POPULARITY
2 episodes with Predimed
3 episodes with Predimed
2 episodes with Predimed
4 episodes with Predimed
Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-422 Overview: Conflicting data on alcohol's health effects leave clinicians uncertain about patient guidance. In this episode, we review the PREDIMED trial's findings on wine and cardiovascular outcomes, explore objective biomarkers for intake, and examine the National Academy of Sciences' recent report to clarify the risks and benefits of moderate consumption, giving you confidence in counseling patients. Episode resource links: Inés Domínguez-López, Rosa M Lamuela-Raventós, Cristina Razquin, et al. Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial, European Heart Journal, 2024;, ehae804, https://doi.org/10.1093/eurheartj/ehae804 National Academies of Sciences, Engineering, and Medicine. 2025. Review of Evidence on Alcohol and Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/28582 Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-422 Overview: Conflicting data on alcohol's health effects leave clinicians uncertain about patient guidance. In this episode, we review the PREDIMED trial's findings on wine and cardiovascular outcomes, explore objective biomarkers for intake, and examine the National Academy of Sciences' recent report to clarify the risks and benefits of moderate consumption, giving you confidence in counseling patients. Episode resource links: Inés Domínguez-López, Rosa M Lamuela-Raventós, Cristina Razquin, et al. Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial, European Heart Journal, 2024;, ehae804, https://doi.org/10.1093/eurheartj/ehae804 National Academies of Sciences, Engineering, and Medicine. 2025. Review of Evidence on Alcohol and Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/28582 Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com
Who can you trust?? In this episode John, Will and Paul discuss the concerning trend in the medical literature - the growth of scientific research articles being retracted. 10,000 retractions in 2023 compare to about as many retractions in the three-year period from 2020 to 2022 This has impacted the PREDIMED study that was discussed on the LiverHealthPOD a few episodes ago. Also we do Mail Bag again!!
En este episodio tenemos el honor de entrevistar a Miguel Ángel Martínez González, uno de los principales investigadores del famoso estudio PREDIMED. Con su carisma y vasto conocimiento, Miguel Ángel nos explica las numerosas ventajas de la dieta mediterránea para la salud. Desde la prevención de enfermedades cardiovasculares hasta su impacto positivo en la longevidad, aprendemos por qué este estilo de vida no es solo una moda, sino una verdadera fuente de bienestar.También profundizamos en el impacto del consumo de alcohol en nuestra salud, analizando los datos preliminares del estudio UNATI. Miguel Ángel comparte con nosotros las últimas novedades y nos ayuda a entender los riesgos asociados al consumo de alcohol, desmintiendo algunos mitos comunes y resaltando la importancia de la moderación. Por último, también abordamos temas cruciales en epidemiología y salud pública, discutiendo cómo se realiza un estudio científico riguroso y cómo identificar datos científicos fiables. Miguel Ángel nos da valiosos consejos sobre la interpretación de estudios y la importancia de la evidencia científica sólida en la toma de decisiones informadas sobre nuestra salud. Este episodio es una verdadera joya para todos los interesados en mejorar su calidad de vida a través de la ciencia y la alimentación saludable.#DietaMediterránea #SaludCardiovascular #EstudioPREDIMED #AlimentaciónSaludable #PrevenciónDeEnfermedades #Longevidad #Epidemiología #SaludPública #EstudioCientífico #ConsumoDeAlcohol #EstudioUNATI #RiesgosDelAlcohol #Moderación #Bienestar #EvidenciaCientífica #MiguelAngelMartinezGonzalez #Nutrición #EstiloDeVidaSaludable #CienciaDeLaSalud #SaludYNutrición #PodcastDeSalud #DatosFiables #InvestigaciónCientífica #Prevención #VidaSaludable Hosted on Acast. See acast.com/privacy for more information.
