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Best podcasts about ldl

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Latest podcast episodes about ldl

The Gary Null Show
The Gary Null Show - 08.12.22

The Gary Null Show

Play Episode Listen Later Aug 12, 2022 60:17


Moderna Clinical Trials Terribly Flawed — and FDA Knew It, Former Pharma Executive Tells RFK, Jr. South African FM: ‘Patronizing bullying' not acceptable Prescription Playground: Why so many children are now taking ADHD drugs | 60 Minutes Australia   HEALTH NEWS Chili peppers for a healthy gut: Spicy chemical may inhibit gut tumors How Tart Cherries Reduce Inflammation and Oxidative Stress Uncovering the links between diet, gut health and immunity Southern-style diet ‘increases death risk' in kidney disease patients Could Hibiscus Tea be Better than High Blood Pressure Drugs? Can breast milk feed a love of vegetables? Chili peppers for a healthy gut: Spicy chemical may inhibit gut tumors University of California, San Diego   August 1, 2022 Researchers at the University of California, San Diego School of Medicine report that dietary capsaicin — the active ingredient in chili peppers — produces chronic activation of a receptor on cells lining the intestines of mice, triggering a reaction that ultimately reduces the risk of colorectal tumors. The receptor or ion channel, called TRPV1, was originally discovered in sensory neurons, where it acts as a sentinel for heat, acidity and spicy chemicals in the environment. TRPV1 was quickly described as a molecular ‘pain receptor.'  But Raz and colleagues have found that TPRV1 is also expressed by epithelial cells of the intestines, where it is activated by epidermal growth factor receptor or EGFR. EGFR is an important driver of cell proliferation in the intestines, whose epithelial lining is replaced approximately every four to six days. “These results showed us that epithelial TRPV1 normally works as a tumor suppressor in the intestines,” said de Jong. In addition, molecular studies of human colorectal cancer samples recently uncovered multiple mutations in the TRPV1 gene, though Raz noted that currently there is no direct evidence that TRPV1 deficiency is a risk factor for colorectal cancer in humans. The current study suggests one potential remedy might be spicy capsaicin, which acts as an irritant in mammals, generating a burning sensation in contact with tissue.  The researchers fed capsaicin to mice genetically prone to developing multiple tumors in the gastrointestinal tract. The treatment resulted in a reduced tumor burden and extended the lifespans of the mice by more than 30 percent. The treatment was even more effective when combined with celecoxib, a COX-2 non-steroidal anti-inflammatory drug already approved for treating some forms of arthritis and pain. “Our data suggest that individuals at high risk of developing recurrent intestinal tumors may benefit from chronic TRPV1 activation,” said Raz. “We have provided proof-of-principle.” How Tart Cherries Reduce Inflammation and Oxidative StressNorthumbria University (UK),  August 4, 2022Michigan researchers had previously shown that a cherry-enriched diet not only reduced overall body inflammation, but also reduced inflammation at key sites (belly fat, heart) known to affect heart disease risk in the obese.This study offers further promise that foods rich in antioxidants, such as cherries, could potentially reduce inflammation and have the potential to lower disease risk.”

Two daily doses of the tart cherry concentrate was associated with significantly lower levels of interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP), compared to placebo, according to findings published in Nutrients.

”This is the first study to investigate the impact of cherries on systemic inflammatory and oxidative stress induced by a series of metabolically challenging cycling bouts. Despite both groups demonstrating a similar drop off in performance and no differences in time trial performance, the results show that both oxidative stress and inflammatory responses were attenuated with Montmorency cherry concentrate supplementation versus placebo.” 

”With millions of Americans looking for ways to naturally manage pain, it's promising that tart cherries can help, without the possible side effects often associated with arthritis medications,” said Kerry Kuehl, M.D, Dr.PH., M.S., Oregon Health & Science University, principal study investigator. “I'm intrigued by the potential for a real food to offer such a powerful anti-inflammatory benefit — especially for active adults.”

Darren E. Huxley, MD says that a natural alternatives to pain medications are proving effective without unwanted side effects. “In this case we have cherries, another potent, natural antioxidant proving to be as, if not more effective than pain medications because of the ability for sustained long-term use without side effects in common anti-inflammatory drugs.Tart cherries have also been shown to contain naturally high levels of melatonin, a key compound in the human sleep-and-wake cycle, and new research in the European Journal of Nutrition confirms that melatonin from tart cherries is absorbed by humans.

In 2001, Burkhardt et al. even observed that the Montmorency variety, in particular, contains about six times more melatonin than the Balaton variety.  Uncovering the links between diet, gut health and immunity University of Sydney, August 5, 2022 A preclinical study from the University of Sydney has found a high-protein diet can change the microbiota of the gut, triggering an immune response. Researchers say the study takes us a step closer to understanding the way diet impacts gut health and immunity. “The focus of our work is on how the gut microbiota—the trillions of bacteria that inhabit the gut—affects the immune system,” said Associate Professor Laurence Macia from the University's Charles Perkins Center and Faculty of Medicine and Health. Traditionally, however, scientists have focused on the role of dietary fiber in maintaining a healthy gut. In this first-of-its-kind study, published in Nature Communications, the team from the Charles Perkins Center used sophisticated modeling to explore the impact of 10 diets with a different makeup of macronutrients—protein, fats and carbohydrate in mice. Mice fed a high protein diet increased their production of bacterial extracellular vesicles, complex cargo containing bacterial information such as DNA and protein. The body subsequently viewed this activity as a threat and triggered a sequence of events where immune cells traveled into the gut wall. “Here we found protein had a huge impact on the gut microbiota and it was not so much about the type of bacteria that were there, but the type of activity. In essence, we discovered a new way of communication between the gut bacteria and the host which was mediated by protein,” said Associate Professor Macia. While it is too early to say if this research might translate in humans, the researchers say activation of the immune system can prove either good or bad news. “By increasing antibodies in the gut you may see strong protection against potential pathogens, for example salmonella, but on the downside, an activated immune system could mean you are at increased risk of colitis, an inflammatory bowel disease, or autoimmune conditions like Crohn's,” said lead author and post-doctoral researcher Jian Tan. The results appear consistent with the population impacts of modern-day diets, with the Western world seeing lower rates of gastrointestinal infection but higher rates of chronic disease.  Southern-style diet ‘increases death risk' in kidney disease patients University of Alabama  1 August 2022 New research published in the National Kidney Foundation's American Journal of Kidney Diseases suggests that eating a “Southern-style diet” is linked with higher death rates in kidney disease patients. Investigating the influence of diet on kidney disease patients, the researchers studied  3,972 participants with stage 3-5 chronic kidney disease who had not started dialysis. Analyzing the dietary habits of the participants, the researchers found that those who regularly consumed foods familiar to Southern diets had a 50% increase in risk of death across the 6.5-year follow-up period. Foods that the authors identify as being part of a Southern diet include processed and fried foods, organ meats and sweetened beverages. Could Hibiscus Tea be Better than High Blood Pressure Drugs? Tufts University,  August 4th, 2022 Naturally healing foods, including hibiscus, don't carry the side effects of pharmaceuticals and can often offer similar (or better) benefits, without padding the pockets of Big Pharma companies. This is one example of a natural solution for high blood pressure. When it comes to high blood pressure, a completely preventable condition, there are many natural solutions. Things like cayenne pepper, apple cider vinegar, and celery are just a few alternatives, along with broad dietary and lifestyle changes. But many people aren't aware of the blood pressure lowering benefits of hibiscus. Dr. Diane McKay presented her own research on hibiscus Dr. McKay, of Tufts University, conducted a study on 65 people between the ages of 30 and 70 who had been diagnosed with prehypertension or mild hypertension. After receiving hibiscus tea daily for six weeks, participants experienced reduced diastolic, systolic, and mean arterial pressures when compared with those who received a placebo. The effects were most pronounced in those with the highest beginning baseline blood pressures. In another study, scientists received a surprise when looking at the effects of hibiscus tea on blood sugar. The study compared the effects of hibiscus and black teas and found that both impacted cholesterol levels. While the black tea positively influenced HDL levels, hibiscus tea helped keep LDL, HDL, and overall cholesterol at healthy levels. Can breast milk feed a love of vegetables?  Monell Chemical Senses Center, August 4, 2022  Want your preschooler to eat veggies without a fuss? Try eating veggies while you're breast-feeding. That's the message from a new study of lactating mothers and their breast-fed babies. The study found that those infants who took in veggie-flavored breast-milk were less likely to turn away from similar-tasting cereal when they graduated to more solid food. “Every baby's sensory experience is unique, but the flavor of their first food, beginning in utero, is dependent on what mom is eating,” said Julie Mennella. She is a biopsychologist at the Monell Chemical Senses Center in Philadelphia, and led the study. “The way I see it is: Mother's milk is the ultimate in precision medicine,” Mennella said. When an expectant mother eats vegetables, they flavor her amniotic fluid—and later, her breast-milk—and those flavors get passed along to her baby. As a result, the researchers said, if the baby learns early how veggies taste, he or she will be less apt to squawk when offered that first spoonful. For her study, Mennella randomly assigned 97 breast-feeding mothers to one of five groups. For a month, three groups drank a half-cup of carrot, celery, beet or vegetable juice before nursing. One group began when babies were two weeks old, another at 1-1/2 months of age and the third at 2-1/2 months. A fourth group of moms drank juice for three months, starting when their babies were two weeks old. A fifth group—the “control” group—did not use juice. The takeaway: Babies who'd been exposed to vegetable flavors in breast-milk preferred carrot-flavored cereal over plain cereal or cereal with the unfamiliar taste of broccoli. Only 8 percent rejected all of the foods, the findings showed.

The Hacked Life
131. Stop Taking Statins: The Truth About Cholesterol (Weight Loss Wednesday)

The Hacked Life

Play Episode Listen Later Aug 10, 2022 28:53


Every Wednesday I go LIVE to talk about a topic, trend, and the latest research in the areas of metabolic health and weight loss. I'm on a mission to help over a million people get healthy and lose weight so that they can start living the highest version of themselves. When you're healthy, you're more confident and have higher self-esteem. That confidence bleeds into every area of your life. Those same people are more purposeful and make greater change in the world.This week we talk about STATINS:do they do what they really say they're supposed to do?why fat clogs our arteries in the first placewhat's the real role behind LDL, the so-called "bad cholesterol"I just created a Weight Loss Diet Blueprint that's FREE! I get often asked "How should I eat? What foods should I eat? How much?" This cheat sheet is your answer. I give this to all my private wellness clients and I want you to have it. Simple message me "I WANT IT" on Facebook or Instagram @joelevancoaching or email me info@joelevancoaching.com

Dr. Baliga's Internal Medicine Podcasts
LDL-Cholesterol Lowering--August 2022 Update

Dr. Baliga's Internal Medicine Podcasts

Play Episode Listen Later Aug 6, 2022 10:27


Why Combination Lipid-Lowering Therapy Should be Considered Early in the Treatment of Elevated LDL-C For CV Risk Reduction Mini G Varughese, MD; Matthew Deshotels, MD; Christie M. Ballantyne, MD, FACC    

Nutrition Rounds Podcast
Small Changes, Big Differences – Eating to Lower Cholesterol

Nutrition Rounds Podcast

Play Episode Listen Later Aug 3, 2022 42:34 Very Popular


Join Dr. Danielle Belardo for the highly anticipated episode on nutrition and lipids. In Part 3 of the cholesterol series, Danielle addresses the impact of diet on cardiovascular disease risk and LDL cholesterol by sharing the key findings from a variety of research papers and studies. The main takeaway is that your overall dietary pattern is what matters most and no one food in one dose will cause disease. So go ahead, be an omnivore, vegan, pescatarian, or whatever works for you, as long as you're including the advice from today's episode.    This week Danielle addresses the following questions surrounding nutrition and lipids:       What is dietary cholesterol and how does it impact lipids?   How can you lower LDL cholesterol without raising triglycerides and reduce APOE?  Which interventions lower cardiovascular risk the most?  Which foods are high in saturated fats and what dietary recommendations lower the risk of atherosclerotic cardiovascular disease and LDL cholesterol?   Why does polyunsaturated fat lower LDL cholesterol?    Which oils are better for your lipid levels?   What is fiber, why is it important in your diet, and how does it lower cholesterol?   Which foods are packed with viscous fiber, and how much per day should you consume?  What is a portfolio diet and what kind of impact does it have on LDL cholesterol?      Find all the papers and research studies discussed this week on Instagram @wellnessfvfjournalclub.    Thank you so much for taking the time to contribute to a generation that values fact over fiction! Be sure to rate, review, and follow on your favorite podcast app and let us know which not-so-wellness trend you'd like to hear debunked. Follow your host on Instagram @daniellebelardomd and the podcast @wellnessfactvsfiction      Thank you to our sponsors for making this episode possible. Check out these deals just for you:  COZY EARTH - Go to cozyearth.com and enter WELLNESS at checkout to SAVE thirty-five  Percent. 

Mayo Clinic Cardiovascular CME
Peripheral Artery Disease (PAD) Treatment

Mayo Clinic Cardiovascular CME

Play Episode Listen Later Aug 2, 2022 23:01


Peripheral Artery Disease (PAD) Treatment Guest: Robert D. McBane, II M.D. Host: Stephen Kopecky, M.D. (@DrSteveKopecky) Most patients, who have Peripheral Artery Disease, do not experience the symptoms right away. However, patients affected with PAD will likely experience symptoms such as pain in the legs during walking and loss of hair. PAD limits the blood flow from the vessels to the heart. Without the proper treatment, the effects of PAD can lead to amputation of the foot or legs. Major amputation can potentially lower the life expectancy of patients that are affected with PAD. Joining us today to discuss Peripheral Artery Disease (PAD) Treatment is Robert D. McBane, II M.D. professor of medicine in the department of cardiovascular medicine at Mayo Clinic in Rochester, Minnesota. Specific topics discussed: How do you define PAD? Is invasive or noninvasive imaging diagnosis required? Or can be based on ABI?  Or is physical exam adequate with a bruit in the carotids, renals, or femorals? In PAD, are risk factors the same as in cardiovascular or cerebrovascular disease? Why is having PAD a greater risk factor for cardiovascular morbidity and mortality than coronary artery disease or cerebrovascular disease? Do any risk factors predominate in PAD? (e.g., is smoking more prevalent?) Are you checking lipoprotein a in patients with PAD at an early age? Has treatment of risk factors been shown to significantly reduce CV morbidity or mortality in patients with PAD? When is ABI indicated and when is toe-brachial index indicated? (What is the definition of noncompressible vessels?) When should we do exercise ABI? For treatment, other than treating the risk factors of lipids, smoking, hypertension, diabetes, or other treatments indicated such as anti-platelet and if so his aspirin adequate, what dose, or other anti-platelet agents indicated? Clopidogrel should be added when? Can be given in place of aspirin? When is cilostazol recommended? Can you give with heart failure-HFpEF and HFrEF?  Does this improve outcomes-walking distance or also overall morbidity and mortality? What home walking program is best to recommend for patients with PAD? Do patients with PAD get as aggressive treatment for risk factor control as do CV or cerebrovascular disease patients? Why are patients with PAD less often treated aggressively for risk factor control? Is that the patient or the caregiver? Any other new drugs available that are beneficial? When is revascularization helpful to consider? There is emerging evidence that lower LDL cholesterol (LDL less than 60) significantly benefits patients with CAD-is there any evidence lower LDL is beneficial in PAD? Connect with Mayo Clinic's Cardiovascular Continuing Medical Education online at https://cveducation.mayo.edu or on Twitter @MayoClinicCV. NEW Cardiovascular Education App: The Mayo Clinic Cardiovascular CME App is an innovative educational platform that features cardiology-focused continuing medical education wherever and whenever you need it. Use this app to access other free content and browse upcoming courses. Download it for free in Apple or Google stores today! No CME credit offered for this episode. Podcast episode transcript found here.  

