Podcasts about nutrition examination survey

We live in a culture obsessed with treating symptoms, weight gain, fatigue, high blood pressure, brain fog, poor sleep, as if each were an isolated problem. But what if these struggles aren't the problem at all? What if they're just the flashing check engine lights on the dashboard of your body, pointing to a deeper issue that's been hiding in plain sight: Metabolic Disease. In this episode, Dr. JC Doornick pulls back the curtain on why nearly every chronic health crisis in America today — from obesity and Type 2 diabetes to heart disease, hypertension, and even dementia — can be traced back to metabolic dysfunction. He explains how the healthcare industry profits from keeping us stuck in a never-ending cycle of pills, injections, and quick fixes, rather than empowering us to address the root cause upstream. You'll also learn about Metabolic Synchronization — a practical, upstream approach that helps realign the body and mind through five key foundations: Proper diet & nutrition Proper movement & muscle development Proper sleep Proper education & mental detox Proper community & support This episode is a wake-up call: the lights are flashing, and the choice is yours. Will you keep patching symptoms downstream, or will you finally pop the hood and reclaim control of your health, your mind, and your future?

Vidcast:  https://www.instagram.com/p/DMYYGQHJoa9/Those consistently eating healthy plant-based foods were half as likely to fall victim to cardiac disease as those on a typical western diet.  Johns Hopkins epidemiologists reviewed data from 7,708 respondents, mean age 45 years, replying to the National Health and Nutrition Examination Survey.  The participants were divided into 4 groups according to their reported consumption of health plant-based foods, and their susceptibility to cardiac disease was quantified by measurement of their circulating cardiac troponins and n-termination natiuretic peptides.The results showed that the risk having of elevated circulating cardiac biomarkers, a sign of cardiac disease, was 49%% lower for those eating the most healthy plant-based diets compared with those consuming the least.  The healthiest plant-based foods included fruits, vegetables, whole grains, beans, and olive or canola oils.  On the other hand, those eating the worst diets containing red meat, fried foods, and palm oils bore a 65% higher risk of heart issues.  Somewhere in-between are the plant-based meats sold under the Beyond and Impossible brands.  These offerings, while lacking meat proteins, are highly processed containing excess salt and saturated fats due to the addition of coconut or palm oils to improve texture.The bottom line: stick with natural sources of plant-based proteins and you'll likely live longer.https://www.medicalnewstoday.com/articles/unhealthy-plant-based-diets-may-significantly-raise-heart-disease-riskhttps://www.sciencedirect.com/science/article/pii/S2666667725001047#plantbased #westerndiet #processed #cardiac #diabetes

Dr. Andres Cardenas, from the Department of Epidemiology and Population Health at Stanford University, joins host Dr. Evgeniy Galimov to discuss a research paper he co-authored in Volume 17, Issue 2 of Aging (Aging-US), titled “Exposome-wide association study of environmental chemical exposures and epigenetic aging in the National Health and Nutrition Examination Survey.” DOI - https://doi.org/10.18632/aging.206201 Corresponding author - Andres Cardenas - andresca@stanford.edu Video interview - https://www.youtube.com/watch?v=A1I6qoVwkfM Longevity & Aging Series - https://www.aging-us.com/longevity Abstract Epigenetic clocks can serve as pivotal biomarkers linking environmental exposures with biological aging. However, research on the influence of environmental exposures on epigenetic aging has largely been limited to a small number of chemicals and specific populations. We harnessed data from the National Health and Nutrition Examination Survey 1999-2000 and 2001-2002 cycles to examine exposome-wide associations between environmental exposures and epigenetic aging. A total of 8 epigenetic aging biomarkers were obtained from whole blood in 2,346 participants ranging from 50-84 years of age. A total of 64 environmental exposures including phthalates, metals, pesticides, dioxins, and polychlorinated biphenyls (PCBs) were measured in blood and urine. Associations between log2-transformed/standardized exposure measures and epigenetic age acceleration (EAA) were assessed using survey-weighted generalized linear regression. A 1 standard deviation (SD) increase in log2 serum cadmium levels was associated with higher GrimAge acceleration (beta = 1.23 years, p = 3.63e-06), higher GrimAge2 acceleration (beta = 1.27 years, p = 1.62e-05), and higher DunedinPoAm (beta = 0.02, p = 2.34e-05). A 1 SD increase in log2 serum cotinine levels was associated with higher GrimAge2 acceleration (beta = 1.40 years, p = 6.53e-04) and higher DunedinPoAm (beta = 0.03, p = 6.31e-04). Associations between cadmium and EAA across several clocks persisted in sensitivity models adjusted for serum cotinine levels, and other associations involving lead, dioxins, and PCBs were identified. Several environmental exposures are associated with epigenetic aging in a nationally representative US adult population, with particularly strong associations related to cadmium and cotinine across several epigenetic clocks. Sign up for free Altmetric alerts about this article - https://aging.altmetric.com/details/email_updates?id=10.18632%2Faging.206201 Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts Keywords - aging, epigenetic aging, environmental exposures, exposome, epigenetics Please visit our website at https://www.Aging-US.com​​ and connect with us: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Bluesky - https://bsky.app/profile/aging-us.bsky.social Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc MEDIA@IMPACTJOURNALS.COM

BUFFALO, NY — March 5, 2025 — A new #research paper was #published in Aging (Aging-US) on February 11, 2025, Volume 17, Issue 2, titled “Exposome-wide association study of environmental chemical exposures and epigenetic aging in the national health and nutrition examination survey.” First author Dennis Khodasevich and corresponding author Andres Cardenas from Stanford University, and colleagues from other U.S. institutions, studied how exposure to harmful chemicals in the environment affects aging. Using data from the National Health and Nutrition Examination Survey (NHANES), they discovered that cadmium, lead, and cotinine are linked to faster biological aging, a process that can increase the risk of age-related diseases. The study analyzed data from 2,346 U.S. adults aged 50 to 84 who participated in a national health survey. Researchers tested their blood and urine for 64 different chemicals, including metals, pesticides, and industrial pollutants. They assessed how these exposures influenced eight different epigenetic aging markers—biological clocks that measure how fast a person's body is aging at the DNA level. "We harnessed data from the National Health and Nutrition Examination Survey 1999-2000 and 2001-2002 cycles to examine exposome-wide associations between environmental exposures and epigenetic aging." The strongest effects were linked to cadmium, a toxic metal found in cigarette smoke and some foods. People with higher levels of cadmium in their blood showed signs of accelerated aging. Higher levels of cotinine, a chemical related to tobacco exposure, were also linked to increased biological age, reinforcing the harmful effects of smoking. Additionally, lead exposure, a heavy metal found in old paint and contaminated water, was also associated with faster aging. The researchers also found that some pollutants, including a type of PCB (PCB118) and a type of dioxin (HpCDD), were linked to slower biological aging. However, it is unclear if this fact is beneficial, as past research shows that slower aging in some cases can still be linked to health risks. This study is one of the largest to investigate how pollution affects the aging process. Unlike previous research that focused on only a few chemicals, it examined a wide range of pollutants in a diverse group of people. The findings suggest that everyday exposure to toxic substances can speed up aging at the cellular level, increasing the risk of age-related diseases. In summary, these findings raise concerns about how widespread environmental contaminants may accelerate aging and contribute to chronic diseases such as heart disease, cancer, and cognitive decline. Reducing exposure to toxic substances like cadmium and lead—found in cigarettes, polluted air, and contaminated food—could help slow biological aging and improve long-term health. These insights highlight the need for stronger environmental health policies to protect individuals from premature aging and disease. DOI - https://doi.org/10.18632/aging.206201 Corresponding author - Andres Cardenas - andresca@stanford.edu Video short - https://www.youtube.com/watch?v=WcL-K399a7M Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts About Aging-US The mission of the journal is to understand the mechanisms surrounding aging and age-related diseases, including cancer as the main cause of death in the modern aged population. Please visit our website at https://www.Aging-US.com​​ and connect with us: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc MEDIA@IMPACTJOURNALS.COM

How can we make sense of conflicting studies? One paper suggests a ketogenic diet reduces all-cause mortality, while another claims it raises blood pressure. Are large-scale survey tools like NHANES—the National Health and Nutrition Examination Survey—really the best way to answer these complex questions? In this insightful interview, Dr. Adrian Soto-Mota, an internal medicine clinician, educator, and data enthusiast, explains how to critically evaluate research findings. He highlights the strengths and limitations of different types of studies, using engaging analogies to help you better understand when and how to apply research conclusions. In this video you'll learn: The importance of choosing the right tool (study) for the task Strengths and weaknesses of large population studies like NHANES Practical advice for interpreting conflicting health and nutrition research If you're passionate about understanding health research and making evidence-based decisions, this interview is a must-watch! Expert Featured: Dr. Adrian Soto-Mota X: @AdrianSotoMota Studies Mentioned Ketogenic diets are associated with an elevated risk of hypertension: Insights from a cross-sectional analysis of the NHANES 2007–2018 https://doi.org/10.1016/j.ijcrp.2024.200342 Comparing Very Low-Carbohydrate vs DASH Diets for Overweight or Obese Adults With Hypertension and Prediabetes or Type 2 Diabetes: A Randomized Trial https://doi.org/10.1370/afm.2968 The ketogenic diet has the potential to decrease all-cause mortality without a concomitant increase in cardiovascular-related mortality https://doi.org/10.1038/s41598-024-73384-x CMEs Mentioned Managing Major Mental Illness with Dietary Change: The New Science of Hope https://www.mycme.com/courses/managing-major-mental-illness-with-dietary-change-9616 Brain Energy: The Metabolic Theory of Mental Illness https://www.mycme.com/courses/brain-energy-the-metabolic-theory-of-mental-illness-9615 Follow our channel for more insights and education from Dr. Bret Scher, including interviews with leading experts in metabolic psychiatry. Learn more about metabolic psychiatry and find helpful resources at https://metabolicmind.org/. About us Metabolic Mind is a non-profit initiative of Baszucki Group working to transform the study and treatment of mental disorders by exploring the connection between metabolism and brain health. We leverage the science of metabolic psychiatry and personal stories to offer education, community, and hope to people struggling with mental health challenges and those who care for them. Our channel is for informational purposes only. We are not providing individual or group medical or healthcare advice nor establishing a provider-patient relationship. Many of the interventions we discuss can have dramatic or potentially dangerous effects if done without proper supervision. Consult your healthcare provider before changing your lifestyle or medications.

A new year and a new beginning. Special guest co-host Pedro Mendes joins Dr. Chris Labos to answer a viewer question about menopause. Become a supporter of our show today either on Patreon or through PayPal! Thank you! http://www.patreon.com/thebodyofevidence/ https://www.paypal.com/donate?hosted_button_id=9QZET78JZWCZE Email us your questions at thebodyofevidence@gmail.com. Assistant researcher: Aigul Zaripova, MD Editor: Robyn Flynn Theme music: “Fall of the Ocean Queen“ by Joseph Hackl Rod of Asclepius designed by Kamil J. Przybos Chris' book, Does Coffee Cause Cancer?: https://ecwpress.com/products/does-coffee-cause- cancer Obviously, I'm not your doctor (probably). This podcast is not medical advice for you; it is what we call information. References: Geographic variability of menopausal symptoms 1) Nappi RE et al. Global cross-sectional survey of women with vasomotor symptoms associated with menopause: prevalence and quality of life burden. Menopause. 2021 May 24;28(8):875-882. doi: 10.1097/GME.0000000000001793. 2) Nappi RE, et al. Prevalence and quality-of-life burden of vasomotor symptoms associated with menopause: A European cross-sectional survey. Maturitas. 2023 Jan;167:66-74. doi: 10.1016/j.maturitas.2022.09.006. What's the normal duration of symptoms 3) Avis NE, et al. Study of Women's Health Across the Nation. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015 Apr;175(4):531-9. doi: 10.1001/jamainternmed.2014.8063. The Women's Health Initiative (WHI) studies Rossouw JE et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. JAMA. 2002 Jul 17;288(3):321-33. doi: 10.1001/jama.288.3.321. Anderson GL et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial. JAMA. 2004 Apr 14;291(14):1701-12. doi: 10.1001/jama.291.14.1701. Decline in HRT after WHI studies Sprague BL, Trentham-Dietz A, Cronin KA. A sustained decline in postmenopausal hormone use: results from the National Health and Nutrition Examination Survey, 1999-2010. Obstet Gynecol. 2012 Sep;120(3):595-603. doi: 10.1097/AOG.0b013e318265df42. Danish Osteoporosis Prevention Study Schierbeck LL metal. Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial. BMJ. 2012 Oct 9;345:e6409. doi: 10.1136/bmj.e6409. Kronos Early Estrogen Prevention Study (KEEPS) Harman SM, et al. Arterial imaging outcomes and cardiovascular risk factors in recently menopausal women: a randomized trial. Ann Intern Med. 2014 Aug 19;161(4):249-60. doi: 10.7326/M14-0353. Kronos Early Estrogen Prevention Study (KEEPS) Hodis HN et al. Vascular Effects of Early versus Late Postmenopausal Treatment with Estradiol. N Engl J Med. 2016 Mar 31;374(13):1221-31. doi: 10.1056/NEJMoa1505241. Stopping hormonal therapy Berman RS et al. Risk factors associated with women's compliance with estrogen replacement therapy. J Womens Health. 1997 Apr;6(2):219-26. doi: 10.1089/jwh.1997.6.219. Grady D, Sawaya GF. Discontinuation of postmenopausal hormone therapy. Am J Med. 2005 Dec 19;118 Suppl 12B:163-5. doi: 10.1016/j.amjmed.2005.09.051. Tapering vs. abrupt stop or hormonal therapy Haimov-Kochman R et al. Gradual discontinuation of hormone therapy does not prevent the reappearance of climacteric symptoms: a randomized prospective study. Menopause. 2006 May-Jun;13(3):370-6. doi: 10.1097/01.gme.0000186663.36211.c0. PMID: 16735933.

What do Americans eat? What do we know about their overall health? Answering questions like those requires measurement on a national scale. For decades, the U.S. Centers for Disease Control and Prevention has continuously fielded its National Health and Nutrition Examination Survey. On this episode, we talk with Tony Nguyen, Chief Medical Officer for the project.

In this episode, Melanie breaks down traditional Mexican food (yum!) and how it can fit in any kidney stone friendly diet. Chen W, Hong Y, Man S, Xu T. Association between dietary fiber intake and kidney stones: results from the National Health and Nutrition Examination Survey (2011-2018). Nutr Res Pract. 2024;18(4):534-543.   Submit a question for Melanie to answer on the podcast! Connect with The Kidney Dietitian! Work with Us! |  Instagram | Facebook | Pinterest | Facebook Group | Newsletter www.thekidneydietitian.org All information in this podcast is meant for educational purposes only and should not be used in place of advice from a medical professional.  

This episode discusses the often-overlooked overactive bladder (OAB) condition and its associations with other health conditions. The discussion is centered around two key studies based on survey data from the U.S. National Health and Nutrition Examination Survey. The first study examines the significant correlation between OAB and depression, highlighting the importance of recognizing mental health issues in patients with OAB. The second study investigates the relationship between cardiovascular health and stress urinary incontinence, emphasizing how better overall health can reduce the likelihood of incontinence. Due to its broader health implications, these findings underscore the importance of taking incontinence seriously.For more information on these studies:https://pubmed.ncbi.nlm.nih.gov/38642902/https://pubmed.ncbi.nlm.nih.gov/39169591/Timeline:00:00 Introduction to Overactive Bladder00:32 Study 1: Overactive Bladder and Depression02:25 Study 1: Findings and Implications05:19 Study 2: Overactive Bladder and Cardiovascular Health07:14 Study 2: Findings and Implications08:43 Conclusion and Final Thoughts

Cardiologists Bob Harrington and Dhruv Kazi discuss the projected burden of cardiovascular disease in 2050, why it's not sustainable, and what can be done to prevent it. This podcast is intended for healthcare professionals only. To read a transcript or to comment, visit https://www.medscape.com/author/bob-harrington INCLUDE URLS and full titles for some of the pertinent studies cited. Forecasting the Burden of Cardiovascular Disease and Stroke in the United States Through 2050 https://doi.org/10.1161/CIR.0000000000001256 Forecasting the Economic Burden of Cardiovascular Disease and Stroke in the United States Through 2050 https://doi.org/10.1161/CIR.0000000000001258 Calculating the 30-day Survival Rate in Acute Myocardial Infarction: Should we Use the Treatment Chain or the Hospital Catchment Model? https://doi.org/10.5301/heartint.5000238 Life's Essential 8: Updating and Enhancing the American Heart Association's Construct of Cardiovascular Health https://doi.org/10.1161/CIR.0000000000001078 Current Trends in Hypertension Identification and Management: Insights from the National Health and Nutrition Examination Survey https://doi.org/10.1161/JAHA.123.034322 Youth-Onset Type 2 Diabetes: The Epidemiology of an Awakening Epidemic https://doi.org/10.2337/dci22-0046 US Trends in Cholesterol Screening, Lipid Levels, and Lipid‐Lowering Medication Use in US Adults, 1999 to 2018 https://doi.org/10.1161/JAHA.122.028205 GLP-1 Receptor Agonist Discontinuation Among Patients With Obesity and/or Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/38787563 Health Care by Food https://healthcarexfood.org/ You may also like: Hear John Mandrola, MD's summary and perspective on the top cardiology news each week, on This Week in Cardiology https://www.medscape.com/twic Questions or feedback, please contact news@medscape.net

For the first time in decades, obesity rates in the U.S. are not on the rise.The adult obesity rate fell to about 40 percent in 2023, down from 41.9 percent in 2020, according to the latest National Health and Nutrition Examination Survey from the CDC.While the study doesn't pinpoint one sole reason for the change, the timing coincides with the rise of a new class of drugs targeting diabetes and weight loss, like Ozempic and Wegovy.As part of our series In Good Health, we discuss these new medications and the falling rate of obesity.Want to support 1A? Give to your local public radio station and subscribe to this podcast. Have questions? Connect with us. Listen to 1A sponsor-free by signing up for 1A+ at plus.npr.org/the1a.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Is breakfast essential for hormonal health, or just another diet myth? Does it help or mess with blood sugars and insulin? Will it trigger daily bloat or cure it? When it comes to managing hormone and gut dysfunction, breakfast may be more important than you think. In this episode, you will be able to: Explore the impact of intermittent fasting on males vs. females. Understand how breakfast can influence insulin and cortisol levels, impacting hormone balance and gut health. Learn how to build a hormone-friendly breakfast to support hormone and gut health. Uncover effective strategies for managing hormone and gut health through diet. Episode notes: Blog how to build a balanced breakfast for balanced hormones Meal plans 1-on-1 nutrition coaching References Giménez-Legarre, N., Miguel-Berges, M. L., Flores-Barrantes, P., Santaliestra-Pasías, A. M., & Moreno, L. A. (2020). Breakfast Characteristics and Its Association with Daily Micronutrients Intake in Children and Adolescents-A Systematic Review and Meta-Analysis. Nutrients, 12(10), 3201.https://doi.org/10.3390/nu12103201 Franz M. J. (1997). Protein: metabolism and effect on blood glucose levels. The Diabetes educator, 23(6), 643–651.https://doi.org/10.1177/014572179702300603 Joo, H. J., Kim, G. R., Park, E. C., & Jang, S. I. (2020). Association between Frequency of Breakfast Consumption and Insulin Resistance Using Triglyceride-Glucose Index: A Cross-Sectional Study of the Korea National Health and Nutrition Examination Survey (2016-2018). International journal of environmental research and public health, 17(9), 3322. Levitt, N. S., Vinik, A. I., Sive, A. A., Child, P. T., & Jackson, W. P. (1980). The effect of dietary fiber on glucose and hormone responses to a mixed meal in normal subjects and in diabetic subjects with and without autonomic neuropathy. Diabetes care, 3(4), 515–519. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6475723/ Hiller-Sturmhöfel, S., & Bartke, A. (1998). The endocrine system: an overview. Alcohol health and research world, 22(3), 153–164. Witbracht, M., Keim, N. L., Forester, S., Widaman, A., & Laugero, K. (2015). Female breakfast skippers display a disrupted cortisol rhythm and elevated blood pressure. Physiology & behavior, 140, 215–221.https://doi.org/10.1016/j.physbeh.2014.12.044 Zaplatosch, M. E., & Adams, W. M. (2020). The Effect of Acute Hypohydration on Indicators of Glycemic Regulation, Appetite, Metabolism and Stress: A Systematic Review and Meta-Analysis. Nutrients, 12(9), 2526.https://doi.org/10.3390/nu12092526

The Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey shows the American diet – once given a grade of ‘F' – has improved to a ‘D' but there is still a lot of work to do to improve our diet. K-State Research and Extension nutrition and wellness educator, Priscilla Brenes, says we need to increase our consumption of fruits and vegetables and reduce the amount of processed meats and sugary drinks we're consuming. She discusses the study's findings and what we can do to improve our diet. Sound Living is a weekly public affairs program addressing issues related to families and consumers. It is hosted by Jeff Wichman. Each episode shares the expertise of K-State specialists in fields such as child nutrition, food safety, adult development and aging, youth development, family resource management, physical fitness and more. Send comments, questions or requests for copies of past programs to ksrenews@ksu.edu. K‑State Research and Extension is a short name for the Kansas State University Agricultural Experiment Station and Cooperative Extension Service, a program designed to generate and distribute useful knowledge for the well‑being of Kansans. Supported by county, state, federal and private funds, the program has county Extension offices, experiment fields, area Extension offices and regional research centers statewide. Its headquarters is on the K‑State campus in Manhattan.

