- und Glutealregion eine coronare. Ausgewertet wurden die MR-Bilder mit Hilfe der Able 3D-Doctor 3.0 Software (Lexington, MA, USA). In der Lendenregion wurden fünf Schnittbilder in caudale Richtung, beginnend an der letzten Rippe, auf das Volumen des Musculus longissimus dorsi und dessen Speckauflage ausgewertet. Für die Oberschenkel- und Glutealregion wurde ein halbautomatisches Auswertungsverfahren gewählt, mit dem vier Schnittbilder in ventrale Richtung ausgewertet wurden, beginnend auf Höhe des Acetabulums. Für Referenzmessungen mittels Dualenergie-Röntgenabsorptiometrie (DXA) wurde ein GE Lunar DPX IQ-Scanner als quantitatives Analyseverfahren eingesetzt. Jedes Schwein wurde nach der MRT-Untersuchung mittels DXA (Modus “Ganzkörper Adult Normal”) untersucht. Die Daten wurden mittels „Proc Reg“ der Statistik-Software SAS 9.2 ausgewertet. Das Volumen des Musculus longissimus dorsi bei 80 kg zeigt eine hohe Beziehung zum Volumen des Musculus longissimus dorsi bei 100 kg (R2 = 0,86; RMSE = 82021 mm3). Bei der Gegenüberstellung der Volumina des Musculus longissimus dorsi bei 80 kg und bei 100 kg allein für die Eber ergibt sich das höchste Bestimmtheitsmaß mit R2 = 0,97 (RMSE = 35340 mm3). Ein ebenso hohes Bestimmtheitsmaß erreicht die Beziehung zwischen dem Volumen der Fettauflage (über dem Musculus longissimus dorsi) bei 80 kg und bei 100 kg allein für die Eber (R2 = 0,97, RMSE = 23757 mm3). Für die Speckauflage aller Tiere bei 80 kg und bei 100 kg resultiert ein Regressionskoeffizient von R2 = 0,91 (RMSE = 41781 mm3). Für die Oberschenkel- und Glutealregion ergeben sich geringere Beziehungen. So kann für die Muskelvolumina bei 80 kg und bei 100 kg ein Regressionskoeffizient von R2 = 0,79 (RMSE = 292079 mm3) erreicht werden. Für die entsprechenden Fettvolumina der Oberschenkel- und Glutealregion liegt das Bestimmtheitsmaß bei R2 = 0,44 (RMSE = 137143 mm3). Im Rahmen einer multiplen Regressionsanalyse kann ein Bestimmtheitsmaß von R2 = 0,82 (RMSE = 3,31 %) erreicht werden, indem das Volumen des Musculus longissimus dorsi und das Volumen der Speckauflage jeweils bei 80 kg als Variablen eingesetzt werden, um das DXA-Gesamtkörperfett (%) bei 100 kg als Referenzwert zu bestimmen. Zudem wurde eine statistische Auswertung verschiedener Einflussfaktoren anhand einer Mischmodell-Analyse mittels REML (restricted maximum likelihood) durchgeführt (p < 0,05). Die Ergebnisse zeigen, dass signifikante Rassen- bzw. Kreuzungsgruppenunterschiede bezogen auf die MRT-Muskel- und Fettvolumina in den untersuchten Regionen, sowie für die DXA-Ergebnisse vorliegen. Eher extensiv genutzte Rassen bzw. Kreuzungsgruppen weisen ein signifikant höheres MRT-Fettvolumen bei erwartungsgemäß signifikant geringem MRT-Muskelvolumen auf. Dabei weisen sie korrespondierend die geringsten DXA-Magerweichgewebewerte und die höchsten DXA-Gesamtkörperfettgehalte auf. Auffällig ist zudem, dass die weniger bemuskelten Rassen bzw. Kreuzungsgruppen über eine höhere Knochenmineraldichte verfügen. Diese Ergebnisse zeigen, dass - obwohl rassespezifische Unterschiede existieren - eine Vorhersage der Körperzusammensetzung (z.B.: DXA-Fettgehalt %) bei 100 kg durch die Untersuchung mittels MRT bei 80 kg möglich ist. Die MRT bietet die Möglichkeit Schlachtkörpermerkmale an potentiellen Zuchttieren in vivo zu erfassen, ohne auf Nachkommenschaftsergebnisse aus der Prüfschlachtung angewiesen zu sein. Somit kann die Schlachtleistung an jedem potentiellen Zuchttier selbst als Eigenleistungsprüfung erhoben werden, was die Kosten der Leistungsprüfanstalten und die für die Versuchsschlachtungen deutlich reduziert. Zudem kann aufgrund der anzunehmend hohen Heritabilitäten das Generationsintervall sowohl für den potentiellen Zuchteber als auch für die potentielle Zuchtsau deutlich reduziert werden, ohne an Genauigkeit zu verlieren.