Heart to Heart Nurses
Familial Hypercholestrolemia, and Elevated Triglycerides: Lipid Management in Clinical Practice

Heart to Heart Nurses

Play Episode Listen Later Aug 2, 2022 11:26


Familial Hypercholesterol, the genetic condition that causes high LDL cholesterol levels, may lead to early heart attacks or heart disease If undiagnosed or untreated. Guest Susan Halli Demeter, DNP, CNP, NP, of the Mayo Clinic, describes diagnosis, heterozyogus and homozygous versions, treatments, and the importance of genetic screening for family members.CE course The Role of Non-Statin Therapies in Optimal Cholesterol ManagementPatient education What is Familial Hypercholesterolemia?Patient & professional tools: Access to Innovative MedicinesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Better with Dr. Stephanie
Keto, Cholesterol, & Heart Disease with Dr. Bret Scher

Better with Dr. Stephanie

Play Episode Listen Later Aug 1, 2022 65:42 Very Popular


Are you A Healthcare Practitioner? Join The Estima Certification Program HereJoin the Hello Betty AMA here: https://www.hellobetty.club/ama We'd like to thank our sponsors, Athletic Greens - redeem an exclusive offer here: athleticgreens.com/stephanieLMNT Electrolytes - A FREE 7-flavor sample pack! - https://www.drinklmnt.com/DrEstimaOrion Red Light Therapy - get 10% off your order with Promo Code “STEPHANIE10” https://www.orionrlt.ca/?ref=StephanieLumen - get $25 off your order with Promo Code “DRSTEPHANIE25” https://www.lumen.me/?fid=1799Ancestral Supplements - Use Promo Code “ASA10” for 10% off any purchase https://shop.ancestralsupplements.com/discount/Tribe10?rfsn=5900205.652074&utm_source=refersion&utm_medium=affiliate&utm_campaign=5900205.652074PRIMEADINE - get 10% Off your Order with Promo Code “DRSTEPHANIE10” - https://oxfordhealthspan.com/products/best-spermidine-supplementBIOOPTIMIZERS - receive 10% off your order with Promo Code "ESTIMA" - www.biooptimizers.com/drstephanie  Episode Overview: 0:00 Introduction6:30 “Evidence Based” Medicine8:30 Metabolic Health13:00 Total Cholesterol18:30 LDL Function & Pattern A/B32:20 Markers for Metabolic Health34:30 Keto's Impact on Lab Panels42:30 Long term Differences between the Sexes on Keto46:30 Thyroid Sensitivity on Keto as a Woman49:10 Insulin Resistance for long term Keto dieters57:00 Intermittent Fasting1:03:00 Conclusion Follow Me On Instagram: https://www.instagram.com/dr.stephanie.estimaGet yourself a copy of my best-selling book, The Betty Body - https://bettybodybook.comJoin the Hello Betty Community here - https://hellobetty.club/ Dr. Bret Scher Links:The Diet Doctor Podcasthttps://www.dietdoctor.com/www.lowcarbcardiologist.com

The Gary Null Show
The Gary Null Show - 08.01.22

The Gary Null Show

Play Episode Listen Later Aug 1, 2022 53:52


Videos : Found on Youtube 1. BlackRock: The Most Evil Business In The World 2. This company owns the world (and it's our fault) – BlackRock   Canadian Study Gives More Evidence Cancer Is A Lifestyle Disease Largely Caused By Food Cancer Control Alberta, Alberta Health Services and University of Calgary, July 22, 2022 Shockingly, worldwide cancer rates are predicted to rise to 1-in-2 women and 1-in-3 men will be diagnosed with some form of cancer. It is so common already, in fact, that it getting cancer is more common than getting married or having a first baby. In reality, one can significantly reduce the likelihood of getting cancer by making lifestyle changes. According to a recently published study out of Canada, the total proportion of cancer rates which can be attributed to lifestyle and environmental factors is quite high, nearing 41%. Regarding the methods used in the study: We estimated summary population attributable risk estimates for 24 risk factors (smoking [both passive and active], overweight and obesity, inadequate physical activity, diet [inadequate fruit and vegetable consumption, inadequate fibre intake, excess red and processed meat consumption, salt consumption, inadequate calcium and vitamin D intake], alcohol, hormones [oral contraceptives and hormone therapy], infections [Epstein-Barr virus, hepatitis B and C viruses, human papillomavirus, Helicobacter pylori], air pollution, natural and artificial ultraviolet radiation, radon and water disinfection by-products) by combining population attributable risk estimates for each of the 24 factors that had been previously estimated.  The list above essentially outlines the wide range of personal choices we know can increase the risk of cancer, mainly pointing out that food causes cancer. Along with exercise, and common avoidable environmental factors, cancer is somewhat preventable. Overall, we estimated that 40.8% of incident cancer cases were attributable to exposure to the 24 factors included in the analysis (Table 2). Tobacco smoking was responsible for the greatest cancer burden, accounting for an estimated 15.7% of all incident cancer cases (2485 cases), followed by physical inactivity and excess body weight, which were responsible for an estimated 7.2% and 4.3% of incident cancer cases, respectively. All other exposures of interest were estimated to be responsible for less than 4.0% of incident cancer cases each. Brain imaging reveals how mindfulness program boosts pain regulation University of Wisconsin-Madison, July 28, 2022 Research at the University of Wisconsin–Madison's Center for Healthy Minds has isolated the changes in pain-related brain activity that follow mindfulness training—pointing a way toward more targeted and precise pain treatment. The study, published in The American Journal of Psychiatry, identified pathways in the brain specific to pain regulation on which activity is altered by the center's eight-week Mindfulness Based Stress Reduction course. These changes were not seen in participants who took a similar course without the mindfulness instruction—important new evidence that the brain changes are due to the mindfulness training itself, according to Joseph Wielgosz. The study is the first to demonstrate pain-related brain changes from a standardized mindfulness course that is widely offered in clinical settings. Around one-third of Americans experience pain-related problems, but common treatments—like medications and invasive procedures—don't work for everyone and, according to Wielgosz, have contributed to an epidemic of addiction to prescription and illicit drugs. Popular with patients and promising in its clinical outcomes, mindfulness training courses like MBSR have taken a central place in the drive for a more effective approach to pain management. By practicing nonjudgmental, “present-centered” awareness of mind and body, participants can learn to respond to pain with less distress and more psychological flexibility—which can ultimately lead to reductions in pain itself. The study also looked at longer-term mindfulness training. Intriguingly, practice on intensive meditation retreats was associated with changes in the neural signature for influences that shape pain indirectly—for example, differences in attention, beliefs and expectations, factors that often increase the perceived levels of distress in non-meditators. These findings help show the potential for mindfulness practice as a lifestyle behavior. Optimistic Women More Likely to Live Past 90 Harvard University, July 23, 2022 Turns out that focusing on the good things really is the recipe for a longer life. A new study from Harvard University, published in the Journal of the American Geriatrics Society, found that higher levels of optimism were positively associated with longer lifespan, with the most optimistic women even living past 90 years old across a variety of racial and ethnic groups. This study included over 150,000 postmenopausal women across a variety of diverse socio-economic and ethnic groups in the United States. These women, aged 50-79, enrolled in the study and were followed for a period of up to 26 years. The results of this study found that the 25% of subjects who were the most optimistic were more likely to have a 5.4% longer lifespan, and a 10% greater likelihood of living beyond 90 years of age compared to the 25% who were the least optimistic. The authors noted that while social structure factors can affect optimism, there is still reason to look on the bright side of life, regardless of these factors, finding that being optimistic is scientifically significant for longer lifespan and overall longevity. According to Hayami Koga, a PhD candidate in the Department of Social and Behavioral Sciences at Harvard T.H. Chan School of Public Health, this new research concluded that “There's value to focusing on positive psychological factors, like optimism, as possible new ways of promoting longevity and healthy aging across diverse groups.” The research from Harvard noted that women who were the most optimistic were 10% more likely to celebrate their 90th birthday than the least optimistic. Based on total demographics, however, the highest vs. lowest optimism quartile in the Women's Health Initiative study is broken down as follows: Overall – Associated with 5.4% longer lifespan White women – 5.1% longer lifespan Black women – 7.6% longer lifespan Hispanic/Latina women – 5.4% longer lifespan Asian women – 1.5% longer lifespan This data shows that Black women have the highest longevity rates (at 7.6%) compared to other demographics specifically when optimism is brought into play. Maintaining a positive outlook and optimism are undeniably large parts of the equation when it comes to living a long life, but there are other factors and lifestyle choices that come into play to ensure not only healthy lifespan, but healthy quality of life. These factors include: A healthy diet —It has always been important to maintain a healthy diet to benefit overall health. While the Mediterranean diet, which emphasizes fruits and vegetables along with healthy fats and whole grains, is known for its health benefits, the Japanese diet is also a great option, with adherence to this diet being associated with a longer lifespan.  Maintaining a healthy weight—Keeping the number on the scale in a healthy range with a combo of diet and exercise is a large aspect of staying healthy. Nutrients—Targeted nutrients can also help support your longevity efforts. These nutrients include: Nicotinamide riboside: A precursor of NAD+, and a form of vitamin B3 that can fight general fatigue, support cellular energy production, and even contribute to anti-aging. Resveratrol: Skip the wine! Resveratrol has potent anti-aging properties, including fighting free radicals and mimicking calorie restricting diets that are key to longevity. Curcumin: The golden spice is knowing for its anti-inflammatory benefits, and with that, its ability to benefit whole-body health. Working to keep your joints and your brain healthy, it's a no brainer that this extract will keep you as young as you feel. Managing stress—Keeping stress at bay is crucial to living a long and healthy life. There's even evidence that managing stress can “un-gray” your hair! And who wouldn't feel optimistic about that? Is Vitamin E Good for PCOS? Nanjing University of Chinese Medicine, July 25, 2022 Can women with polycystic ovary syndrome (PCOS) get pregnant? The answer is: yes…but it can be more challenging than for women without this hormone imbalance condition. For reproductive-age women, the hallmark of PCOS is high androgen levels (the “male” hormone), which can lead to irregular periods and difficulty getting pregnant. But, as daycares full of babies conceived with a little “help” can attest, there are options. A new study published in BMC Women's Health suggests that vitamin E may be helpful for women with PCOS undergoing ovulation induction. According to the study, women with polycystic ovary syndrome undergoing ovulation induction who received vitamin E had lower levels of oxidative stress and required lower doses of human menopausal gonadotropin. In addition to potentially supporting fertility, vitamin E has many other health benefits for women with PCOS: it also helps maintain healthy levels of insulin, triglycerides and LDL. In addition to the BMC Women's Health publication, placebo-controlled studies have shown the benefits of vitamin E for women with PCOS, especially regarding their reproduction and fertility. In the retrospective study from BMC Women's Health, 321 women with PCOS underwent ovulation induction. 105 received 100 mg/d of vitamin E during the follicular phase 106 received 100 mg/d of vitamin E during the luteal phase 110 did not receive vitamin E The results? Those who took vitamin E showed improved resistance to oxidative damage, healthy endometrium thickness, and decreased hMG dosage for healthy ovulation. Total darkness at night is key to success of breast cancer therapy — Tulane study Tulane University, July 25, 2022 Exposure to light at night, which shuts off nighttime production of the hormone melatonin, renders breast cancer completely resistant to tamoxifen, a widely used breast cancer drug, says a new study by Tulane University School of Medicine cancer researchers. The study, “Circadian and Melatonin Disruption by Exposure to Light at Night Drives Intrinsic Resistance to Tamoxifen Therapy in Breast Cancer,” published in the journal Cancer Research, is the first to show that melatonin is vital to the success of tamoxifen in treating breast cancer. “In the first phase of the study, we kept animals in a daily light/dark cycle of 12 hours of light followed by 12 hours of total darkness (melatonin is elevated during the dark phase) for several weeks,” says Hill. “In the second study, we exposed them to the same daily light/dark cycle; however, during the 12 hour dark phase, animals were exposed to extremely dim light at night (melatonin levels are suppressed), roughly equivalent to faint light coming under a door.” Melatonin by itself delayed the formation of tumors and significantly slowed their growth but tamoxifen caused a dramatic regression of tumors in animals with either high nighttime levels of melatonin during complete darkness or those receiving melatonin supplementation during dim light at night exposure. These findings have potentially enormous implications for women being treated with tamoxifen and also regularly exposed to light at night due to sleep problems, working night shifts or exposed to light from computer and TV screens. “High melatonin levels at night put breast cancer cells to ‘sleep' by turning off key growth mechanisms. These cells are vulnerable to tamoxifen. But when the lights are on and melatonin is suppressed, breast cancer cells ‘wake up' and ignore tamoxifen,” Blask says. A Cup of Cranberries a Day Keeps Dementia Away University of East Anglia (UK), July 26, 2022 While aging is inevitable, cognitive decline doesn't have to be. A recent study from the University of East Anglia found some “berry” good news about a way to help support and maintain brain function: cranberry intervention. According to the study, having the equivalent of one cup of fresh cranberries a day can improve memory, neuronal functioning, and vascular health, enhancing blood flow to the brain. And as a sweet bonus, researchers found the red fruit also helps lower LDL (low-density lipoprotein) cholesterol levels, which can build up in the arteries and result in a higher risk for cardiovascular disease and Alzheimer's. “Cranberries are rich in these micronutrients [flavonoids, anthocyanins and proanthocyanidins] and have been recognized for their antioxidant and anti-inflammatory properties,” the authors said. The researchers from the University of East Anglia performed a placebo-controlled study of parallel groups of healthy 50 to 80-year-olds adults to assess the effects of freeze-dried cranberry powder on cognition, brain function and biomarkers for brain cell signaling. The results revealed that taking cranberry extract for 12 weeks improved memory of everyday events (visual episodic memory) and enhanced blood circulation to certain parts of the brain (regional brain perfusion) compared to the placebo group. Better blood flow means essential nutrients such as oxygen and glucose reach areas of the brain associated with memory consolidation and retrieval.