Welcome to the Plant-Based Canada Podcast. In this episode we are joined by Prof Jordi Salas-Salvadó to chat about the Mediterranean diet.Prof Jordi Salas-Salvadó is a medical doctor and a Distinguished Professor of Nutrition and research at Rovira i Virgili University, in Spain. He is the Director of the Food, Nutrition and Mental Health Research Group recognized by the Government of Catalonia; Principal Investigator of the CIBER Network Physiopathology of Obesity and Nutrition (CIBERobn) of the Carlos III Health Institute; Director of the Catalan Nutrition Centre of the Institute of Catalan Studies; Chairman of the Professorship Tree Nut World Forum for Nutrition Research and Dissemination; member of the Group of Experts of the Public Health Agency of Catalonia. Prof Salas-Salvadó is an expert in clinical trials evaluating the effect of diets and dietary compounds on cardiometabolic health. He was a lead researcher of the PREDIMED study, a landmark trial evaluating the effect of the Mediterranean Diet on the primary prevention of cardiovascular diseases. He is currently the Director and Chair of the Steering Committee of the PREDIMED-Plus trial. He has published >900 scientific articles (h-index 101; >30,000 citations; Clarivate Analytics “Highly Cited Researcher”) and has received multiple awards and recognitions. In addition to all the above, he has been a mentor to many researchers & health professionals, including the host of the podcast episode, and we are grateful to have him join the podcast and share his expertise as an honorary Canadian.In this episode:-History behind the Mediterranean diet-PREDIMED Trial: development, findings, impact-PREDIMED-Plus Trial: development, findings, impact-The future of PREDIMED-Plus & nutrition researchEpisode Resources:PREDIMED-Mediterranean Diet & Heart DiseasePREDIMED-Plus: Design & methodsPREDIMED-Plus: 1-Yr results11 clinical trials that will shape medicine in 2023 Prof. Jordi Salas-Salvadó's Socials:WebsiteX/ Twitter: @JordiSalasSalva & @nutrihumana_URVWeb of ScienceORCIDPlant-Based Canada's Socials:Instagram @plantbasedcanadaorgFacebookWebsiteX / Twitter @PBC_orgConference-May 25, 2024 Bonus: Check out University of Guelph's online Plant-Based Nutrition Certificate.Each 4-week course will guide you through essential plant-based topics including nutritional benefits, disease prevention, and environmental impacts. You can also customize your learning with unique courses such as Plant-Based Diets for Athletes and Implementing a Plant-Based Diet at Home.As the first university-level plant-based certificate in Canada, you'll explore current research, learn from leading industry experts, and join a community of like-minded people.Use our exclusive discount code PBC2024 to save 10% on all Plant-Based Nutrition Certificate courses!www.uoguel.ph/pbn.Thank you for tuning in!Support the show
On this week's podcast, Brad Marshall, evolutionary biologist, talks with Paul about how signaling to our body that winter is coming is not advantageous for humans and why humans may want to stop consuming olive oil. They do a deep dive into the human metabolism, what European diets are truly like, and touch on other kinds of oils & fats as well. 00:00:00 Podcast begins 00:02:50 Brad's weight loss journey 00:10:50 The human metabolism 00:15:10 How olive oil makes us fat 00:34:24 Deep dive into European diets 00:48:50 PREDIMED trial comparing different types of olive oil 00:51:05 De novo lipogenesis (DNL) 00:53:50 What happens when humans eat canola oil 00:59:20 A story about the Inuit & long-term ketosis 01:07:20 Takeaways about olive oil Connect with Brad: https://www.youtube.com/@fireinabottle3410 References: Diabetes prevalence, 2021: https://ourworldindata.org/grapher/diabetes-prevalence Trends of overweight, obesity and anthropometric measurements among the adult population in Italy: The CUORE Project health examination surveys 1998, 2008, and 2018: https://journals.plos.org/plosone/article/figure?id=10.1371/journal.pone.0264778.g004 OBESITY AMONG CHILDREN IN EUROPE: https://landgeist.com/2023/02/18/obesity-among-children-in-europe/ Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the period 2016-2030: https://pubmed.ncbi.nlm.nih.gov/29886156/ Effects of free omega-3 carboxylic acids and fenofibrate on liver fat content in patients with hypertriglyceridemia and non-alcoholic fatty liver disease: A double-blind, randomized, placebo-controlled study: https://www.lipidjournal.com/article/S1933-2874(18)30362-3/fulltext Quality of Dietary Fat Intake and Body Weight and Obesity in a Mediterranean Population: Secondary Analyses within the PREDIMED Trial: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6315420/