Proton pump inhibitors, or PPIs, are a class of popular drugs that reduce the amount of acid produced in the stomach. They are often the first-line treatment for conditions related to acid, such as esophagitis, non-erosive reflux disease, and peptic ulcer disease. We talk about PPIs and dementia with Misha Kogan, MD, ABIOM, RCST, medical director of the GW Center of Integrative Medicine and associate professor of Medicine here at GW. Studies show that people who take proton pump inhibitors (PPIs) for more than four years and are 45 or older have a 33% higher risk of developing dementia than those who have never taken PPIs. An expert on neurodegenerative diseases, Dr. Kogan completed the Geriatric Fellowship at GW. He is the chief editor of the first definitive textbook on Integrative Medicine and aging, “Integrative Geriatric Medicine,” part of Andrew Weil Integrative Medicine Library series. Dr. Kogan is also on the faculty of the GW Institute for Brain Health and Dementias; associate director of the Geriatrics Fellowship Program at GW; and founder and director othe George Washington University Integrative Geriatrics Fellowship Track. ◘ Related Content Institute for Brain Health and Dementia https://brainhealth.gwu.edu/ Choudhury A, Jena A, Jearth V, et al. Vitamin B12 deficiency and use of proton pump inhibitors: a systematic review and meta-analysis. Expert Rev Gastroenterol Hepatol. 2023;17(5):479-487. doi:10.1080/17474124.2023.2204229 https://pubmed.ncbi.nlm.nih.gov/37060552/ Gommers LMM, Hoenderop JGJ, de Baaij JHF. Mechanisms of proton pump inhibitor-induced hypomagnesemia. Acta Physiol (Oxf). 2022;235(4):e13846. doi:10.1111/apha.13846 https://pubmed.ncbi.nlm.nih.gov/35652564/ Geng T, Chen JX, Zhou YF, et al. Proton Pump Inhibitor Use and Risks of Cardiovascular Disease and Mortality in Patients With Type 2 Diabetes. J Clin Endocrinol Metab. 2023;108(6):e216-e222. doi:10.1210/clinem/dgac750 https://pubmed.ncbi.nlm.nih.gov/36573284/ Liu W, Wang J, Wang M, Wang M, Liu M. Association of proton pump inhibitor use with risk of kidney stones: an analysis of cross-sectional data from the US National Health and Nutrition Examination Survey (2007-2018). BMJ Open. 2023;13(10):e075136. Published 2023 Oct 16. doi:10.1136/bmjopen-2023-075136 https://pubmed.ncbi.nlm.nih.gov/37844987/ Gao S, Song W, Lin T, et al. Prolonged Use of Proton Pump Inhibitors, but Not Histamine-2 Receptor Antagonists, Is Associated With Lower Bone Mineral Density in Males Aged Over 70. Front Med (Lausanne). 2021;8:725359. Published 2021 Aug 23. doi:10.3389/fmed.2021.725359 https://pubmed.ncbi.nlm.nih.gov/34497815/ ◘ Transcript https://bit.ly/3V1BoJT ◘ This podcast features the song “Follow Your Dreams” (freemusicarchive.org/music/Scott_Ho…ur_Dreams_1918) by Scott Holmes, available under a Creative Commons Attribution-Noncommercial (01https://creativecommons.org/licenses/by-nc/4.0/) license. ◘ Disclaimer: The content and information shared in GW Integrative Medicine is for educational purposes only and should not be taken as medical advice. The views and opinions expressed in GW Integrative Medicine represent the opinions of the host(s) and their guest(s). For medical advice, diagnosis, and/or treatment, please consult a medical professional.

Diese Woche mit Julia Nestlen und Aeneas Rooch. Ihre Themen sind: - Wer viel daddelt, muss nachts öfter pinkeln. Hä?! (00:35) - Beschlagnahmtes Koks wird zu Beton verarbeitet. Kann man das da auch wieder rausholen? (06:58) - Eine Rakete soll demnächst als Lieferdienst fungieren. Wie heiß wird da bitte die Pizza? (15:08) - Von wegen kleine grüne Männchen – Aliens sind lila! (21:16) Weitere Infos und Studien gibt's hier: Association between TV and/or video time and nocturia in adults: An analysis of the National Health and Nutrition Examination Survey: https://onlinelibrary.wiley.com/doi/10.1002/nau.25406 Anmerkung der Redaktion: Beachtet den Titel der Fachzeitschrift…. Perú reducirá impacto ambiental con nuevo método de destrucción de drogas https://www.gob.pe/institucion/mininter/noticias/940215-peru-reducira-impacto-ambiental-con-nuevo-metodo-de-destruccion-de-drogas Purple is the new green: biopigments and spectra of Earth-like purple worlds: https://academic.oup.com/mnras/article/530/2/1363/7645230?login=false Unser Podcast-Tipp der Woche: PlusMinus. Mehr als nur Wirtschaft. Alle Themen, die auf den ersten oder auch den zweiten was mit Wirtschaft zu tun haben. https://1.ard.de/plusminus Habt ihr auch Nerd-Facts und schlechte Witze für uns? Schreibt uns bei WhatsApp oder schickt eine Sprachnachricht: 0174/4321508 Oder per E-Mail: faktab@swr2.de Oder direkt auf http://swr.li/faktab Instagram: @charlotte.grieser @julianistin @sinologin @aeneasrooch Redaktion: Charlotte Grieser und Chris Eckardt Idee: Christoph König

"There's something beautiful, almost magical about the realization that what you are doing is participating in a procreative action. That is something that same sex intercourse cannot do. The point of this episode isn't to say that people with same-sex attraction should be demonized, hated, or unjustly treated. Rather, the point is that awareness needs to be raised of the health risks, both psychologically and biologically, that are associated with homosexual and bisexual lifestyles. There are people who are born with same-sex attraction and can live holy and healthy lives. If we love them, then we ought to help them, not by forcing them to do anything, but by providing resources and information that they could willingly choose to accept or reject." Studies Mentioned: Sara Reardon, “Massive Study Finds No Single Genetic Cause of Same-Sex Sexual Behavior,” https://www.scientificamerican.com/article/massive-study-finds-no-single-genetic-cause-of-same-sex-sexual-behavior/ Andrea L. Roberts, M. Maria Glymour, and Karestan Koenen, “Does Maltreatment in Childhood Affect Sexual Orientation in Adulthood?” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3535560/ Richard Fitzgibbons, Phillip Sutton, Dale O'Leary, “The Psycopathology of ‘Sex Reassignment Surgery: Assessing its Medical, Psychological, and Ethical Appropriateness,” http://www.laityfamilylife.va/content/dam/laityfamilylife/Documenti/donna/culturasocieta/english/psychopathology-of-sex-reassignment-surgery.pdf Ron de Graaf, Theo Sandfort, Magreet ten Have, “Suicidality and Sexual Orientation: Differences between Mena and Women in a General Population Based Sample from the Netherlands,” https://pubmed.ncbi.nlm.nih.gov/16799841/ Kevin Heslin, Johanna Alfier, “Sexual Orientation Differences in Access to Care and Health Status, Behaviors, and Beliefs: Findings from the National Health and Nutrition Examination Survey, National Survey of Family Growth, and National Health Interview Survey,” https://www.cdc.gov/nchs/data/nhsr/nhsr171.pdf Stephen Russell, Jessica Fish, “Mental Health in Lesbian, Gay, Bisexual, and Transgender Youth,” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4887282/ Kevin Heslin, Johanna Alfier, “Sexual Orientation Differences in Access to Care and Health Status, Behaviors, and Beliefs: Findings from the National Health and Nutrition Examination Survey, National Survey of Family Growth, and National Health Interview Survey,” https://www.cdc.gov/nchs/data/nhsr/nhsr171.pdf Jeffrey Parsons, T. Starks, K. Gamaarel, C. Grov, “Non-monogamy and Sexual Relationship Quality among Same-Sex Male Couples,” https://pubmed.ncbi.nlm.nih.gov/22906124/ Center for Disease Control, “Sexually Transmitted Diseases,” https://www.cdc.gov/msmhealth/STD.htm#:~:text=the%20United%20States.-,Gay%2C%20bisexual%2C%20and%20other%20men%20who%20have%20sex%20with%20men,who%20have%20sex%20with%20men.

Vidcast:  https://www.instagram.com/p/C4L8irNrMGq/ Eating a diet rich in healthy plant-based foods or a pure vegetarian diet is associated with a 16-20% improvement in breath-holding during sleep.  On the other hand, wolfing down unhealthy plant-associated offerings led to a 22% sleep apnea exacerbation.   These are the overall conclusions by Australian investigators reviewing dietary and sleep quality data from 14,210 participants in that nation's National Health and Nutrition Examination Survey.  That data revealed that women saw a greater benefit from healthy eating enjoying a 33% apnea improvement versus only a 10% improvement in men.  However, the ladies eating unhealthy plant based food  fared worse than the men with 42% worse apnea versus only 13%. Healthy plant-based foods included whole grains, fruits, vegetables, nuts, beans, tea and coffee.  Non-healthy plant-based foods were refined grains, potatoes, sugar-sweetened beverages, sweets and desserts, salty foods.   How healthy you eat during the day is how healthy you breathe at night. https://openres.ersjournals.com/content/erjor/early/2024/01/04/23120541.00739-2023.full.pdf #plantbased #diet #apnea 

Hier zeg ik meteen even bij: dit onderzoek heeft zo zijn beperkingen. Daar zo meer over, eerst even wat ze denken te hebben gevonden: mensen die lang achter elkaar televisiekijken, moeten er 's nachts vaker uit om te plassen.  Dit onderzoek gedaan door Chinese wetenschappers kijkt naar data uit de National Health and Nutrition Examination Survey van de VS. Specifiek naar vragenlijsten die zijn ingevuld tussen 2011 en 2016, door iets meer dan 13.000 mensen boven de 20.   Van die groep gaf 32 procent aan twee keer of meer uit bed te moeten tijdens de nacht om naar de wc te gaan. Nadat werd gecorrigeerd voor dingen als leeftijd, geslacht, afkomst, BMI en het wel of niet hebben van diabetes, zagen ze dat mensen die minstens vijf uur achter elkaar naar een scherm keken een bijna 50 procent grotere kans hadden om er 's nachts veel uit te moeten. Ten opzichte van mensen die minder dan een uur achter elkaar keken.   Nou gaat het hier om vragenlijsten die mensen zelf hebben ingevuld, dus helemaal zeker weten dat de informatie klopt doe je niet. Ook kunnen ze hiermee nog geen oorzaak-gevolg aantonen.  Toch hebben ze wel ideeën over hoe het één het ander zou kunnen beïnvloeden. Misschien drinken mensen meer tijdens het binge watchen, of heeft het lang naar een scherm kijken invloed op de kwaliteit van hun slaap, of leidt het vele zitten tot het vasthouden van meer vocht, of zelfs tot verstoorde signaleringen tussen hersenen en blaas.  Zoals je hoort: een heleboel onzekerheden. Maar interessant om verder uit te zoeken is het wel.   Lees hier meer: Binge watchers more likely to need multiple night-time loo breaksSee omnystudio.com/listener for privacy information.

Host: Ashley Baker, MSN, PMHNP Guest: Chi D. Chu, MD, MAS The National Health and Nutrition Examination Survey found that kidney disease awareness among patients in the U.S. is very low. And alarmingly, the proportion of awareness has not changed much over the 15-year period of this study. To uncover more of the findings and how to improve CKD awareness, tune into this discussion with Psychiatric Nurse Practitioner Ashley Baker as she takes a deep dive with Dr. Chi D. Chu, Assistant Professor of Medicine in the Division of Nephrology at the University of California San Francisco and coauthor of the article published in the American Journal of Kidney Diseases, titled “CKD Awareness Among US Adults by Future Risk of Kidney Failure.

Wondering what the thyroid levels from your thyroid lab test mean? I'll break down what the different thyroid hormones indicate and dispel some misconceptions about which levels actually require medication.  If you have any additional questions you would like answered in the future, let me know in the comments! Watch/Read Next… Optimal Thyroid Levels: https://drruscio.com/optimal-thyroid-levels  Hyperthyroidism vs Hypothyroidism: https://drruscio.com/hyperthyroidism-vs-hypothyroidism/  Early Signs of Thyroid Problems: https://drruscio.com/what-are-early-warning-signs-of-thyroid-problems/  How to Get Off Thyroid Medication Naturally: https://drruscio.com/how-to-get-off-thyroid-medication/  Thyroid & Hair Loss: https://drruscio.com/thyroid-hair-loss/  Why Your Thyroid Diagnosis Might Be a MISDiagnosis: https://drruscio.com/thyroid-diagnosis/    Timestamps 00:00 Intro to the thyroid   03:57 TSH 05:02 Free T4  05:59 Free T3  07:07 TPO (thyroid antibodies)  08:13 Hashimoto's  10:00 TG (thyroglobulin)  12:58 Defining hypothyroidism 13:27 Defining hyperthyroidism  13:48 The grey area “Sluggish thyroid” 18:07 Treatments  20:20 Where symptoms can come from 24:25 Thyroid lab interpretation guide   Featured Studies  Physiology, Thyroid: https://pubmed.ncbi.nlm.nih.gov/30137850/  Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III): https://pubmed.ncbi.nlm.nih.gov/11836274/  Serum thyrotrophin and circulating thyroglobulin and thyroid microsomal antibodies in a Finnish population: https://pubmed.ncbi.nlm.nih.gov/760358/  The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area: https://pubmed.ncbi.nlm.nih.gov/14558922/  Hypothyroidism Prevalence in the United States: A Retrospective Study Combining National Health and Nutrition Examination Survey and Claims Data, 2009-2019: https://pubmed.ncbi.nlm.nih.gov/36466005/  Correlation between sonography and antibody activity in patients with Hashimoto thyroiditis: https://pubmed.ncbi.nlm.nih.gov/24154902/  Laboratory Testing in Thyroid Conditions - Pitfalls and Clinical Utility: https://pubmed.ncbi.nlm.nih.gov/30215224/  Hashimoto thyroiditis: an evidence-based guide to etiology, diagnosis and treatment: https://pubmed.ncbi.nlm.nih.gov/35243857/  Anti-Thyroperoxidase Antibody Levels >500 IU/ml Indicate a Moderately Increased Risk for Developing Hypothyroidism in Autoimmune Thyroiditis: https://pubmed.ncbi.nlm.nih.gov/27607246/  Hyperthyroidism: https://pubmed.ncbi.nlm.nih.gov/32206604/  Subclinical Hypothyroidism: https://pubmed.ncbi.nlm.nih.gov/30725655/  Transient high thyroid stimulating hormone and hypothyroidism incidence during follow up of subclinical hypothyroidism: https://pubmed.ncbi.nlm.nih.gov/34879182/  Association of Thyroid Hormone Therapy With Quality of Life and Thyroid-Related Symptoms in Patients With Subclinical Hypothyroidism: A Systematic Review and Meta-analysis: https://pubmed.ncbi.nlm.nih.gov/30285179/  Treating hypothyroidism is not always easy: When to treat subclinical hypothyroidism, TSH goals in the elderly, and alternatives to levothyroxine monotherapy: https://pubmed.ncbi.nlm.nih.gov/34766382/  Symptoms Originally Attributed to Thyroid Dysfunction Were Instead Caused by Suboptimal Gastrointestinal Health: A Case Series and Literature Review: https://pubmed.ncbi.nlm.nih.gov/35999903/  The Relationship between Gastrointestinal Health, Micronutrient Concentrations, and Autoimmunity: A Focus on the Thyroid: https://pubmed.ncbi.nlm.nih.gov/36079838/  Combined treatment with Myo-inositol and selenium ensures euthyroidism in subclinical hypothyroidism patients with autoimmune thyroiditis: https://pubmed.ncbi.nlm.nih.gov/24224112/  Effects of vitamin D on thyroid autoimmunity markers in Hashimoto's thyroiditis: systematic review and meta-analysis: https://pubmed.ncbi.nlm.nih.gov/34871506/  Probiotics Ingestion Does Not Directly Affect Thyroid Hormonal Parameters in Hypothyroid Patients on Levothyroxine Treatment: https://pubmed.ncbi.nlm.nih.gov/29184537/    Get the Latest Updates Facebook - https://www.facebook.com/DrRusciodc Instagram - https://www.instagram.com/drrusciodc/ Pinterest - https://www.pinterest.com/drmichaelrusciodc    DISCLAIMER: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Music featured in this video: "Modern Technology" by Andrew G, https://audiojungle.net/user/andrew_g  *Full transcript available on YouTube by clicking the “Show transcript” button on the bottom right of the video.

There's a silent health crisis affecting millions of people—and you may be one of them. Chances are, you don't even know it.    What's this stealth threat? Poor metabolic health. And in this episode, I'm joined by nurse practitioner and intermittent fasting expert Cynthia Thurlow to get clear on what's causing this epidemic and what we can do to turn it around.    You'll learn why women are more likely to struggle, the two most pressing changes to make, when fasting might not be right for you, and how you can be proactive about reducing your risk of long-term disease.    Even if you're metabolically well, someone in your life likely isn't—and this episode could be the beginning of a journey to better health.    FULL show notes: jjvirgin.com/everydaywellness   Get my FREE Ultimate Health Roadmap: http://jjvirgin.com/ultimatehealth   Subscribe to my podcast: http://subscribetojj.com   Read my book, The Sugar Impact Diet: https://store.jjvirgin.com/collections/books/products/sugar-impact-diet-paperback-book   Learn more about Cynthia Thurlow: http://cynthiathurlow.com   Read Intermittent Fasting Transformation: https://amzn.to/46et3oC   Listen to Everyday Wellness: https://cynthiathurlow.com/podcast/   Study: Metabolic Syndrome and Related Disorders: Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016: https://www.liebertpub.com/doi/full/10.1089/met.2018.0105   Monitor your metabolic health with YourLabWork: https://yourlabwork.com/jj-virgin/   Own Your Labs: https://ownyourlabs.com/ YourLabwork: jjvirgin.com/yourlabwork    Read The Ultimate Weight Solution by Dr. Phil McGraw: https://amzn.to/3QOmHa2   Study: Cell Metabolism: A Smartphone App Reveals Erratic Diurnal Eating Patterns in Humans that Can Be Modulated for Health Benefits: https://www.cell.com/cell-metabolism/pdf/S1550-4131(15)00462-3.pdf   Reignite Wellness™ All-In-One Shakes: https://store.jjvirgin.com/collections/shakes   Dr. Joe Dispenza meditations: https://drjoedispenza.com/?rfsn=6914154.37386a&utm_source=refersion&utm_medium=affiliate&utm_campaign=6914154.37386a   Designs for Health Inositol Capsules: https://amzn.to/46m9U4a   Reignite Wellness™ Clean Creatine Powder: https://store.jjvirgin.com/products/clean-creatine-powder   Designs for Health CatecholaCalm adaptogenic herbs: https://amzn.to/40KhunZ   Oura Ring: https://ouraring.com/   Whoop: https://www.whoop.com/us/en/   More episodes with Cynthia Thurlow: https://jjvirgin.com/?s=Cynthia+Thurlow   Check out Cynthia Thurlow's YouTube channel: https://www.youtube.com/cynthiathurlow   Follow Cynthia Thurlow on Instagram: https://www.instagram.com/cynthia_thurlow_   Follow Cynthia Thurlow on Twitter: https://twitter.com/_cynthiathurlow?lang=en   Join the Intermittent Fasting Lifestyle/Cynthia Thurlow Facebook Group: https://www.facebook.com/groups/1004505663061383/ Get Cynthia's FREE Intermittent Fasting Guide: https://cynthiathurlow.activehosted.com/f/27  