Circulation on the Run
Circulation August 2, 2022 Issue

Circulation on the Run

Play Episode Listen Later Aug 1, 2022 37:05


This week, please join authors Paul Ridker and Eric Van Belle, editorialist Robert Harrington, and Guest Editor Allan Jaffe as they discuss the original research articles "Effects of Randomized Treatment With Icosapent Ethyl and a Mineral Oil Comparator on Interleukin-1β, Interleukin-6, C-Reactive Protein, Oxidized Low-Density Lipoprotein Cholesterol, Homocysteine, Lipoprotein(a), and Lipoprotein Associated Phospholipase A2: A REDUCE-IT Biomarker Substudy" and “Cerebral Microbleeds During Transcatheter Aortic Valve Replacement: A Prospective Magnetic Resonance Imaging Cohort” and the editorial "Trials and Tribulations of Randomized Clinical Trials." 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:             It's double feature time Greg. We've got two totally unique and interesting papers that we'll be discussing. The first, a biomarker substudy from the REDUCE-IT trial, that is looking at the effects of randomized treatment with icosapent ethyl, versus a mineral oil comparator, on inflammatory biomarkers. Now, don't use roll your eyes at me, because I'm telling you, this has results that you may not expect, and very, very important clinical implications, and implications for clinical trials. The second paper, very much up your alley, Greg, is a prospective MRI study of cerebral microbleeds during TAVR. But okay, enough now to whet your appetite, let's now just first grab coffees, and discuss the other papers and the issue, shall we? Dr. Greg Hundley:           You bet, Carolyn. And how about if I go first? Dr. Carolyn Lam:             Please. Dr. Greg Hundley:           So, Carolyn, my first paper comes from a group of investigators led by Dr. Araz Rawshani from the Institute of Medicine, and it included 715,143 patients with diabetes, registered in the Swedish National Diabetes Register, and compared them with over two million match controls, randomly selected from the general population, to determine the role of diabetes in the development of valvular heart disease, and particularly, the relation with risk factor control. Dr. Carolyn Lam:             Huh? Interesting, diabetes and valve disease. All right. What did they find, Greg? Dr. Greg Hundley:           Right, Carolyn. So they found, that individuals with type one and two diabetes, have greater risk for stenotic lesions. Whereas, risk for valvular regurgitation was lower in type two diabetes. Patients with well controlled cardiovascular risk factors, continued to display higher risk for valvular stenosis, without a clear stepwise decrease in risk between various degrees of risk factor control. So Carolyn, diabetes and a link with valvular heart disease. Dr. Carolyn Lam:             Wow. Really interesting, Greg. Thanks. Well, the next paper is a preclinical study with really interesting clinical implications. Now, we know the human heart has limited capacity to regenerate new cardiomyocytes, and that this capacity declines with age. Now, because loss of cardiomyocytes may contribute to heart failure, it is important to explore how stimulating endogenous cardiac regeneration, to favorably shift the balance between loss of cardiomyocytes and birth of new cardiomyocytes, occurs in the aged heart. Now, these authors, Doctors Rosenzweig, from Massachusetts General Hospital, and Dr. Lee from Harvard University and colleagues, previously showed that cardiomyogenesis can be activated by, guess what? Exercise in the young adult mouse heart. However, whether exercise also induces cardiomyogenesis in aged hearts, however, is not yet known. So in today's paper, the authors aim to investigate the effect of exercise on generation of new cardiomyocytes in the aged heart. And here, we're talking about 20 month old mice, who were subjected to an eight week voluntary running protocol, and age matched sedentary animals who served as controls. Dr. Greg Hundley:           Wow, Carolyn. Really interesting evaluation of exercise on cardiomyogenesis. So what did they find? Dr. Carolyn Lam:             Endogenous cardiomyogenesis can be stimulated by exercise in aged hearts. Comparative global transcriptional analysis further revealed, that exercise and age specific changes occurred in gene programs. The regulator of calcineurin RCAN1.4 was specifically found to be induced with exercise in aged hearts, and was accompanied by reduced calcineurin activity. So what's a take-home message? Exercise induced cardiomyogenesis may counter the increased cardiomyocyte loss and reduced cardio myogenic capacity in elderly patients. Dr. Greg Hundley:           Great, Carolyn. Well from the mail bag, there's an exchange of letters to the editor from Professor Zhou and Veith regarding a prior letter to the editor from Professor Jin and associates, pertaining to the previously published article “SPARC, A Novel Regulator of Vascular Cell Function in Pulmonary Hypertension.” And also, there's a Perspective piece, from Professor Mentz entitled, “Catastrophic Disruptions in Clinical Trials.” Dr. Carolyn Lam:             There's also a Research Letter by Dr. Kumar on [entitled] “von Willebrand Factor Is Produced Exclusively by Endothelium, Not Neointima, in Occlusive Vascular Lesions in Both Pulmonary Hypertension and Atherosclerosis.” There's also this beautiful tour of Cardiology News from the literature, from Tracy Hampton, which ranges from a study linking COVID-19 to higher long term cardiovascular risks, which was published in Nature Med, to uncovering alternative metabolic pathways involving cell fate transitions, published in Nature, to designing an autonomous biohybrid fish, from human stem cell derived cardiac muscle cells, that was published in Science. Wow. Isn't that amazing, Greg? Well, let's get on now though, to our two feature papers. Shall we? Dr. Greg Hundley:           You bet. Welcome listeners, to these two feature discussions on this particular day. And our first feature today, we have with us Dr. Paul Ridker, from Brigham and Women's Hospital in Boston, Massachusetts. Dr. Bob Harrington, from Stanford University in California. And also, Dr. Allan Jaffe, from Rochester, Minnesota. Welcome to you all. And Paul, we're going to start for you. Can you describe for us, the background information that really went into the construct of your study, and what was the hypothesis that you wanted to address? Dr. Paul Ridker: Sure, Greg. So first of all, my thanks to the AHA and the Circulation for publishing this paper, we always want to support the AHA, and we're delighted to be here today for these podcasts. The field of omega-3 fatty acids has been a complicated one for a long time. Epidemiology suggested that, fish consumption would lower cardiovascular risk, and there was a number of trials done. And my friend and colleague here at the Brigham, Deepak Bhatt, was the lead of a very big trial, called REDUCE-IT. Some 8,000 plus patients who received EPA alone, and they got a terrific result. A 25% reduction in their primary endpoint. And this was a New England Journal paper, back in 2019 or so. But another friend of mine, Steve Nicholls, ran another large trial of a combination of eicosapentaenoic acid, or EPA, plus docosahexaenoic acid that's DHA called STRENGTH. And that one showed, really, no benefit. And so, there's been some controversy out there. In any event, when Deepak and his colleagues published their original paper, they said it's interesting, because they got this big risk reduction, but it wasn't apparently due to the triglyceride lowering of the drug. And so, my interest, as many people know, has largely been in inflammation biology. And so we said, well maybe we should just do a test. Well, we said, we'll measure a number of biomarkers that we know were associated with atherosclerosis, some inflammatory, some with coagulation. And so, that was the core hypothesis, was simply to look at some other markers, and see what we might learn. And sometimes, you learn things that you didn't expect. And I think, that goes to the heart of what complicated clinical trials are all about. And I'd also say perhaps, what the roles of surrogate endpoints are, as compared to hard clinical endpoints, and things that make this whole field kind of interesting. Dr. Greg Hundley:           Right. Very nice, Paul. So you mentioned REDUCE-IT, so describe a little bit more for your study. What was the study population, and what was your study design? Dr. Paul Ridker: We were fortunate enough to work with REDUCE-IT investigators, to use their biobank. They had put together, again, it's 8,000 plus patients. I think, it was two thirds secondary prevention, one third primary prevention. And when they received the combination of EPA and DHA, as I said earlier, they had about a 25% reduction in the risk of their primary endpoint, which was cardiovascular death, nonfatal AMI, nonfatal stroke, coronary revascularization, and the like. What we did is, we basically said, "Okay, since the mechanism was uncertain, why don't we go ahead and measure a series of biomarkers?" Things that a lot of us are interested in, homocysteine, LPLa, oxidized LDL, my own interest in inflammation. We measured, IL-1β, we measured, IL-6, we measured CRP. We measured another molecule, Lp-PLA2, that people have been interested in. And the hypothesis, of course, was to see what the drug did, as compared to the comparator did. And the findings were interesting to us, in that, to simplify them, the actual icosapent ethyl arm didn't do much to most of those biomarkers, very little change. But the mineral oil comparator arm had some small to modest effects on all those biomarkers, all of which went up again. Now, some of these effects are pretty small, two to 3% for things homocystine, LPLa. Others were moderate, 10 to 20% increases in oxidized LDL, Lp-PLA2. And the inflammatory markers went up about 25%, sometimes, even a little more. So it's complicated. It's important to point out, that these changes on an absolute scale are relatively small. On a percent scale, they're different. The REDUCE-IT investigators themselves, to their credit, had earlier published that, they saw some increase in LDL cholesterol as well, about 10, 11% in those who had received the mineral oil comparator. So it's not exactly what we thought we were going to find, I guess, is the simplest way to express it. Dr. Greg Hundley:           Very nice. And so, describe for us just a little bit more, any differences in men and women, and what about age? Or for example, premenopausal, postmenopausal women. Dr. Paul Ridker: No, the effects were quite consistent across all various subgroups. It's a very large study. There were, again, 8,000 patients, lots of blood samples been drawn. And I should again, commend the REDUCE-IT investigators, for allowing us to do this work with them. And again, as I point out, sometimes you find things out that weren't what you expected. And the hard part, I was glad this got tossed over with Dr. Harrington, is sort to figure out well, what's it really mean? Because again, as a clinical trial list, I will say, my instincts are to trust the primary endpoint of the trial. That's what they did. They're going to go out and lower heart attacks and strokes. And then, here we are a couple years later, trying to figure out what the mechanism might be, and just came across some puzzling results. Dr. Greg Hundley:           Very nice. Well, next listeners, we're going to turn to the editor that actually processed this manuscript, Dr. Allan Jaffe. Allan, what drew you to this particular article? Dr. Allan Jaffe:   Well, I was asked to be a guest editor this week, by the Journal, because of some conflicts that were intrinsic to the editorial board. And since I have an interest in biomarkers, and had for a long time, it made perfect sense for me to become involved. I was particularly interested in this particular area, because I was aware that there were these two trials that had found different endpoints, and that there were some controversy as to what the mechanisms might be by which these effects could occur. And so I was pleased to get involved. And I think it's a compliment to the REDUCE-IT investigators, and to Dr. Ridker, that they were willing to put the data out there so that everybody could see it. And we could then begin to look. So it was of interest to me. I thought it was important to the field, to get really good reviewers who would be, make sure that the data that would eventually be published was clear, so that readers would understand it. And so that, at the end, we'd be able to at least, come to some conclusions that we could end up having an expert in clinical trials. And I thought about Bob Harrington, right from the beginning, might be able to comment on. Dr. Greg Hundley:           Very nice. Well, Bob he's setting you up here nicely, both Paul and Allan, to really help us put these results in perspective with other studies that have been performed in this space. What are your thoughts? Dr. Robert Harrington:   So first off, Greg, thanks for having me. And Allan, thanks for inviting me to review and comment on the paper. As both Allan and Paul have indicated, that I've spent the last 30 plus years doing clinical trials of all sizes. Very small, where we try to understand mechanisms, and very large, where what we're trying to understand is clinical outcomes. And I've been intrigued in this field, because of the inconsistency of the data across the field. Where in some trials, Paul had indicated this STRENGTH, there seemed to be no effect of omega-3 fatty acids, and in REDUCE-IT, there was quite a pronounced effect of the test agent. And so, when one sees discordance in a field, one tries to understand, well, why might that be? And so in the editorial, I took the position that, well, what are we trying to do in clinical trials? And in outcomes trials, we're trying to figure out what matters to patients. Do they live longer? Do they feel better? Do they avoid bad stuff happening to them? Like having to undergo revascularization procedure. So you're trying to do things that are really clinically meaningful, but that doesn't say that you're also not trying to understand mechanism. And as Allan said, there have been some questions raised. And so, trying to understand mechanism in the edit in trials can be quite useful, not just to understand that trial results, but to really form hypothesis for a field going forward. And so, I took the approach of, we learn things from different trials, and sometimes we learn things in the same trial. Meaning that, there's mechanistic work embedded in the large trial. One of the most famous examples of this, in the GUSTO trial 30 years ago, we learned through the mechanistic substudy, that it was rapid reprofusion TIMI-3 establishment of TIMI-3 flow, that really explained the difference between TPA and streptokinase. So I was very intrigued by how we might use these data to explore the results. And I find the findings fascinating, as Paul said. It is complicated, but it raises a really fundamental issue in clinical trials. There's an assumption in a placebo control trial, that because randomization is allowing you to balance everything, except for the randomized treatment groups, and therefore, that comparison has causal information in it. There's an underlying assumption that's really important. And that is, that the placebo is inert. That it has no biological effect of its own. Well, that assumption was violated here. The placebo is not inert in this clinical trial. Now, the investigators, I think to their credit, have said, "Well, this is small, probably doesn't matter." And that might be right, but it also may be wrong. And you can't just say, well, it doesn't matter, these are small effects. As Paul said, some of the effects are small, some are medium, some are large. So what explains it? And I made a point in the editorial, you could model all of this. If you get 5% of this, and 10% of this, and 20% of this, you could make some assumptions and say, well, the magnitude of the benefit was so great that it couldn't have been overcome by this. But that's just modeling, and there's uncertainty. So for me, as a trialist, and somebody who really believes in using evidence to guide practice and to guide public policy, I think there's uncertainty here. It's likely that the treatment effect is not as large as was observed, but how large is it? And how large is important? And how large might we want to consider to put into our practice guidelines? I think all of those open questions, particularly in a field where there is inconsistency across trials, in terms of the observation of the outcome. So my conclusion is, we need more work. We need another trial, if we really want to understand this. And we need to use an inert placebo, to really understand what the contribution was. I'd like nothing better to see that it didn't matter. But I can't say that it doesn't matter because I don't know. Dr. Greg Hundley:           Well, listeners, boy, we've got kind of some interest here in that an unexpected result. So Paul, it's nice doing an interview like this listeners, because each speaker sets up the next one. Paul, Bob is saying, well, what should we do next to clarify the results here? So maybe we'll go through each of you, and start with Paul. Just describe for us, what do you think is the next study that we need to perform? Dr. Paul Ridker: Well, Greg, it's a really interesting issue. We saw it, as authors, to write as neutral a paper as we could possibly write, and sort of do our academic job and say, here are the data. And I think we did it that way because, we don't really know what the interpretation should be. On the one hand, you have a very big beneficial result, which is great for patients. And there's a prior clinical trial called JELIS, which was open label, the same drug, and also got a large benefit. And we were trying to figure out mechanism. That being said, as Bob pointed out, I think what we stumbled into is some level of uncertainty. And the question is, how uncertain would it be, and does it matter in the big picture? Allan was interesting, because the Journal asked us to use the word comparator, rather than placebo. Now this was designed as a placebo controlled trial, but our paper uses the word comparator, because of the possibility, that as Bob Harrington points out, it may not be totally inert. So the writing of this was quite carefully done. I think, at the end of the day, my REDUCE-IT colleagues, who I have great respect for, and really worked terribly hard to do the main trial, understandably feel, that the trial would've showed, and I have a lot of sympathy for that, because it's the hard endpoints we should go with. On the other hand, I have sympathy with the idea that it never hurts to have more data. And if there could be a way to have a second trial, and I might change the population a little bit, maybe I'd do it in true primary prevention. This was one third primary prevention. My colleague, Joanne Manson had done her, she had a trial where they showed some potential benefit in the black populations. Maybe you might over sample some minority groups. But just the pragmatic issues here, make it tough to have a second trial. And so, uncertainty is just part of what we, as physicians, have to learn to live with. Dr. Greg Hundley:           Allan, turning to you. What do you think is a next study to perform in this space? Dr. Allan Jaffe:   Well, I think what Paul has said is correct. That it would be very hard to generate enthusiasm funding for a large trial. But it might not be nearly as difficult to begin to explore the effects of the mineral oil comparator, versus the active agent, versus perhaps, another potential placebo, and see over time what happens in primary prevention patients, as a way of beginning to put some context around what these results might mean. So for example, it could turn out that, the active agent actually kept the values from rising as they normally would've, and mineral oil had no effect at all. Alternatively, mineral oil may well have been a negative. It had a negative effect. And I think, those are the sorts of questions that could be explored reasonably in the short term, without doing another multimillion dollar randomized trial. Dr. Greg Hundley:           And Bob, your thoughts. Dr. Robert Harrington:   Well, and I mentioned this in the editorial, Greg. I didn't make my recommendation lightly. I know that these trials are expensive. I know these trials take a great deal of time, a great deal of energy. And I know that the REDUCE-IT investigators worked enormously hard over the years to get this done. So I don't say tritely, "Oh, just do another trial." But if you think about the magnitude of the public health issue here, there are millions of people to who this kind of therapy might apply globally. And so, shouldn't we be more certain than less certain, if we want to include it, for example, in ACC/AHA guidelines? I would say, the answer to that is yes. And so, I think of it as, okay, let's make some assumptions. Let's assume, that the effect that was observed in JELIS and REDUCE-IT, is the true effect. That's ground truth. Well, there are different study designs one might think about, from an analytic perspective, using Bayesian statistics, as opposed to frequency statistics. One might think about an intense interim analysis plan, to understand where the data are going, and be able to pull in the prior data for evaluation. I would advise getting a smart group of people together, who spend their lives thinking about trials in the atherosclerotic space, and the REDUCE-IT team is pretty darn good, and say, "How could we do this efficiently?" I do think, there's enough uncertainty that it would be ethical, from an equipoise perspective, to include high risk patients in a second evaluation, because we do have uncertainty. And if we really want to nail this down, I think we could look at high risk patients with hypertriglyceridemia, and try to use some interesting design issues, and some interesting analytical issues, to try to reduce the sample size, lot of attention in interim analyses, to try to answer the question. I'd like, as I said, nothing better to say, "Oh look, REDUCE-IT was the truth." This next trial is consistent. That'd be, to me, a terrific outcome of this. On the other hand, if you said to me, "Well, the effect's not 25%, it's more in the 15% range." Well, maybe then we think about how we apply it to our patients a little differently, maybe a little more cautiously. So I don't make the recommendation lightly, as I said, but I do think that there are some conversations that could be had, being respectful of the effort and the expense that goes into these kind of things. To try to answer the question efficiently. Dr. Greg Hundley:           Very nice. Well listeners, we want thank Dr. Paul Ridker, from Brigham and Women's Hospital, Dr. Bob Harrington from Stanford University, Dr. Allan Jaffe, from the Mayo Clinic, for bringing us the results of a substudy of the REDUCE-IT trial, that assessed a variety of serum biomarkers, pertaining to systemic inflammation, and highlighting uncertainty around the mechanism regarding the efficacy of icosapent ethyl, that's been used previously for primary or secondary prevention of cardiovascular events. And next listeners, we are going to move to our second feature discussion and review some data pertaining to microbleeds in the central nervous system, during and after TAVR procedures. Welcome listeners, to our second feature discussion on this August 2nd. And we are going to explore some of the world of TAVR and its potential complications. And we have with us today, Dr. Eric Van Belle, from Lille, France. And also, Dr. Manos Brilakis, from Minneapolis, Minnesota. Welcome gentlemen. And Eric, we'll start with you. Can you describe for us a little, the background information that you use to assemble and construct your study, and describe, or list for us, the hypothesis that you wanted to address? Dr. Eric Van Belle:           Yes. Thanks a lot for the question. So we knew for many years, that some of the complication of the TAVR procedure relate to the brain. And it has been described by many others, that there were some complication in the brain of patient undergoing TAVR. And there was no previous investigation on potential bleeding or microbleeding in this population. And on the other side, there are previous publication on, of course, initially chronic microbleeding, in patient with some of, let's say, disease in the brain, but also, a possibility of acute microbleeding. And especially, in some interesting population relating to the TAVR feed, that is patient with valve disease, patient with endocarditis, or patient with assist device. In this population, microbleedings, acute microbleeding, have been described. And what is interesting, if you look at all these populations, these are population in which the Von Willebrand factor has been impacted and modified, and could be one of the reason of the microbleeding. And one of the similar feature of the patient with aortic stenosis that undergo TAVI, or TAVR, that are patient with indeed also, this kind of Von Willebrand disease. So if we put everything together that is previously, we only looked at antibody complication in those population, and that Von Willebrand disease, which is present in patient with aortic valve stenosis, could promote a bleeding, in particular, bleeding in the brain. We decided to look at the potential appearance of microbleeding, in patient undergoing TAVR procedure. Dr. Greg Hundley:           Very nice. And Eric, can you describe for us, your study design, and who was your study population? Dr. Eric Van Belle:           Yes. So basically, the study population is a basic population of patient undergoing TAVI. Just to make sure that one of the difficulty of this study, was to conduct and perform an MRI, a brain MRI, before the procedure, and as short as possible after the procedure, within three days, which is logistically challenging. And also, to make sure that we keep most of the population to undergo the MRI, we had to exclude patient with a high risk of pacemaker, or patient with pacemaker that could not undergo the MRI. But basically, without this, it's just a regular population. And if we indeed, compare to some of the previous work I was mentioning, about describing the acute MRI, it was important for us to make sure, or to be as sure as we could get, that indeed, this microbleeding, if we observe them, could be related to the procedure. And it means that, the MRI, after the procedure, should be done as short as possible. And also, that an MRI, a baseline MRI, should be performed. Because we know, that in this population, you could have some microbleedings also observed before starting the procedure. Dr. Greg Hundley:           So a cohort study design where MRIs are performed before, and then very soon after, TAVR procedures. So Eric, what did you find? Dr. Eric Van Belle:           So what we observed, the first thing that we confirmed was indeed, that in this population of that age, that is patient around 80 years old, when we do the baseline MRI, you find in about one out of four patients already, some microbleedings. And this was expected, and it is very similar to what is expected in this kind of population. But what was indeed more striking, that when we repeated the MRI after three days, we observed another 23% of patient with a new microbleedings that were observed. This is indeed the most important observation. What was also important that, the patient with microbleedings, and the location of the microbleedings, were not related to the cerebellum brain, because indeed we could observe some cerebellum arise in this population, as it is expected. And there was no relation between the two. So it's also, an important observation, suggesting that this microbleeding are not hemorrhagic transformation of cerebellum brain, for instance. And we also observed that, the risk of microbleeding, or the chance to observe the microbleeding, was increased when the procedure was longer. And also, when the total duration of anticoagulation was longer, we also observed that, when the procedure was, when we used protamine at the end of the procedure, the risk of microbleeding was less. And also, importantly, the status of the Von Willebrand factor, and indeed, an alteration of the multimer of Von Willebrand factor, was also associated with the risk of microbleeding in this population. Dr. Greg Hundley:           Very nice. So in this cohort of 84 individuals, average age around 80, undergoing TAVR procedure, and about 50/50 men and women, you had several factors. Prior history of bleeding, amount of heparin, absence of protamine, all indicating a higher risk of these microbleeds. So very practical information. Well, Manos, you have many papers come across your desk. What attracted you to this particular paper? And then secondly, how do we put these results really, in the context of maybe other complications that can occur during or after TAVR procedures? Dr. Emmanouil Brilakis: Yes, thanks so much, Greg. And also, congratulations Eric, for a wonderful paper, and thanks for sending it to circulation. I think, with increasing the number of targets, as you know, TAVR now is becoming the dominant mode for treating severe aortic stenosis. Safety is of paramount importance. And even though there's been a lot of progress, we still have issues with the safety of the procedure. So understanding how can make it safer is very important. And I think, what was unique in this paper, again, congratulations for creating this study, is that it opens a new frontier. We worry about stroke. We're all very worried about the stroke, and having the patient have a permanent neurologic damage during the procedure. But there may be more to it than the classic embolic stroke. And I think, this study opens actually, a new frontier with the micro cerebral bleeds. Now we don't completely understand, despite the study, we don't understand the functional significance from this. And I think, that's one of the areas that will need further research. But I think, trying to understand what causes them, and preventing those microbleeds, would have a very important role in the future, for making TAVR even safer than it is. Dr. Greg Hundley:           Very nice. Well, Manos, you really lead us into the kind of the next question. So Eric, what do you see as the next study to be performed in this sphere of research? Dr. Eric Van Belle:           Again, to me, and to follow with the comment of Manos, we need to include, I would say, to solve two questions. We have to solve the question of, what could really impact these microbleedings. And what would be the impact of this microbleeding on the long term outcome of this patient? So it's means that we have to set, as part of the studies that we will design, potentially studies on aortic immolation. Or let's say for instance, we could investigate the role of protamine. It has been suggested that protamine could be something interesting, so it could be tested as part of a randomized study. But this means that, as part of such randomized study on the use of protamine, for instance, you would include a last cohort of patients with MRI after the procedure. And also, a long term follow of the neurological complication, which indeed, is the missing part of our current study. We would need to have a much larger cohort of patients, to be able to reconnect the neurological outcome to the MRI outcome, and also to include this. So let's say, for me, one of the studies we would be interested to perform, is to conduct a study on the use of protamine, which is very simple, randomized, yes or no, and includes brain MRI in this population, as a systematic investigation, which is difficult to conduct. You have to know that it's difficult to do, but it will be very important. And then, to look at the long term neurological outcome. Dr. Greg Hundley:           And I see, Eric, you mentioned the long term, because really in the short term, so within six months, you really didn't see any changes in neurological functional outcome or quality of life. So Manos, just coming back to you. What do you see is the next study that should be performed in this space? Dr. Emmanouil Brilakis: Yeah, I agree actually, with Eric. The next step is, this was an 80 patient study. Right? It's a very small preliminary data, all that opens a new system for evaluation, we're still a very small number of patients. So having a larger number of patients, I think for me, the key thing is to understand the connection. Does this actually cause neurologic symptoms? What does it mean having a microbleed? I think right now, we're still confused on the study. There was not really much impact on the neurologic status of the patient. So for me, the number one thing is, to understand how it impacts the patient's quality of life, the neurologic status. Perhaps more sensitive studies, neurocognitive studies, to understand exactly how it impacts. And then after doing that, I agree with Eric, if this is a bad, something really bad, then we can find different ways to prevent them from happening. Protamine is one of them during the procedure time, and not be a very feasible one. Or it could be interesting to see if different valves, for example, have different propensity for causing those microbleeds. Dr. Greg Hundley: Very nice. Well listeners, we want to thank Dr. Eric Van Belle, from Lille, France, and also, our own associate editor, Dr. Manos Brilakis, from Minneapolis, Minnesota for bringing this very important study, highlighting that one out of four patients undergoing TAVR has cerebral microbleeds before the procedure. And then, after the procedure, one in four patients develop new cerebral microbleeds. And then, procedural and antithrombotic management, and persistence of acquired Von Willebrand factor defects, were associated with the occurrence of these new cerebral microbleeds. Well, on behalf of Carolyn and myself, we want to wish you a great week, and we will catch you next week On the Run. Dr. Greg Hundley:           This program is copyright of the American Heart Association 2022. The opinions expressed by speakers in this podcast are their own, and not necessarily those of the editors, or of the American Heart Association. For more, please visit ahajournals.org.