Minnesota Coronary Experiment, Sydney Diet Heart Study, Rose Corn Oil, LA Veterans, Lyon Diet Heart Study, PREDIMED study, and all the major studies on Seed Oils. Are seed oils bad for you? Are seed oils good for your heart? Are seed oils healthy? Cardiologist explains the data! https://dralo.net/links
What are lectins, and are they dangerous? These “antinutrients” have come under attack and were recently the subject of a dietary fad fueled by a popular book. As always, there's more to the story.In today's episode, Jonathan is joined by Dr. Will Bulsiewicz to dive deep into the world of lectins. They dissect questionable studies, debunk myths, and offer expert advice about how to approach foods containing these misunderstood compounds.Will is a board-certified gastroenterologist with 14 years of experience. He's also the New York Times best-selling author of Fiber Fueled and ZOE's U.S. medical director. If you want to uncover the right foods for your body, head to joinzoe.com/podcast and get 10% off your personalized nutrition program.Download our FREE guide — Top 10 Tips to Live Healthier: https://zoe.com/freeguide Follow ZOE on Instagram.Mentioned in today's episode:Lectins as bioactive plant proteins: A potential in cancer treatment from Critical Reviews in Food Science and NutritionPlant-derived lectins as potential cancer therapeutics and diagnostic tools from BioMed Research InternationalA legume-based hypocaloric diet reduces proinflammatory status and improves metabolic features in overweight/obese subjects from the European Journal of NutritionDietary legume consumption reduces risk of colorectal cancer: Evidence from a meta-analysis of cohort studies from Scientific ReportsIntake of legumes and cardiovascular disease: A systematic review and dose-response meta-analysis from Nutrition, Metabolism and Cardiovascular DiseasesLegume consumption is inversely associated with type 2 diabetes incidence in adults: A prospective assessment from the PREDIMED study from Clinical NutritionThe effects of legume consumption on markers of glycaemic control in individuals with and without diabetes mellitus: A systematic literature review of randomised controlled trials from NutrientsEffects of dietary pulse consumption on body weight: a systematic review and meta-analysis of randomized controlled trials from The American Journal of Clinical Nutrition The "white kidney bean incident" in Japan from Methods in Molecular BiologyFructan, rather than gluten, induces symptoms in patients with self-reported non-celiac gluten sensitivity from GastroenterologyIs there a...
Links: Subscribe to PREMIUM Go to episode page Learn more about the podcast Sigma's recommended resources About This Episode: PREDIMED (Prevención con Dieta Mediterránea) is a landmark clinical trial conducted in Spain. The study made a huge splash due to the rarity in nutrition of having large RCTs with hard endpoints. In addition, it had results of a large magnitude; showing a 30% reduction in cardiovascular events. But the study did face criticisms and controversies over methodological issues, including randomization procedures at certain centers, ultimately leading to a retraction of the original paper and a re-analysis. Participants in the PREDIMED trial were randomly assigned to one of three groups: A Mediterranean diet supplemented with extra-virgin olive oil. A Mediterranean diet supplemented with mixed nuts (walnuts, almonds, and hazelnuts). A control group following a low-fat diet. Despite the issues it still ends up being an incredibly useful source of data. In this episode we discuss the findings from PREDIMED, some of the potential limitations, and where it sits among the wider Mediterranean Diet literature. Note: This is a Premium-exclusive episode, so in order to listen to the full episode you'll need to subscribe to Sigma Nutrition Premium.