You can also listen to this episode on Spotify!The new weight loss drugs such as Ozempic are stunningly effective at helping patients lose weight and improve their metabolic health. Their existence also seems to have intensified polarizing rhetoric around weight, health and BMI. On one end of the ideological spectrum, there is the “Healthy at Every Size” (HAES) movement that aims to decouple weight from worthiness—and argues that doctors who recommend weight loss to their patients with obesity do more harm by enabling body shaming without evidence to support the benefits of weight loss on health. On the other end of the spectrum is the camp that believes obesity is a result of poor health and life choices—and that patients with obesity should simply eat better and exercise more rather than succumb to the pharmaceutical industry's latest fad. is a Professor at Brown University, a best-selling author, and a leading voice in health economics. In her wildly popular newsletter, , she tackles pressing health issues of the day, helping people frame risk in order to make everyday decisions. Dr. Oster joins Dr. McBride on this week's episode of Beyond the Prescription to discuss the data on BMI and health, and how to empower readers and listeners with nuanced information to be healthy, inside and out. They review the data on the health benefits of exercise, independent of weight loss; the arbitrariness of BMI cut-offs; and the importance of focusing on health habits over a specific target weight. They agree that doctors do harm when they narrowly define health as a number on a scale—and the metabolic health involves addressing the medical, nutritional, behavioral or social-emotional elements of people's health. As Dr. McBride says, “Sometimes that includes weight loss medication. Sometimes it's a prescription to stop dieting and start eating lunch.”The transcript of our conversation is here![00:00:00] Dr. Lucy McBride: Hello, and welcome to my office. I'm Dr. Lucy McBride, and this is Beyond the Prescription, the show where I talk with my guests like I do my patients, pulling the curtain back on what it means to be healthy, redefining health as more than the absence of disease. As a primary care doctor, I've realized that patients are more than their cholesterol and their weight.[00:00:31] We are the integrated sum of complex parts. Our stories live in our bodies. I'm here to help people tell their story and for you to imagine and potentially get healthier from the inside out. You can subscribe to my free weekly newsletter at lucymcbride.substack.com and to the show on Apple Podcasts, Spotify, or wherever you get your podcasts.[00:00:57] So let's get into it and go Beyond the Prescription. Today we have an amazing guest joining us, my friend Dr. Emily Oster. Emily is a renowned economist, a bestselling author, and a professor at Brown University. Emily is one of the leading voices in health economics. Her superpower is applying data to some of society's thorniest health questions, including why people don't always make rational health decisions.[00:01:30] In her wildly popular newsletter called Parent Data, Emily tackles pressing issues about pregnancy and parenting, helping decisions. I grabbed Emily today because I wanted to talk with her about her recent piece on body weight and health: What is the relationship between BMI and health? She pulled together a lot of data, and because weight is something I talk about with my patients every day, I thought I'd grab her for a chat. Emily, thank you so much for joining me today.[00:02:03] Emily Oster: Thank you so much for having me. It is a delight as always to see you. It's such a treat.[00:02:09] LM: Emily, you are no stranger to controversy. In fact, I was with you in the proverbial bunker during COVID, hiding from the haters who didn't like that you and I were trying to help message about risk. We were trying to help people better calibrate their degree of anxiety around COVID to their level of actual risk.[00:02:31] By the way, I stand by everything I said and wrote. I hope you do too. And it was so fun to work with you then as it is now. So when I think about sensitive subjects, I think also about weight. And so, why did you want to write about weight? Is it just that you like putting your finger in the electrical socket? Or, did you have something to say?[00:02:49] EO: So I've actually written about weight a bunch of times. So it is a topic that I work on in my academic work. So as a professor in economics, the work that I do is about health economics and statistical methods. And I actually work a lot on diet and dietary choices and why people make the dietary choices they do.[00:03:07] And so it's not specifically about weight, but it really is about food. And so this is a kind of source of data that I think about a lot. And as a result, I've written about a lot in many different ways. And every time I come at this and I've come at it from all of the angles. So I wrote a piece once called what's the best diet? [00:03:31] And it was just like the diet that you can stick to which is a sort of standard finding. But the frame was, you know, a lot of people are interested in diet. And when I write that, many people are very angry. They're sort of like, no diet works, we should never talk about dieting, is kind of what comes back.[00:03:48] I did an interview with Virginia Sol Smith, who I really like, and we don't always agree but is just one of my favorite people to talk to. She always makes me think about her book Fat Talk, which is very much in the other direction, sort of very much in the space of, we should definitely not be talking about BMI, we should throw away our scales, all foods are neutral.[00:04:10] And when I published that interview, I got it from the other side. I got the, you know, how could you possibly say this, cake and apple are not the same, like this is, this is insane. And I've written about Ozempic, so just anything, I mean, you know this—anytime you write about it in this space, there's really, really strong feelings from both sides.[00:04:26] So this piece was trying, as I always do, more or less, sometimes more successfully than others, is to try to thread the needle and say, look, let's look at the data and see between the view of BMI is completely meaningless and correlated with nothing, and the view that your BMI is completely deterministic of your health and that is the only information we should use.[00:04:49] Where is the truth? And how can we use the data to get to that?[00:04:52] LM: It is such a crucial question because everybody who's paying attention reads the headlines and understands from their doctor even that weight and weight management is good for your health. We have diet culture seeping into our pores. I mean, it's sort of in the air we breathe, everything you look at on the covers of magazines, on Instagram, and in doctor's offices is about weight, or it feels like it's about weight.[00:05:20] I see people all the time who have avoided coming to see me, even if I've known them for decades, because they thought they would feel better about themselves, and I would feel more proud of them if they had just lost weight before they came in. And as I say to patients all the time, weight is one piece of a larger puzzle.[00:05:36] It is not a reflection of your value, your worth. And it certainly doesn't tell us everything about your health. So I'd love to hear about your findings about the relationship between BMI and actual health. [00:05:50] EO: In my mind, the most, the sort of most important thing to note here is that something can be correlated and can have some explanatory power and not be all of the explanatory power. So one version of this question is to say, on average, if your weight is higher, are you more likely to have other health conditions?[00:06:13] And I should say, that's actually different from the question of whether weight causes other health conditions. But purely taking this from like a correlational standpoint, if you saw one piece of data about someone, you saw their BMI, would you learn anything about their health? And the answer is, yes. On average, there is a relationship, particularly at the upper end of BMI, between increasing BMI and worse health.[00:06:41] And in particular, worse metabolic health. So things like, there's a strong correlation between high weight and diabetes. That's just true in the data. Now, those relationships... are there, but they're actually not as big, I think, as many people think. And that's sort of the other thing that comes out of this.[00:06:58] And that, that has two parts. So one is actually, even to the extent that there's a positive relationship there, it doesn't show up until you start getting to sort of higher levels of BMI. So sometimes we talk, we talk about overweight being 25 BMI versus 24. Actually, the health differences between people with a BMI in the 25 to 30 versus 20 to 25, if anything, probably favor the 25 to 30, but you're certainly not seeing much in that range.[00:07:30] As you get into a BMI of 35-40 you do see some of those, some of those correlations. But it's also true that in almost any health outcome you look at there is variation within a group and that's the thing I was sort of trying to illustrate in the piece is you look at something like diabetes or the distribution of blood pressure, like the distribution of blood pressure, it's shifted up for people who are higher BMI, but there's a lot of overlaps.[00:07:56] Plenty of people with high blood pressure whose BMI is 19 and plenty of people with low blood pressure whose BMI is 38. And so that's the sense in which like this number Tells you maybe a little bit, but really not that much.[00:08:12] LM: let's talk about what BMI is. BMI, I mean, you define it for us here, Emily.[00:08:17] EO: BMI is a weight in kilograms divided by your height in meters squared. It's just a number.[00:08:22] LM: So what you pointed out so beautifully in your piece is that medicine does this weird thing where we say that a normal BMI, body mass index, is between 20 and 24.9, and overweight is 25-29. 9 [00:08:37] EO: You guys love a sharp cutoff. It's your, it's your favorite. You love it.[00:08:42] LM: I don't, but fine. The medical establishment loves these arbitrary cutoffs. There's nothing magical or particularly different between somebody who has a BMI of 24.9 and 25 and moreover, there are so many different elements that go into this whole person's health. That to call it a diagnosis point X and not a diagnosis at X minus .1 is ridiculous. So, you know, herein lies why we're here to talk about pulling back the curtain on what this actually means.[00:09:18] EO: Right. And, and so I should say, like, you might wonder why have any cutoffs in this at all? I think the answer to that is that when people are describing, not even doctors, when population health scientists are describing characteristics of populations, it can sometimes be useful to define categories.[00:09:40] So, you see this in weight, you also see it in something like low birth weight is another good example which has some cut-offs, right? So when we talk about baby weight, there's a number, 2,500 grams. And if a baby is below 2,500 grams, they're classified as low birth weight, and if they're above 2,500 grams, they're not.[00:09:56] There's nothing special about 2,500 grams, obviously, but it's helpful when we sort of describe a population. You want to say, does this, you know, is the low birth weight share in this population bigger than this population? We want to have a common language. And so saying, like, that's the cutoff we're going to use, so we have some number to compare, is helpful, it can be helpful. The same thing happens here. You want to describe characteristics of a population. I think the problem, and it actually shows up in the birth weight also, but the problem comes when we start, we take that, which is just away to use a number to make some descriptive statements about some population.[00:10:35] When we take that number and we decide it's meaningful. It's like a somehow a meaningful number that we would, that would tell us something if you were on either side of it. Of course it's not. And when you're using it for populations, for individuals and populations on which it was not based, I mean, this is a much deeper issue, but when we talk about BMI in particular, this is something, these are sort of cutoffs that were developed with reference to like a white European population, they may have very different meanings and relationships with health for different populations off of which they are not based. So there's a sort of whole other can of worms there.[00:11:14] LM: Totally. It's, I mean, to make an analogy briefly that you and I are familiar with is, you know, COVID risk, right? It's not that a 65-year-old, every 65 year old is at so much higher risk for outcomes. Then every 64-year-old, but there is truth to the fact that older people tend to get sicker on a population level when I'm talking to a patient who has just turned 65 and who is generally very healthy and active. I'm not going to counsel them in the same way. I'm going to talk to a 64 year old who's technically not at higher risk, who has myriad health problems. So population level data is one thing and then individual risk calibration and counseling.[00:11:58] EO: Yeah, and I think the piece of this that my senses provoke so much anxiety and discomfort in people is that it is true that, and I don't think you do this, but it is, I think, an experience people either have or fear having in their doctors. They'll be weighed, their BMI will be calculated, and then they'll be told, you know, well, you just, you edged up above, you know, 20, now you're 25.1, and like this is how we're going to define you, and that becomes such an important, like, number in the conversation, and so salient, and the words, I mean, the words we use, overweight versus normal weight, obese, those take on an attention and a meaning, and they didn't just label them BMI category one, BMI category two, which, Maybe would have been more helpful.[00:12:46] You're really using words that suggest that there's a way to be, which is normal, and then other ways to be. And that, that's, it's just not helpful. It's not, I don't think it's a helpful part of counseling. It starts people off on, on a bad, on a bad foot.[00:13:00] LM: Yeah, I mean, I think people, for better or worse, look at doctors as authority figures and people who, whose judgment matters. And if you have a doctor who is doing a little tsk, tsk, tsk, ooh, you're getting up there, that has real power in many ways. And so I think that has real power and can do real harm.[00:13:20] Which is not to say that doctors shouldn't be honest about the data in that patient's situation and what they could do and help to arm them with tools and information to be healthier. It's to say that shame is not appropriate or meaningful in any space, not to mention[00:13:37] EO: Yeah, and I think the other, the other piece that I sort of spent some time on in, in this, and is actually quite closely related to stuff I work on, is that it's actually, It's very hard for most people to lose weight. Like, we know, I mean, we can sort of put Ozempic, Wegovy aside, but for people just changing diet, changing habits, consistent long term weight loss happens for a very small share of the population.[00:14:04] And so, when we sort of start with the advice, you should lose weight, which people get, you know, in these situations, often that's just not possible. So it's like giving people a set of advice that they just... They're just going to fail on and then giving it as if, well, if only you could have this kind of willpower, if only you could achieve this, like that would be so important.[00:14:24] I think the whole dynamic ends up in a place where you're giving people advice they can't follow based on a number that may or may not be that meaningful and isn't very nuanced, and you can easily see why that generates frustration, sadness, discomfort, lack of productive conversation with your doctor.[00:14:43] And then by the way, turns off your ability to have a productive conversation because now we're like in defensive. Now you're like, well, you know, screw you, don't tell me what to do. What do you know?[00:14:54] LM: Right? If we learned nothing else during the pandemic, that trust is precious. And when you don't have trust between the doctor or patient, and there's a moralization of human behavior, we're just at a standstill. And so how do you see the data that you've pulled together in this piece and before this piece helping people, individuals who are reading your stuff and then going to the doctor's office, understand better what their weight.[00:15:21] EO: The piece I pulled out at the end that I thought was really meaningful was, in this piece I'm actually pulling data from the NHANES, the National Health and Nutrition Examination Survey, which is a very big survey of, of people, it weighs them, it measures them, collects a lot of biomarkers, which is why we can say all this stuff about, about health.[00:15:39] They also collect information about their exercise. And so if you look at people, if you sort of take a, a second, uh, almost a second metric of health and you ask like, okay, does this person do like some, some moderate amount of exercise a week and it's like some cutoff and you look at that relationship.[00:15:57] One of the things I show in the piece is that doing more exercise is correlated with better metabolic outcomes, better kind of health outcomes in various ways. And it's quit informative on top of BMI, and so people who are doing sort of exercise who have a BMI of like 40 actually have sort of similar metabolic health to people who like aren't doing any exercise and have a BMI that we would consider, you know, normal or, or thin.[00:16:26] And so I think for me that has sort of two pieces of it. One is that it just again emphasizes like this is one other thing you could like if you said like you can only learn two things about people It's like well, how much more could I add with a second thing? Well, actually like quite a lot the characteristic knowing somebody's BMI and whether they have exercised rigorously or moderately in the last week that tells you a lot more about their health than knowing their BMI alone You could add on top of that smoking… it's just one simple illustration of like how much more you could learn if you ask some more questions The other thing, and here I'm going to reveal what my husband is always saying, it's just like, just because you like to exercise, fine.[00:17:08] But like, actually, I think we should tell people to exercise. I think that we spend too much time telling people to lose weight with their diet, which is something we know is really difficult, and I think we should spend more time telling people, like, you should go take a walk after, like, try to walk for ten minutes every day.[00:17:27] You know, actually, it's not saying, like, you need to go run a marathon. But just some aerobic exercise. I think we have a lot of evidence from a lot of different places that that's associated with better health. And I think if we started telling people that and talking about that, we would then get to the questions like, well, how can we make it possible for everyone to do that?[00:17:45] How can we make there be safe places for people to do that? How can we increase access to sports? How can we be in a position where everybody is welcome to... to go running no matter what, you know, their race or body size or anything? And I think that's, you know, for me, that's something that's pretty, that's pretty important. And I think we're kind of missing with this focus on food.[00:18:08] LM: I totally agree. And what I love about the NHANES data is what you earlier said, which is that there's an incredibly tight correlation between the amount of exercise and health outcomes, even more than BMI and health outcomes. So when I'm talking to a patient who wants to lose weight or, you know, Needs to lose weight, perhaps I often tell them, let's not think about the number.[00:18:35] In fact, I commonly say, let's not think about the number. That's not our end point. And, and I'm not saying that to be politically correct, to pussyfoot around hard conversations is because the number on the scale is immaterial. When we were talking about this whole person, we are the complex sum of these integrated parts.[00:18:57] And you can, as you said have a BMI of 40, which is technically obese. But if you are exercising on a regular basis, first of all, your mood is better, your sleep is going to be more efficient, your blood sugar control is going to be better, your blood pressure is going to be better, most likely. And so, I focus, with my patients, less on the number and more on the behaviors.[00:19:21] The relationship with food, not just what you're eating. The cadence of how you're eating. Sometimes you don't need a fancy diet, you just need to have lunch. I just wrote a piece about that. Lunch is an underrated food group, like eat lunch. Honestly, that is huge. Sometimes we don't need to, you know, go to the doctor and be told that our weight is technically higher than it should be.[00:19:43] We need to be given materials and information on the benefits of exercise. Not just on our weight, but on our mental health, our metabolic health, our cognition, and not just... Are you told to exercise, but to help people figure out where to put it and how to incorporate it in their everyday life. Because as you know, telling someone to exercise is one thing, helping them figure out what to do is another.[00:20:10] So I think you're absolutely right, Emily. We need to treat people, not just as a set of metrics and data, but as people. And as you know, from your research, human behavior is complicated. We do things that don't serve us all day long. Even doctors do, which is again, ridiculous, why I would shame anybody for a behavior that's part of the human nature.[00:20:30] So to do a lot of shooting with patients or to say you should do this is less productive than to say like, how do you think you could incorporate a little more movement because of the data on the benefits of regular movement into your whole health?[00:20:44] EO: I actually think, you know, when we do this kind of counseling and when people hear this counseling and they hear, they sort of hear the phrase diet and exercise, like you should improve your diet and exercise. They think of that as improve your diet and exercise so you'll weigh less. And that's the link we should sever.[00:20:59] It would be, I think there's a place to say, improve your, let's think about are there changes you could make to your diet that would make you feel better? Are there ways for you that you could incorporate exercise, which by the way, like 10 minutes of walking slightly faster than you would otherwise, that's exercise.[00:21:16] That's an exercise activity, so just like making it clear that these things are possible. But also without saying, and if you did that then the number will look better on the, no, if you did that maybe some of these elements of health, metabolic health, maybe some of this would improve, your sleep might improve, your mood might improve, that's what we're aiming for. We're not aiming for some number.[00:21:37] LM: That's right. And by the way, when you're sleeping better and your mood is better and your dopamine hormone axis is being triggered by the lights of being outside and feeling more fit and getting the endorphins going that is good for our metabolic, metabolic health too. But I also want to be clear that I don't shy away from talking about a number when it is relevant.[00:22:00] So if somebody has bilateral knee osteoarthritis, bone on bone, and their BMI is 40, and they're resistant to, you know, getting a knee replacement, we have to talk about weight. So it would be irresponsible for me to say, oh, weight loss isn't going to matter to this gravity-dependent set of joints. And so that is where it gets really hard, but it is where I actually like for me it's my like superpower is never to have judgment about it because by the way when you have bone-on-bone arthritis in your knees As a result of age and genetics and weight all together you can't exercise and You gain weight more easily.[00:22:43] And so this is what happens. So there's no shame about it. It's just, let's figure out what to do. But we have to talk about the number, not just the number, but we have to talk about what weight might make sense to that offset pressure on the knee.[00:22:56] EO: Yeah, I mean, that's such an interesting, like, it's, this conversation is so hard because it takes, like, it's so hard to have that conversation. And I bet you are really good at this, but I think for me, it's very hard to have that conversation without it feeling like shame because of the, as opposed to just saying, look, there are a bunch of things, like, there is a physical reason why this, this number matters, not because this number has to do with whether you're a good person or not a good person or have willpower or whatever, it's just like, this is putting pressure on your knees.[00:23:23] LM: Well, and that's why I'd really like to reinvent the healthcare system to have doctors incentivized to have more time with their patients to understand their story and to build trust and rapport and for patients to feel comfortable and then to train doctors on sensitivity on these subjects. Which, by the way, doctors went into medicine, the field of medicine to do that, but it's just people don't have time and then people don't trust and then there's diet culture and then it's just lose weight, exercise more, see you next year.[00:23:50] EO: This is totally off topic. I mean, it's a little bit off topic, but, but one of the things that's been pretty effective in, you know, obstetrics is these group prenatal care. People have exactly this sort of same complaint about, like, there isn't enough time to talk about all the issues that have come up, da, da, da.[00:24:05] And so they do these things where it's like six people, but you get two hours, you know, and we do, like, there's this sort of examination component that happens, like, that's short for each person, but then we all, they, people all talk together, and it turns out to actually be, some good evidence on the relationship between that and preterm birth, particularly for black women.[00:24:20] So I wonder if there's like, I almost think there's like a parallel care model, where it's like, we have a group of people here for counseling about, you know, whatever it is, improving their heart disease metrics or something.[00:24:33] LM: Yeah, stay tuned for some courses I'm going to be offering in 2024. One of my little kind of mantras is that health is about more than BMI. It is about having awareness of our health ecosystem, which includes ur story, it includes our data, it includes understanding our genetics, and then sort of a laddering up to acceptance of the things we can't control.[00:25:01] Maybe we are predestined to have a higher-than-ideal body mass index because of our genetics. And we have to accept that. We have to accept that we are predisposed to diabetes. And then agency over the things we can control. So, arming yourself with tools and information to carve out space in your life to work on the things you have control over, which are a lot.[00:25:26] But if you're stuck in the acceptance bucket where you're not accepting hard parts of your genetics or your story that you can't control and you're then listening to a lot of kind of wellness gurus who are telling you that, you know, thin is better or whatever, even just all this messaging. And then you're spending a lot of brain space trying to accept things you really need, or trying to control things you can't control, that's where people run into trouble, and that's where shame is born, and that's where people, frankly, binge on things like food and alcohol, and that's where we land in trouble. And so if we could just help people understand they're not alone, they're human, and that we all have our challenges. One of them, for a lot of Americans, is weight.[00:26:12] And that they're not alone, and that there are things they can do to be a lot better off. So... What was the takeaway from this piece you wrote? Like, what was the reaction? Because, as you said, like, there's sort of two camps. It's like health at every size, there's a movement, which I agree with in many ways, except that there are certain medical realities we have to acknowledge.[00:26:32] And then there's the sort of, weight is genetic, and there's nothing you can do about it. And, I mean, there's just, there's just these false dichotomies. [00:26:39] EO: So I think like with most things, most people are in the center. And so this kind of like, I think that many people found this interesting. You know, I'm not sure everybody thinks about this data quite the same way, and sort of seeing some graphs about it, it made some people think. A bunch of the comments were like, yes, like I started exercising, and I felt like this is very validating, because like, that, you know, that totally changed, but then my weight didn't change, but still I feel better, and I was trying to understand that.[00:27:08] So there was like some good stuff there. And then I did get, certainly, some people who said, you know, talking about BMI at all is very fatphobic and I am, like, I will say, like, I'm a relatively thin person and so I think, you know, I don't know, I guess that's part of, part of it. And then certainly there were people on the other side who said, you know, this whole thing is like, you know, anybody who's overweight is just, you know, is just lazy and I don't agree with that at all. But some of those people fought with each other and, you know, that's what comments are for.[00:27:39] LM: That's what's comments are for. And that is why Emily Oster is here. Emily is here to help us get to these story issues, and ask the questions that... People are wrestling with every day, like, can you have a glass of wine when you're pregnant? Can you have bluebean cheese when you're pregnant? Can you jettison some of the shame about parenting and the parenting industrial complex?[00:28:01] And thank God for you because I think you're doing so much good, Emily, and you're reassuring people based on evidence. You're not reassuring people for the sake of reassuring them for you to look good. You're reassuring them because you have the data to show. How to calibrate risk to, or sort of how to calibrate anxiety to the actual[00:28:21] EO: Yeah, I mean, I see a lot of what I try to do is sort of help people see what those risks are and make the choices that work for them, which [are] going to reflect our own risk tolerances and preferences and, and what's important to us.[00:28:33] LM: Yeah. I mean, at the end of the day, as we talked about during COVID quite a lot, it's about framing risk. It's not about telling people how to feel or telling people how to choose. It's about framing risk. And then it's like, you do you, and that's fine. And if you do something that's not healthy for you, that is fine too. As long as you're armed with the data, then that, that, that is, that is great. Emily, thanks for joining me. And by the way, how can people sign up for parent data?[00:28:56] EO: So, parentdata.org, you can find me there, we have a newsletter that goes out, we have an enormous volume of writing for pregnant people and parents and, and some things for people who are not parents, and we have like a little search AI, so parentdata.org is the best place, or you can find me on Instagram at profemilyaster.[00:29:20] LM: Thank you all for listening to Beyond the Prescription. Please don't forget to subscribe, like, download, and share the show on Apple Podcasts, Spotify, or wherever you catch your podcasts. I'd be thrilled if you liked this episode to rate and review it. And if you have a comment or question, please drop us a line at info@lucymcbride.com. The views expressed on this show are entirely my own and do not constitute medical advice for individuals. That should be obtained from your personal physician. Get full access to Are You Okay? at lucymcbride.substack.com/subscribe

Genetic Testing and Stone Disease Co-host: Kyle Wood, MD Population analysis demonstrated that genetic conditions resulting in stone disease are magnitudes higher than those seen in clinical cohorts, suggesting underdiagnosis. Urologist play a unique role as we often times have many touch points with these patient given their presentation for stone disease. With the advancement of treatments, specifically in primary hyperoxaluria, it is essential that urologist play a more active role in the earlier diagnosis of patients. Genetic testing has become readily available at lower cost and much of the perceived barriers to genetic testing are addressed by current available programs. Outline: 1. The contribution of genetics to kidney stone disease 2. Specific studies using genetic testing 3. Primary Hyperoxaluria as an example 4. Current Genetic Testing and Ease 5. The role of the Urologist References: - Hill AJ, Basourakos SP, Lewicki P, et al. Incidence of kidney stones in the United States: The Continuous National Health and Nutrition Examination Survey. J Urol. 2022;207(4):851-856. - Singh P, Harris PC, Sas DJ, Lieske JC. The genetics of kidney stone disease and nephrocalcinosis. Nat Rev Nephrol. 2022;18(4):224-240. - Goldfarb DS, Fischer ME, Keich Y, Goldberg J. A twin study of genetic and dietary influences on nephrolithiasis: a report from the Vietnam Era Twin (VET) Registry. Kidney Int. 2005;67(3):1053-1061. - Daga A, Majmundar AJ, Braun DA, et al. Whole exome sequencing frequently detects a monogenic cause in early onset nephrolithiasis and nephrocalcinosis. Kidney Int. 2018;93(1):204-213. - Braun DA, Lawson JA, Gee HY, et al. Prevalence of monogenic causes in pediatric patients with nephrolithiasis or nephrocalcinosis. Clin J Am Soc Nephrol. 2016;11(4):664-672. - Halbritter J, Baum M, Hynes AM, et al. Fourteen monogenic genes account for 15% of nephrolithiasis/nephrocalcinosis. J Am Soc Nephrol. 2015;26(3):543-551. - Knoers N, Antignac C, Bergmann C, et al. Genetic testing in the diagnosis of chronic kidney disease: recommendations for clinical practice. Nephrol Dial Transplant. 2022;37(2):239-254. - Groothoff JW, Metry E, Deesker L, et al. Clinical practice recommendations for primary hyperoxaluria: an expert consensus statement from ERKNet and OxalEurope. Nat Rev Nephrol. 2023;19(3):194-211. - van der Hoeven SM, van Woerden CS, Groothoff JW. Primary hyperoxaluria type 1, a too often missed diagnosis and potentially treatable cause of end-stage renal disease in adults: results of the Dutch cohort. Nephrol Dial Transplant. 2012;27(10):3855-3862. - Hopp K, Cogal AG, Bergstralh EJ, et al. Phenotype-genotype correlations and estimated carrier frequencies of primary hyperoxaluria. J Am Soc Nephrol. 2015;26(10):2559-2570. - Garrelfs SF, Frishberg Y, Hulton SA, et al. Lumasiran, an RNAi therapeutic for primary hyperoxaluria type 1. N Engl J Med. 2021;384(13):1216-1226. - Baum MA, Langman C, Cochat P, et al. PHYOX2: a pivotal randomized study of nedosiran in primary hyperoxaluria type 1 or 2. Kidney Int. 2023;103(1):207-217. - Soliman NA, Nabhan MM, Abdelrahman SM, et al. Clinical spectrum of primary hyperoxaluria type 1: Experience of a tertiary center. Nephrol Ther. 2017;13(3):176-182. - Schonauer R, Scherer L, Nemitz-Kliemchen M, et al. Systematic assessment of monogenic etiology in adult-onset kidney stone formers undergoing urological intervention-evidence for genetic pretest probability. Am J Med Genet C Semin Med Genet. 2022;190(3):279-288.