Vida Potencial | Salud, Nutrición y Estilo de Vid
Todo sobre la vitamina D // Deficiencia y cómo se manifiesta, rango óptimo y mucho más.

Vida Potencial | Salud, Nutrición y Estilo de Vid

Play Episode Listen Later Jul 31, 2022 62:33


Más en: https://www.vidapotencial.com Tienes un 80 % de probabilidad de tener niveles bajos de vitamina D. La vitamina D es una hormona que juega un papel clave en montón de aspectos de nuestra biología y cuya deficiencia puede causar muchos problemas a nuestra salud. En este podcast nos centramos en 5 de ellos, cuya incidencia, como consecuencia del estilo de vida y alimentación que llevamos, se ha disparado en los últimos años. Puedes ver la línea del tiempo más abajo. Gana salud con nosotros: Nuestro programa de Pérdida de Peso -- https://bit.ly/programa_perdida_peso Nuestro programa de Dieta antiinflamatoria -- https://bit.ly/programa_dieta_antiinflamatoria Otros cursos y programas -- https://bit.ly/cursosvidapotencial PROGRAMAS DE NUTRICIÓN Pierde peso de manera saludable, iníciate en la dieta cetogénica o en el ayuno intermitente o mejora tu salud con una dieta antiinflamatoria o regula tus hormonas en la menopausia de la mano de la Dra. Isabel Belaustegui. https://programas.vidapotencial.com CURSOS DE ENTRENAMIENTO Y BIENESTAR Iníciate en el entrenamiento de fuerza o en el entrenamiento con kettlebells de la mano de los mejores profesionales. https://www.campuspotencial.com CURSO 50+ MUJER Optimiza tus hormonas y tu salud. https://www.campuspotencial.com/curso-menopausia/ - Únete a la comunidad, es gratis y siempre lo va ser, suscríbete a nuestra newsletter y descarga GRATIS nuestra GUÍA sobre la combinación de alimentos: https://www.vidapotencial.com/unete/ - Nuestras redes sociales: INSTAGRAM: https://www.instagram.com/vidapotencial/ FACEBOOK: https://www.facebook.com/vidapotencial/ - 0:00 Introducción 1:53 Cómo subir niveles de vitamina D 5:05 Deficiencia de vitamina D 9:20 Salud de los huesos, osteoporosis y vitamina D 13:35 Déficit de vitamina D en niños 15:15 Vitamina D en embarazadas y lactantes 17:10 Rango óptimo de vitamina D 19:05 Niveles de vitamina D y cáncer 22:30 Esguinces y luxaciones y vitamina D 25:35 Dosis adecuada de vitamina D y cómo tomarla 29:45 Hipertensión arterial y vitamina D 32:20 Vitamina D y LDL colesterol 36:20 Deficiencia de vitamina D e inflamación 39:05 Vitamina D y la Covid-19 41:45 Enfermedad de Crohn, colitis ulcerosa y vitamina D 43:45 Impacto de la vitamina D en el sistema inmune 44:40 Alimentación infantil y vitamina D 49:10 Salud cerebral y vitamina D 50:05 Enfermedad de Parkinson, esclerosis múltiple y vitamina D. - Recuerda que: “Todos los productos y contenidos ofrecidos por Vida Potencial (tales como, programas y cursos de nutrición, actividad física y vida saludable, libros, vídeos, artículos, posts, podcast, Vlogs y vídeo-tutoriales) tienen naturaleza meramente informativa y divulgativa y en ningún caso constituye servicio médico o sanitario de ningún tipo ni sustituye la consulta con un médico especialista, por lo que no deben ser aplicados sin la aprobación previa y supervisión de un médico o profesional de la salud especializado, particularmente en casos de personas con patologías, lesiones, limitaciones o anomalías físicas o nutricionales o cualquier otra condición especial. Ninguno de los productos, servicios y contenidos ofrecidos por Vida Potencial pueden servir de consejo médico, diagnóstico, prescripción ni tratamiento de tipo alguno de dolencia, enfermedad o patología.” - Si tienes ideas o sugerencias de cómo podemos mejorar estos videos, o posibles temas que te gustaría que tocáramos, por favor déjalo en los comentarios. - ¡Muchísimas GRACIAS por estar ahí!

High Intensity Health Radio with Mike Mutzel, MS
High Triglycerides more Problematic than High LDL Cholesterol, Science You Should Know

High Intensity Health Radio with Mike Mutzel, MS

Play Episode Listen Later Jul 30, 2022 24:55


The consensus in the medical community about the importance of low-density lipoprotein cholesterol (LDL-C) reduction is finally shifting. Ample research shows that elevated triglycerides and triglyceride-related lipoproteins are more problematic than LDL-C when it comes to the risk of heart and metabolic disease. This new Electrolyte + Creatine Combo can help you crush your next workout: https://bit.ly/electrolyte-stix Use code podcast at checkout to save Enroll in the Blood Work MasterClass Live, our next call is Tuesday August 2nd, 2022: https://bit.ly/blood-work-masterclass Link to Video and Research:  Time Stamps: bit.ly/3JjJTbH 0:45 Triglyceride-rich lipoprotein is a hallmark of diabetic dyslipidemia. It cannot be controlled by statins.  4:50 Remnant cholesterol is independently associated with the onset of diabetes.  5:33 Remnant lipoproteins are a consequence of lipid absorption from the GI tract.  6:50 Apo-B is on the extra cellular surface of atherogenic vLDL, IDL, LDL, and remnant lipoprotein.  7:40 HDL have the Apo-A1 protein on the extra-cellular surface.  8:35 Test your Apo-B to Apo-A1 ratio and your vLDL, LDL and remnant lipoprotein assessment.  9:15 IDL and vLDL are enriched in triglycerides and cholesterol and drive inflammatory processes. 9:45 Statins are anti-inflammatory.  10:45 Remnant lipoproteins drive metabolic disease by increasing ectopic lipid deposition.   11:35 Remnant lipoproteins induce endothelial dysfunction. 12:00 Clotting cascades can be driven by remnant lipoproteins.  13:35 Remnant lipoproteins can penetrate the arterial wall and become trapped and oxidized, creating plaque. 15:00 Remnant triglyceride rich lipoproteins are more atherogenic than LDL cholesterol. 15:50 Dietary fat composition can render lipoproteins more oxidizable.  17:00 Request the labs listed on page 1 of the Bloodwork Cheat Sheet. Do fasted labs then non-fasted lipid levels.  18:15 Lipid Load Test: if your blood triglycerides are more than 220 nanograms/ml, you have difficulty processing fats in the post meal window. 18:55 Lose weight, especially around the abdomen.  19:35 Eat a low carb diet. 20:05 Exercise regularly, both resistance training and aerobic exercise. 20:25 Statins lower triglycerides 20 to 30%. They also induce insulin resistance, which increases triglycerides. 20:55 Omega 3 fats reduce triglycerides. Test your omega 3s. 23:05 Optimal fasting triglycerides are around 60 and 70. Postprandial triglycerides should be less than 180.

Nutrition Rounds Podcast
All You Need to Know About Cholesterol Metabolism

Nutrition Rounds Podcast

Play Episode Listen Later Jul 27, 2022 29:23 Very Popular


This week, Dr. Danielle is back for part two of her highly requested cholesterol series, where she is setting you up with the foundational knowledge about cholesterol and lipid metabolism. She covers why this topic is so important for your health, and she arms you with the tools to debate any cholesterol denier or self-proclaimed bio-hacker at your next dinner party.  In order to truly understand the way nutrition, diet, lifestyle, and medications impact cholesterol and heart disease, you have to understand lipid metabolism. The Cholesterol class is in session!    On today's episode, Danielle addresses the following questions surrounding cholesterol metabolism:   Why is lipid metabolism important?   Where does cholesterol actually come from and how does your body make it? And how does your body get rid of cholesterol?   What happens when cholesterol is turned into bile? What happens to VLDL, LDL, and HDL particles in the body? Where do they go? What happens when we eat food, including dietary cholesterol? How do the cells in your small intestine play a role in lipid metabolism? What are chylomicrons, what do they do, and why aren't we measuring them?   How does our body know how to regulate the amount of cholesterol it makes? And much more!   Thank you so much for taking the time to contribute to a generation that values fact over fiction! Be sure to rate, review, and follow on your favorite podcast app and let us know which not-so-wellness trend you'd like to hear debunked. Follow your host on Instagram @daniellebelardomd and the podcast @wellnessfactvsfiction       Thank you to our sponsors for making this episode possible. Check out these deals just for you:  COZY EARTH - Go to cozyearth.com and enter WELLNESS at checkout to SAVE thirty-five  Percent. 

Know Diabetes by Heart™ Professional Education Podcast Series
2022 Episode 6 – Three Basic Targets

Know Diabetes by Heart™ Professional Education Podcast Series

Play Episode Listen Later Jul 27, 2022 39:30 Very Popular


Diabetes is more than a blood sugar problem. Help your patients with type 2 diabetes understand their risk of cardiovascular disease and the importance of blood pressure, lipid, and glucose control in managing risk.  Listen to Nathan Wong, PhD, MPH and Colette Knight, MD discuss ways for patients to know and understand their numbers in LDL cholesterol, triglycerides, blood pressure, A1C, and more.  

Let's Know Things

This week we talk about CRISPR/cas9, LDL, and human trials. We also discuss sickle-cell, the human germline, and super-tomatoes. Support the show: patreon.com/letsknowthings & letsknowthings.com/support Show notes/transcript: letsknowthings.com Check out my other shows & publications: understandary.com

Mayo Clinic Talks
Elevated Triglycerides: Implications for Cardiovascular Health

Mayo Clinic Talks

Play Episode Listen Later Jul 26, 2022 29:39


Host: Joshua D. Luciew, MPAS, P.A.-C. Guest: Abigail K. Stockland, APRN, C.N.P., M.S.N. Guest: Michaeleen M. Burroughs, M.S., RDN, LD A fasting lipid panel is part of a patient's routine health maintenance visit. This common laboratory test has many values on it including total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. This test helps clinicians calculate a patient's 10-year atherosclerotic cardiovascular disease risk (ASCVD risk) to help guide treatments. If a patient's risk is determined to be high, statin medications can be considered. However, despite using statin therapy and addressing modifiable risk factors, some patients still have elevated triglycerides.  What role do triglycerides play in a patient's health?  Does hypertriglyceridemia contribute to cardiovascular disease? Tune in to this episode to find out more from our panel discussion. Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

The Working With... Podcast
Why Bother Setting goals?