Mathilde TouvierSanté publique 2022-2023Collège de FranceColloque - Nutritional Determinants of Health: Recent Research Discoveries and Translation into Public Health Action : Nutritional Epidemiology of Chronic Diseases in the Omics EraIntervenant(s)Pr Frank Hu, Department of Nutrition, Harvard School of Public Health, Boston, Mass., USARésuméNutritional epidemiology plays a critical role in understanding the relationship between diet and risk of chronic diseases. With recent advances in omics technologies including genomics, metabolomics, proteomics, and metagenomics, there are new opportunities to explore biological mechanisms underlying diet, metabolic pathways, and health outcomes. In my presentation, I will discuss our efforts to incorporate omics technologies especially high throughput metabolomics into our large cohort studies including the Nurses' Health Study and Health Professionals' Follow-up Study as well as the PREDIMED trial. The integration of omics data in nutritional epidemiology holds great promises in identifying novel biomarkers for dietary intakes and predicting future disease risk. The repeated measures of diet enable us to examine long-term relationships between dietary factors and chronic disease risk and whether these associations are mediated or modified by individuals' metabolic profiles. These analyses have the potential to facilitate more effective precision or personalized nutrition interventions. Continued efforts and collaboration are necessary to fully leverage the potential of omics data in nutritional epidemiologic research and chronic disease prevention.Franck HuDr. Frank Hu is Chair of Department of Nutrition, Fredrick J. Stare Professor of Nutrition and Epidemiology at Harvard T.H. Chan School of Public Health and Professor of Medicine, Harvard Medical School and Brigham and Women's Hospital. Dr. Hu received his MD from Tongji Medical College in China and MPH and PhD in Epidemiology from University of Illinois at Chicago. He completed a postdoctoral fellowship in Nutritional Epidemiology at Harvard T.H. Chan School of Public Health. Dr. Hu's major research interests include epidemiology and prevention of cardiometabolic diseases through diet and lifestyle; gene-environment interactions; nutritional metabolomics; and nutrition transitions in low- and middle-income countries. Currently, he is Director of Boston Nutrition and Obesity Research Center Epidemiology and Genetics Core and Director of Dietary Biomarker Development Center at Harvard University. He has published a textbook on Obesity Epidemiology (Oxford University Press) and >1400 peer-reviewed papers with an H-index of 290. He served on the Institute of Medicine (IOM) Committee on Preventing the Global Epidemic of Cardiovascular Disease, the Obesity Guideline Expert Panel, American Heart Association Nutrition Committee, and the 2015 Dietary Guidelines Advisory Committee, USDA/HHS. He has served on the editorial boards of Lancet Diabetes & Endocrinology, Diabetes Care, and Clinical Chemistry. Dr. Hu was elected to the National Academy of Medicine in 2015.
Miguel Ribeiro, CEO e fundador da Predimed Imobiliária, foi o convidado do 2º episódio do Podcast “A Arte de errar”. A Predimed é uma das maiores redes de mediação imobiliária a operar em Portugal, com mais de 130 agências e mais de 1.300 consultores. Neste episódio, desafiámos o Miguel a contar-nos a história da fundação da sua empresa, a relação com o seu pai, empresário na área da promoção imobiliária, os principais obstáculos que ultrapassou e os erros que foi cometendo ao longo do caminho. Abordámos ainda o momento difícil da crise do subprime e a forma como teve que se adaptar a uma nova realidade e a um novo mercado. Por fim, desafiámos o Miguel a comentar o mercado imobiliário, a relação entre as principais marcas, as estratégias de recrutamento, o papel dos portais e o futuro do mercado. Uma conversa imperdível, para quem gosta de negócios, empreendedorismo e imobiliário... Um Podcast de Rodrigo Alfaiate e Francisco Mota Ferreira.