Zielsetzung: Ziel der Arbeit ist es, die Vorhersagekraft der Knochendichtemessung am proximalen Femur durch DXA zur Bestimmung des individuellen Frakturrisikos durch die toplogische Analyse der Mineralsalzdichteverteilung der Scan-Bilder zu steigern. Die Evaluation basiert auf den sog. Minkowski-Funktionalen (MF). Die Ergebnisse des neuen Verfahrens werden mit denen der Osteodensitometrie verglichen. Material und Methode: Untersucht wurden 30 postmenopausale Patientinnen (Alter 73,9 ± 10,3 Jahre), bei denen in 15 Fällen eine Fraktur der Hüfte vorlag. Innerhalb der ersten Woche nach dem Trauma wurde eine Knochendichtemessung durch DXA durchgeführt, im Fall der Frakturpatienten an der intakten, kontralateralen Hüfte. Die DXA-Scanbilder wurden durch die MF in 2D hinsichtlich Grauwert- bzw. Kalksalzdichteverteilung topologisch analysiert. Durch Anwendung eines optimierenden integrativen Filterverfahrens wurde eine skalare Grösse MF2D aus der Spektraldarstellung der MF jedes Bilddatensatzes extrahiert und in Beziehung zum Frakturstatus gesetzt. Die Diskriminanzanalyse und die ROC-Analyse wurden zur Erfassung der prädiktiven Wertigkeit des neuen Verfahrens im Vergleich zur konventionellen Osteodensitometrie hinsichtlich korrekter Differenzierung zwischen Patientinnen mit / ohne Hüftfraktur durchgeführt. Ergebnis: Die Knochenmineraldichte [der T-Wert] für die Patienten mit Hüftfraktur betrug 0,67 ± 0,12 g/cm2 [–2,77 ± 0,9 SD], im Vergleichskollektiv 0,77 ± 0,18 g/cm2 [–2,09 ± 1,22 SD]. Die Fläche unter der ROC-Kurve für die korrekte Differenzierung zwischen Frakturpatienten und der Kontrollgruppe durch den BMD-Wert [T-Wert] war 0,72 (p = 0,04) [0,63 (p = 0,23)]. Es lag keine statistisch relevante Beziehung zwischen der Knochendichte BMD und MF2D vor (R2 = 0,045, p = 0,262). Der mittlere MF2D-Wert lag bei den Patienten mit Hüftfraktur bei 10,04 ± 17,2 gegenüber –58,7 ± 82,29 bei den Vergleichsfällen. Die Fläche unter der ROC-Kurve für die korrekte Differenzierung zwischen Frakturpatienten und der Kontrollgruppe betrug für MF2D 0,85 (p = 0,001). Bei der Diskriminanzanalyse ergab sich im Fall der alleinigen Verwendung der Knochenmineraldichte [des Parameters MF2D] eine korrekte Klassifizierung in 63% [70%] der Fälle, mit dem Kombinationsmodell aus beiden Parametern konnten 77% der Fälle korrekt klassifiziert werden. Schlussfolgerung und Ausblick: Das vorgestellte Postprocessing-Verfahren basierend auf der topologischen Analyse der Grauwertverteilung in DXA-Scans des Hüftgelenkes mit Minkowski-Funktionalen in 2D erweist sich als gut geeignet, um Patientinnen mit einer Fraktur des proximalen Femurs zu identifizieren, im untersuchten Patientenkollektiv ist es der konventionellen Knochendensitometrie überlegen. Wegen der verhältnismäßig geringen Kollektivgröße sollte eine Validierung im Rahmen einer größeren, vorzugsweise prospektiv ausgerichteten Studie erfolgen. Hier ließe sich zudem untersuchen, ob sich das neuartige Verfahren auch zur Verlaufskontrolle z.B. unter medikamentöser Therapie eignet.