Dr. Katie Young, co-director of the cardioobstetrics clinic here at Mayo Clinic sits down to talk about peripartum cardiomyopathy. This is something we will likely consider many times in our careers for patients with shortness of breath in and around late pregnancy. Find out what interventions are key, what patients are most likely to suffer a bad outcome and more. CONTACTS X - @AlwaysOnEM; @VenkBellamkonda YouTube - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com REFERENCES & LINKS Gierula J, et al. Prospective evaluation and long-term follow up of patients referred to secondary care based upon natriuretic peptide levels in primary care. European Heart Journal – Quality of Care and Clinical Outcomes. 2019. 5, 218-224 Bay M, et al. NT-proBNP: A new diagnostic screening tool to differentiate between patients with normal and reduced left ventricular systolic function. Heart. 2003. 89,150-154 Dockree S, et al. Pregnancy reference intervals for BNP and NT-pro BNP – changes in natriuretic peptides related to pregnancy. Journal of Endocrine society. 2021. 5(7)1-9 Mueller C, et al. Heart failure association of the European society of cardiology practical guidance on the use of natriuretic peptide concentrations. European Journal of Heart Failure. 2019. 21, 715-731 Ravichandran J, et al. High-sensitivity cardiac troponin I levels in normal and hypertensive pregnany. American J of Medicine. 2019. 132,362-366 High sensitivity troponin T and I among pregnant women in the US – the National Health and Nutrition Examination Survey. JAMA Cardiology. 2023. 8(4)406-408 Tweet MS, et al. Spontenaoues Cardic Artey Dissection associated with pregnancy. Journal of the American College of Cardiology. 2017. 70,426-435 Baggish AL, et al. The differential diagnosis of an elevated amino-terminal Pro-B-Type Natriuretic Peptide level. Am J Cardiol. 2008. 101,43A-48A Lichtenstein DA, Meziere GA. Relevance of lung ultrasound in the diagnosis of acute Respiratory Failure – the Blue Protocol. Chest. 2008. 134,117-125 Smit MR, et al. Comparison of linear and sector array probe for handheld lung ultrasound in invasively ventilated ICU patients. Ultrasound in Med & Biol. 2020. 46(12)3249-3256 Haller EP, Nestler DM, Campbell RL, Bellamkond VA. Point-of-care ultrasound findings of acute pulmonary embolism: McConnell sign in the emergency medicine. JEM. 2014. 47(1)e19-e24 Halpern DG, et al. Use of medication for cardiovascular disease during pregnancy:JACC State of the Art Review. J Am Coll Cardiol. 2019. Feb, 73(4)457-476 Loyanga-Rendon RY, et al. Outcomes of patients with peripartum cardiomyopathy who received mechanical circulatory support. 2014. Circ Heart Failure. 7,300-309 Adedinsewo DA, et al. Detecting cardiomyopathies in pregnancy and the postpartum period with an electrocardiogram-based deep learning model. European Heart Journal – Digital Health. 2021. 2,586-596 Zieleskiewicz L., et al. Lung ultrasound-guided management of acute breathlessness during pregnancy. Anesthesia. 2013. 68,97-101 Balaceanu A. B-type natriuretic peptides in pregnant women with normal heart or cardiac disorders. Medical Hypotheses. 2018. 121,149-151

Muscle loss is a common yet preventable part of the aging process. As we age, muscle mass naturally decreases due to a decrease in physical activity and slowed metabolism. This process is known as sarcopenia, and it can have long-term health implications if not addressed. In this article, we'll discuss the importance of muscle, why it's so difficult to build in the first place, and how to prevent age-related muscle loss. The Importance of Muscle Preservation Higher levels of muscle mass offer myriad health benefits. One significant advantage is that muscles act as metabolic powerhouses. They burn calories even when we're at rest, helping to maintain optimal body weight and prevent obesity.Wolfe, RR. "The underappreciated role of muscle in health and disease." The American journal of clinical nutrition 84.3 (2006): 475-482. Muscle tissue also plays a pivotal role in improving insulin sensitivity, reducing the risk of type 2 diabetes.Srikanthan, Preethi, and Arun S. Karlamangla. "Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the third National Health and Nutrition Examination Survey." The Journal of Clinical Endocrinology & Metabolism 96.9 (2011): 2898-2903. The greater the muscle mass, the more glucose our bodies utilize, reducing the chance of diabetes development. For mobility, muscle mass contributes to better balance and stability, which becomes crucial as we age.Landi, Francesco, et al. "Sarcopenia as the biological substrate of physical frailty." Clinics in geriatric medicine 31.3 (2015): 367-374. This enhanced stability reduces the likelihood of falls and injuries, contributing to a longer and healthier life. Muscles also regulate our body's response to inflammation and infection. A study by Johns Hopkins University found that individuals with solid muscle mass had a stronger immune response.Fiuza-Luces, Carmen, et al. "Exercise is the real polypill." Physiology 28.5 (2013): 330-358. Moreover, preserving muscle mass aids in maintaining mental well-being. Research reveals a strong correlation between muscle strength and improved mood, reduced anxiety, and decreased instances of depression.Gordon, Brett R., et al. "Association of efficacy of resistance exercise training with depressive symptoms meta-analysis and meta-regression analysis of randomized clinical trials." JAMA psychiatry 75.6 (2018): 566-576. So, muscle mass is not just about physical strength and aesthetics but a keystone of our overall health and longevity. Why Is It So Difficult to Build Muscle? Muscle hypertrophy, or the increase in muscle mass, is a complex process that becomes increasingly difficult as we age. This phenomenon is orchestrated by several factors, including hormones, proteins, and our bodies' connective tissues. Testosterone and growth hormone are two crucial players in muscle building. These hormones function like biochemical foremen, directing the construction and repair of muscle tissue. Testosterone promotes protein synthesis, the process by which the body uses dietary protein to build new muscle fibers.West, D. W., & Phillips, S. M. (2012). Associations of exercise-induced hormone profiles and gains in strength and hypertrophy in a large cohort after weight training. European journal of applied physiology, 112(7), 2693-2702. On the other hand, growth hormone stimulates cell growth and regeneration, playing an integral part in muscle repair and recovery.Devesa, J., Almengló, C., & Devesa, P. (2016). Multiple effects of growth hormone in the body: Is it really the hormone for growth?. Clinical medicine insights. Endocrinology and diabetes, 9, Cmed-88159. However, with advancing age, our bodies naturally produce less of these hormones. This reduction results in slower muscle growth and recovery, making muscle building more challenging.Pritzlaff, C. J., Wideman, L., Weltman, J. Y., Abbott, R. D., Gutgesell, M. E., Hartman, M. L., ... & Weltman, A.

Approximately 93% of the population is affected by an issue that predicts heart disease about 10 years before you have elevated cholesterol—and very few people realize they have it.  This same condition is the precursor to several common chronic illnesses, and your doctor probably isn't testing for it.  The good news is, this condition is almost 100% treatable, preventable, and reversible if you know what to do.  In today's episode, you're going to learn what this epidemic is, why it's critical to your health, and what you can do to avoid being another statistic. Join me and weight loss, metabolism, and anti-aging specialist and board-certified nutritionist Jonny Bowden for an eye-opening conversation about how to safeguard your health, now and for years to come.  Full show notes: https://jjvirgin.com/jonny Learn more about Jonny Bowden: https://www.jonnybowden.com Subscribe to my podcast: http://subscribetojj.com Read my book, The Sugar Impact Diet: https://store.jjvirgin.com/collections/books/products/sugar-impact-diet-paperback-book Read The Great Cholesterol Myth: https://amzn.to/43XsVJa Read The 150 Healthiest Foods on Earth: https://amzn.to/3OOZogt Study: Metabolic Syndrome and Related Disorders, Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009-2016: https://pubmed.ncbi.nlm.nih.gov/30484738/ HOMA-IR calculator: https://www.mdcalc.com/calc/3120/homa-ir-homeostatic-model-assessment-insulin-resistance DEXA scan: https://dexascan.com/ YourLabWork advanced lipid panel: https://yourlabwork.com/jj-virgin/ Find it under cholesterol tests/heart health YourLabWork fasting insulin test: https://yourlabwork.com/jj-virgin/ Find it under sugar metabolism & diabetes screening Study: Current Opinion in Clinical Nutrition and Metabolic Care: Sleep and Obesity: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632337/ American Diabetes Association: https://diabetes.org/ Reignite WellnessTM All-in-One Shakes: https://store.jjvirgin.com/collections/shakes Catalina Crunch Keto Protein Cereal: https://amzn.to/47jLv0X Rockport Test calculator: https://www.sport-fitness-advisor.com/rockport-test-calculator.html Learn more about Blue Zones: https://www.bluezones.com/ Podcast: What Causes Obesity? with Dr. Richard Johnson: https://jjvirgin.com/main-podcast/what-causes-obesity-with-dr-richard-johnson-ep-490/ Get Jonny's 7 Uncommon Daily Habits to Turbocharge Weight Loss & Energy: https://rockwell-health.com/7habits

This week, host Andy Bellavia is joined by two researchers from the Cochlear Center for Hearing and Public Health at Johns Hopkins University. Nicholas Reed, AuD, and Kening Jiang, MHS, discuss their research into the complex relationships between hearing loss, fatigue, sleep disturbances, and cognitive decline. Kening Jiang discusses her study on the connection between hearing loss and self-reported fatigue, exploring future research possibilities including the impact of addressing hearing loss on fatigue. The pair emphasize the need to understand individual factors and interactions contributing to cognitive health in the complex relationship between hearing loss and fatigue. References: * Sleep Characteristics and Hearing Loss in Older Adults: The National Health and Nutrition Examination Survey 2005–2006 https://academic.oup.com/biomedgerontology/article/77/3/632/6327644) *Associations of sleep characteristics in late midlife with late-life hearing loss in the Atherosclerosis Risk in Communities-Sleep Heart Health Study (ARIC-SHHS) https://www.sciencedirect.com/science/article/abs/pii/S235272182300133X) * Hearing Loss and Fatigue in Middle-Aged and Older Adults https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2806828) More information about the research taking place at the Cochlear Center can be found here: https://jhucochlearcenter.org/ Be sure to subscribe to our channel for the latest episodes each week and follow This Week in Hearing on LinkedIn and Twitter. - https://twitter.com/WeekinHearing - https://www.linkedin.com/company/this-week-in-hearing - https://hearinghealthmatters.org/thisweek/

This week, Brian Taylor welcomes Professor Christina Roup from The Ohio State University to discuss adults with normal audiograms and self-reported hearing difficulty. The prevalence of this condition is estimated to be around 12-15% in younger and middle-aged adults, with a higher prevalence in older age groups and those with a history of traumatic brain injury. Dr. Rouf reviews some of the latest research on this topic and how it can inform clinicians who work with this population. She also presents insights from her research, where she found that amplification with mild gain hearing aids significantly improved speech-in-noise performance for adults with normal audiograms and self-reported hearing difficulties. She encourages clinicians to listen to their patients' complaints and take them seriously, using speech-in-noise tests as a routine part of their clinical battery to provide appropriate treatment options. Studies mentioned in this interview: Beck, D, & Danhauer, J.L. (2019). Amplification for adults with hearing difficulty, speech in noise problems – and normal thresholds. Journal of Otolaryngology-ENT Research, 22(1), 84-88. Cameron, S. & Dillon, H. (2007). Development of the Listening in Spatialized Noise- Sentences test (LiSN-S). Ear and Hearing, 28(2), 196-211. Helfer, K. S., & Jesse, A. (2021). Hearing and speech processing in midlife. Hearing Research, 402, 108097. Helfer, K.S., & Vargo, M. (2009). Speech recognition and temporal processing in middle-aged women. Journal of the American Academy of Audiology, 20, 264-271. DOI: 10.3766/jaaa.20.4.6 Roup, C.M., Custer, A., & Powell, J. (2021). The relationship between, self-perceived hearing ability and binaural speech-in-noise performance in adults with normal pure-tone hearing. Perspectives of the ASHA Special Interest Groups, 1-12. Roup, C.M., Post, E., & Lewis, J. (2018). Mild-gain hearing aids as a treatment for adults with self-reported hearing difficulties. Journal of the American Academy of Audiology, 29, 477-94. Spankovich, C., Gonzalez, V. B., Su, D., & Bishop, C. E. (2018). Self reported hearing difficulty, tinnitus, and normal audiometric thresholds, the National Health and Nutrition Examination Survey 1999-2002. Hearing Research, 358, 30-36. DOI: 10.1016/j.heares.2017.12.001 Tremblay, K., Pinto, A., Fischer, M.E., Klein, B. E. K., Klein, R., Levy, S. . . . Cruickshanks, K. J. (2015). Self-reported hearing difficulties among adults with normal audiograms: The Beaver Dam Offspring Study. Ear and Hearing, 36(6), e290-e299. DOI: 10.1097/AUD.0000000000000195 Be sure to subscribe to our channel for the latest episodes each week and follow This Week in Hearing on LinkedIn and Twitter. - https://twitter.com/WeekinHearing - https://www.linkedin.com/company/this-week-in-hearing - https://hearinghealthmatters.org/thisweek/

Trends in hair, skin, and nail supplement use: Data from the National Health and Nutrition Examination Survey 2011-2020. Trepanowski N, Moore KJ, Kim DY, Hartman RI. Journal of the American Academy of Dermatology. 2023 Jul 1;89(1):161-3.Median canaliform nail dystrophy in a 2-year-old boy: Case report and review of the literature. Wilson A, Tariq Khan M, Murrell DF. Pediatric Dermatology. 2022 Nov 13.The use of marigold therapy for podiatric skin conditions. Hadfield RA, Vlahovic T, Khan MT. Foot and Ankle Online Journal. 2008 Jul 1.

There is an obesity epidemic in the United States. According to the National Health and Nutrition Examination Survey, more than two in five American adults are obese and nearly one in five American children are obese. So is a drug used to help decrease blood sugar levels in type two diabetics the answer to weight loss?

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: Lilly becomes the first of the big three insulin makers to settle a class action lawsuit over pricing, the FDA approved Beta Bionics' iLet system, oral meds trialed for T2D seem to work as well as Ozempic injectable, Lego adds a T1D "friend" to their line and a big win for an American Ninja Warrior competitor with T1D. Please visit our Sponsors & Partners - they help make the show possible! Take Control with Afrezza  Omnipod - Simplify Life Learn about Dexcom  Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines happening now XX In the news is brought to you by VIVI Cap Keeps your insulin at the exact right temperature, even in extreme heat or cold. XX Our top story, Eli Lilly has agreed to pay $13.5 million to end a six-year, class-action lawsuit accusing the company of overpriced its insulin. As part of the settlement, Lilly has agreed to cap out-of-pocket costs for its insulin at $35 per month for four years. That's three months after Lilly said it would cut insulin prices to that level. The lawsuit was filed in 2017, against insulin makers Lilly, Novo Nordisk and Sanofi. Plaintiffs claimed the companies joined in an “arms race” to raise list prices of their meds while the “real” price to pharmacy benefit managers remained constant or in some cases dipped. Price increases of insulins that previously cost $25 per prescription were pushed up to $450, the suit said. The increases, taken in “lockstep,” were “astounding and inexplicable,” according to the class action lawsuit. Novo and Sanofi have yet to settle this case. https://www.fiercepharma.com/pharma/eli-lilly-inks-settlement-long-running-insulin-pricing-lawsuit XX The FDA is changing its draft guidance for industry regarding Antidiabetic Drugs and Biological Products. It's been 15 years since an update. Topics covered in the draft guidance include: Hemoglobin A1c (A1C), a measure of average blood sugar, remaining an acceptable primary efficacy endpoint The FDA now considering a reduction in the risk of hypoglycemia (low blood sugar) to be a clinically relevant outcome measure for diabetes drug clinical trials, when accompanied by either a reduction or maintenance of an acceptable A1C. The use of data collected by continuous glucose monitoring (CGM) systems, which allow for nonstop, passive glucose monitoring, in clinical trials to potentially support hypoglycemia labeling claims. Recent advancements in CGM technology have led the agency to recognize the advantages of data collected from these systems in clinical drug development. The FDA will be accepting comments on the guidance until August 24, 2023. https://www.appliedclinicaltrialsonline.com/view/fda-on-track-to-updates-diabetes-efficacy-endpoints-guidance XX The iLet bionic pancreas from Beta Bionics gets FDA approval for people with type 1 age 6 and up. This is a unique system in that it starts with only the user's weight and requires meal announcements – no carb counting – to automate blood sugar. It will launch with the Dexcom G6 CGM. You'll hear from the company CEO this Tuesday in our next episode where we do a deep dive into the system. https://www.medicaldevice-network.com/news/beta-bionics-fda-insulin-pump/ XX Researchers had observed an increased incidence of type-1 diabetes cases during the COVID-19 pandemic. Now, a new study has confirmed the link and established a temporal association between the development of type-1 diabetes in children and infection with the SARS-CoV-2 virus. The new study published in Jama Network was the first research that used data, which indicated if the type-1 diagnosed children previously had COVID-19 infection. The researchers found the likelihood to develop type-1 diabetes increased by 57% in children who had a confirmed COVID-19 infection, compared to those who did not have the infection. https://www.medicaldaily.com/covid-19-infection-increases-incidence-type-1-diabetes-children-study-469854 XX New oral medication from Pfizer seems to stack up well next to Ozempic for weight loss. New study looked at people with type 2 found danuglipron when given twice a day, lowered blood sugar in patients at all doses and reduced body weight at the highest dose after 16 weeks. The weight loss with danuglipron is of a similar magnitude to that observed in the mid-stage data for Novo Nordisk's semaglutide, known as Ozempic when used for diabetes and Wegovy for obesity. The treatments, including Pfizer's danuglipron, belong to a class of drugs that mimic the gut hormone glucagon-like peptide-1 (GLP-1), which works by suppressing appetite and were initially developed to treat type 2 diabetes. Pfizer is also testing another oral diabetes drug, lotiglipron, which is given once daily and has said it plans to initiate late-stage development of only one of the two candidates. The company believes an oral therapy could appeal to patients who want to avoid injections. https://www.reuters.com/business/healthcare-pharmaceuticals/pfizer-diabetes-drug-reduces-weight-similar-novos-ozempic-2023-05-22/ XX Artificial intelligence (AI) algorithms used to screen for and predict type 2 diabetes may be racially biased, which could perpetuate health disparities, according to a study published last week in PLOS Global Public Health. Risk prediction models for type 2 diabetes have shown promise in bolstering early detection and clinical decision-making, but the researchers pointed out that these models can bias the decision-making process if risk is miscalibrated across patient populations. The research team found that the Framingham Offspring Risk Score underestimated type 2 diabetes risk for non-Hispanic Black patients, but overestimated risk for their white counterparts. The ARIC Model and PRT overestimated risk for both groups, but to a greater extent for white patients. Research like this highlights that while data analytics and AI approaches may help find gaps in chronic disease management and care, racial disparities are still a major obstacle to achieving health equity for diabetes patients. A 2021 study of city-level data revealed significant disparities in diabetes mortality rates across the United States. The analysis sourced data from the 30 largest cities in the US and demonstrated that mortality rates were higher for Black individuals than for white individuals. Disparities were also found to be up to four times larger in some cities compared to others, with Washington, DC experiencing the highest rates of diabetes mortality inequities. https://healthitanalytics.com/news/potential-racial-bias-found-in-type-2-diabetes-risk-prediction-models XX 1 in 3 adults with Type 2 diabetes may have undetected cardiovascular disease. Elevated levels However, mildly elevated concentrations of of two protein biomarkers that indicate heart damage may be an early warning sign of changes in the structure and function of the heart, which may increase the risk for future heart failure, coronary heart disease or death. Researchers analyzed health information and blood samples for more than 10,300 adults collected as part of the U.S. National Health and Nutrition Examination Survey from 1999 to 2004. Study participants had reported no history of cardiovascular disease when they enrolled in the study. One-third (33.4%) of adults with Type 2 diabetes had signs of undetected cardiovascular disease, as indicated by elevated levels of the two protein markers, compared to only 16.1% of those without diabetes. https://medicalxpress.com/news/2023-05-adults-diabetes-undetected-cardiovascular-disease.html XX VIVI CAP XX MTV Documentary Films has acquired worldwide rights to Pay or Die, a film about Americans living with diabetes who face a cruel choice: pay the “extortionate” cost of insulin charged by pharmaceutical companies or risk death. Scott Alexander Ruderman and Rachael Dyer directed and produced the documentary, which premiered in March at SXSW. MTV Documentary Films plans a theatrical release later this year, followed by a debut on streaming platform Paramount+. Those personal stories in the film stretch across the country. “From a mother-and-daughter struggling to rebuild their lives after spending their rent money on insulin, to a young adult diagnosed with Type 1 diabetes during the COVID-19 pandemic, to a Minnesota family thrust into the national spotlight when their 26-year-old son dies from rationing his insulin, Pay or Die highlights this devastating struggle to survive while living with diabetes.” https://deadline.com/2023/05/pay-or-die-mtv-documentary-films-acquisition-directors-scott-alexander-ruderman-rachael-dyer-news-1235382566/ XX Katie Bone win the “American Ninja Warrior Women's Championship” — not only claiming the title but a cash prize of $50,000. She donated $5,000 to the Juvenile Diabetes Research Foundation and Pumped NM. Bone has not only appeared on three iterations of the competition series, but is also a nationally-ranked rock climber. While not the youngest competitor anymore, she was the shortest standing at 5 foot, 2 inches. She's been making waves since competing in “American Ninja Warrior Jr.” in 2020. To train for the event during the pandemic, her father built a ninja course in their backyard. During that competition, Bone, who was diagnosed with Type 1 diabetes at 11 years old, competed with both her insulin pump and glucose monitor on her arms. Being on the show also presents Bone with the opportunity to be an ambassador for Type 1 diabetes awareness and representation. Bone says Type 1 diabetes didn't end her life, it just changed it. “I hope I inspire a little kid to wear their pump on their arm,” Bone said. “It makes everything that you do that more amazing.” In February, Bone competed at the USA National Women's Team Climbing trials in Austin, Texas. During her fourth climb, she fell. “Katie heard four pops,” Tammy Bone said. “She tore her ACL and both sides of her meniscus. This was a moment she was preparing for all her life and it got put on pause.” Bone had surgery and has been getting physical therapy in Colorado. The family returned Monday night to New Mexico after being away for three months. Bone still has her eyes on the Olympics, though the road to recovery may take some more time. “I don't need easy, I just need possible,” she said. https://www.abqjournal.com/2602750/17-year-old-new-mexico-ninja-warrior-katie-bone-takes-the-title-in-womens-championship-competition.html XX Today LEGO has revealed the first wave of Friends sets for 2023, bringing in a new cast of characters and an update to the branding with a new logo. A new LEGO Friends television series will also accompany the new sets. LEGO's annual Play Well study revealed that 3 out of 4 children felt there were not enough toys with characters that represent them, so LEGO is aiming to bring more diverse representation to Heartlake City that's inclusive of not just various ethnicities and genders, but also disabilities and neurodivergence. LEGO says the 2023 sets and series will feature characters with limb difference, Downs Syndrome, anxiety, vitiligo, and even pets with disabilities, including a blind dog and a dog with a wheelchair. She has a CGM printed on her arm and even has a printed phone tile showing her blood sugar. Her name is Hannah and she's in 41744 Sports Center https://www.brothers-brick.com/2022/10/27/lego-friends-reveals-5-sets-for-2023-with-diverse-characters-to-better-represent-children-news/ XX XX On the podcast next week.. Beta Bionics CEO Sean Saint. Last week I MedT 780G That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.  