The Working With... Podcast

Play Episode Listen Later Jul 25, 2022 13:12


Why set goals? After all, most people fail to achieve them and for those lucky few that do, what then? What do you do after you've achieved your goal? Find out in this week's episode. You can subscribe to this podcast on: Podbean | Apple Podcasts | Stitcher | Spotify | TUNEIN Links: Email Me | Twitter | Facebook | Website | Linkedin Email Mastery Course The Time Blocking Course The Working With… Weekly Newsletter The Time And Life Mastery Course The FREE Beginners Guide To Building Your Own COD System Carl Pullein Learning Centre Carl's YouTube Channel Carl Pullein Coaching Programmes The Working With… Podcast Previous episodes page Episode 238 | Script Hello and welcome to episode 238 of the Working With Podcast. A podcast to answer all your questions about productivity, time management, self-development and goal planning. My name is Carl Pullein, and I am your host for this show. It always surprises me that many topics come round in cycles, and suddenly I am inundated with questions and queries about that topic. And that's what happened with this week's question. I got a podcast question and then a few emails about the subject, and then it came up in two of my coaching sessions. Now I suspect the goals question has come up because of the realisation we've just gone past the halfway point of the year, and when we look at the list of things we wanted to do this year—our goals and projects—we discover we are way off achieving the things we wanted to do, and our goals appear on our radar again. So, why do we set goals? What's the point? With a statistic that claims only 8% of you will achieve your goals, it suggests even attempting to go after a goal is going to result in disappointment for 92% of you.  Well, this statistic hides the real purpose of a goal—it's not about achieving the goal; it's about what you have to change about yourself to achieve that goal. And that is what we are going to look at in a little more detail today. So, I guess that means it's time for me now to hand you over to the Mystery Podcast Voice for this week's question.  This week's question comes from Liam. Liam asks, hi Carl, I recently went through my goals for 2022 after your recommendation in your weekly newsletter, and I realised I am miles away from achieving them. If I am being honest, I haven't really done much about them at all. What can I do to stay focused on my goals? I do this every year, and it's really frustrating. Hi Liam, thank you for your question and please don't worry. You are certainly not alone. Most people will find themselves in the same position as you are right now.  Okay, first, let's look at what a goal is for. Setting goals gives you a roadmap—a direction, if you like—to help you grow and flourish as a human being. Without a goal or a set of goals, we drift. We will be pulled and pushed towards what everyone else wants for us, and that's never usually what we desire or want. Without that direction, you are setting yourself up for a very disappointing life.  I remember reading Bronnie Ware's book The Top Five Regrets of the Dying several years ago, and it scared me. I realised I was heading in the same direction as many of the people in that book. Who knows when we will leave this world? All we do know is there will come a time for us to depart. So the only question we need to ask is what would I like to do with my short life?  And that's the key here. What do you want? If you don't have an answer to that question, you will drift through life and become another dead being, having achieved nothing and done nothing. Sorry to be so dramatic. I hope that scares you, it should do. It scares me.  So now we've dealt with the morbid part; let's look at the bright side.  Having a few long-term goals gives you a sense of purpose and a pathway to follow. You can change that pathway at any time if you feel you no longer want to pursue the direction you were going, but at least you have a direction, and you are growing and developing while you are on that path.  If I look back at my early life, I wanted to be a police officer, a Royal Marine, a vet and a physiotherapist—these were all goals I had while I was at school. However, like all teenagers, I changed my mind and went in a different direction. But each one of those occupations were goals at one time or another that I abandoned. But the abandonment was not in vain. I learned what it takes to become a police officer and a marine. I also learned a little about animals and human physiology.  Now, as I am older, my goals are more refined and more long-term, but I still have them. My goals don't change much. Indeed, they haven't changed much at all over the last ten years. I wanted to build a business—which I've now done, and now I want to grow that business. One change I have had to make about myself in the last ten years is to change my mindset from an employee one to a business owner. That was a lot more difficult than I expected, but it has been a wonderful journey.  And that is where having goals brings its the biggest benefit. You have to change. If you don't have to change, then there's no goal.  For instance, a lot of people set themselves the goal of losing weight. Great, with two-thirds of the western world population overweight or obese, that's a good goal to have. However, the goal is not really to lose weight. Anyone can lose weight. Skip dinner tonight and weigh yourself tomorrow morning. You will have lost weight. But skipping meals long-term is not sustainable. Instead, what a weight loss goal needs to do is change your eating habits and lifestyle. A weight loss goal is a lifestyle change. Most of us eat too much of the wrong types of food and develop painful, debilitating diseases as a result. So, the goal is to change our eating habits, move more and keep the weight off so we can live a healthy, active long life. If your only purpose is to lose a few pounds, you'll likely lose it, but if you are not changing your habits at the same time, you will quickly put that weight back on.  One of my biggest current goals is to buy a piece of land and build our family home to our specifications. Right now, I do not have the money to buy the land, but the habit I needed to change to achieve this goal is to become less of a spender and more of a saver. I have cut out a lot of my expenditure, and I save a lot more money now than I did before. I became aware of just how much I was spending and was able to reign that spending in.  If we choose to abandon that goal in a few years' time, it won't matter. What matters is I now longer spend frivolously. I have become a saver, not a spender. My whole identity has changed.  So, what about you, Liam? What do you want?  For you to achieve what you want, what do you need to change about yourself?  We humans can achieve almost anything we want to achieve. Millions of people before us have achieved incredible things. How did they do that? They did it by first learning what they need to change and then dedicating themselves to changing. How do you write a book? You have to dedicate an amount of time each day to doing focused writing. To do that, you need to learn how to focus and do deep work without distractions. You need to change your habits. Rather than sitting down and consuming, you need to change to be a creator.  If you desire to be the CEO of a leading company, you need to change from being a follower to being a leader. Again, it's not easy, and you will need to learn about leadership by reading about leadership and learning from the greatest leaders.  There's a concept that Tony Robbins teaches. It's called CANI (C-A-N-I), which stands for Continuous And Neverending Improvement. As humans, we thrive and grow when we are continuously improving ourselves. We can do that by learning—reading, and studying. We can do that through exercise if we want to improve our health or by learning more about the food we eat.  There has never been a better time to apply CANI. We have an abundance of resources through YouTube and blog posts to be in a state of continuous improvement.  And finally, a word about failing. You never really fail unless you quit. Altering your goals, refining them or changing them completely is fine. Quitting is not. However, if you start down a path and struggle, you are not failing; all you are doing is gaining data points.  Failing is a part of achieving goals. The failure gives you data you can use to adjust your approach so you can try it a different way. This is part of the fun of having goals.  My first attempted marathon was a complete failure. I remember the day well. It was a hot, humid day, and the marathon I was attempting was ten times up and down a large hill. Stupid of me to try this as my first marathon, but there you go. I managed to do half the course before pulling out.  However, while I was disappointed, I learned I needed to change my training. I needed to add a few long runs of around eighteen to twenty miles, and I needed to get off the flat ground and start adding a few hills to my training runs.  I changed my approach, and three months later, I ran my first full-course marathon.  Did I fail at the first one? of course not. It turned out it was a training run (although, at the time, I treated it as a proper race). I learned a lot from that first attempt and was able to make adjustments so I could complete a full course marathon three months later.  So, I urge you, Liam and anyone else listening who has struggled with their goals to focus on what you need to change about yourself to achieve your goal. What is it that has prevented you from achieving them before that you could change and start to achieve your goals?  Remember, if you write 500 words a day for 120 days, you will have written a 60,000-word book. That's just four months. Develop the habit of writing.  If you cut out soft drinks full of sugar, refined carbohydrates and fast food, in three months, your blood sugars and LDL cholesterol will have returned to normal (or close to normal). Make some minor changes to your diet, and you'll be a lot healthier.  A goal is less about accomplishing the goal. It's much more about who you become in the process of achieving the goal.  Thank you, Liam, for your question and thank you to you too for listening. It just remains for me now to wish you all a very, very productive week.   

Surfing the Nash Tsunami
S3-E37.4 - The "Pincer Movement" In Cirrhosis Technology: Patient Support vs High-End MedTech

Surfing the Nash Tsunami

Play Episode Listen Later Jul 24, 2022 11:43


This week, Surfing the NASH Tsunami returns to a subject we have explored from time to time over the past two years: helping patients with cirrhosis. While the immediate stimulus for doing so was the semaglutide late-breaker at #ILC2022, our more general interest is that many patients with cirrhosis will start to decompensate and decline in a fairly short period of time. This conversation focuses on what Roger Green describes as a "pincer movement" in technological development: high-end technology to empower better diagnosis, staging and treatment and low-end technology to capture more patients, capture them earlier in disease and keep them engaged in the process.The conversation starts with Roger posing a question of whether the major need in improving cirrhosis diagnosis and treatment is a human systems or a medical technology issue. After some conversation, the answer turns out to be "both."Louise Campbell responds first. She focuses on human systems needs: send the right letter, engage the patient and provide the proper and necessary information to educate the patient and keep them involved. She goes on to note that (i) these needs appear to be global in scope although the challenge takes different forms in different countries; and (ii) for patients with progressive disease, "not feeling worse" is an outcome they will pursue aggressively. This observation, coming after earlier discussions about medical treatment issues, leads Roger to make his "pincer movement" comment. Jörn Schattenberg agrees that there is a "disparity" between investment in high-end medical technologies and physician and hospital office systems that rely on older technology and inadequate systems. He states that he considers it important to invest in health structure improvements as well as advancing technologies.Roger asks Lars what role high-end technologies will play in advancing patient care. Lars suggests that technology's major role will be in driving better decisions about which drugs to develop and how. He goes on to state that advances in clinical practice need to be simple, affordable and practical. The example Lars gives is an effort years ago to persuade Swedish patients with dyslipidemia and cardiovascular disease to focus on Apo B instead of LDL. The task became impossible because, in spite of more compelling data on Apo B, the concept of LDL-lowering as the therapeutic target was so well embedded that it proved impossible to dispel, or even modify meaningfully. As this conversation winds down, Roger asks Lars to describe work he is doing that will benefit patients. Lars talks about exploring the effects of cirrhosis on other organ systems, specifically the heart and kidney. Jörn follows up with a question about deploying standard imaging (his example is back pain) to identify previously undiagnosed liver issues. Lars responds by discussing an AI-aided study he is working on with 30,000 patients looking at multi-organ imaging issues using CT. He suggests that in the future, simply having a section of liver in the CT will provide this kind of guidance.

Wealthy Wellthy Wise
#245 An Unknown Fountain of Youth – Learn the Benefits of Fasting w/Dr. William Hsu

Wealthy Wellthy Wise

Play Episode Listen Later Jul 22, 2022 58:13


My guest this week is Dr. William Hsu. After 20 years of a distinguished career as an endocrinologist at Harvard's Joslin Diabetes Center, Dr. William Hsu joined L-Nutra in 2019 as Chief Medical Officer. In this role, Dr. Hsu leads the clinical development effort at L-Nutra, oversees the Medical Affairs Department, and advances the education and adoption of fasting and Fasting Mimicking Diet as an innovative tool to extend human healthspan. Among his prior roles, he served as Vice President at Joslin Diabetes Center, a teaching affiliate of Harvard Medical School, responsible for its international education and healthcare advisory programs. He served on multiple national-level professional committees, including the American Diabetes Association, setting national standards of medical care in diabetes. His previous research interests focused on the pathophysiology of diabetes and the application of digital technology in chronic care. Dr. Hsu went to Cornell University for college and received his medical degree from Mount Sinai School of Medicine. He completed his Internal Medicine residency training at Yale School of Medicine and completed his fellowship training in Endocrinology and Metabolism at Harvard Medical School. He was Assistant Professor of Medicine at Harvard Medical School. Topics Mentioned: Changes in the function of hormones, cells, and genes Reduction of insulin resistance, lowering the risk for type 2 diabetes and helping to reverse it Reduces oxidative stress and inflammation in the body Promotes heart health by improving blood pressure, blood triglycerides, and LDL cholesterol Induces cellular repair throughout the entire body Promotes brain health by reducing oxidative stress and brain inflammation Prevents neurodegenerative diseases such as Alzheimer's, Parkinson's and Huntington's diseases Dr. Hsu gives us the backstory and knowledge we need to better understand the sacred mechanism of fasting.  Did you know that around 5-6am is when all the stress hormones surges? This is when the adrenal glands really begin to kick in. When reasonably applying fasting, there is major rejuvenation going on within the body.  As Dr. Hsu says: “If we were to reduce or take away the source of calories for a period of time, the body is in this crisis moment, so it taps inside and goes to the fats– the central fats– it asks itself: ‘what can I get rid of?' And when that fasting period passes, when the nutrients come, now the body can form new parts to rejuvenate new cells.” Fast. Re-eat. Fast. Re-eat. These are the cycles of fasting and the cells way of remaining youthful…longer! I think we all want that ;) Fun fact: Fasting affects every cell in the body– including brain cells!  After 5 days of prolonged fasting, people experience 4 levels of changes… Midsection weight loss (this fat is a source). Your body finds fasting as stress. So this is a stress that sharpens your mind & preserves your muscles.  You feel better! Clarity of the mind. Focused. You feel a sense of achievement. Your cells are rejuvenated  Dr. Hsu's pro tip? Repeat this 3x a year!  To be your healthiest yet, Dr. Hsu has provided a code! You can use “wealthywellthy” for 15% for ProLon on ProLonFMD.com or ProLonFast.com.   Links: Dr. Hsu's Twitter Dr. Hsu's Facebook Dr. Hsu's LinkedIn

The Dive - A League of Legends Esports Podcast
The Dive | Is TSM Saved and Would Fearless Mode Help The LCS?

The Dive - A League of Legends Esports Podcast

Play Episode Listen Later Jul 21, 2022 95:31 Very Popular


Hey there Dive friendos, we're back with lots to talk about after a spicy weekend of upsets & news. We've got Azael, Kobe & Mark full of caffeine & full of news to kick off your week in league. The squad shared their thoughts on TSM's recent coaching swap and where they see this rejuvenated squad going. Plus, they talk about the newest format change to LDL, Fearless mode, and whether this would promote or hamper the growth of players in North America. They are pretty divided on the topic so leave your opinions below! They also talk about the upcoming Pro focused balance changes & whether Nilah is actually still broken after her hotfix nerfs. The bunch then dives into the LCS teams: Are EG unstoppable? What does success look like for Team Liquid Honda? How competitive is the middle of the pack & are teams using Swain to their full potential? Thank you for those of you that send in questions! A reminder that if you tweet them, use #TheDiveLol and if you send them on Anchor.FM, include your name in the audio! We love shouting out our fans.Games kick back off Saturday with EG facing off against CLG at 1:30PM PDT. Make sure you tune in to capture all the action! --- Send in a voice message: https://anchor.fm/the-dive-esports-podcast/message

Fresh Leaf forever
Staying heart healthy & warding off diseases using a Lifestyle approach - Part 1

Fresh Leaf forever

Play Episode Listen Later Jul 21, 2022 43:43


Staying heart healthy is becoming more and more significant in this fast paced modern day scenario.Given this paramount need to focus on heart health, I sat down with an expert physician, book author, septuagenarian athlete on the show. Our guest Dr.Akil Taher recovered from a heart bypass surgery himself, and has transformed his state of health to one of vibrant & robust living by tweaking his diet and lifestyle practices.Dr.Taher and I discuss the following aspects in this enlightening conversation:- Role of success in an individual's life and how this breeds ignorance and arrogance- Chronic conditions versus conditions needing immediate attention- Dr.Taher's own journey with heart health- "Man made conditions" versus genetics- Role of lifestyle in reversing diseases that are chronic- How epigenetics can transform body's response to DNA- Lifestyle implications on health- How heart health is influenced by cultural habits/diets and across cultures- Why heart health is compromised a lot in South Asian population- Susceptibility to heart conditions in the above cohort- Saturated fats, sugars and connection to oil in our lives- Impact of illnesses on mental health- Spirituality, meditation and benefits- Exercise, cardio protective exercising parameters- HDL, LDL, Triglycerides and what they mean and ideal levelsand much more ....Please be sure to tune in to Part 2 of this conversation on this podcast to get Dr.Taher's wholesome perspective on this topic.Tune in today to benefit from this conversation and spread the word! Follow the podcast on Spotify, Google, Apple , Amazon or on any major podcast source.Fresh leaf forever  website has all the episodes for anyone to enjoy.Follow me on Instagram for interesting digital media content and all that I do and follow me on twitter as well.Dr.Taher's book,  all  resources and contact information may be found via his website https://www.akiltaher.comAlso, click this Buzzsprout link to get started with your own podcasting hosting service with Buzzsprout.Following the above link  let's Buzzsprout know we sent you, gets you a $20 Amazon gift card if you sign up for a paid plan, and helps support our show.You can also support this show otherwise by using support the show link at the bottom. Fresh leaf forever podcast comes to you from Listen Ponder Change LLC, founded by Host Vai Kumar.DISCLAIMER: THIS EPISODE IS NOT A SUBSTITUTE FOR IN PERSON MEDICAL ADVICE. PLEASE CONSULT YOUR DOCTOR FOR CASE TO CASE NEEDS.Buzzsprout - Let's get your podcast launched! Start for FREEInstacart - Groceries delivered in as little as 1 hour. Free delivery on your first order over $35.Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the show

Nutrition Rounds Podcast
Why Everyone Should Care About Cholesterol

Nutrition Rounds Podcast

Play Episode Listen Later Jul 20, 2022 41:49 Very Popular


This week, Dr. Danielle is hopping on the mic solo to dive into one of your most requested topics (drum roll, please) — cholesterol. As a cardiologist, lipids and cholesterol are practically her second language, and she has heard every question under the sun from her patients. In part one of this multi-part series, she covers the foundations of cholesterol, common terminology, and myths and misconceptions. Welcome to Cholesterol 101!        On today's episode, Danielle addresses the following questions surrounding cholesterol:      What is it and is it true your body needs it?  How does it cause heart disease?  Is it true that LDL causes heart disease?  What does a lipid panel tell you?  What is the difference between total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides, and how does each one relate to cardiovascular risk?  What are some of the values we are looking to target to get an optimal lipid panel?      Thank you so much for taking the time to contribute to a generation that values fact over fiction! Be sure to rate, review, and follow on your favorite podcast app and let us know which not-so-wellness trend you'd like to hear debunked. Follow your host on Instagram @daniellebelardomd and the podcast @wellnessfactvsfiction    Thank you to our sponsors for making this episode possible. Check out these deals just for you:  COZY EARTH - Go to cozyearth.com and enter WELLNESS at checkout to SAVE thirty-five  Percent. 