Im Rahmen dieser Arbeit wurde die Körperzusammensetzung junger Kälber mithilfe der Dualenergie-Röntgenabsorptiometrie (DXA) im Vergleich zur Standardreferenzmethode der Totalzerlegung ermittelt. Ziel war die Überprüfung der Genauigkeit der DXA-Methodik und der Vergleich verschiedener Scanmodi untereinander, um herauszuarbeiten, welcher Modus für welchen Einsatz geeignet erscheint. Im Zeitraum von Juni 2004 bis März 2005 wurden insgesamt 30 männliche Kälber der Rassen Fleckvieh, Deutsche Holsteins und deren Kreuzungen untersucht. Alle Tiere wurden mit einem DXA-Scanner (Lunar® DPX-IQ) in jeweils zwei verschiedenen Scanmodi („Adult normal“ und „Pädiatrie groß“) in vivo gescannt und im Durchschnitt drei Tage danach im Versuchsschlachthof Grub geschlachtet. Dort wurde die rechte Schlachtkörperhälfte eines jeden Tieres manuell in die Komponenten Magerfleisch, Knochen und Fett zerlegt, wohingegen die linke Hälfte post mortem einer Ganzkörperanalyse unterzogen wurde – wiederum mit zwei Scanmodi („Pädiatrie medium“ und „Pädiatrie klein“). Es wurden jeweils die absoluten Werte für Fett, Magerfleisch und Knochenmineralstoffe und die dazugehörigen prozentualen Anteile ermittelt. Zudem wurden die Gesamtgewichte der gescannten Tiere errechnet. Die Untersuchungen zeigten erwartungsgemäß beim Vergleich der Post-mortem-Analysen mit den Ergebnissen der Totalzerlegung insgesamt eine höhere Beziehung als beim Vergleich der In-vivo-Analysen mit den Zerlegungs-Ergebnissen. Allerdings stellte sich heraus, dass die Beziehungen bei den absoluten Werten gegenüber den Beziehungen bei den prozentualen Anteilen große Unterschiede aufwiesen. Im Modus „Adult normal“ bestanden sehr enge Beziehungen für Gesamtgewichte (R²=0,985), Magerfleischgewebe (R²=0,940) und Knochen (R²=0,838) und eine hohe Beziehung für Fett (R²=0,419), jedoch wurde nur eine mittlere Beziehung für Knochenanteil (R²=0,265) und niedrige Beziehungen für Magerfleischgewebeanteil (R²=0,093) und Fettanteil (R²=0,003) ermittelt. Im Modus „Pädiatrie klein“ ergaben sich ebenfalls sehr enge Beziehungen für Gesamtgewichte (R²=0,993), Magerfleischgewebe (R²=0,983) und Knochen (R²=0,766) und hohe Beziehungen für Fett (R²=0,643). Indessen ergaben sich hohe Beziehungen beim Vergleich des Modus „Pädiatrie klein“ mit den Zerlegeergebnissen für Magerfleischgewebeanteil (R²=0,533) und mittlere Beziehungen für Fettanteil (R²=0,282) und Knochenanteil (R²=0,240). Betrachtet man die Beziehungen zwischen den DXA-Scanmodi, stellt sich heraus, dass die „In-vivo“-Modi „Adult normal“ und „Pädiatrie groß“ sowie die „Post-mortem“-Modi „Pädiatrie mittel“ und „Pädiatrie klein“ in engeren Beziehungen zueinander stehen als die anderen Kombinationen untereinander. Eine hohe Beziehung für den Fettgewebeanteil (R²=0,694) ergab sich beim Vergleich von „Adult normal“ zu „Pädiatrie groß“, eine niedrige Beziehung für den Fettgewebeanteil (R²=0,081) ergab sich beim Vergleich von „Adult normal“ zu „Pädiatrie klein“. Der Modus „Adult normal“ scheint für höhere Gewichte und größere Körpermaße am besten geeignet zu sein, da in diesem Modus mehr Gewebe durchdrungen und damit gemessen werden kann. Er würde sich für Fragen der Körperzusammensetzung während des Wachstums beim Kalb anbieten. Wenn man Versuche mit Schlachtkörpern plant, wäre es zweckmäßig, für durchschnittliche Schlachtkörperhälftengewichte unter ca. 15kg den Modus „Pädiatrie klein“ und über ca. 15kg den Modus „Pädiatrie medium“ zu verwenden. Abschließend ist anzumerken, dass die DXA-Methode nicht als uneingeschränkt geeignetes Verfahren zur Messung der Körperzusammensetzung junger Kälber angesehen werden kann. Im Bereich der Fleischindustrie ist mit der heutigen Weiterentwicklung der DXA-Geräte jedoch ein sinnvoller Einsatz zur Ermittlung der Zusammensetzung von Teilstücken verschiedener Schlachttiere und Hackfleisch möglich geworden. Allerdings muss die Anwendung in der Fleischindustrie noch perfektioniert werden.