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https://ratethispodcast.com/man    Do you want to know what you can do to enhance your testosterone levels and elevate yourself to peak performance?   In today's episode, we unravel the raw power of testosterone—the ultimate hormone that fuels men's physical performance and mental fortitude. We'll explore the ins and outs of testosterone, from its muscle-building and energy-boosting capabilities to the alarming decline in testosterone levels among men over the past decade. Find out how you can naturally raise your testosterone levels along with the pros and cons of supplements, hormone replacement therapy (HRT) and testosterone replacement therapy (TRT), and the remarkable ways testosterone can unleash your inner beast. “When our testosterone is primed up, it really is like a super power” - J Dragon   You're going to leave this episode with…   A breakdown of what testosterone does and how it is your superpower   What factors in your life might be affecting your testosterone levels   The pros and cons of testosterone supplementation for peak performance   How hormone replacement therapy (HRT) and testosterone replacement therapy (TRT) can help you balance your testosterone levels   Inspiration from J Dragon's personal journey overcoming low testosterone and transforming his physique   Strategies for building your muscle, enhancing your libido, and reclaiming your vitality     How your testosterone changes with age   What you can do to increase your testosterone naturally prior to consulting about hormone replacement therapy   Understanding how early testosterone usage can affect you long term   What having more sex does to your testosterone levels   The importance of finding out your free testosterone levels    The Manhood Experiment of the week that will help you increase your testosterone levels     ----- 

What is the Manhood Experiment?
   It's a weekly podcast where we give you one experiment to level up your mind, career, business, health, relationships and more!   -----   For more tips and behind the scenes, follow us on:   
- Instagram @ManhoodExperiment   
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   Submit your questions @ www.manhoodexperiment.com -----   Resources Mentioned:   Patel P, Fantus R, Lokeshwar S, et al. Trends in Serum Testosteron Levels Among Adolescent and Young Adults Men in the United State. Presented at: 2020 AUA Virtual Experience; May 15, 2020. Abstract MP78-01.   Impaired sleep is associated with low testosterone in US adult males: results from the National Health and Nutrition Examination Survey.   Sleeping five instead of eight hours a night for a week lowered testosterone by around 15%   Study on 531 Chinese men also found a link between sleep and testosterone.   The more fat you carry, the lower your testosterone tends to be Study 1 Study 2   One study found that testosterone levels rise on days couples have sex and decline on days without it   Another study found that sex increased testosterone by 72%    A study by Amy Cuddy and her colleagues at Harvard University assessed how making postural changes impacts levels of stress hormones and testosterone. High power poses were able to increase testosterone meanwhile low power poses lowered testosterone   This study moved subjects from a diet containing 40% of calories from fat to a diet containing 25% of calories from fat and then back to a 40% fat diet. Results showed that the low fat diet decreased testosterone levels significantly   This study had 20 male university students with no previous resistance training experience follow a weight lifting plan three times per week. Thanks to this the students boosted their testosterone levels by 40% in four weeks, and they also lowered their resting cortisol levels by 24%   Resistance training up-regulates testosterone receptors. This means your body can use testosterone more effectively   BPA lowers testosterone and can cause erectile dysfunction Study 1 Study 2   In a study involving 2,299 men found that those with a sufficient vitamin D level had much higher testosterone than those who were deficient in this vitamin    An eight-week study with 46-men with infertility problems found that 675-gram ashwagandha root extract increased serum testosterone levels by 17% compared to a placebo   A study found that five grams of ashwagandha a day for 90 days increased testosterone by 16% to 40% in infertile men and by an average of 15% in fertile ones   One group of “moderately stressed” participants increased their testosterone by 37% and lowered their cortisol by 16% as a result of consuming 200 mg of a tongkat ali extract for four weeks   Tongkat Ali  - suggested as influencing the release rate of “free” testosterone from its binding hormone, sex-hormone-binding-globulin (SHBG) 

As a society, we are eating and drinking low-calorie sweeteners more and more. Researchers are working to understand the long-term impact of such sweeteners for adults and, of course, for children. This interview is part of a series on the impact of sweeteners. Our guest today is Dr. Allison Sylvetsky, Associate Professor in the Department of Exercise and Nutrition Sciences at the George Washington University - Milken Institute School of Public Health. Interview Summary   Boy, these sweeteners are in the news all the time, and that's been the case for many years. And people are really interested in whether they're safe, whether they help people control their weight and the like. You have a vast knowledge on this, and I'd like to begin with kind of a fundamental question. So, how has the consumption of these sweeteners changed over time? How much are they being used and who is using them?   What's really interesting is that these sweeteners have been around, at least some of them, for quite a while. But what we've seen is that as there's been more and more emphasis on reducing the consumption of added sugars and sugar sweetened beverages, there's been a widespread increase in the use of various low-calorie sweeteners in the food supply, which of course has been followed by increases of consumption. So, across all different population subgroups, we're seeing increases in the intake of low-calorie artificial sweeteners.   So, how much are they used and who are the people who are using them the most?   So, in terms of how much they're used, that depends to some extent on how we look at this, because it's very hard to actually quantify the intake given that manufacturers are not required to disclose the amount of different artificial or low-calorie sweeteners in food and beverage products. So, most of the data that we have to rely on either comes from household purchasing data or comes from self-reported dietary intake data from large surveys, for example, the National Health and Nutrition Examination Survey. But, what we've seen in these data are that low-calorie sweeteners are being used across the population, though the highest consumption or highest prevalence of consumption is seen in females, in individuals with diabetes and obesity, individuals from higher-income households, and also older adults and older individuals. However, more and more, we are also seeing consumption of low-calorie sweeteners among children, and consumption in products that people wouldn't necessarily expect would contain these artificial or low-calorie sweeteners.   Let's talk about that. So, where do the low-calorie sweeteners show up in the food supply? Has this changed over time?   This has definitely changed over time. Several decades ago, you would think of low-calorie sweeteners as being in diet beverages, which of course they still are. Or in sweetener packets that you find on the tabletop. For example, Sweet'n Low that contains saccharin or Equal that contains aspartame. But now we're seeing these sweeteners showing up across product categories. So, in products including light yogurts, artificially sweetened yogurts, dairy desserts such as ice cream, snack foods such as microwave popcorn, cereals, ready-to-heat oatmeals, all sorts of different products, protein bars, protein shakes, really, you name it. I've actually even seen low-calorie sweeteners show up in pickled ginger that usually is used along with sushi. So, again, places where people just wouldn't expect to find them. We see these sweeteners popping up, and this is more and more the case as there's been more and more emphasis on reducing the intake of added sugars.   Low-calorie sweeteners in microwave popcorn, who would've thought? I mean, that's just one example and you gave other ones about where these things are showing up. So, big time exposure to these, isn't there?   Exactly. Also, something like microwave popcorn typically wouldn't be thought of as a diet food, and that's part of what is very confusing to consumers. It's one thing if the product is labeled as "diet" or "no sugar added" even. Not that everybody would recognize that as perhaps being suggestive of having a low-calorie sweetener, but in products like microwave popcorn or certain English muffins, for example, people typically aren't using these products as a way to manage their weight or as some sort of a diet or reduced calorie food, because they're not diet or low-calorie foods.   Let's get right to one of the most fundamental questions of all. What are your thoughts on how these low-calorie sweeteners affect health?   So, that is the big question, and there's a lot of uncertainty and there's been more and more research on the topic, which has been exciting and informative. But there still are a lot of questions with regard to how these sweeteners affect health. One thing that is important to clarify right from the start is that, at least the work that I do and the work that a lot of people are focused on to understand their health effects, is different from more of a traditional toxicological safety assessment. So, when I'm talking about their effects on health, I'm really referring to their metabolic and health effects, their role in weight management and chronic disease prevention as opposed to more traditional safety outcomes. Because of course, these low-calorie sweeteners have been reviewed and approved for use in food by the Food and Drug Administration and other regulatory agencies worldwide. But, in terms of weight management and chronic disease prevention, what's really interesting is, it depends on the type of evidence that you look at. There have been quite a number of randomized control trials primarily in adults that have shown that when added sugars or sugar-sweetened beverages are replaced with low-calorie sweeteners on a one-to-one basis, there typically is either a neutral effect or a modest benefit. Where we do see some modest reductions in energy intake as well as a modest reduction in body weight. But that doesn't necessarily tell the whole story because that doesn't necessarily reflect how they're used, especially given what we've just discussed about the use of low-calorie sweeteners in the food supply. What's interesting is when we look at observational evidence from large perspective cohort studies, typically the vast majority of these studies show positive associations between consumption of diet beverages and low-calorie sweeteners with a variety of adverse health outcomes. This includes higher risk of obesity, higher risk of diabetes, heart disease, and some recent studies also showing an increased risk of certain types of cancer.   So that then leads to the question of: well, what explains this discrepancy? There are several explanations. One is that there are flaws to any type of study, including that a lot of these studies that look at associations may be subject to reverse causality or sort of a chicken and egg situation - which is what's happening first. But they're also very plausible biological and behavioral mechanisms that have been put forth to explain how low-calorie sweetener intake may be causally related to some of these outcomes. And that's really where a lot of the research is focused right now, is trying to understand, what do these low calorie sweeteners actually do metabolically in the body and how does that impact health?   That whole range of metabolic consequences is a very interesting one. You led off this discussion by mentioning toxicology, and I realize that you're not a toxicologist, nor am I, but I do have a question in that arena. Whatever standards of the FDA uses to assess safety for these things, I'm assuming it's a range of standard toxicological tests, do you think there's still a chance that these things, even though they're considered safe, will have long-term consequences that people don't know about yet? Just because some of the newer ones, for example, haven't been on the market long enough for people to have 20 or 30 years of exposure? Is there a reason to be concerned on that front, do you think?   I would say there's a reason to be concerned in terms of while the levels that they're consumed are believed to be safe in terms of, as you said, these thresholds that are set forth based on toxicological data - we don't know what the threshold of exposure is that would be required to have these metabolic effects. When we're talking about metabolic and health effects, as you've alluded to, these are long-term processes, right? We don't develop diabetes or cancer overnight, but it takes months, years, decades of exposure to see some of these outcomes. So, it is very possible that even though these are safe from a toxicological standpoint, the repeated exposure in the ways that we consume them, in addition to the fact that we don't consume these in isolation, we consume low-calorie sweeteners in combination with each other, other low-calorie sweeteners, as well as other food additives, other ingredients in various forms. So we don't fully understand yet what that means for long-term human health.   Thank you for that explanation. Thus far, we've been talking about these low-calorie sweeteners as a group, but of course there are different compounds that have different biological effects. What do you think about the different effects of the different versions of low-calorie sweeteners?   That's become an extremely important question, especially because over time there's been changes in not just the use of low-calorie sweeteners as a group, but in certain low-calorie sweeteners. As you mentioned, these sweeteners are different compounds. Of course, they're grouped together because they contain characteristics, such as low-calories that have high potency sweetness and are palatable replacements for added sugars in food. But they are of course, different compounds. And therefore, while they may have some overlapping effects due to their sweetness, they also may have different effects due to their specific chemistry and their way that they are absorbed, metabolized, processed in the body. That's something that we're really, as a field, just beginning to understand. In a lot of the research to date, low-calorie sweeteners have been referred to as a group. And that's in part because, especially in observational studies, it's very difficult to tease out which ones are being consumed. And that's in part due to limitations of dietary assessment approaches, and in part due to constantly changing formulations of these products by food and beverage manufacturers.   So, it's difficult in a lot of the existing research to actually tease apart what specific low-calorie sweeteners we're talking about. That said, there is more and more of an emphasis on trying to understand these as individual compounds and then hopefully be able to make more tailored and nuanced dietary recommendations for or against their consumption. There's been some recent studies looking at, for example, comparing different low-calorie sweeteners on outcomes such as body weight over 12 weeks. What that study showed (that was a study out of Purdue University), is that while saccharin consumption actually led to weight gain that was similar to real sugar, sucralose consumption in this particular study led to reductions in body weight. So, while this is just one example, clearly it's possible and likely that these sweeteners may actually have some different effects, which really reiterates the need to look at them separately and compare their effects on different outcomes.   It's interesting that you mentioned the research at Purdue, and I'd like to remind our listeners that we reported a podcast with Dr. Richard Mattes, who's a professor at Purdue, who's done a good bit of work on this topic. So, let's turn our attention to children. And I know many parents are very concerned about consumption of these products by their children. So, is their worry warranted? What do you think about use of these things in children?   Yes, I would say their worry is warranted. That said, it's also not conclusive that these are harmful, but at the same time, it's not conclusive that these are actually beneficial for their intended benefits of helping to reduce sugar intake and help with weight management. Really when it comes to kids, it's a question of how you look at the data, because what is obvious is that there is a lack of data in kids. In some cases, kids could be thought of as small adults. But kids also are very different than just being small adults, not just because they're smaller, but because they're developing. And we know that early life exposure makes the difference in terms of future dietary patterns. Given that there are many questions about the metabolic and health effects of low-calorie sweeteners in adults that have yet to be answered, to start in a widespread manner, providing these to children is concerning until we have a better handle on how these actually work in the body. As mentioned, there is very limited evidence in children, but at the same time, we've seen an explosion of low-calorie sweeteners in products, including products that are directly marketed to children. For example, fruit drinks that have often added sugar in addition to low-calorie sweeteners such as sucralose and acesulfame potassium. We've done some work talking to parents as have others, and trying to understand, "Well, what do parents think about this?" And most parents will tell us that they do not want to provide these to their children. Meanwhile, other research has shown that parents cannot identify or recognize products that contain them. What's happening is that given a lot of different factors, but particularly the fact that more and more of these sweeteners are showing up in children's products, children are being exposed to low-calorie sweeteners from a very young age. And it's unclear what that means for their health. There is reason to be concerned, both based on data in adults as well as some of the more mechanistic evidence that's come out recently related to how these sweeteners may adversely impact glucose homeostasis or insulin resistance, or alter the composition of the gut microbiome. There are a lot of questions when it comes to this topic in general, but particularly for children, it would seem that we may want to take a more cautious approach before widely incorporating these into products that are going to be consumed by youth.   What are some of the key questions that people in this field are addressing now?   So, some of the key questions, and there are many of them, but one is really just to understand the mechanisms through which these sweeteners work, both as a group and individually. That will provide really much needed insight to explain these epidemiologic findings and also to understand some of the discrepancies between the randomized control trial literature and the observational data. That's one big area of focus. Another is to understand early life exposure. Both exposure among children as well as intergenerational exposure. What happens when a pregnant mother or breastfeeding mother consumes these every day or multiple times a day? We know that they are transferred to the baby. In the case of breastfeeding, for example, we've done some work in that area. What we don't know is what that actually means for the child in terms of their taste preferences, their appetite, their weight trajectory, and their future health. Understanding that early life exposure and intergenerational transmission, as well as focusing on cardiometabolic outcomes beyond body weight. So, we know that when these are used in a certain way, very judiciously, these may... Low-calorie sweeteners, and I'm generalizing the term here, but may be useful for helping with weight management. But we need to study these in a way that better reflects how they're actually consumed in real life. And then also, as we've already discussed, really start to understand the effects of these different compounds as individual sweeteners in addition to as a group of compounds that have some similar sensory property, that being that they're sweet. I think those are some of the main areas in addition to continuing to translate some of the more mechanistic work that's been done in rodent models into the context of human consumption.   The whole idea behind these artificial sweeteners in the first place is that people enjoy sweet taste in things. And so, why not go ahead and provide that? And it better to have it in some form that's not creating the same health problems that sugar has. But what about just changing that assumption and saying that people should get accustomed to less sweetness in things overall, which would then lower intake of both artificial sweeteners and sugar. And I'm wondering if you think that might be possible? Let's just say that the food industry agreed to or was required to reduce the sweetness in its food by 5% each year for the next 15 years or whatever it would be, so that people wouldn't notice it from year to year, but generally you would get accustomed to lower levels of sweetness in things. Do you think that would be possible for people to become accustomed to?   I would think it would be possible, certainly that we know that repeated exposure to different levels of sweetness will affect sweetness preference and dietary choices. What you're describing is very similar to what's been done with sodium in terms of gradual voluntary reduction of sodium. And I am aware, and as I'm sure you are, of efforts through, for example, the National Salt and Sugar Reduction Initiative (NSSRI), to do exactly that, which is to set targets for lowering the sugar content and therefore lowering the sweetness, assuming that there's not replacement with low-calorie sweeteners of different products across different product categories. I think there is a lot of promise in that concept, but I do think we would need to obviously see how that actually affects various outcomes before knowing whether it was effective or not. But I think that concept of it's not just sugar, but also we need to think about the sweetness and how that pertains to other dietary choices and longer term dietary patterns, is really important.   Bio Dr. Allison Sylvetsky is an Associate Professor in the Department of Exercise and Nutrition Sciences and is Director of the Bachelor of Science in Nutrition program at the George Washington University Milken Institute School of Public Health. Dr. Sylvetsky joined the GW faculty in 2014, prior to which, she was a post-doctoral fellow in the Diabetes, Endocrinology, and Obesity Branch of NIDDK in the Intramural Research Program of the National Institutes of Health (NIH). She received a doctorate in Nutrition and Health Science from Emory University. Dr. Sylvetsky's research focuses broadly on obesity and diabetes in youth. Her primary research interests are in studying the consumption and health effects of sugar-sweetened beverages and low-calorie (artificial) sweeteners, with a key focus on their consumption during childhood.  

A client reports she's about to lose a kidney due to a kidney stone. That seems . . . extreme, doesn't it? What's probably happening is that she has a staghorn calculus: a stone that takes up all the space in her kidney. If it's not removed it will continue to grow, which could lead to all kinds of problems. What is a staghorn calculus? And what accommodations do we need to make for a person who has lost an entire vital organ? These questions and more on this episode of “I Have a Client Who . . .”   Sponsors:       Books of Discovery: www.booksofdiscovery.com       Advanced-Trainings: www.advanced-trainings.com     Host Bio:                    Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP's partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner's books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.                                      Recent Articles by Ruth:          “Working with Invisible Pain,” Massage & Bodywork magazine, November/December 2022, page 36, http://www.massageandbodyworkdigital.com/i/1481961-november-december-2022/38   “Unpacking the Long Haul,” Massage & Bodywork magazine, January/February 2022, page 35, www.massageandbodyworkdigital.com/i/1439667-january-february-2022/36.   “Chemotherapy-Induced Peripheral Neuropathy and Massage Therapy,” Massage & Bodywork magazine, September/October 2021, page 33, http://www.massageandbodyworkdigital.com/i/1402696-september-october-2021/34.           “Pharmacology Basics for Massage Therapists,” Massage & Bodywork magazine, July/August 2021, page 32, www.massageandbodyworkdigital.com/i/1384577-july-august-2021/34.           Resources:    Pocket Pathology: https://www.abmp.com/abmp-pocket-pathology-app   Hill, A.J. et al. (2022) ‘Incidence of Kidney Stones in the United States: The Continuous National Health and Nutrition Examination Survey', Journal of Urology, 207(4), pp. 851–856. Available at: https://doi.org/10.1097/JU.0000000000002331.   Staghorn Calculus: Causes, Symptoms & Treatment (no date) Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/22509-staghorn-calculus (Accessed: 22 February 2023).   ‘Struvite and Staghorn Calculi: Practice Essentials, History of the Procedure, Problem' (2021a). Available at: https://emedicine.medscape.com/article/439127-overview (Accessed: 23 February 2023).   Struvite Stones (2021b) National Kidney Foundation. Available at: https://www.kidney.org/atoz/content/struvite-stone (Accessed: 23 February 2023).   Struvite Stones: Symptoms, Causes, Treatment, and Diet (no date). Available at: https://www.healthline.com/health/kidney-health/struvite-stones (Accessed: 23 February 2023).   Torricelli, F.C.M. and Monga, M. (2020) ‘Staghorn renal stones: what the urologist needs to know', International Brazilian Journal of Urology : official journal of the Brazilian Society of Urology, 46(6), pp. 927–933. Available at: https://doi.org/10.1590/S1677-5538.IBJU.2020.99.07.   About our Sponsor:   Massage Mentor Institute In 2019, Diane Matkowski, aka the Massage Mentor, began a closed Facebook page for hosting discussions with industry leaders. These interviews gave her an idea for The Massage Mentor Institute and Jam Series workshops. The goal was to create various continuing education classes offered in one spot. The Institute is a space for massage therapists to learn different approaches and philosophies of bodywork and business classes. It's also home to the Shoulder, Hip, Neck, and Back Jam workshops. We believe that no one technique works for every human being. Our goal is to help you find your path. We have selected teachers we trust, admire, and believe will help you grow as a licensed massage therapist.   Website: themassagementorinstitute.com   Facebook Group: facebook.com/themassagementor   Instagram: @massagementorinstitute  