Hotline League
Did TSM make the right move? Should LCS SELL the 10th place team to Mr Beast? ft. TSM Soul | HLL 231

Hotline League

Play Episode Listen Later Jul 19, 2022 120:33 Very Popular


00:00:00 Intro - Soul's history and path to LCS 00:23:50 YoungAspiring's take: EG will be the straw that broke the camel's back in Bjergsen's career 00:40:25 Alienware break! 00:42:45 djmerali thinks TSM has a unique opportunity to gain fans with new roster 00:56:40 CLOSE YOUR DOOR KOBE 00:57:25 Omar's take: LDL's fearless draft format would be good for LCS 01:14:50 Xanadu's take: 100T's year is doomed 01:23:05 Dblg's take: the hype around TSM is unwarranted 01:33:55 Kobe joins HLL to sell MrBeast an LCS team 01:39:10 TGI x Grubhub 01:42:26 lazerfruit's take: is TSM commits to Soul, he'll be top 3 NA by next year 01:48:22 Lofei asks if TSM is the drippiest LCS team ever to exist 01:52:15 Warshipper expresses gratitude to TSM fans and Soul 01:55:20 Follow Soul on Twitter 01:57:10 Outro

Health Newsfeed – Johns Hopkins Medicine Podcasts
You may soon be hearing a new term to assess your heart disease risk, Elizabeth Tracey reports

Health Newsfeed – Johns Hopkins Medicine Podcasts

Play Episode Listen Later Jul 19, 2022 1:04


You've probably already heard about total cholesterol and its cousins HDL and LDL, especially if you see a cardiologist. Now a new term called remnant cholesterol is entering the conversation, with a recent study concluding that it can increase accuracy in predicting heart disease risk. Seth Martin, a cardiologist at Johns Hopkins, explains. Martin: This […]

Health Newsfeed – Johns Hopkins Medicine Podcasts
Can so called ‘remnant cholesterol' help you reduce your heart disease risk? Elizabeth Tracey reports

Health Newsfeed – Johns Hopkins Medicine Podcasts

Play Episode Listen Later Jul 19, 2022 1:03


We know that reducing LDL cholesterol, often by using a statin, helps reduce someone's heart disease risk. Now that so-called ‘remnant cholesterol' is being added to the calculations, what can be done about it? Johns Hopkins cardiologist Seth Martin says, not much at this point. Martin: When we think about what we can do in […]

Kym McNicholas On Innovation
Cutting-Edge Cardiovascular Bloodwork

Kym McNicholas On Innovation

Play Episode Listen Later Jul 19, 2022 45:36


Are your arteries on fire? Are there hidden (or obvious) correctable risk factors that are fueling the fire? In most cases specialized blood testing, along with a careful evaluation by a knowledgeable healthcare provider, can uncover multiple addressable areas that can reduce your risk of ongoing artery damage. On this week's The Heart of Innovation, hosts Kym McNicholas and Dr. John Phillips are joined by Dr. Michael Dansinger, Medical Director at heart-health company Boston Heart Diagnostics, that does specialized blood testing to help doctors and patients manage and prevent vascular diseases including peripheral artery disease. Boston Heart also provides ultra-personalized nutrition and lifestyle prescriptions for patients based on their blood test results and other factors specific to each patient. Blood tests must be ordered by healthcare providers and are partially covered by medical insurance in most cases. They discuss a variety of different advanced blood tests for cardiovascular health and what they mean. Why is it important to perform advanced bloodwork? It's for: Uncovering obvious and hidden risk factors for ongoing cardiovascular damage Designing an optimal eating strategy based on an individual's specific blood test results, medical issues, and food preferences Identifying appropriate treatments including lifestyle recommendations, medications and/or supplements Measuring improvements resulting from treatments including lifestyle habits, medications, and/or supplements There are seven different categories of specialized cardiovascular blood tests offered through Boston Heart Diagnostics: Particles that cause artery damage Cholesterol source Cholesterol elimination Fatty acid balance Diabetes risk Inflammation Genetics During this show, we focused mainly on particles that cause artery damage, cholesterol source, cholesterol elimination, inflammation, and diabetes risk. More specifically: Particles that cause artery damage LDL cholesterol: The concentration of cholesterol in LDL particles. Levels around 60-70 mg/dL are optimal for artery health, especially in people with known cardiovascular disease or peripheral vascular disease. It usually requires statin medications to get that low. Levels of 70-100 mg/dL are reasonably good for people without known vascular disease. ApoB: This measures the concentration of LDL particles rather than the concentration of cholesterol contained in LDL particles. ApoB levels predict cardiovascular risk slightly better than LDL cholesterol. LDL-P: This is an alternative way to measure the concentration of LDL particles. Small-dense LDL cholesterol: Most of the damage caused by the smallest and densest LDL particles. Boston Heart measures the amount and percentage of cholesterol specifically in small-dense LDL particles. Publishes studies show this test is a superior predictor of cardiovascular disease, and you want the levels to be as low as possible. Along with appropriate medications and/or supplements, lifestyle changes such as weight loss, eating less refined sugars and starch, and daily exercise can reduce small-dense LDL cholesterol. Lipoprotein (a): This is an artery-damaging particle that is too high in about 20% of men and women. High levels can run in families since it is genetically determined. Cholesterol Source Testing Cholesterol production: The liver makes cholesterol. In some people the liver makes too much cholesterol leading to high levels of LDL particles, including small-dense LDL particles. This may happen for genetic reasons, or because there is a lot of fat accumulated in the liver, or for other reasons. There are blood tests that identify whether high cholesterol levels are due to overproduction. Weight loss can reduce fatty liver and cholesterol overproduction. Statin drugs (for example Crestor or Lipitor) reduce cholesterol production from by the liver. Repeat testing of cholesterol production levels can demonstrate the effectiveness of treatments. Cholesterol absorption: The intestines absorb cholesterol. In some people (about 25-30%) the main source of high LDL cholesterol levels is from over-absorption rather than over-production of cholesterol. These people are more sensitive than others to dietary cholesterol, and they do not respond as well to statin drugs. They respond well to medications (like ezetimibe) and supplements (like fiber and plant sterols/stanols) that block cholesterol absorption by the intestines. In this way, knowing the source of high LDL cholesterol can guide treatment decisions by doctors and patients. Cholesterol Elimination HDL cholesterol: Most people call this “good cholesterol” but it is actually a way to measure the level of HDL particles. HDL particles help remove excess cholesterol from the body. Higher levels of HDL cholesterol indicate lower risk of heart and vascular diseases. Exercise raises HDL cholesterol; smoking lowers HDL cholesterol. Large HDL particles: You want your HDL particles to be large. The large HDL particles are the ones that remove cholesterol most effectively. Unfortunately unhealthy refined sugars and starches, abdominal obesity, and insulin resistance prevent the HDL particles from becoming large and mature. Think of apples on a tree that never become large and ripe because the tree is not getting what it needs. People with cardiovascular disease often lack the large HDL particles, which can be measured most effectively with the “HDL Map” test by Boston Heart. Studies show the HDL map test is very effective at measuring improvements caused by favorable lifestyle changes. Diabetes Risk Studies show that among people age 65 and older in the U.S., about 25% have diabetes, plus another 50% have prediabetes! We are all at risk for diabetes in our lifetime, and there are blood tests for measuring that risk. Healthy lifestyle choices and certain medications can delay the progression from prediabetes to full type 2 diabetes, or potentially improve type 2 diabetes to the point of remission. Hemoglobin A1c: this simple blood test is in common use, and can be used to measure the risk or extent of prediabetes or diabetes. It provides a 2 to 3 month average blood sugar reading by showing how “sugar coated” your blood is. Insulin testing: This simple blood test is done after an overnight fast. Insulin is a hormone made by the pancreas to move sugar (glucose) from the blood into tissues to be used for energy. Some people have abnormally high or low insulin levels in the blood, which an be used to provide measures of diabetes risk. Improvements in insulin levels can be used to measure improvements in diabetes risk. At Boston Heart we offer a test called the “Beta Cell Function and Risk Index” which uses fasting insulin and glucose levels to monitor diabetes risk and recommend treatments based on the specific results. Prediabetes assessment testing: This test offered by Boston Heart gives doctors and patients a measure of how rapidly a patient is moving from prediabetes toward prediabetes toward type 2 diabetes. The test uses a combination of multiple blood tests and clinical factors that have been shown to predict (with an accuracy of 92%) the 10-year risk of diabetes in patients with prediabetes. Inflammation When we talk about “fire” in the arteries that is another way saying “inflammation” in the arteries. We can use special blood tests to measure different aspects of inflammation. C-reactive protein (CRP): This is the most common test for inflammation. Increased blood levels means there is inflammation somewhere in the body, from any cause. If there is no sign of infection, injury, or illness that could cause inflammation, then an increased blood level is often a measure of the intensity of ongoing artery damage from any cause. MPO: This is also known as “myeloperoxidase”. It is a general measure of active white blood cells and inflammation. In someone with known coronary artery disease, high levels of MPO can signal “hot plaque” that is at risk to cause a heart attack. LpPLA2: This is also known as the “PLAC test”. It is a measure of inflammation caused by cholesterol plaque inside the artery walls. It is more specific to artery health than C-reactive protein or MPO.

Surfing the Nash Tsunami
S3-E36.3 - REGENERATE Redux: Safety and Tolerability With Obeticholic Acid

Surfing the Nash Tsunami

Play Episode Listen Later Jul 16, 2022 12:44


On July 7, Intercept Pharmaceuticals released new results from the continuation of the REGENERATE trial and announced their intent to file a new NDA for obeticholic acid (OCA) in NASH fibrosis. In this conversation, Stephen Harrison leads Jörn Schattenberg, Louise Campbell and Roger Green in examining how the larger sample and longer time patients were on therapy changed the safety and tolerability profile from the initial analysis.After reviewing the four key points from Intercept's press release, Stephen Harrison kicks off this conversation by discussing the safety evaluation, which included a far larger population with significantly longer exposure to study drug. After describing the enriched population, he quotes from the press release, "Emergent adverse events treatment, emergent serious adverse events, and deaths were generally balanced across the OTC and placebo treatment groups." He goes on to cite the considerable differences in pruritus across groups (22% in placebo, 33% in 10mg and 55% in 25mg), share the comment that most discontinuation stemmed from pruritus, note that gall bladder-related events occurred in less than 3% of patients and, finally, that OCA 25mg had a higher rate of biliary events. He then asked the rest of the group for comments.Jörn commented first, noting that this was mostly "recapitulated" data, but with a much broader set of subjects. Because risk:benefit ratio was perceived as the pivotal issue around the time of the original Complete Response Letter (CRL), he describes the data as improved "by a lot."Louise describes as "reassuring" the idea that the NASH dose could be so much higher than the approved PBC dose (25mg vs. 5 or 10mg) but not demonstrate additional safety concerns. She goes on to declare that practices planning to use OCA should be "planning pathways into delivery" in anticipation that the high level of pruritus will lead to a significant set of discontinuation with a careful approach to patient orientation and management. Roger shared his recollection that increases in LDL levels and the implicit associated cardiovascular risk were major issues in the negative risk:benefit assessment, but that this analysis appears to report that levels returned to normal within the first year of treatment. This might increase chances for approval.At this point, Stephen reads the press release carefully to identify potential safety hazards that are not addressed directly in the document, although, as he notes, one can fit only so much into a press release. As the conversation ends, Stephen asks Jörn if he has "ongoing lingering questions". Jörn notes that he wondered how the reads were done and that he also looked for LDL data. He makes a few other points, but suspects that they may have been covered in the 2019 paper.

Fin de Semana
Dr. Josep María Argemí: “La edición genética del colesterol está cerca, es prometedora”

Fin de Semana

Play Episode Listen Later Jul 16, 2022 9:56


El especialista de la Unidad de Hepatología de la Clínica Universidad de Navarra explica en Fin de Semana con Cristina el novedoso tratamiento para esta enfermedad tan extendidaHace unos días supimos de las bondades de la edición del ADN en pacientes con dolencias o enfermedades. Pues bien, este avance se va haciendo poco a poco realidad: hemos conocido que en Nueva Zelanda han logrado bajar el colesterol de un paciente en el primer caso de edición genética de células del hígado. El colesterol, según la OMS, mata a 2,6 millones de personas y que hace perder 27,9 millones de años de vida entre la población humana cada año. Está en el origen de muchas enfermedades cardiovasculares, que son en conjunto la principal causa de muerte en el planeta.Lo de Nueva Zelanda es un avance espectacular que nos suscita muchas preguntas que vamos a resolver en Fin de Semana con Cristina con el Dr. Josep María Argemí, especialista de la Unidad de Hepatología de la Clínica Universidad de Navarra, quien explica que “este ensayo se ha hecho allí por una empresa ubicada en Cambridge, Boston, y busca pacientes con hipercolesterolemia familiar, tienen un defecto congénito que les hace tener el colesterol muy alto desde el nacimiento y tienen muchos problemas derivado del conocido como ‘colesterol malo', LDL, en las arterias. Lo que han hecho es una edición de...

The Keto Kamp Podcast With Ben Azadi
Dr Brian Lenzkes | The Real Cause of Insulin Resistance & How to Lower Your Insulin Levels KKP: 436