Autor: Maristela Strufaldi • Ramos S, et al. Terapia Nutricional no Pré-Diabetes e no Diabetes Mellitus Tipo 2. Diretriz Oficial da Sociedade Brasileira de Diabetes (2022). Acesso em 28 de março de 2023. • Evert AB, et al. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care. 2019 May;42(5):731-754. • Schwingshackl L, et al. A network metaanalysis on the comparative efficacy of different dietary approaches on glycaemic control in patients with type 2 diabetes mellitus. Eur J Epidemiol. 2018 Feb;33(2):157–70 • Toledo E, et al. Effect of the Mediterranean diet on blood pressure in the PREDIMED trial: results from a randomized controlled trial. BMC Med. 2013 Sep 19;11:207. • Salas-Salvadó J, et al. Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial. Diabetes Care. 2019 May;42(5):777-788. • Delgado-Lista J, et al. Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial. Lancet. 2022 May 14;399(10338):1876-1885. • Weber B, et al. Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial. Am Heart J. 2019 Sep;215:187-197. • Chiavaroli L, et al. DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Nutrients. 2019 Feb 5;11(2):338. • Freire R. Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets. Nutrition. 2020 Jan;69:110549. • Davies MJ, et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022 Dec;65(12):1925-1966.
PREDIMED author Dr. Miguel Ángel Martínez-González discusses the keys of the ”real” Mediterranean Diet and the role of extra virgin olive oil in preventive healthcare with us. Can the Mediterranean Diet help us live longer? What does extra virgen olive oil have to do with cardiovascular diseases, diabetes and breast cancer? What are some of the best and worst things we can eat from a health perspective?We tackle some common myths, such as whether the famous digestif really helps with digestion, that the healthiest diet is low-fat or that you shouldn't fry with olive oil.In this episode we do something we usually never do - talk about health and diet. The only reason we decided to make this exception is because we got a true expert, an internationally recognized eminence in his field, to share his knowledge with us: Dr. Miguel Ángel Martínez-González is a Professor of Public Health at the University of Navarra, Visiting Professor at Harvard, a cardiologist and one of the leading European researchers in the field of preventative medicine and nutrition. He has led the Predimed trial, the largest study conducted to date on the effects of the Mediterranean diet and health habits, which included over 7,400 participants.
Today we continue our interview with Dr. Stephanie Nishi as we talk about her post-doctorial work in Spain with the PREDIMED study group and her journey into a post-doc. Thank you to Manulife, our affinity sponsor, for supporting the student and alumni experience. Discover the benefits of affinity products here: https://uoft.me/DNSAA
Episode 92: Paleo vs Keto vs Mediterranean. Sapna and Danish explain the main differences between three meal plans: Paleo, Keto, and Mediterranean. Intro about fad diets.Introduction: Fad diets. By Hector Arreaza, MD. It is estimated that 2/3 of Americans are overweight or have obesity (73% of men and 63% of women), but only 19% of people claim to “be on a diet”, and 77% of people are trying to “eat healthier”[1]. It seems like many of us are on the weight-loss wagon together, hoping for a cure for this disease.These days it is commonplace to hear about fad diets. Fad diets are short-lived eating patterns that make unrealistic claims about weight loss and improving health, with little to no effort on your part. “The Super-Duper diet will make you lose 100 pounds, eliminate your cellulite, erase stretch marks, remove your wrinkles, and give you extra energy to fly to the moon and back, buy the super-duper diet now!” We surely have a lot of products that make senseless promises, claim many victims, and leave people with empty pockets. Today is May 6, 2022. Sapna and Danish will enlighten us again with more nutrition discussions. When you go around your grocery store, have you wondered what “keto-friendly” really means? We hope after today, you get a better idea about it. Today we are presenting a brief discussion to compare three common dietary approaches for weight loss: Keto, Paleo, and Mediterranean. I'm sure you have heard some things about these diets, but we want to add to your fund of knowledge. Whether they are fad diets or not, we'll let you decide. Enjoy it! This is Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care physician for additional medical advice.