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.02.10.528042v1?rss=1 Authors: Cohn, E. F., Clayton, B. L. L., Madhavan, M., Yacoub, S., Federov, Y., Paul-Friedman, K., Shafer, T. J., Tesar, P. Abstract: Exposure to environmental chemicals can impair neurodevelopment. Oligodendrocytes that wrap around axons to boost neurotransmission may be particularly vulnerable to chemical toxicity as they develop throughout fetal development and into adulthood. However, few environmental chemicals have been assessed for potential risks to oligodendrocyte development. Here, we utilized a high-throughput developmental screen and human cortical brain organoids, which revealed environmental chemicals in two classes that disrupt oligodendrocyte development through distinct mechanisms. Quaternary compounds, ubiquitous in disinfecting agents, hair conditioners, and fabric softeners, were potently and selectively cytotoxic to developing oligodendrocytes through activation of the integrated stress response. Organophosphate flame retardants, commonly found in household items such as furniture and electronics, were non-cytotoxic but prematurely arrested oligodendrocyte maturation. Chemicals from each class impaired human oligodendrocyte development in a 3D organoid model of prenatal cortical development. In analysis of epidemiological data from the CDC's National Health and Nutrition Examination Survey, adverse neurodevelopmental outcomes were associated with childhood exposure to the top organophosphate flame retardant identified by our oligodendrocyte toxicity platform. Collectively, our work identifies toxicological vulnerabilities specific to oligodendrocyte development and highlights common household chemicals with high exposure risk to children that warrant deeper scrutiny for their impact on human health. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Videos : Those who speak out are shouted down until they are proved right, says Neil Oliver – 10:06 Gad Saad: Why Rational People Fall for ‘Parasitic' Ideas | American Thought Leaders CLIP – 9:11 Scientist Carl Sagan testifying to the U.S. Senate in 1985 on the greenhouse effect: – 2:44 Parent Eviscerates School Board Over Censorship– 4:59 Vitamin C supplementation associated with improved lung function in COPD Medical College of Lanzhou University (China), September 23 2022. The International Journal of Chronic Obstructive Pulmonary Disease published a systematic review and meta-analysis of clinical trials that found improvement in lung function among chronic obstructive pulmonary disease (COPD) patients who received vitamin C. The disease is characterized by airflow limitation and persistent respiratory symptoms. Ting Lei of Medical College of Lanzhou University in Lanzhou, China and associates identified 10 randomized, controlled trials that included a total of 487 adults with COPD for the meta-analysis. The trials compared lung function and/or antioxidant enzyme or nutrient levels of COPD patients who received vitamin C to a placebo or control group. The meta-analysis found improvement in forced expiratory volume in one second as a percentage (FEV1%, a measure of lung function) in association with vitamin C supplementation. When dosage was analyzed, it was determined that consuming more than 400 milligrams vitamin C per day was needed experience a significant benefit. The ratio of FEV1 to forced vital capacity (another lung function assessment), and levels of vitamin C and glutathione, both of which are antioxidants, also improved among participants who received vitamin C supplements. The authors remarked that oxidative stress, which is a disturbance of the oxidant to antioxidant balance, has been suggested as playing a role in the development of COPD. The current investigation is the first systematic review and meta-analysis to assess the effect of vitamin C supplementation in people with COPD. “We found that supplementing vitamin C to patients with COPD demonstrated vital clinical significance,” Lei and associates concluded. “Vitamin C supplementation could increase the levels of antioxidation in serum (vitamin C and glutathione) and improve lung function (FEV1% and FEV1/FVC), especially in patients treated with vitamin C supplementation greater than 400 mg/day.” Single Flavanoid (Found in 6 Foods) Reduces Cognitive Impairment Drastically Fourth Military Medical University (China), September 19, 2022 A singular flavanoid can protect the brain against cognitive deficit and other cellular damage, according to studies from the Fourth Military Medical University. The news comes from Xi'an, People's Republic of China, and shows great promise for those suffering from mental impairment due to Alzheimer's disease, vascular dementia, and other debilitating cognitive conditions. The study abstract concludes: “Our results provide new insights into the pharmacological actions of rutin and suggest that rutin has multi-targeted therapeutical potential on cognitive deficits associated with conditions with chronic cerebral hypoperfusion such as vascular dementia and Alzheimer's disease.” Rutin is a biologically active flavonoid found in the following foods:  Buckwheat – Possibly the best source of rutin, and much better than boiled oats, uncooked buckwheat leaf flower offers about 675 mg in a 1.1 cup serving. Uncooked buckwheat groats contain 230 mg of rutin per 1 kg, dark buckwheat flour has 218 mg per 1 kg and buckwheat noodles provide 78 mg. Elderflower Tea – When dried, the white flowers of the elderflower make a delicious and rutin-filled tea. According to the Czech Journal of Food Science, elderflower tea contains approximately 10.9g/kg of rutin per brewed cup. Amaranth Leaves – In Western cultures, most people are familiar with the edible seeds of amaranth, though in Chinese and Southeast Asian cooking the leaves are also gaining traction, partly due to their high rutin content. You can expect around 24.5g/kg from the dried leaves. Seeds only contain trace amounts of the important nutrient. Unpeeled Apples – Keep the peel on your apples to enjoy lots of rutin. Just be sure that they are organic, since apple peels are especially prone to pesticide build-up. Apple skins are 6x as powerful as the flesh at preventing high blood pressure due to this flavanoid, too. • Unfermented Rooibos Tea – While rooibos tea contains fewer antioxidants than black or green teas, it is a good source of rutin, providing around 1.69 mg/g. • Figs – These little gems contain about the same amount of rutin as apples, so be sure to add them to your diet. The scientists found that rutin works primarily through anti-inflammatory mechanisms, and reducing hypofusion in the brain. Resistance-breathing training found to lower blood pressure University of Colorado and University of Arizona, September 23, 2022 A team of researchers with members from the University of Colorado, the University of Arizona and Alma College, has found that resistance-breathing training can lower blood pressure as much as some medicines and/or exercises. The study is published in the Journal of Applied Physiology. Hypertension, also known as chronic high blood pressure, can lead to a wide variety of health problems, from loss of vision to strokes and heart attacks. For that reason, doctors take it seriously. Typically, patients are directed to modify their diet and to exercise more. If that does not fix the problem, medications are prescribed. In this new effort, the researchers looked into a new type of therapy to reduce blood pressure levels—resistance-breathing training. Resistance-breathing training involves breathing in and out of a small device, called, quite naturally, a POWERbreathe, every day for several minutes. The device forces the patient to use their breathing muscles to push and pull air through it, making them stronger. And that, the researchers found, also reduces blood pressure. The device has been in use for several years as a means to assist athletes, singers and people with weak lung muscles. Several groups of healthy volunteers practiced the training for a few minutes every day for six weeks. Each was breathed in and out with the device 30 times each session. Each of the volunteers had their blood pressure measured before and after the training. The researchers found a sustained average drop of 9 mmHg in systolic blood pressure (the top number in blood pressure readings)—normal pressure is defined as 120/80. They describe the change as significant, as much as some patients see with medication. They also note that it is similar to changes in many patients who begin an aerobic exercise regimen, such as walking, cycling or running. They suggest such training could be used by patients of all ages who are unable to exercise to lower their blood pressure. How To Maintain Peak Brain Health: Scientists Say It Comes Down To These 3 Factors Norwegian University of Science and Technology, September 23, 2022 What's the best way to maintain peak brain health as we age? There are countless studies detailing ways to prevent cognitive decline, so scientists in Norway sought to simplify the science of managing strong brain health to three recommendations. This report is something of a summation covering modern science's current understanding of how best to cultivate robust brain health. The team at NTNU cite 101 references to prior articles in this latest theoretical perspective paper. “Three factors stand out if you want to keep your brain at its best,” Prof. Sigmundsson adds. The three identified keys to strong brain health are: Physical exercise Social activity Strong, passionate interests and hobbies It's common knowledge that spending all day on the couch isn't healthy for the body, but physical activity is also key to brain health. “An active lifestyle helps to develop the central nervous system and to counteract the aging of the brain,” according to study authors. Researchers add that consistency is essential. Do your best to get in at least a little movement each and every day. Even if you work a sedentary job that requires lots of sitting, get moving every hour or so for just a few minutes at the very least. Some people are naturally more social than others, but researchers stress that no one is an island. Even if you prefer a quiet night in to attending a party, make an effort to stay in touch with the people who matter to you. Our brains thrive on social interactions and connections. “Relationships with other people, and interacting with them, contribute to a number of complex biological factors that can prevent the brain from slowing down,” Prof. Sigmundsson explains. Just like bicep curls help us build muscle, keeping the brain active promotes strong lifelong cognition. Consider taking up a new hobby, or learning a new skill. Perhaps most importantly, though, don't force it; find something you're actually passionate about. It's never too late in life to learn something new! “Passion, or having a strong interest in something, can be the decisive, driving factor that leads us to learn new things. Over time, this impacts the development and maintenance of our neural networks,” Prof. Sigmundsson says. “Brain development is closely linked to lifestyle. Physical exercise, relationships and passion help to develop and maintain the basic structures of our brain as we get older,” Prof. Sigmundsson concludes. Calcium supplements may support a healthy colon: Harvard study Harvard School of Public Health, September 18, 2022 Supplements of calcium or non-dairy products fortified with the mineral may reduce the risk of colorectal cancer, according to meta-analysis of prospective observational studies by researchers at Harvard School of Public Health. For every 300 mg increase in calcium from supplements was associated with a 9% reduction in risk, wrote NaNa Keum and her co-authors in the International Journal of Cancer . Every 300 mg increase in total calcium was associated with a similar reduction in risk (8%), they added. “Our findings have several important clinical and public health implications,” they explained. “First, according to the 2003 to 2006 National Health and Nutrition Examination Survey, a nationally representative cross-sectional survey in the U.S., median total calcium intake of adults aged over 50 years was approximately 650 mg/day for no calcium-supplement users and 1,000 mg/day for calcium-supplement users. “As the benefit of calcium intake on CRC is expected to continue beyond 1,000 mg/day, not only non-supplement users but also supplement users may further reduce their CRC risk through additional calcium intake.” “Second, while dairy products, especially milk, are the major sources of calcium in many countries, they are a substantial source of calories and contain potentially harmful factors such as saturated fat, hormones, and casein proteins. Since our analyses provide evidence for an equivalent benefit of dietary and supplementary calcium, the benefit of calcium on CRC risk may be obtained through supplements and non-dairy products fortified with calcium.” The Boston-based scientists conducted dose-response meta-analyses of 15 studies involving 12,305 cases of colorectal cancer and calcium intakes ranging from 250-1,900 mg/day. The studies varied in duration from 3.3 to 16 years. The data indicated that both total and supplemental calcium were associated with reductions in the risk of colorectal cancer. “In conclusion, both dietary and supplementary calcium intake may continue to decrease colorectal cancer risk beyond 1,000 mg/day,” wrote Keum and her co-authors. Yoga's Age-Defying Effects Confirmed by Science Defence Institute of Physiology and Allied Sciences (India), September 21st 2022 While yoga's longevity promoting effects have been the subject of legend for millennia, increasingly modern science is confirming this ancient technology for spiritual and physical well-being actually can slow aging and stimulate our regenerative potential. One particularly powerful study published lin the journal Age titled, “Age-related changes in cardiovascular system, autonomic functions, and levels of BDNF of healthy active males: role of yogic practice”, found that a brief yoga intervention (3 months) resulted in widespread improvements in cardiovascular and neurological function. Indian researchers studied healthy active males of three age groups (20-29, 30-39, and 40-49 years) by randomly assigning them to practice one hour of yoga daily for 3 months. The observed significant differences between the younger and older participants in the study, specifically: “Significantly higher values of heart rate (HR), blood pressure (BP), load in heart (DoP), myocardial oxygen consumption (RPP), and total cholesterol (TC) were noted in senior age group.” The yogic practice resulted in significant reductions in all of these parameters (HR, BP, DoP, RPP and TC). Also observed in the older participants were decreases in high frequency (HF), total power (TP), all time domain variables of heart rate variability (HRV), and skin conductance (SC) — all of which increased following yogic practice. Higher levels of catecholamines (“stress hormones”) and low frequency (LF) power of HRV were noted in advancement of age, both of which decreased following yogic practice. Additionally, the senior age group had highest levels of cortisol and adrenocorticotrophic hormone (ACTH), both of which decreased following yogic practice. Finally, brain-derived neurotropic factor (BDNF), serotonin, and dopamine were low in higher age group, but these increased following yogic practice; an indication of improved brain function and cognition. The researchers concluded: ‘This study revealed that yogic practices might help in the prevention of age-related degeneration by changing cardiometabolic risk factors, autonomic function, and BDNF in healthy male.” There are a number of promising studies revealing the age-defying potential of this ancient practice. Here are some additional benefits confirmed in 2014 alone: Age-Related Respiratory Problems: A 2014 study from the journal of Human Kinetics found that a 3 month yoga intervention in 36 elderly women (average age 63.1) significantly improved pulmonary (respiratory) function. Age-Related Brain Cognitive Decline: A review in the Journals of Gerontology, involving a two month Hatha yoga intervention in the elderly (average age 62.0) resulted in significant improvements in “executive function measures of working memory capacity and efficiency of mental set shifting and flexibility compared with their stretching-strengthening counterparts.” Age-Related Hormone Insufficiency: A study published in Evidence Based Complementary and Alternative Medicine found that a 3 month yogic intervention in men (average age 42.8) and women (average age 44.75) resulted in improvements in the level of growth hormone and DHEAS, two essential hormones that drop off precipitously as we age. Age-Related Sleep Problems: Astudy published in Alternatives Therapies in Health and Medicine found a 12 week yogic intervention (yoga 2x a week) resulted in significant improvements in the quality of sleep in older individuals (average age 60). Age-Related Depression: From the Chinese Journal of Nursing found that not only did yoga improve sleep as found in the study above but also significantly reduced the depressive symptoms of elderly participants…after 6 months. “ This is just a small sampling of the literature. There is older research revealing that yoga has even more benefits for aging populations.

Should I take a multivitamin? That's a great question. And it's one that scientists have researched and debated for years and years. In today's episode, we take a no-nonsense look at multivitamins. You'll discover . . . Who should take a multivitamin Can multivitamins be bad for you Are extra B-vitamins good for you Can you get everything you need from food Do multivitamins work Do multivitamins have side effects Can multivitamins make you hungry Do I take a multivitamin The best and worst multivitamins And everything is backed by science from the National Institute of Health, the National Health and Nutrition Examination Survey, and others. If you want the truth about multivitamins, then this episode is for you! Rise Nutritional Supplements Website: https://challenge2rise.com/ (https://challenge2rise.com/) Rise Essential Nutrients Amazon: https://www.amazon.com/dp/B09D9ZN66P (https://www.amazon.com/dp/B09D9ZN66P) Rise Elite Nutrients Amazon: https://www.amazon.com/dp/B09GKZMFF5 (https://www.amazon.com/dp/B09GKZMFF5)

Strawberries could help reduce harmful inflammation in the colon University of Massachusetts, August 20, 202 Inflammatory bowel disease (IBD) is a set of painful conditions that can cause severe diarrhea and fatigue. Treatments can include medications and surgery. But now researchers report that a simple dietary intervention could mitigate colonic inflammation and improve gut health. In this case, a strawberry—or rather, less than a cupful of strawberries—a day could help keep the doctor away. The dietary consumption of fruits and vegetables has been associated with a lowered risk of IBD. To establish an effective and practical approach to decrease colonic inflammation in both IBD patients and the general population, Xiao and his team at the University of Massachusetts Amherst focused on strawberries due to their wide consumption.  The researchers found that dietary consumption of whole strawberries at a dose equivalent to as low as three-quarters of a cup of strawberries per day in humans significantly suppressed symptoms like body weight loss and bloody diarrhea in mice with IBD. Strawberry treatments also diminished inflammatory responses in the mice's colonic tissue. But decreased inflammation wasn't the strawberry's only conferred benefit during this study.  Following the dietary treatments of whole strawberries, the researchers observed a reversal of that unhealthy microbiota composition in the IBD mice. Xiao's team also obtained experimental data that indicated strawberries might impact abnormal metabolic pathways in the IBD mice, which in turn could lead to the decreased colonic inflammation they observed. Higher diet quality relates to decelerated epigenetic aging  Tufts University, August 1, 2022 DNA methylation–based epigenetic age measures have been used as biological aging markers and are associated with a healthy lifespan. Few population-based studies have examined the relation between diet and epigenetic age acceleration. We aimed to investigate the relation between diet quality and epigenetic age acceleration. We analyzed data from 1995 participants (mean age, 67 years; 55% women) of the Framingham Heart Study Offspring Cohort. Cross-sectional associations between the Dietary Approaches to Stop Hypertension (DASH) score and 3 whole-blood DNA methylation–derived epigenetic age acceleration measures—Dunedin Pace of Aging Methylation (DunedinPoAm), GrimAge acceleration (GrimAA), and PhenoAge acceleration (PhenoAA)—were examined. Conclusions:  Higher diet quality is associated with slower epigenetic age acceleration, which partially explains the beneficial effect of diet quality on the lifespan. Our findings emphasize that adopting a healthy diet is crucial for maintaining healthy aging. Feeling anxious or blue? Ultra-processed foods may be to blame Florida Atlantic University, August 25, 2022 Do you love those sugary-sweet beverages, reconstituted meat products and packaged snacks? You may want to reconsider based on a new study that explored whether individuals who consume higher amounts of ultra-processed food have more adverse mental health symptoms. Researchers from Florida Atlantic University's Schmidt College of Medicine and collaborators explored a nationally representative sample of the United States population to determine if individuals who consume high amounts of ultra-processed foods report significantly more adverse mental health symptoms including depression, anxiety and mentally unhealthy days.  They measured mild depression, number of mental unhealthy days and number of anxious days in 10,359 adults 18 and older from the U.S. National Health and Nutrition Examination Survey. Results of the study, published in the journal Public Health Nutrition, showed that individuals who consumed the most ultra-processed foods as compared with those who consumed the least amount had statistically significant increases in the adverse mental health symptoms of mild depression, "mentally unhealthy days" and "anxious days." They also had significantly lower rates of reporting zero "mentally unhealthy days" and zero "anxious days." Findings from this study are generalizable to the entire U.S. as well as other Western countries with similar ultra-processed food intakes.   Many types of leisure time activities may lower risk of death for older adults National Cancer Institute, August 25, 2022 Older adults who participate weekly in many different types of leisure time activities, such as walking for exercise, jogging, swimming laps, or playing tennis, may have a lower risk of death from any cause, as well as death from cardiovascular disease and cancer, according to a new study led by researchers at the National Cancer Institute, part of the National Institutes of Health. The findings suggest that it's important for older adults to engage in leisure time activities that they enjoy and can sustain, because many types of these activities may lower the risk of death, the authors wrote. Using data from 272,550 adults between the ages of 59 and 82 who had completed questionnaires about their leisure-time activities as part of the NIH-AARP Diet and Health Study, the researchers looked at whether participating in equivalent amounts of seven different exercise and recreational activities—including running, cycling, swimming, other aerobic exercise, racquet sports, golf, and walking for exercise—was associated with lowered risk of death. The researchers found that achieving the recommended amount of physical activity per week through any combination of these activities was associated with a 13% lower risk of death from any cause compared with no participation in these activities. When they looked at the role of each activity individually, playing racquet sports was associated with a 16% reduction in risk and running with a 15% reduction. However, all the activities investigated were similarly associated with lower risks of death. The levels of activity by the most active individuals (those who exceeded the recommended levels of physical activity) were associated with even greater reductions in the risk of death, but there were diminishing returns as activity levels increased. Even people who did some recreational activity, though less than the recommended amount, had a 5% reduction in risk of death than those who did not participate in any of the activities studied. These activities were also associated with a lower risk of death from cardiovascular disease and cancer. Playing racquet sports was associated with the greatest reduction in risk of cardiovascular deaths (27% reduction), while running was associated with the greatest reduction in risk of cancer deaths (19% reduction).   Avocado may resist the effects of leukemia University of Waterloo (Canada), August 19, 2022 One of the many health benefits avocados offer is their ability to ward off cancer. Avocados contain avocatin B, which is a compound found to fight against a type of leukemia called acute myeloid leukemia (AML), according to a study carried out by a researcher from the University of Waterloo, Canada. AML is known by many names, like acute myelocytic leukemia, acute myelogenous leukemia, acute granulocytic leukemia, and acute non-lymphocytic leukemia. AML is a type of blood cancer that is most common in older people. Approximately 90 percent of people with this type of cancer die within five years of diagnosis. In the in vitro study, Canadian researcher Paul Spagnuolo found that avocatin B fights AML by targeting leukemia stem cells – which are the root of the disease – without harming healthy, non-cancerous cells. This indicated that the compound is both effective against AML and not toxic to the body. Avocados can also fight against prostate and oral cancer cells. Researchers from the University of California, Los Angeles conducted a review of studies on the potential health benefits of avocados and looked at evidence that specific avocado extracts can inhibit the growth of prostate cancer cells and oral cancer cells. They found that the active compounds in avocados make them potentially beneficial for preventing cancer.   News addiction is linked to not only poor mental well-being but physical health too, new study Texas Tech University, August 25, 2022 People with an obsessive urge to constantly check the news are more likely to suffer from stress, anxiety, and physical ill health, finds a new study published in the peer-reviewed journal Health Communication. For many people, reading bad news can make us feel temporarily powerless and distressed. For others, being exposed to a 24-hour news cycle of continually evolving events can have serious impacts on mental and physical well-being—as these new findings, out today, show, with those who have a high-levels of news addiction reporting "significantly greater physical ill-being." "Witnessing these events unfold in the news can bring about a constant state of high alert in some people, kicking their surveillance motives into overdrive and making the world seem like a dark and dangerous place," says Bryan McLaughlin, associate professor of advertising at the College of Media and Communication at Texas Tech University. "For these individuals, a vicious cycle can develop, in which rather than tuning out, they become drawn further in, obsessing over the news and checking for updates around the clock to alleviate their emotional distress. But it doesn't help, and the more they check the news, the more it begins to interfere with other aspects of their lives." To study this phenomenon, McLaughlin and his colleagues,  analyzed data from an online survey of 1,100 US adults. The results revealed that 16.5% of people surveyed showed signs of "severely problematic" news consumption. Such individuals frequently became so immersed and personally invested in news stories that the stories dominated the individual's waking thoughts, disrupted time with family and friends, made it difficult to focus on school or work, and contributed to restlessness and an inability to sleep. 73.6% of those recognized to have severe levels of problematic news consumption reported experiencing mental ill-being "quite a bit" or "very much"—while frequent symptoms were only reported by 8% of all other study participants. 61% of those with severe levels of problematic news reported experiencing physical ill-being "quite a bit" or "very much" compared to only 6.1% for all other study participants. According to McLaughlin, the findings show that there is a need for focused media literacy campaigns to help people develop a healthier relationship with the news.