The Keto Kamp Podcast With Ben Azadi

Play Episode Listen Later Jul 15, 2022 81:47 Very Popular


Today, I am blessed to have here with me Dr. Brian Lenzkes. He is an internal medicine doctor based in San Diego who has focused much of his attention on clinical nutrition. He owned his own medical practice with a group of physicians from 2004-2020. Dr. Lenzkes is co-host of the popular LowCarbMD podcast, which has more than 1.4 million downloads, and is a professional speaker. Dr. Lenzkes attended UC Irvine and received a Bachelor of Science in Biology before attending the University of Southern California Medical School. After graduating in 1999, he started his Residency Program at Scripps Mercy Hospital in San Diego. He extended his residency for a year to serve as Chief Resident before starting his private practice career at Internal Medicine Associates in 2004. Dr. Lenzkes has been voted one of the "Top Doctors" in San Diego for 11 years. Even after gaining the medical community's and his patients' respect, Dr. Lenzkes felt a void as many patients with chronic conditions became sick and required more medications. At the same time, Dr. Lenzkes battled his own weight gain while following 'standard medical advice.' In this episode, Dr. Lenzkes first reveals how he learned about a fasting and low-carb lifestyle. After trying it himself, Dr. Lenzkes lost the weight he gained while following 'standard medical advice.' Dr. Lenzkes dives deep into the correlation between high insulin levels and cardiovascular disease. If you haven't already, now is the time to check your insulin levels. Tune in as we chat about reversing type 2 diabetes, the importance of muscle mass, and the massive problem with chronic stress.   Download my free keto grocery shopping list: http://www.ketokampblueprint.com Get Keto Flex on Audible for Free (New Customers Only): https://adbl.co/36d6A24 Get Keto Flex on Audible here for current customers: https://adbl.co/3699lBm / / E P I S O D E   S P ON S O R S  Paleo Valley beef sticks, apple cider vinegar complex, organ meat complex & more. Use the coupon code KETOKAMP15 over at https://paleovalley.com/ to receive 15% off your entire order. Upgraded Formulas Hair Mineral Deficiency Analysis & Supplements: http://www.upgradedformulas.com Use KETOKAMP15 at checkout for 15% off your order.  Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list.  [01:10] Learning About Fasting and Low-Carb In The Medical Community  Throwing drugs at people with diabetes, hypertension, and obesity doesn't do anything. One patient found fasting successful, and Dr. Lenzkes decided to research the lifestyle. After losing weight with fasting and low-carb, Dr. Lenzkes was hesitant to share this new information with his patients.  Dr. Lenzkes got a lot of backlash from his colleagues. However, Dr. Lenzkes gets patients off insulin; not many people can say that.  [13:30] The Correlation Between High Insulin Levels and Cardiovascular Disease  There's a massive correlation between high insulin levels and cardiovascular disease. Nearly 100% of Dr. Lenzkes's patients have never had an insulin check until seeing him. You don't just wake up with type two diabetes; you have ten years to predict that diabetes is coming before you get it.  Lower your insulin levels; that way, you won't need as much insulin to get the desired effect.  Dr. Lenzkes highly recommends checking out Dr. Jason Fung's work. Find it here: https://www.thefastingmethod.com/. [19:40] How Exercise and Movement Will Help Prevent Type 2 Diabetes  Most diabetics, if you look at their lab work untreated, they're going to have high triglycerides in that 300 to 500 range. LDL can be increased or low; it doesn't matter. HDL will be low.  When you get HDL right and the triglycerides come down, you feel a lot better. Exercise and stress management is essential because it helps burn sugar and your fat reserves.  When you run out of reserves, you have diabetes because the sugar stays in your bloodstream.  [31:50] The Reason Doctors Don't Talk About Diet and Lifestyle During A Visit Dr. Lenzkes uses a company called Ulta Lab Tests: https://www.ultalabtests.com/. Patients can order Ulta, or your doctor can get it for less.  Doctors have been trained a certain way, so they may not want to test for insulin.  Plus, doctors are pressed for time and are judged based on how many patients they see each day.  Many doctors only see a patient for nine minutes. It is impossible to talk about diet and lifestyle during these visits.  [36:10] Many Doctors Don't See The Truth; Instead, They Stick With What They Learned In Medical Schools  Doctors are taught that you need three meals daily, and breakfast is the day's most important meal. However, that's simply not the case.  Doctors stick with what they learn no matter what evidence says otherwise.  Many doctors will see high blood pressure and tell people to cut salt. Well, salt is high because insulin is high. High insulin causes you to retain sodium in your kidney. The answer should be to lower insulin instead.  [42:50] Lower Your Insulin Through Sleep, Exercise, and Stress Management What's more important to lower insulin, sleep or exercise? If you prioritize something, it's sleep. Next, don't be stressed out and angry. Then, eat real food that isn't processed to lower insulin.  Regular exercise will also help lower insulin.  The more muscle mass you have, the more insulin sensitive you are.  Putting muscle mass on is never going to be the wrong answer. The more muscle mass you have, the longer you live. The lower your insulin levels are, the longer you live.  [57:30] Chronic Stress Could Be Causing Your Metabolical Sickness  Fatty liver disease means you are metabolically sick. When you are metabolically sick, you risk dying from all different types of diseases.  The biggest scare we have is high insulin.  When you're under chronic stress, it's not good. Think about ways to get your priorities straight through sleep and stress management.  AND MUCH MORE! Resources from this episode:  Check out LowCarbMD San Diego: https://www.lowcarbmdsandiego.com Low Carb MD Podcast: https://www.lowcarbmd.com Life's Best Medicine Podcast: https://lifesbestmedicine.com/ Follow Dr. Lenzkes Facebook: https://www.facebook.com/LowCarbMDSanDiego Twitter: https://twitter.com/brianlenzkes Instagram: https://www.instagram.com/blenzkes/ Follow Life's Best Medicine Facebook: https://www.facebook.com/LifesBestMedicinePodcast Twitter: https://twitter.com/LifesBestMed YouTube: https://www.youtube.com/channel/UCZJKTI7GaIDB5eoLxucG-wA Dr. Jason Fung: https://www.thefastingmethod.com/ Dr. Ben Bikman: https://www.instagram.com/benbikmanphd/ Ulta Lab Tests: https://www.ultalabtests.com/ Join the Keto Kamp Academy: https://ketokampacademy.com/7-day-trial-a Watch Keto Kamp on YouTube: https://www.youtube.com/channel/UCUh_MOM621MvpW_HLtfkLyQ Get Keto Flex on Audible for Free (New Customers Only): https://adbl.co/36d6A24 Get Keto Flex on Audible here for current customers: https://adbl.co/3699lBm / / E P I S O D E   S P ON S O R S  Paleo Valley beef sticks, apple cider vinegar complex, organ meat complex & more. Use the coupon code KETOKAMP15 over at https://paleovalley.com/ to receive 15% off your entire order. Upgraded Formulas Hair Mineral Deficiency Analysis & Supplements: http://www.upgradedformulas.com Use KETOKAMP15 at checkout for 15% off your order.  Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list.  *Some Links Are Affiliates* // F O L L O W ▸ instagram | @thebenazadi | http://bit.ly/2B1NXKW ▸ facebook | /thebenazadi | http://bit.ly/2BVvvW6 ▸ twitter | @thebenazadi http://bit.ly/2USE0so ▸clubhouse | @thebenazadi Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.

Surfing the Nash Tsunami
S3-E36 - REGENERATE Redux - Can OCA Succeed With New Data?

Surfing the Nash Tsunami

Play Episode Listen Later Jul 14, 2022 57:52


On July 7, Intercept Pharmaceuticals released new results from the continuation of the REGENERATE trial and announced their intent to file a new NDA for obeticholic acid (OCA) in NASH fibrosis. In this episode, Stephen Harrison leads the Surfers through a discussion of the new REGENERATE results and the Surfers discuss what they find compelling in the new data, discuss the possibility of approval, and ask (and answer) what an approval might mean for the Fatty Liver community.The basic structure of this episode is: Stephen Harrison walks the group through issues, opportunities and considerations raised in the July 7 press release and the rest of the panel responds with comments and questions as appropriate. He starts by noting that in a recent episode, the Surfers identified the release of updated REGENERATE data and subsequent OCA approval in NASH fibrosis as a potentially transformational event in the Fatty Liver community and proceeds to read the four bullet points that Intercept Pharmaceuticals highlighted:1.  The 25mg dose of OCA met the agreed primary endpoint of improvement in liver fibrosis without worsening of NASH at 18 months. 2.  The 25mg dose of OCA  doubled the fibrosis response rate vs. placebo.3.  This data set includes larger and more robust safety database of 2477 patients with nearly 1000 on study drug for four years. 4.  Intercept will refile an NDA in liver fibrosis due to NASH, starting with a pre-submission meeting with the FDA later this month. From there, Stephen dives into the data, starting with the efficacy results. He notes that the results for reduction of fibrosis without worsening of NASH are comparable to the initial REGENERATE results statistically: highly significant improvement in the 25mg dose vs. placebo, but not in the 10 mg dose. He also notes a small but statistically insignificant numerical difference in NASH resolution without worsening of fibrosis. The 25mg score is roughly the same as in the earlier trial, but the placebo score dropped, possibly due to a change in the methodology for reading histology slides .  In the previous analysis, two histopathologists each read half the slides independently. This time, two teams of three histopathologists read slides in a design that forced consensus on each slide included in the final data. In discussing efficacy data, Jörn describes this study as "groundbreaking" and Louise notes the impact of a two-years-later approval in terms of patients who did not receive drug benefit over that time.  In agreeing with Jörn, Stephen notes that this study proves that we can get a fibrosis drug "over the finish line" by meeting FDA efficacy criteria.The group moves on to discuss safety criteria. Stephen notes that pruritus is still the most common side effect and reason for discontinuation, while Roger comments that LDL and cardiovascular issues, which were implicated as the major risk issue in the earlier data, appear to resolve over time and not present as much risk this time. Jörn and Louise both praise the increased robustness of safety data based on sample size and duration of therapy, after which Stephen notes the questions that the press release does not answer (but, presumably, the full data release will).  The rest of the discussion focuses on some decisions Intercept made about how to present data and the overall implications of this trial. Stephen and Roger praise Intercept for their continued commitment to OCA in the face of FDA's 2019 Complete Response Letter and the group agrees that this data is more likely to gain approval. When Roger asks for a prediction of what the world might look like 1-2 years from now, the group considers that we might have two approved agents (with resmetirom) as early as the end of 2023.

MeatRx
How Doctors Treat Type 1 Diabetes Is Frustrating | Dr. Shawn Baker & Dr. Ryan Attar

MeatRx

Play Episode Listen Later Jul 13, 2022 55:22


Dr. Ryan Attar is a Naturopathic Physician & Nutritionist currently practicing in Fairfield, Connecticut. Dr. Attar has also been living with T1 diabetes since 2007. He was diagnosed while serving in the US Army, where he advanced to the rank of Captain.  After his diagnosis he was medically retired from the Army, and became frustrated with the way diabetes is managed by nearly all doctors. He began to educate himself on health, nutrition and diabetes, and saw his blood sugars normalize to non-diabetic levels.  He is an advocate for the low carbohydrate management of diabetes, and follows the method of Dr. Richard Bernstein, who he had the opportunity to shadow with as a student. Dr. Attar's frustration with the standard management of diabetes inspired him to change careers and go back to school first for a master's in human nutrition, followed by a doctorate in naturopathic medicine.  Dr. Attar has been exploring the carnivore diet for the past 3 years, and feels his health has never been better. Most notably, thyroid antibodies and TSH both lowered since following a carnivore diet. He recommends this way of eating to many of his patients.  Dr. Attars other interests including jiujitsu (currently a blue belt), CrossFit, and traveling (having been to 75 countries).  Timestamps 00:00 Introduction 05:11 Type 1 diabetes diagnosis 11:48 Cutting carbs 15:46 Managing type 1 diabetes 19:25 Different types of insulin 23:55 Exercise and blood glucose 26:16 Dosing insulin 30:51 LDL and diabetes 36:01 Endocrinologists and normalization of blood sugar 40:49 Hypoglycemia 44:23 Getting patients on the carnivore diet 48:38 Cheating on the carnivore diet 53:50 Type 1 diabetics on carnivore diet Website: www.DrAttar.com TikTok: www.tiktok.com/@drryanattar YouTube: www.youtube.com/c/DrRyanAttar Twitter: twitter.com/ryanattar Facebook: www.facebook.com/AttarND Instagram: www.instagram.com/drryanattar/ See open positions at Revero: https://jobs.lever.co/Revero/ Join Carnivore Diet for a free 30 day trial: https://carnivore.diet/join/ Book a Carnivore Coach: https://carnivore.diet/book-a-coach/ Carnivore Shirts: https://merch.carnivore.diet Subscribe to our Newsletter: https://carnivore.diet/subscribe/ . ‪#revero #shawnbaker #Carnivorediet #MeatHeals #HealthCreation   #humanfood #AnimalBased #ZeroCarb #DietCoach  #FatAdapted #Carnivore #sugarfree  ‪

Fundamental Health with Paul Saladino, MD
July 2022 Bloodwork Review!

Fundamental Health with Paul Saladino, MD

Play Episode Listen Later Jul 12, 2022 74:06 Very Popular


On today's podcast, Paul reviews his most recent bloodwork, in detail, in comparison to his past blood work that was taken while eating a strictly carnivore diet. He touches on overall benefits of an animal based diet, and reiterates why “high” LDL cholesterol does not cause atherosclerosis. A note from Paul: Throughout my training and practice as a physician, I have come to one very disappointing conclusion:  Western medicine isn't helping people lead better lives. Now that I've realized this, I've become obsessed with understanding what makes us healthy or ill. I want to live the best life I can and I want to be able to share this knowledge with others so that they can do the same. This podcast is the result of my relentless search to understand the roots of chronic disease. If you want to know how to live the most radical life possible I hope you'll join me on this journey. Time Stamps: 00:09:05 Podcast begins 00:10:30 What does Paul eat? 00:13:30 The importance of fasting insulin and the problems with mainstream bloodwork interpretation 00:16:15 Diving into Paul's lab work (Fasting insulin, Hemoglobin A1C, and Fasting glucose)  00:23:30 Diving into Paul's lab work (Lipids and cholesterol levels) 00:35:00 Why does LDL rise on an animal based diet? 00:44:50 Diving into Paul's lab work (Inflammation and Calcification) 00:49:45 Diving into Paul's lab work (Homocysteine) 00:54:20 Diving into Paul's lab work (Omega-3 and Omega-6 Fatty Acids) 00:59:15 Diving into Paul's lab work (Thyroid) 01:00:20 Diving into Paul's lab work (Metabolic Hormones) 01:04:30 Diving into Paul's lab work (Kidney Health, Electrolytes, Bone Health, Blood Health) 01:10:30 Diving into Paul's lab work (Vitamins & Minerals) 01:11:30 End of most recent blood work analysis 1:12:00 Thoughts on uric acid and TMAO Sponsors: Heart & Soil: www.heartandsoil.co  White Oak Pastures: www.whiteoakpastures.com, use code CarnivoreMD for 10% off your first order or Carnivore5 for 5% off subsequent orders Calima Salt: drpaulsalt.com, for a free bag of Calima Sea Salt Eight Sleep: www.eightsleep.com/carnivoremd to get $150 off your order Primal Pastures: www.primalpastures.com, use code CarnivoreMD for 10% off your first order

Mikkipedia
Lean Mass Hyper-Responders - Keto and cholesterol with Nick Norwitz PhD

Mikkipedia

Play Episode Listen Later Jul 12, 2022 74:00


This week on the podcast Mikki speaks to Nick Norwitz about ketogenic diets, cholesterol numbers and why we see differences into the cholesterol response between people who are overweight and have metabolic disorder, compared to otherwise healthy, lean individuals. Nick is a co-author on a couple of papers that investigate this phenomenon, lean mass hyperresponder (LMHR) which notes a massive rise in LDL cholesterol when some individuals go on a ketogenic diet. We discuss what is known, what isn't known in regards to health risk and what to do about it. Dr. Nicholas Norwitz obtained his PhD in ketogenic metabolism and neurodegenerative diseases at Oxford University and is now working towards his MD at Harvard Medical School.Nick can be found here https://www.researchgate.net/profile/Nicholas-Norwitz and https://twitter.com/nicknorwitz Contact Mikki:https://mikkiwilliden.com/https://www.facebook.com/mikkiwillidennutritionhttps://www.instagram.com/mikkiwilliden/https://linktr.ee/mikkiwillidenSave 20% on all NuZest Products with the code MIKKI20 at www.nuzest.co.nz and www.nuzest.com.auSave 30% on Hoka One One with the code TEAMMIKKI at www.Hoka.co.nz

Forever Young Radio Show with America's Natural Doctor Podcast
Episode 362: Ep 362 Heart Health & Advanced Aging.mp3

Forever Young Radio Show with America's Natural Doctor Podcast

Play Episode Listen Later Jul 12, 2022 44:39


On this episode we shared with our listeners about HDL, LDL, andother important components of Heart Health.Heart disease is the leading cause of death for both men and womenin the United States. The good news? It is also one of the most preventable.Learn more at Foreveryoungpodcast.com 

The Kevin Bass Show
A vaccine against heart disease

The Kevin Bass Show

Play Episode Listen Later Jul 10, 2022 20:12


In this episode, I discuss Inclisiran, an injectable PCSK9 inhibitor that produces dramatic LDL cholesterol reductions with just two intramuscular injections per year. I spell out the implications of such a dramatic reduction in LDL cholesterol and point out the massive potential impact that this might have on the future of cardiovascular disease prevention.===Like, comment, subscribe.For more, find me at:PODCAST The Kevin Bass ShowYOUTUBE https://www.youtube.com/user/kbassphiladelphiaSUBREDDIT www.reddit.com/r/kevinbassWEBSITE http://thedietwars.comTWITTER https://twitter.com/kevinnbass/https://twitter.com/healthmisinfo/INSTAGRAM https://instagram.com/kevinnbass/TIKTOK https://tiktok.com/@kevinnbassAnd above all, please donate to support what I do:PATREON https://patreon.com/kevinnbass/DONATE https://thedietwars.com/support-me/