video: 1. 87% of Clinical Trial Data Hidden from Medical Journals; Fmr FDA Director: Not Our Job to Correct Faulty Drug Data in Articles – Roman Balmakov from Matter of Fact  (10:00) 2. Sotomayor Voices Strong Defense Of Clarence Thomas (4:17) 3. Lara Logan Rapid Fires Truth Bombs On Ukraine Propaganda & The Democrat Narratives Of The Day (2:57) 4. There was an unexpected 40% increase in ‘all cause deaths' in 2021 (8:28) 5. New Rule: I Want My Lawyer! | Real Time with Bill Maher (HBO) ( 8:27)   Resveratrol may turn white fat into ‘healthier' brown-like fat Washington State University, June 26, 2022 Resveratrol, a polyphenol from grapes and red wine, may convert excess white fat into calorie-burning brown-like fat, suggests a new study from Washington State University. According to data from lab mice, supplementing a high fat diet with resveratrol reduced weight gain by about 40% compared with control mice fed the high fat diet only. Professor Min Du and his co-workers demonstrated that mice fed a diet containing 0.1% resveratrol were able to change their excess white fat into the active, energy-burning ‘beige' fat. The researchers also showed that an enzyme called AMPK, which regulates the body's energy metabolism, stimulates this transition of white fat into the brown-like fat.  “We provide evidence that resveratrol induces the formation of brown-like adipocytes in mouse [white adipose tissue in the groin] by increasing the expression of genes specific to brown adipocytes and stimulating fatty acid oxidation, which appeared to be primarily mediated by AMPK-alpha1,” wrote the researchers in the International Journal of Obesity   “These data demonstrate, in addition to the inhibition of adipogenesis and stimulation of lipolysis, a novel browning role of resveratrol in white adipose tissue, which contributes to the beneficial effects of resveratrol in metabolism. Higher serum antioxidant vitamins predict lower risk of respiratory illness and mortality National Institutes of Health, July 1 2022.  A pooled analysis published in Respiratory Research concluded that having lower serum levels of vitamins C and E was associated with a greater risk of suffering from wheeze or respiratory diseases, and that lower vitamin A, C and D were associated with an increased risk of dying from respiratory diseases. Paivi M. Salo and colleagues analyzed data from 16,218 men and women who participated in the National Health and Nutrition Examination Survey III (NHANES III), and 17,838 adults who were continuous NHANES participants who had information available concerning at least one serum antioxidant vitamin level.  Forty-two percent of the participants reported using vitamin supplements.  Lower vitamin C levels were associated with a greater risk of wheeze. Among smokers, lower levels of the alpha-tocopherol form of vitamin E were associated with increased wheeze and chronic bronchitis/emphysema.  A higher risk of death from chronic lower respiratory disease was associated with lower levels of vitamin C. Among smokers with lower levels of 25-hydroxyvitamin D, chronic lower respiratory disease and influenza/pneumonia deaths were increased. Greater influenza and pneumonia mortality was also associated with lower vitamin A levels. In pooled analysis of NHANES III and continuous NHANEs participants, vitamin C deficiency doubled the risk of dying from influenza or pneumonia in comparison with sufficiency.  Eat dark chocolate to beat the midday slump? Northern Arizona University, July 1, 2022 Larry Stevens eats a piece of high-cacao content chocolate every afternoon, which is in part because he has developed a taste for the unsweetened dark chocolate. Research shows that eating a piece of high-cacao content chocolate every afternoon lowers blood pressure and his new study reveals that it improves attention, which is especially important when hitting that midday slump. The study, published in the journal NeuroRegulation, examines the acute effects of chocolate on attentional characteristics of the brain and the first-ever study of chocolate consumption performed using electroencephalography, or EEG technology. EEG studies take images of the brain while it is performing a cognitive task and measure the brain activity. Stevens and his colleagues in the Department of Psychological Sciences performed the EEG study with 122 participants between the ages of 18 and 25 years old. The researchers examined the EEG levels and blood pressure effects of consuming a 60 percent cacao confection compared with five control conditions. The results for the participants who consumed the 60 percent cacao chocolate showed that the brain was more alert and attentive after consumption. Their blood pressure also increased for a short time. The most interesting results came from one of the control conditions, a 60 percent cacao chocolate which included L-theanine, an amino acid found in green tea that acts as a relaxant. This combination hasn't been introduced to the market yet, so you won't find it on the candy aisle. But it is of interest to Hershey and the researchers. “L-theanine is a really fascinating product that lowers blood pressure and produces what we call alpha waves in the brain that are very calm and peaceful,” Stevens said. “We thought that if chocolate acutely elevates blood pressure, and L-theanine lowers blood pressure, then maybe the L-theanine would counteract the short-term hypertensive effects of chocolate.” For participants who consumed the high-cacao content chocolate with L-theanine, researchers recorded an immediate drop in blood pressure. “It's remarkable. The potential here is for a heart healthy chocolate confection that contains a high level of cacao with L-theanine that is good for your heart, lowers blood pressure and helps you pay attention,” Stevens said. Only seven percent of adults have good cardiometabolic health Tufts University, July 1, 2022 Less than 7 percent of the U.S. adult population has good cardiometabolic health, a devastating health crisis requiring urgent action, according to research led by a team from the Friedman School of Nutrition Science and Policy at Tufts University in a pioneering perspective on cardiometabolic health trends and disparities published in the Journal of the American College of Cardiology.  Researchers evaluated Americans across five components of health: levels of blood pressure, blood sugar, blood cholesterol, adiposity (overweight and obesity), and presence or absence of cardiovascular disease (heart attack, stroke, etc.). They found that only 6.8 percent of U.S. adults had optimal levels of all five components as of 2017-2018. Among these five components, trends between 1999 and 2018 also worsened significantly for adiposity and blood glucose. In 1999, 1 out of 3 adults had optimal levels for adiposity (no overweight or obesity); that number decreased to 1 out of 4 by 2018. Likewise, while 3 out of 5 adults didn't have diabetes or prediabetes in 1999, fewer than 4 out of 10 adults were free of these conditions in 2018. The study looked at a nationally representative sample of about 55,000 people aged 20 years or older from the 10 most recent cycles of the National Health and Nutrition Examination Survey.  Generations Were Raised To Believe Processed Fruit Juice Was Health Food When It's Actually Junk Food Prevent Disease, June 30, 2022 There was a time when fruit juices were marketed as the ultimate health drink. A glass of sunshine packed with vitamins and energy. However, one of the great scams of the industrial food cartel is the so-called “fresh” juices sold in supermarkets. Many of these “fresh” juices can be stored for a year, so how fresh are they? The idea goes back to the 1920s, when American nutritionist Elmer McCollum blamed a condition called acidosis, an excess of acid in the blood, on diets rich in bread and meat. His solution was lots of lettuce and — paradoxically — citrus fruits. At the time orange juice was not hugely popular, but juice got an even bigger boost thanks to World War II when the U.S. Government wanted a new way to get a product rich in vitamin C to troops overseas. It poured money into research.  In 1947 — just in time for the post-war consumer boom — scientists invented a way to remove water from juice and freeze the concentrate into a palatable product.  The blocks of this concentrate could be sold to the new fridge-owning U.S. consumers or stored by manufacturers for months at a time, and sales exploded.  Turns out there's a lot more to making juice than simply squeezing some citrus. As part of the mass-production process, big-name brands like Tropicana, Minute Maid, Simply Orange, and Florida's Natural add artificial flavouring in order to make sure your juice tastes consistent from carton to carton–and to make sure it tastes like oranges. Pasteurized, not-from-concentrate orange juice takes up a lot of storage space. In order to keep it from spoiling without adding chemical preservatives, the companies “deaerate” (or strip the oxygen out of) the juice. (Another surprise: During production, deaerated juice often sit in million-gallon tanks for as long as a year before it hits supermarket shelves.) The process strips the juice of flavour, which has to be added afterwards.  Findings of a Consumer Reports investigation about arsenic and lead levels in apple juice and grape juice have prompted the organization to call for government standards to limit consumers' exposure to these toxins. Mediterranean diet plus olive oil or nuts associated with improved cognitive function Institute of Biomedical Investigations (Spain), July 2, 2022 Supplementing the plant-based Mediterranean diet with antioxidant-rich extra virgin olive oil or mixed nuts was associated with improved cognitive function in a study of older adults in Spain but the authors warn more investigation is needed, according to an article published by JAMA Internal Medicine. Previous research suggests following a Mediterranean diet may relate to better cognitive function and a lower risk of dementia. However, the observational studies that have examined these associations have limitations, according to the study background. Emilio Ros, M.D., Ph.D., of the Institut d'Investigacions Biomediques and coauthors compared a Mediterranean diet supplemented with olive oil or nuts with a low-fat control diet. The randomized clinical trial included 447 cognitively healthy volunteers (223 were women; average age was nearly 67 years) who were at high cardiovascular risk and were enrolled in the Prevencion con Dieta Mediterranea nutrition intervention. Of the participants, 155 individuals were assigned to supplement a Mediterranean diet with one liter of extra virgin olive oil per week; 147 were assigned to supplement a Mediterranean diet with 30 grams per day of a mix of walnuts, hazelnuts and almonds; and 145 individuals were assigned to follow a low-fat control diet. The study found that individuals assigned to the low-fat control diet had a significant decrease from baseline in all composites of cognitive function. Compared with the control group, the memory composite improved significantly in the Mediterranean diet plus nuts, while the frontal and global cognition composites improved in the Mediterranean diet plus olive oil group. The authors note the changes for the two Mediterranean diet arms in each composite were more like each other than when comparing the individual Mediterranean diet groups with the low-fat diet control group. “Our results suggest that in an older population a Mediterranean diet supplemented with olive oil or nuts may counter-act age-related cognitive decline. 

Are health equity and better outcomes within reach for all patients with type 2 diabetes? Drs Enrique Caballero and Silvio Inzucchi discuss how we can change the status quo. Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/963277). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources National Health and Nutrition Examination Survey https://www.cdc.gov/nchs/about/factsheets/factsheet_nhanes.htm Prevalence of Diabetes by Race and Ethnicity in the United States, 2011-2016 https://jamanetwork.com/journals/jama/fullarticle/2757817 Diabetes mellitus in the Pima Indians: Genetic and evolutionary considerations https://pubmed.ncbi.nlm.nih.gov/6624895/ HbA1c Performance in African Descent Populations in the United States With Normal Glucose Tolerance, Prediabetes, or Diabetes: A Scoping Review https://www.cdc.gov/pcd/issues/2021/20_0365.htm

Welcome back to the Hunger Hunt Feast Podcast! In today's episode, Zane talks with electrical engineer and author Tristan Scott!  Tristan is an electrical engineer whose passion for health developed from his struggle to recover from Post Concussive Syndrome and he found that an animal-based diet helped him reduce inflammation, but Tristan has taken his expertise even further. Listen in as Tristan talks about his book "Bitcoin and Beef" which he wrote to address the current problems with the increasing wealth gap and decreasing health stemming from an over-centralized system. In his book, he addresses the fallacies about a negative environmental impact of both the raising of beef and bitcoin mining. For more resources, or to get in touch, check out the links below!  -- Episode Specific Links:  Ritchie, Hannah, and Max Roser. 2020. "CO2 and Greenhouse Gas Emissions." Our World in Data. https://ourworldindata.org/emissions-by-sector  Energy Mix https://ourworldindata.org/energy-mix#:~:text=Despite%20producing%20more%20and%20more,in%20the%20last%2010%20years The United States Environmental Protection Agency. 2014. 2014 NATA: Assessment Results.  https://www.epa.gov/national-air-toxics-assessment/2014-nata-assessment-results 2021. Overview of Greenhouse Gases. November 19.  https://www.epa.gov/ghgemissions/overview-greenhouse-gases#methane. 2021. Sources of Greenhouse Gas Emissions. July 27.  https://www.epa.gov/ghgemissions/sources-greenhouse-gas-emissions. 2021. Understanding Global Warming Potentials. October 18. https://www.epa.gov/ghgemissions/understanding-global-warming-potentials. Buis, Alan. 2019. "The Atmosphere: Getting a Handle on Carbon Dioxide." Global Climate Change. October 9. https://climate.nasa.gov/news/2915/the-atmosphere-getting-a-handle-on-carbon-dioxide/ Oxford Martin Programme on Climate Pollutants. 2017. Climate metrics under ambitious mitigation. Oxford: Oxford Martin School. https://www.oxfordmartin.ox.ac.uk/downloads/academic/Climate_Metrics_%20Under_%20Ambitious%20_Mitigation.pdf Bigelow, Daniel P., and Allison Borchers. 2017. Major Uses of Land in the United States, 2012. U.S. Department of Agriculture. https://www.ers.usda.gov/webdocs/publications/84880/eib-178_summary.pdf?v=6159.2 Matlock, Terry. 2021. Corn planted acreage up 2% from 2020: Soybean acreage up 5% from last year. June 30. Accessed November 10, 2021. https://www.nass.usda.gov/Newsroom/2021/06-30-2021.php U.S. Department of Agriculture. 2015. USDA Coexistence Fact Sheets Soybeans. Washington D.C.: U.S. Department of Agriculture. https://www.usda.gov/sites/default/files/documents/coexistence-soybeans-factsheet.pdf Mottet, Anne, Cees de Haan, Alessandra Falucci, Giuseppe Tempio, Carolyn Opio, and Pierre Gerber. 2017. "Livestock: On our plates or eating at our table? A new analysis of the feed/food debate." Global Food Security 1-8. https://www.sciencedirect.com/science/article/abs/pii/S2211912416300013.  Araujo, Joana, Jianwen Cai, and June Stevens. 2019. "Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009-2016." Metabolic Syndrome and Related Disorders 46-52. https://www.liebertpub.com/doi/full/10.1089/met.2018.0105. OECD. 2019. State of Health in the EU Germany Country Health Profile 2019. OECD. https://www.euro.who.int/__data/assets/pdf_file/0005/419459/Country-Health-Profile-2019-Germany.pdf Open Secrets. 2018. Client Profile: Bayer AG. https://www.opensecrets.org/federal-lobbying/clients/summary?cycle=2018&id=D000042363 2021. Client Profile: PepsiCo Inc. https://www.opensecrets.org/federal-lobbying/clients/summary?cycle=2020&id=D000000200. 2020. Commercial Banks: Top Contributors to Federal Candidates, Parties, and Outside Groups. https://www.opensecrets.org/industries/contrib.php?cycle=2020&ind=F03 Good Jobs First. 2021. Violation Tracker 100 Most Penalized Parent Companies. https://violationtracker.goodjobsfirst.org/parent-totals 2021. Violation Tracker Industry Summary Page. https://violationtracker.goodjobsfirst.org/industry/financial%20services. Office of Public Affairs. 2020. "Goldman Sachs Charged in Foreign Bribery Case and Agrees to Pay Over $2.9 Billion." The United States Department of Justice. October 22. https://www.justice.gov/opa/pr/goldman-sachs-charged-foreign-bribery-case-and-agrees-pay-over-29-billion Jones, Katie. 2020. "How Total Spend by U.S. Advertisers Has Changed, Over 20 Years." Visual Capitalist. October 16. https://www.visualcapitalist.com/us-advertisers-spend-20-years/ Bank of America. 2021. Annual Report. Bank of America Corporation. https://about.bankofamerica.com/annualmeeting/static/media/BAC_2020_AnnualReport.9130a6d8.pdf  Carter, Nic. 2021. "How Much Energy Does Bitcoin Actually Consume?" Harvard Business Review. May 5. https://hbr.org/2021/05/how-much-energy-does-bitcoin-actually-consume Connect with Tristan: IG: @tristan_health  or @bitcoinandbeef Twitter: @bitcoinand_beef 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 Get to know Tristan Scott What led Tristan to an Animal-based diet When Tristan became passionate about Bitcoin Why everyone should be paying attention to Blockchain A look into the environmental impact of beef and Bitcoin The importance of regenerative farming The real hurdle we face in the agriculture world The business side of junk food  How much energy should a monetary system take? What you need to control a population

"About 19 percent of children and adolescents in the U.S. are obese — a record high, according to the latest data from the National Health and Nutrition Examination Survey."https://www.beckershospitalreview.com/public-health/childhood-obesity-rates-hit-all-time-high-survey-finds.htmlhttps://www.cdc.gov/obesity/data/childhood.htmlHow can we change this?  It can start right in your kitchen!This month is all about ways to incorporate cooking, healthy snacking, and gathering at the table together.  Whatever your family dynamic is - make it a priority this month to sit at the table together more often.  Make it a priority to make a new recipe together…even if it's chaotic and messy because it really isn't the end product, but rather the experiences they are having with YOU.Mark Your Calendars:  "National Kids Take Over the Kitchen Day is on September 13th. We will be chatting all month about fun ways to cook with your kids, fun and healthy recipes to make at home, ways to incorporate learning in the kitchen, and the importance of gathering at the table together. If possible (and time allows), let your kids help with packing their lunches.   This teaches them responsibility and different ways to make healthy eating choices.  Make the presentation colorful and fun!  Check out kid-safe skewers on Amazon.Use unique containers like bento boxes and special containers for dips like hummus and peanut butter.To carry on the tradition from my childhood, I write a quick note or draw a quick picture to let my kids know that we love them and are thinking about them while at school.  If you homeschool – you can still write a cute note!5 Healthy Lunch Ideas:1. Naan cheese pizza (make ahead – put small amount of sauce and cheese and bake) + sliced peppers/carrots + fruit salad2.  Mini ants on a log + pretzels (regular or gluten-free) + cheese and meat skewers + watermelon cubes3.  Burger skewers with meat/cheese/lettuce + melon cubes + gluten-free pretzels/veggie straws4.  Ham and cheese roll-ups + applesauce + veggie straws5.  Peanut butter mini pancakes + berry mix/jam + hardboiled eggsSome days it's a lunchable….I mean…let's be honest….we're doing our best!Resources:https://wholefully.com/healthy-school-lunch-ideas/https://www.yourhomebasedmom.com/peanut-butter-pancakes/ (we make these all the time)Links to Skewers and Bento Boxes (I am an Amazon Affiliate):Bento Boxes:  https://amzn.to/3zLUAycLunch Skewers for Kids:  https://amzn.to/3jH4c87Snag your FREE copy of the Whole Mama Survival Guide:  http://iamthewholemama.com/index.php/sign-up-for-the-whole-mama/Join the Whole Mama Mastermind:http://iamthewholemama.com/index.php/the-whole-mama-mastermind/Be a guest on my podcast!!  Email me at jenna@iamthewholemama.com to request a spot or to offer topic suggestions for the podcast. Support the show (https://www.buymeacoffee.com/thewholemama)

กัญชา สมุนไพรที่อยู่คู่กับมนุษย์มาอย่างช้านาน ทั้งในเรื่องของการใช้เพื่อสันทนาการ และการนำประโยชน์มาใช้ในทางการแพทย์ แล้วกัญชานั้นแบ่งออกเป็นกี่สายพันธุ์ มีข้อดี ข้อเสีย หรือข้อควรระวังในการใช้อย่างไรบ้าง มาติดตามได้ในรายการ Dr.Amp Podcast เรื่องเล่าสุขภาพดี กับ หมอแอมป์ ตอน "กัญชา คุณค่าสมุนไพรจากธรรมชาติ" โดย นพ. ตนุพล วิรุฬหการุญ -ประธานเจ้าหน้าที่ปฏิบัติการ และ ผู้อำนวยการ BDMS Welness Clinic -ผู้อำนวยการ RoyalLife โรงพยาบาลกรุงเทพ -นายกสมาคมแพทย์ฟื้นฟูสุขภาพและส่งเสริมการศึกษาโรคอ้วน กรุงเทพ (BARSO) สามารถค้นหารายชื่อแพทย์ที่ผ่านการอบรมหลักสูตรการใช้กัญชาที่กรมการแพทย์ หรือ กรมการแพทย์แผนไทยและการแพทย์ทางเลือกให้การรับรองได้ที่: http://hemp.fda.moph.go.th/FDA_MARIJUANA/SAS/VISIT_DOCTOR

In Episode #133 I sit down with Dr Matthew Nagra to tackle the almighty protein topic! You know, the nutrient we are all fascinated by. What is protein? How much do we need? What's the difference between animal and plant protein? The best types of protein for good health? How do we optimise protein intake for promoting lean muscle and strength? We cover all of this and more - all through an evidence-based lens. Not what random folks are saying at the gym or online in the comments section. But what the highest quality science says. Specifically we cover: What protein is How much protein we need How much protein the average omnivore and vegetarian/vegan consumes Incomplete versus complete protein - how people are incorrectly using these terms Protein quality - how scoring systems work The difference between animal and plant protein when it comes to quality - and what this means for your food selection Animal versus plant protein and health outcomes Is soy protein safe? (e.g tempeh, tofu and soy milk) Best protein swaps you could consider making today Animal versus plant protein and performance outcomes (e.g lean muscle and strength) Optimising protein intake for performance Take home messages Resources: Follow Matt and Simon on Instagram Current Protein Intake Protein intake trends and conformity with the Dietary Reference Intakes in the United States: analysis of the National Health and Nutrition Examination Survey, 2001-2014 Protein Intake in Western living Vegetarian and Vegans Nutrient Profiles of Vegetarian and Non Vegetarian Dietary Patterns Christopher Gardner's 2019 paper on protein Maximizing the intersection of human health and the health of the environment with regard to the amount and type of protein produced and consumed in the United States Plant's contain all amino acids Dietary Protein and Amino Acids in Vegetarian Diets—A Review Maximizing the intersection of human health and the health of the environment with regard to the amount and type of protein produced and consumed in the United States Joel Craddock's paper on scoring systems used to calculate protein quality Limitations with the Digestible Indispensable Amino Acid Score (DIAAS) with Special Attention to Plant-Based Diets: a Review The study that Dr Nagra mentions where they fed cooked plant protein to pigs (rather than raw)True ileal amino acid digestibility and digestible indispensable amino acid scores (DIAASs) of plant-based protein foods Animal versus plant protein and health outcomes (risk of cardiovascular disease, mortality etc)

Dr. Corey covers his top 5 items to eliminate from your diet for optimal health.Dr. Corey's Website: http://www.drcoreysondrupdc.comFacebook: Corey  Sondrup, DCInstagram: @coreysondrupdcTikTok: @drcoreychiroEmail: dr.corey.ohd@hotmail.comPrevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009-2016. Metabolic Syndrome and Related Disorders, 2018. 10.1089/met.2018.0105

A recently published Serial cross-sectional analysis of National Health and Nutrition Examination Survey data has been published suggesting that overall blood pressure control in adults with hypertension over the last 4 years has declined. Why is this? What tips can the pharmacist and prescriber use to improve control? Can these professionals work together to improve BP control? Can we survive under pressure? Additional Resources/References: Muntner P, Hardy ST, Fine LJ, et al. Trends in Blood Pressure Control Among US Adults With Hypertension, 1999-2000 to 2017-2018. JAMA. 2020;324(12):1190–1200. doi:10.1001/jama.2020.14545 This episode is accredited for CPE. Subscribe at CEimpact (https://www.ceimpact.com/pharmacist) and claim your CE today! See omnystudio.com/listener for privacy information. Learn more about your ad choices. Visit megaphone.fm/adchoices