The Gary Null Show
The Gary Null Show - 07.08.22

The Gary Null Show

Play Episode Listen Later Jul 8, 2022 56:58 Very Popular


Video: 1. Jonathan Pie: The World's End 2. New Rule: OK, Zoomer | Real Time with Bill Maher (HBO) 3. Forget the Great Reset. Embrace the Great Escape. – Zach Weissmueller of ReasonTV (8:20 4. An Imminent Threat from Artificial Intelligence | Aidan Gomez | TEDxOxford   Study finds people who practice intermittent fasting experience less severe complications from COVID-19 Intermountain Healthcare, July 7, 2022 Intermittent fasting has previously shown to have a host of health benefits, including lowering the risk of diabetes and heart disease. Now, researchers from Intermountain Healthcare have found that people who regularly fast are less like to experience severe complications from COVID-19. In a new study published this week in BMJ Nutrition, Prevention & Health, Intermountain researchers found that COVID-19 patients who practiced regular water-only intermittent fasting had lower risk of hospitalization or dying due to the virus than patients who did not. “Intermittent fasting has already shown to lower inflammation and improve cardiovascular health. In this study, we're finding additional benefits when it comes to battling an infection of COVID-19 in patients who have been fasting for decades,” said Benjamin Horne, Ph.D., director of cardiovascular and genetic epidemiology at Intermountain Healthcare. They identified 205 patients who had tested positive for the virus. Of those, 73 said they regularly fasted at least once a month. Researchers found that those who practiced regular fasting had a lower rate of hospitalization or death due to coronavirus. “Intermittent fasting was not associated with whether or not someone tested positive COVID-19, but it was associated with lower severity once patients had tested positive for it,” Dr. Horne said. Fasting reduces inflammation, especially since hyperinflammation is associated with poor COVID-19 outcomes. In addition, after 12 to 14 hours of fasting, the body switches from using glucose in the blood to ketones, including linoleic acid. “There's a pocket on the surface of SARS-CoV-2 that linoleic acid fits into—and can make the virus less able to attach to other cells,” he said. Low CoQ10 levels linked with neurodegeneration: Study University of Tokyo , July 4, 2022 Researchers have found low levels of CoQ10 in people with multiple system atrophy, and suggested supplementation could help. The study , published in JAMA Neurology, shows a link between low levels of blood coenzyme Q10 (CoQ10) and patients with multiple system atrophy (MSA).  The data backs recent hypotheses that CoQ10 deficiency could be linked with development of the neurodegenerative disorder, and that supplementation could be beneficial for MSA sufferers, the team said. The study included 44 Japanese patients with MSA (average age of 64) and 39 Japanese control patients (average age 60). CoQ10 has properties similar to vitamins, but since it is naturally synthesized in the body it is not classed as such. With chemical structure 2,3-dimethoxy-5-methyl-6-decaprenyl-1,4-benzoquinone, it is also known as ubiquinone because of its ‘ubiquitous' distribution throughout the human body. The coenzyme is concentrated in the mitochondria – the ‘power plants' of the cell – and plays a vital role in the production of chemical energy by participating in the production of adenosince triphosphate (ATP), the body's co-called ‘energy currency'. A role beyond the mitochondria is also acknowledged, with CoQ10 acting as a potent antioxidant. The coenzyme plays an important role in preserving levels of vitamin E and vitamin C. They found plasma levels of CoQ10 were significantly lower in MSA patients, regardless of age, sex and Coenzyme Q2, polyprenyltransferase (COQ2) genotype. COQ2 is a protein coding gene which plays a part in the biosynthesis of CoQ10, Dr Tsuji explained. Gardening can cultivate better mental health University of Florida, July 6, 2022 Many longtime gardeners will tell you that the garden is their happy place. New research suggests that many people may indeed reap mental health benefits from working with plants — even if they've never gardened before. In a study published in the journal “PLOS ONE,” University of Florida scientists found that gardening activities lowered stress, anxiety and depression in healthy women who attended twice-weekly gardening classes. None of study participants had gardened before. Our study shows that healthy people can also experience a boost in mental wellbeing through gardening,” said Charles Guy, principal investigator on the study and a professor emeritus in the UF/IFAS environmental horticulture department. Thirty-two women between the ages of 26 and 49 completed the study. All were in good health, which for this experiment meant screening for factors such as chronic health conditions, tobacco use and drug abuse, and having been prescribed medications for anxiety or depression. Half of the participants were assigned to gardening sessions, while the other half were assigned to art-making sessions. Both groups met twice a week for a total eight times. The art group served as a point of comparison with the gardening group. “Both gardening and art activities involve learning, planning, creativity and physical movement, and they are both used therapeutically in medical settings. This makes them more comparable, scientifically speaking, than, for example, gardening and bowling or gardening and reading,” Guy explained. Given the relatively small number of participants and the length of the study, the researchers were still able to demonstrate evidence of what medical clinicians would call the dosage effects of gardening — that is, how much gardening someone has to do to see improvements in mental health. Vitamin B3 reduces the risk of skin cancer University of Sydney, July 5, 2022 Research published in the New England Journal of Medicine offers new hope to those at high risk of developing the most common types of skin cancer. The study found that a form of vitamin B3 significantly decreased the chance of high-risk patients developing non-melanoma skin cancer. Nicotinamide, the active form of vitamin B3, was found to reduce the rate of non-melanoma skin cancer by 23 percent. Commonly available in over-the-counter supplements, it has been found to be very well tolerated without unfavorable side effects. 12-month study points to reduced skin cancer risk with vitamin B3 Lab and animal studies have already shown nicotinamide to hold promise in preventing skin cancers, particularly the most common, non-melanoma variety that are the subject of this latest human study. But even though it was suspected that taking vitamin B3 could reduce skin cancer risk, the results were surprisingly dramatic. The 12-month study involved 386 healthy subjects, all with a history of at least two non-melanoma skin cancers over the past five years, making them at risk for further skin cancers. Subjects were assigned to one of two groups: one receiving 500 mg of nicotinamide twice-daily and the other receiving only a placebo. After 12 months, the rate of new non-melanoma skin cancers was reduced by 23 percent in those receiving the nicotinamide supplement compared to subjects receiving the placebo. It is unusual for a single, natural change to have such a significant impact. An Avocado A Day Helps Keep Bad Cholesterol At Bay Penn State University, July 7, 2022 An avocado a day helps keep bad cholesterol away, a new study reveals. Researchers from Penn State have found that eating an avocado daily for six months decreased unhealthy cholesterol levels. The “healthy” fats in avocados also had no negative effect on a person's belly fat or waist circumference, though it didn't lead to any weight loss either. Previous studies have pointed to the benefits of eating avocados for losing weight, but the current study  is the largest to date that looks at multiple health effects of avocados. “While the avocados did not affect belly fat or weight gain, the study still provides evidence that avocados can be a beneficial addition to a well-balanced diet,” says Penny Kris-Etherton, an Evan Pugh University Professor of Nutritional Sciences at Penn State, in a university release. “Incorporating an avocado per day in this study did not cause weight gain and also caused a slight decrease in LDL cholesterol, which are all important findings for better health.” Doing good deeds helps socially anxious people relax Simon Fraser University (Canada) July 1, 2022  Being busy with acts of kindness can help people who suffer from social anxiety to mingle more easily. This is the opinion of Canadian researchers Jennifer Trew of Simon Fraser University and Lynn Alden of the University of British Columbia, in a study published in Springer's journal Motivation and Emotion. Sufferers from social anxiety are more than just a little shy. Dealings with others might make them feel so threatened or anxious that they often actively avoid socializing. Although this protects them from angst and possible embarrassment, they lose out on the support and intimacy gained from having relationships with others. They have fewer friends, feel insecure when interacting with others, and often do not experience emotional intimacy even in close relationships. Performing acts of kindness to the benefit of others is known to increase happiness and may lead to positive interactions and perceptions of the world at large. The present study investigated if, over time, the pro-social nature of kindness changes the level of anxiety that socially anxious people experienced while interacting with others, and helped them to engage more easily. It extends previous findings by Alden and Trew about the value that doing good deeds holds to socially anxious people. Undergraduate students who experience high levels of social anxiety were enrolled in the study. The 115 participants were randomly assigned into three groups for the four-week intervention period. One group performed acts of kindness, such as doing a roommate's dishes, mowing a neighbour's lawn, or donating to a charity. The second group was only exposed to social interactions and was not asked to engage in such deeds, while the third group participated in no specific intervention and simply recorded what happened each day. A greater overall reduction in patients' desire to avoid social situations was found among the group who actively lent a helping hand. The findings therefore support the value of acts of kindness as an avoidance reduction strategy. It helps to counter feelings of possible rejection and temporary levels of anxiety and distress. It also does so faster than was the case for the participants who were merely exposed to social interactions without engaging in good deeds.

Bodies By Design Radio
052: The Ultimate Prescription for Life

Bodies By Design Radio

Play Episode Listen Later Jul 6, 2022 14:34


These days it takes more than an apple a day to keep the doctor off your back. The good doc is going to pester you about your blood pressure and cholesterol levels - apple or not. And who can blame him/her? According to the American Heart Association, nearly 110 million adults have borderline to high risk blood cholesterol levels. In addition, nearly one in three adults suffers from high blood pressure. And these numbers grow every year. So what do you do? Pop a pill and try not to think about it? Or maybe you don't even bother to have your blood pressure and cholesterol checked – what you don't know can't hurt you, right? Whether you've had your blood pressure and cholesterol levels checked lately or not, these conditions are deadly and sneaky - many people are unaware of the danger lurking in their own arteries. In this episode, Fred and Donovan break down The Ultimate Prescription for Life. You'll also learn about: High blood pressure and cholesterol levels The difference between HDL and LDL when it comes to cholesterol How exercise effects your cholesterol If you care about your longevity and staying control of your health, give this episode your attention. You'll be glad you did. --- Send in a voice message: https://anchor.fm/bodiesbydesign/message

Cardionerds
219. Guidelines: 2021 ESC Cardiovascular Prevention – Question #16 with Dr. Roger Blumenthal

Cardionerds

Play Episode Listen Later Jul 5, 2022 11:22 Very Popular


The following question refers to Section 4.6 and Figure 13 of the 2021 ESC CV Prevention Guidelines. The question is asked by student doctor Shivani Reddy, answered first by NP Carol Patrick, and then by expert faculty Dr. Roger Blumenthal. Dr. Roger Blumenthal is professor of medicine at Johns Hopkins where he is Director of the Ciccarone Center for the Prevention of Cardiovascular Disease. He was instrumental in developing the 2018 ACC/AHA CV Prevention Guidelines. The CardioNerds Decipher The Guidelines Series for the 2021 ESC CV Prevention Guidelines represents a collaboration with the ACC Prevention of CVD Section, the National Lipid Association, and Preventive Cardiovascular Nurses Association. Question #16 True or False: For patients with established ASCVD, secondary prevention entails adding a PCSK9 inhibitor if goal LDL is not met on maximum tolerated doses of a statin and ezetimibe. Answer #16 The correct answer is True. The ultimate on-treatment LDL-C goal of

The Food Code
Calories In/Calories Out - How Much Do Calories Matter?

The Food Code

Play Episode Listen Later Jul 4, 2022 30:17 Very Popular


In todays episode we talk about things that may be preventing weight loss even in a negative energy balance i.e. a calorie deficit. We discuss the common drivers of dysfunction in the body and how that creates stress that can halt weight loss/fat loss... We also discuss why exercise is not the way to create a deficit, how calories are not metabolized equally, how foods affect our hormones and, in turn, can affect how we use or store energy.  One of the big take homes today is to consider your HEALTH and quality of food versus just calories as many people fill their intake with 'diet' food that contains a lot of chemicals, which are associated with obesity, type 2 diabetes, cardiovascular disease, high LDL cholesterol, mental health illness, neurological decline and all cause mortality. Not so fun, FUN FACT: In Europe there are more than 1,300 chemicals that are not legally allowed to be added into food due to their toxic effect on human health. The US has only curbed 11 of these. Note: not made illegal, just recommended against...we will share more about this in a coming episode! Join our private FitMom Lifestyle community HEREWant to schedule a strategy call with us? Schedule HERETo connect with Liz Roman click HERETo connect with Becca Chilczenkowski click HERERead More on FitMom Lifestyle HERECheck out Liz's COOKBOOK, FitCookery HERECheck out our PLANNER, Win The Day HEREThis episode is brought to you by FitMom Lifestyle Marketing and Production by brandhard Want to check out some of our favorite supplements like the Daily Greens, Digestive Enzymes, and some of the best tasting protein to help you recover from your workout (Fruit D Loop is one of our favorites) visit 1stPhorm now.Looking for high quality supplements at a discount? Purchase through our Wellevate account HEREStay SALTY with our favorite electrolyte packets, LMNT! LMNT is a electrolyte drink mix that is formulated to help anyone with their electrolyte needs and is perfectly suited to folks following a keto, low-carb, or paleo diet AND it is soo tasty - great for flavoring water and helping you drink more! Our favorite flavors include Watermelon, Raspberry, Mango Chili, Grapefruit and Citrus!Please do us that favor and share this with your friends and family so we can reach more lives!

Hunger Hunt Feast | Strategic Fitness
104. Linoleic acid and metabolic disease

Hunger Hunt Feast | Strategic Fitness

Play Episode Listen Later Jul 4, 2022 67:53


The discussion over what aspect of our diet has been driving the escalation of metabolic disease over the last 100 years has been a confusing one full of contradictory information. It would be logical to look for a change in our diet associated with such a dramatic change in the health of a population There are both correlated evidence and dietary trials to support the theory that the increase in linoleic acid, provided by the introduction of PUFA processed oils into our diet, is the driver. In this episode of Hunger Hunt Feast, I want to share a collection of them to help clarify some of the confusion. -- Episode Specific Links:  Linoleic acid concentrations in fats and oils http://www.distributionkatrina.com/english/comparison-of-dietary-fats.html Increase in Adipose Tissue Linoleic Acid of US Adults in the Last Half-Century https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC4642429/ Composition of adipose tissue and marrow fat in humans by 1H NMR at 7 Tesla https://www.sciencedirect.com/science/article/pii/S0022227520346733 Diets could prevent many diseases https://www.researchgate.net/publication/10673140_Diets_could_prevent_many_diseases Corn Oil in Treatment of Ischemic Heart Disease https://ncbi.nlm.nih.gov/pmc/articles/PMC2166702/ Linoleic acid causes greater weight gain than saturated fat without hypothalamic inflammation in the male mouse https://pubmed.ncbi.nlm.nih.gov/27886622/#:~:text=the%20male%20mouse-,Linoleic%20acid%20causes%20greater%20weight%20gain%20than%20saturated%20fat%20without,doi%3A%2010.1016%2Fj Effects of fatty acids on mitochondria: implications for cell death https://pubmed.ncbi.nlm.nih.gov/12206909/ Can linoleic acid contribute to coronary artery disease? https://pubmed.ncbi.nlm.nih.gov/8192728/ Effects of linoleate-enriched and oleate-enriched diets in combination with alpha-tocopherol on the susceptibility of LDL and LDL subfractions to oxidative modification in humans https://pubmed.ncbi.nlm.nih.gov/8148354/ Acrolein is a product of lipid peroxidation reaction https://www.jbc.org/article/S0021-9258(18)80708-6/fulltext#seccestitle90 The role of dietary oxidized cholesterol and oxidized fatty acids in the development of atherosclerosis https://pubmed.ncbi.nlm.nih.gov/16270280/ Rapeseed oil and sunflower oil diets enhance platelet in vitro aggregation and thromboxane production in healthy men when compared with milk fat or habitual diets https://pubmed.ncbi.nlm.nih.gov/1641826/ Stearoyl-CoA Desaturase-1 Is Associated with Insulin Resistance in Morbidly Obese Subjects https://link.springer.com/article/10.2119/molmed.2010.00078 Circulating levels of linoleic acid and HDL-cholesterol are major determinants of 4-hydroxynonenal protein adducts in patients with heart failure https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3909262/ Circulating levels of linoleic acid and HDL-cholesterol are major determinants of 4-hydroxynonenal protein adducts in patients with heart failure https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3909262/ Role of Physiological Levels of 4-Hydroxynonenal on Adipocyte Biology: Implications for Obesity and Metabolic Syndrome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038367/ “The Hateful Eight: Enemy Fats That Destroy Your Health - Dr. Cate.” Dr. Cate, 22 May 2020,  https://drcate.com/the-hateful-eight-enemy-fats-that-destroy-your-health/ Effects of diets enriched in linoleic acid and its peroxidation products on brain fatty acids, oxylipins, and aldehydes in mice https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6180905/ Strong increase in hydroxy fatty acids derived from linoleic acid in human low-density lipoproteins of atherosclerotic patients https://pubmed.ncbi.nlm.nih.gov/9488997/ Brief episode of STZ-induced hyperglycemia produces cardiac abnormalities in rats fed a diet rich in n-6 PUFA https://journals.physiology.org/doi/full/10.1152/ajpheart.00480.2004?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org Changes in Dietary Fat Intake Alter Plasma Levels of Oxidized Low-Density Lipoprotein and Lipoprotein(a) https://pubmed.ncbi.nlm.nih.gov/9844997/ “Dr. Knobbe Presents, ‘Macular Degeneration - Preventable & Treatable - With an Ancestral Diet?' at Weston A. Price Foundation's Annual Conference - Wise Traditions - 2017 - Cure AMD Foundation.” Cure AMD Foundation, https://www.cureamd.org/dr-knobbe-presents-macular-degeneration-preventable-treatable-with-an-ancestral-diet-at-weston-a-price-foundations-annual-conference-wise-traditions-2017/ Unsaturated fatty acids and their oxidation products stimulate CD36 expression in human macrophages https://www.researchgate.net/publication/11260045_Unsaturated_fatty_acids_and_their_oxidation_products_stimulate_CD36_expression_in_human_macrophages Lowering dietary linoleic acid (LA) reduces bioactive oxidized linoleic acid metabolites in humans https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC3467319/ Can linoleic acid contribute to coronary artery disease? https://www.researchgate.net/publication/15005994_Can_linoleic_acid_contribute_to_coronary_artery_disease A high linoleic acid diet increases oxidative stress in vivo and affects nitric oxide metabolism in humans https://pubmed.ncbi.nlm.nih.gov/9844997/ Dietary Linoleic Acid Elevates Endogenous 2-AG and Anandamide and Induces Obesity https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2012.38 Use of dietary linoleic acid for secondary prevention of coronary heart disease and death: evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis https://www.bmj.com/content/346/bmj.e8707 Connect with Zane: ReLyte Electrolytes by Redmond Real Salt: https://shop.redmond.life?afmc=Zane Follow me on Instagram: https://www.instagram.com/zanegriggsfitness Follow me on YouTube: https://www.youtube.com/c/ZaneGriggs QUICK EPISODE SUMMARY What causes modern disease The hateful eight oils The correlation between vegetable oils and obesity The oxidation effects of LDL The truth about the dairy data How much cholesterol is in your brain  Where you can find a copy of today's mentioned study What we know about Linoleic acid