In today's episode, we'll talk about everything the BMI gets wrong Are you "overweight"? Am I "overweight"? That single question creates more anxiety & stress to women than any other question. Being overweight implies that there's a weight we should be at. In today's society, THAT weight is determined by BMI. The Body Mass Index, the metric that uses to classify people in groups. Moreover, it's the measure of "obesity" as per medical view and a simple calculation of 2 factors: weight and height. To convert the measurement to the unit of BMI in kg/m2, you must divide the weight in pounds by the height in inches squared, then multiply by 703. My BMI Story For the purpose of this article, I did my BMI calculation using the official CDC BMI calculator. If you are between 18-24.9 you are deemed normal, 25-29.9 "overweight" and 30 or above "overweight". I bet you're curious to know my result? 39. I'm considered a class 2 "obese". As a matter of fact, for the longest, I can remember I was never not considered “overweight” based on BMI. During one of my many diet cycles in my adulthood, I remember hitting one of my lowest body weights, 180 lbs., body fat of 18% and wore size 8 p but when I calculated my BMI: "overweight". I remember the day I did the calculation and seeing the result. It sent me down a spiral of shame and binging. I still wasn't enough. Not only was I healthy as ever but also had just received a full annual health check and no longer was considered pre-diabetic. My cholesterol was well below normal, my blood pressure was stellar, my inflammation blood markers were the lowest they could be... and overweight. Is BMI an accurate measure of health? What happens if you are over-the BMI weight prescribe? Is BMI ratio an accurate measure of health? Many experts disagree that just stating the fact that BMI ratio was never created with the intention of measure of health. Recently, a 2016 study by researchers at UCLA published this month in the International Journal of Obesity looked at 40,420 adults in the most recent U.S. National Health and Nutrition Examination Survey and assessed their health as measured by six accepted metrics (not including BMI) blood pressure, triglyceride, cholesterol, glucose, insulin resistance and C-reactive protein. It found out that 47 percent of people classified as "overweight" by BMI and 29 percent of those who qualified as obese were healthy as measured by at least five of those other metrics. Meanwhile, 31 percent of normal-weight people were unhealthy by two or more of the same measures. That means, we can be healthy and yet be considered "overweight". It bears the question: Over what weight exactly? So, why do we worry about BMI? What you'll learn listening to this episode: The history of the BMI How to determine your health status The many health impacts of weight stigma. Health at Every Size & Weight neutral approach to health Mentioned on the show: Start with our Intuitive Eating Guide Study on Health Marker Beyond BMI Body Respect Book Tools for weigh-in at a doctor visit What to say at the doctor's office? For fat patients and their doctors Connect with our guest Website Facebook Instagram Ditch the Diet Facebook Support Community

Health Beyond Diet and Weight Loss For many of us in this community, our first encounter with dieting wasn't a concern with health. Similarly, for me and all the women I work with inside of my programs, their first diet was strictly focused on being in a smaller body. That is to say, we dieted for aesthetic reasons, not health. As women, we do not want to diet. Instead, we want to be in a thinner body. Our modern society believes that being thinner is better, smarter, and healthier. In other words, all of us have been taught at a very young age that health = thinness but is it true or is it just an assumption? What if health wasn't the outcome of the weight on the scale? Would you still want to diet? Does “Obesity” Cause One to Be Unhealthy? As of today in October 2019, there isn't one study or research evidence that directly points to being overweight (BMI-based status) as a causative factor in diseases. That said, many studies will link/correlate obesity to health risks. In other words, weight status is never the sole factor in any health condition. In this groundbreaking research on BMI and metabolic health, one-third to three-quarters of people classified as obese were metabolically healthy. Four health factors were measured and evaluated to achieve health status. These include blood pressure, high-density lipoprotein cholesterol, triglycerides, and plasma glucose. Moreover, when BMI categorized an individual as obese, this study showed that obesity did not affect the risks of cardiovascular diseases, stroke, and mortality. However, it did increase diabetes risk although cumulative incidence remained low in healthy people. In fact, the problem with considering weight as the main factor to your health is our inability to lose weight and sustain the weight loss. Hence, 95-98% of dieters regain all of their weight loss within 1-5 years.  Dr. Traci Mann, a UCLA associate professor of psychology and lead author of this study said, “We found that the majority of people regained all the weight, plus more. Sustained weight loss was found only in a small minority of participants, while complete weight regain was found in the majority. Diets do not lead to sustained weight loss or health benefits for the majority of people.”. Is Health Beyond Dieting Possible? The short answer is yes. Based on research, it would appear that health isn't attributed to the weight on the scale, therefore, we can say that health is possible without seeking weight loss. A 2016 study by researchers at UCLA published in the International Journal of Obesity looked at 40,420 adults in the most recent U.S. National Health and Nutrition Examination Survey. It assessed their health as measured by six accepted metrics (not including BMI). The metrics include blood pressure, triglyceride, cholesterol, glucose, insulin resistance, and C-reactive protein. It found that 47 percent of people were classified as overweight by BMI. Twenty-nine percent of those who qualified as obese were healthy as measured by at least five of those other metrics. Meanwhile, 31 percent of normal-weight people were unhealthy by two or more of the same measures. So, if weight isn't what ensures our long-term health, then what is? Studies that have actually controlled for fitness have found that it is more predictive for mortality than weight. This study defined ‘fit' as 3-4 hrs/week of walking. In this episode, we will cover how we can as women seek health beyond dieting and weight loss. Likewise, we will explore everything we can do today that can and will impact our health long term. What you'll learn listening to this episode: What is health? Does “obesity” cause one to be unhealthy? Is health beyond diet and weight loss possible? What is Health at Every Size? What is a weight-neutral approach to health? Body dissatisfaction & shame and health behaviors Shifting from weight management to health behavior What happens if we take the Going Beyond The Food Method™️ approach to health? Who is the ideal candidate for The Going Beyond The Food Method™️ Health approach? How to get started with a weight-neutral approach to health Mentioned on the show: Register for the free workshop: 8 steps to health beyond dieting and weight loss Get Started with our FREE Intuitive Eating Introduction Course   Links & studies mentioned on the show: Research on BMI and metabolic health Cardiometabolic Disease Risk in Metabolically Healthy and Unhealthy Obesity Promoting Public Health in the Context of the “Obesity Epidemic” Research on Health Assessments on Adults Beyond BMI Relationship between low cardiorespiratory fitness and mortality in normal-weight, overweight, and obese individuals Impact of non-diet approaches on attitudes, behaviors, and health outcomes Healthy lifestyle habits and mortality in overweight and obese individuals Greater Weight Satisfaction Report More Positive Health Behaviors and Have Better Health Status    

Vidcast:  https://youtu.be/tmSkorpdkQ8 If you're a woman with bone density problems, you'd better watch the ingredients in your toothpaste, mouthwash, and soap.  A study just published in The Journal of Clinical Endocrinology & Metabolism shows that the common antibacterial triclosan, added to many consumer products, is associated with bone issues in women. The study reviewed data from more than 1800 women participating in the National Health and Nutrition Examination Survey.  Those women found to have higher levels of triclosan in their urine samples had a higher incidence of bone issues including osteoporosis of the thigh, hip, and lower spine. Triclosan is simply bad news.  Earlier this year, I reported to you that it can also inactivate certain antibiotics including amoxicillin and ciprofloxacin.  You should avoid it in all products by checking the ingredients before you buy. Shaofang Cai, Jiahao Zhu, Lingling Sun, Chunhong Fan, Yaohong Zhong, Qing Shen, Yingjun Li. Association between urinary triclosan with bone mass density and osteoporosis in the US adult women, 2005-2010. The Journal of Clinical Endocrinology & Metabolism, 2019; DOI: 10.1210/jc.2019-00576 #Triclosan #osteoporosis #demineralization #women #postmenopausal

Dr. Carolyn Lam: Welcome to "Circulation on the Run," your weekly podcast summary and backstage pass to the journal and its editors. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center and Duke‐National University of Singapore. Our featured discussion this week focuses on the new 2017 ACC/AHA high blood pressure guidelines, and the potential impact of these guidelines on the U.S. population. A must listen, coming right up after these summaries. The first original paper this week provides insights into how extracellular matrix remodeling contributes to in‐stent restenosis and thrombosis. First author, Dr. Suna, corresponding author, Dr. Mayr, and colleagues from King's College London, implanted bare metal and drug‐eluting stents in pig coronary arteries with an overstretch and then harvested the stented segments up to 28 days poststenting for proteomics analysis of the media and neointima. The authors found significant differences by proteomics in the extracellular matrix of coronary arteries after stent implantation. Most notably, an upregulation of aggrecan, a major extracellular matrix component of cartilaginous tissues that confers resistance to compression. In fact, this study provided the first evidence implicating aggrecan and aggrecanases in the vascular injury response after stenting. This opens a door to consideration of aggrecanase activity as new drug targets that may alter extracellular matrix remodeling in the vasculature. The next paper tells us that empagliflozin could address a significant unmet need in patients with chronic kidney disease. First and corresponding author, Dr. Wanner, from Wurzburg University Clinic in Germany investigated the effects of empagliflozin on clinical outcomes in patients with chronic kidney disease in the EMPA‐REG OUTCOME trial, where patients with type 2 diabetes, established cardiovascular disease, and an eGFR above 30 at screening were randomized to receive empagliflozin or placebo, in addition to standard of care. In the current study, prevalent kidney disease was defined as an eGFR of less than 60 or urine albumin/creatinine ratio of more than 300 at baseline. In these patients, empagliflozin reduced the risk of cardiovascular death by 29% compared with placebo, reduced the risk of all‐cause mortality by 24%, and reduced the risk of hospitalization for heart failure by 39%, and the risk of allcause hospitalization by 19%. The effects of empagliflozin on these outcomes were independent of renal function or albuminuria status at baseline. Furthermore, the adverse event profile of empagliflozin was similar across subgroups by renal function at baseline. Adverse events of particular concern in this population, such as urinary tract infection, acute renal failure, hypokalemia or fractures, lower limb amputations or hypoglycemia were not increased with empagliflozin compared to placebo. The next study provides mechanistic insights into exercise intolerance in heart failure with preserved ejection fraction or HFpEF. First author, Dr. Houstis, corresponding author, Dr. Lewis and colleagues from Massachusetts General Hospital, investigated the mechanism of exercise intolerance in 79 patients with HFpEF and 55 controls referred for cardiopulmonary exercise testing who were also studied with invasive monitoring to measure hemodynamics, blood gases and gas exchange during exercise. These measurements were used to quantify six steps of oxygen transport and utilization in each HFpEF patients, identifying the defective steps that impaired each one's exercise capacity. The authors then quantified the functional significance of each pathway defect by calculating the improvement in exercise capacity that a patient could expect from correcting the defect. The authors found that the vast majority of HFpEF patients harbored defects at multiple steps of the pathway, the identity and magnitude of which varied widely. Two of these steps, namely, cardiac output and skeletal muscle oxygen diffusion were impaired relative to controls by an average of 27% and 36% respectively. Due to interactions between a given patient's defects, the predicted benefit of correcting any single defect was often minor. At the individual level, the impact of any given pathway defect on a patient's exercise capacity was strongly influenced by comorbid defects. The authors concluded that a personalized pathway analysis could identify patients most likely to benefit from treating a specific defect. However, the system properties of oxygen transport favor treating multiple defects at once, such as, with exercise training. What are the potential benefits or risks of intensive systolic blood pressure lowering in individuals with a low diastolic blood pressure? Well, the final paper today tells us. In this study by first and corresponding author, Dr. Beddhu, and colleagues from Salt Lake City in Utah, a post hoc analysis of the SPRINT trial was performed. Remember that the SPRINT trial was a randomized control trial that compared the effects of intensive versus standard systolic blood pressure control in older adults with high blood pressure at increased risk of cardiovascular disease. The current post hoc analysis examined whether the effects of the systolic blood pressure intervention differed by baseline diastolic blood pressure. The authors found that there were U‐shaped relationships of baseline diastolic blood pressure with the primary cardiovascular disease outcome and all‐cause death. However, the beneficial effects of intensive systolic blood pressure lowering on the primary cardiovascular disease outcome in all‐cause death were not modified by baseline level of diastolic blood pressure. Increased risk of kidney events and serious adverse effects of the intervention were consistent across baseline diastolic blood pressure quintals. Therefore, there was no evidence that the benefit of intensive systolic blood pressure lowering differed by baseline diastolic blood pressure levels. These findings suggest that the reason for the observed associations of worse outcomes with lower diastolic blood pressure was due to underlying processes, such as increased arterial stiffness that lead to a decline in diastolic blood pressure, rather than the level of diastolic blood pressure per se. Furthermore, lower levels of diastolic blood pressure within the ranges examined in SPRINT, should not be an impediment to intensive treatment of hypertension, at least in those without diabetes or stroke. Well, that wraps it up for our summaries. Now for our feature discussion. The ACC/AHA guidelines for the management of hypertension in adults has really been a hot topic. Just published this year, and it really updates the seventh JNC report, which was published in 2003. Well, today's feature paper deals directly with a comparison of these two guidelines and how it may impact our practice. I'm so pleased to have with us today the first and corresponding author of this paper, Dr. Paul Muntner, from University of Alabama at Birmingham and a very familiar wonderful voice, Dr. Wanpen Vongpatanasin, associate editor from UT Southwestern. Welcome! Dr. Paul Muntner: Hi. Thank you for having me. Dr. Wanpen Vongpatanasin: Hi, Carolyn. Dr. Carolyn Lam: Paul, could I ask for you to start by painting the differences between the 2017 ACC/AHA guidelines and the JNC 7? We understand you were part of writing the guidelines, so who better than to draw our attention to the main differences. Dr. Paul Muntner: I think that the new guideline, the ACC/AHA guideline, it was fairly comprehensive included 15 chapters, so there's a lot of new information in the guideline, everything from a dedicated section on the measurement of blood pressure to aspects of patient care. The manuscripts featured in "Circulation" in this issue is focused on, in the past, there's different blood pressure thresholds in the guideline for defining hypertension, as well as recommendations for antihypertensive medication treatments, as well as blood pressure goals. As everyone probably knows form JNC 7, hypertension was defined as a systolic blood pressure greater than or equal to 140 mmHg and/or a diastolic blood pressure greater than or equal to 90 mmHg, versus in the 2017 ACC/AHA guideline, these were lowered to 130/80. In terms of treatment recommendations, there's really a fundamental shift with the new guideline, where the new guideline focuses not just on blood pressure levels, but also on overall cardiovascular disease risk. So going to the new guideline, people are recommended treatment if their blood pressure is above 140/90 but also there's a group with a blood pressure in the 130 to 139 range for systolic blood pressure, of 80 to 89 mmHg for diastolic blood pressure, who are recommended treatment if they have a high cardiovascular disease risk. Finally, I'll just finish with this last note is that blood pressure control for people taking antihypertensive medication is now 130/80 so a goal blood pressure for people taking antihypertensive medication is systolic blood pressure less than 130 mmHg, and a diastolic blood pressure less than 80 mmHg. Dr. Carolyn Lam: That was beautifully explained. Paul, I just really loved table 1 of your paper, and I want to refer our audience to it. It so nicely summarizes the differences between the 2017 guidelines and JNC 7. At risk of oversimplifying, when you compare the two in this approach, it's sort of comparing using a cardiovascular risk in conjunction with blood pressure‐type approach with a blood pressureonly number approach, isn't it? Dr. Paul Muntner: Right. I think that's a key important piece of the new guideline and really CVD risk is used in conjunction with blood pressure levels to guide the recommendation to initiate antihypertensive medication. This decision was based on a wide variety of data from randomized trials, observational studies, as well as simulation or economic analyses that consistently showed the benefits of considering an individual's overall cardiovascular disease risk and providing effective and efficient treatment for lowering blood pressure. Dr. Carolyn Lam: Right. And you analyzed the impact of this in the NHANES data in today's paper. Could you tell us a bit more about that? Dr. Paul Muntner: The U.S. National Health and Nutrition Examination Survey, or NHANES, provides an opportunity to generate national representative point estimates on the prevalence of hypertension and treatment recommendations. So we're able to use data on about 9500 U.S. adults. Each person came in for a clinic examination where they had their blood pressure measured three times, and they were asked about their use of antihypertensive medication. What we found was the prevalence of hypertension, or the percentage of U.S. adults with hypertension according to the new guideline, is about 46%, which compares to 32% according to the JNC 7 guideline, so really a big increase in the prevalence of hypertension of about 14%. However, by using the combination of risk and blood pressure, we're not recommending treatment for everyone with hypertension but rather people with hypertension with very high blood pressure as well as those at high cardiovascular disease risk. So antihypertensive treatment, pharmacological antihypertensive treatment, is now being recommended for about 36% of U.S. adults compared to 34% of U.S. adults according to JNC 7. The rest of the people with hypertension are recommended nonpharmacological therapies; exercise, diet, alcohol reduction, weight loss for people who are overweight and obese. Really, it's an opportunity to treat people with pharmacological therapy if they're high risk. Then for people who aren't high risk, there's an opportunity for nonpharmacological therapies, so they can, hopefully, prevent the need for further treatment. Overall, this equates to about 103 million U.S. adults with hypertension, so it's a very large number. However, only about 82 million of these individuals are recommended pharmacological antihypertensive treatment, so there's a big portion of the U.S. population who have hypertension, have high blood pressure, yet we think would benefit from nonpharmacological therapy. Dr. Carolyn Lam: Wanpen, could I get you to chime in on what you think of the clinical implications of today's paper? Dr. Wanpen Vongpatanasin: I think that this paper gives us at least reassurance that although we have 30 million more people with hypertension now, not all of them have to be started on medication right away. But it also put an emphasis on cardiovascular risk assessment, which we as the cardiologist are already doing this on a regular basis. It is a major step forward to incorporate cardiovascular risks as another way to gauge how people should be treated intensively, which we like that aspect of it. Dr. Carolyn Lam: I agree. I think it's reassuring because most people think, "Oh, my goodness. We have got so much more hypertensives to manage." But then it tells us that a restratified approach really keeps it manageable, I suppose. But Wanpen, did you have some specific concerns or questions? Dr. Wanpen Vongpatanasin: We look at the people who by JNC 7 calls prehypertension, which it's now some of them turn out to be a stage 1 hypertension. The question I have for Paul is that even though guidelines call for nonpharmacologic treatment first, the guidelines said give a try from three to six months, but what happens after that if they're still not reaching the goal? Would people on the guidelines propose drug treatment eventually because, as you know, nonpharmacology treatment is easier said than done. Even though you might be able to tackle some aspect of it, but I doubt you can tackle everything; exercise, diet, sodium, weight loss all at the same time in a three to six month period. Dr. Paul Muntner: It's a great question and it's something that the guidelines really spent a lot of time considering and reviewing the evidence. First, what the recommendation is that we recommend nonpharmacological intervention as you mentioned and the re‐evaluation. If the person's blood pressure remains in the stage 1 hypertension range and they're not a high cardiovascular disease risk, then they are recommended to continue attempts at the nonpharmacological interventions. I've been asked several times since the guideline has been published, "What, are we supposed to just wait until people become high risk?" And my viewpoint on this is, it's hard enough to get people to adhere to their medications currently, let's be judicious about this, focus on the high‐risk people, and maybe if we can communicate with people that have high‐risk for cardiovascular disease, we can work with patients to improve medication adherence and really focus on the low‐risk people in preventing the need for lifelong therapy. Dr. Wanpen Vongpatanasin: That's great, I think that's really helpful in clarifying this point. Because even if you say that 30 million doesn't need to be started on the drug right away, that eventually have to be started on drug in six months, I think that doesn't really give us a reassurance but, obviously, we still have to continue to work on these patients who are on the fence of needing pharmacology intervention. Dr. Paul Muntner: Right. I think what's interesting here is a lot of people since the guideline has been published have said to me, "Now this is done." I said, "No. Now we're really just starting. Now is the most important part of the guideline, which is implementation." And how are we going to implement the guideline, which, as we were just discussing, isn't just about initiating pharmacological therapy, but it's also about the nonpharmacological therapies as well as medication adherence and all these other issues that are in the guideline, proper measurement of blood pressure, etc. I think that now is going to be the most important time to really have a big impact on our patients' lives by really using the evidence and now that it's in the guideline, we're using the evidence to direct treatment appropriately. Dr. Carolyn Lam: Indeed, Paul. Just one thing. Along the lines of implementation, how about the issue of the lower target BP, to treat to? What did your study from NHANES show about that, numbers reaching targets, and do you see that as an issue? Dr. Paul Muntner: It's an interesting question because the findings from our study found that it's currently over half of U.S. adults according to the new guideline, over half of U.S. adults on antihypertensive medication, have blood pressure above the goal in the new guideline. So in our study, 53% of U.S. adults taking antihypertensive medication had a blood pressure above 130/80. This represents an increase from the JNC 7 guideline of people with blood pressure above 140/90, of course, of about 14.4%. According to our estimates, there are about 8 million U.S. adults who are going to be recommended more intensive antihypertensive medication. The blood pressure of less than 130/80 is a uniform goal for all people taking antihypertensive medication. This comes from several meta‐analyses that have consistently shown the cardiovascular and mortality risk reduction associated with achieving a blood pressure of less than 130/80. I think there's very firm evidence to stand on. One interesting thing from the guidelines, it's in one of the tables, and I think it's a very important point to make, is that a lot of people who have above goal blood pressure, according to the new guideline, they're only taking one or two classes of antihypertensive medication. The vast majority of them are not taking multiple classes of antihypertensive medication, so we feel that these therapies can be optimized and we're not going to be pushing people into antihypertensive polypharmacy but rather they can receive substantial risk reductions without really giving them too many additional pills. Dr. Carolyn Lam: Wow. Really about implementation. Wanpen, did you have any other comments before we close? Dr. Wanpen Vongpatanasin: Yes, I think that is really interesting to see also with these guidelines how is this going to be embraced to the rest of the world. Actually, prior to this guideline, at least hypertension control rate in the U.S. is better than most countries, European countries, as well as in Asia. But now even lowering the bar, we use the same criteria for the rest of the world, that would be a lot worse control rate than now. I think it will be challenging, not only in this country but throughout the world. Dr. Paul Muntner: That's a great point. Obviously, these guidelines are U.S. guidelines, however, new European guidelines should be coming out in 2018, is what I've heard. I think that even though these guidelines were developed by the American College of Cardiology and the American Heart Association, the data that we're using really comes from worldwide evidence. The evidence didn't stop at the borders. A lot of the evidence that was used in choosing the blood pressure levels to define hypertension, the blood pressure levels to recommend pharmacological interventions, as well as the blood pressure goals do come from other countries. A lot of data from Asia, Europe, Australia, so I think that the data used in these guidelines should be generalized when it's out of the United States. I think there may be challenges with implementing these guidelines in different settings, and, obviously, a lot of things will have to be tailored to where they will be implemented. However, the overall goal is to reduce the burden of cardiovascular disease and renal disease related to hypertension and, hopefully, that can be a worldwide goal. Dr. Carolyn Lam: What a great reminder. It is worldwide data, worldwide evidence for a worldwide problem. Well, listeners, you heard it right here on "Circulation on the Run." Thank you so much for joining us today and don't forget to tune in again next week.