___________________________Paleo vs Keto vs Mediterranean. Prepared by Sapna Patel, MS4, and Danish Khalid, MS4, Ross University School of Medicine. Comments by Hector Arreaza, MD.Welcome back to our Nutrition series!D: In our previous episode, we talked about calorie balance and macronutrients. The basics of nutrition. So, if you haven't already listened to that, pause this, and go listen to that first. As we will only continue to build on that knowledge. Now, let's begin…S: Whether your goals are to lose fat or gain muscle. Nowadays, we've got so many ways to achieve our nutritional goals. It can be difficult and overwhelming to know which one is best for you. So today, we will talk about some of the main “diets'' that are well known to all.Comment: People hate the word “Diet”, should we call them meal plans or Nutrition plans?S: The Paleo meal plan. The Ketogenic meal plan. The Mediterranean meal plan. And as we go through each of them, we will compare them and discuss which fit certain nutritional goals.Comment: These meal plans are very trendy right now, some people call them fad diets, but only time can tell if these diets really work long term or not. D: Let's start with the Paleo meal plan. What is it? Also known as the Paleolithic diet, Caveman diet, or Stone-Age diet, this meal plan revisits the way humans ate almost 2.5 million years ago—The hunter-gatherer lifestyle. Overall, the meal plan is high in protein, moderate in fat (mainly unsaturated fats), low-moderate in carbohydrates (restricting high-glycemic carbohydrates), high in fiber, and low in sodium and refined sugars. It includes mainly lean meats, fish, fruits, vegetables, nuts, and seeds.Comment: It is low in carbs because carbs were so rare and uncommon in nature before agriculture was introduced to humanity. Animals (including humans) had to wait until the season when the fruit was ripe to enjoy something sweet.S: So, what are some of the benefits of the Paleo meal plan? Well, studies have shown that the paleo meal plan produces greater short-term benefits, including- Greater weight loss- Reduced waist circumference- Decreased blood pressure- Increased insulin sensitivity- Improved cholesterolD: You must be wondering, what's the catch? Aside from the diminishing long-term effects. Although the meal plan focuses on many essential food groups, it also omits others such as whole grains, dairy, and legumes. This could lead to suboptimal intake of important nutrients. Additionally, the restrictive nature of the meal plan may also make it difficult for people to adhere to such a meal plan in the long run. With these confounding facts, there hasn't been a strong link that the paleo meal plan improves cardiovascular risk or metabolic disease.S: Basically, for those looking for a cleaner meal plan, the paleo meal plan is geared towards eliminating high-fat and processed foods that have little nutritional value and too many calories. Moving on to the Ketogenic Meal plan.D: What is the Ketogenic Meal plan? Basically, the ketogenic meal plan is a high fat, moderate protein, and low carb lifestyle. It's about creating ketones. For example, beta-hydroxybutyrate, acetoacetate, and acetone. Ketones are basically a fourth macronutrient. Although we don't find it in our day-to-day food, it's what our body creates.So why do we need ketones, and why does our body create them in the first place? Our body uses carbohydrates, more specifically glucose, as the major source of energy for its daily needs. So, imagine, when we are in periods of starvation and deprive ourselves of carbohydrates. The body would resort to breaking down protein to create glucose for our demanding body in a process called gluconeogenesis. That seems illogical, right? Why would our body break down muscle? That is where ketones come in. While our body is trying to keep up with demands, our liver is working on creating another source of energy. A process called ketogenesis, where ketones are made through fat, more specifically medium-chain fatty acids, to fuel our body.S: So, what's so great about the Ketogenic Meal plan? Well, for starters, during ketogenesis due to low blood glucose feedback, the stimulus for insulin secretion becomes low, which sharply reduces the stimulus for fat and glucose storage. Additionally, people will initially experience rapid weight loss up to 10 lbs. in the first 2 weeks or less. Although the first few pounds may be water weight loss due to the diuretic effect of this meal plan, eventually you obtain fat loss.In this meal plan, lean body muscle is largely spared. So those who are overweight individuals with metabolic syndrome, insulin resistance, and type II diabetes mellitus, are more likely to see improvements in clinical markers for disease risk. Additionally, reducing weight, mainly truncal obesity, may help improve blood pressure, blood glucose regulation, triglyceride levels, and HDL cholesterol.D: That sounds awesome! What do I have to eat? Well, the dietary macronutrients are divided into approximately 55-60% fats, 30-35% protein, and 5-10% carbohydrates. Specifically, no more than 50 grams of carbohydrates.Comment: The difference between ketosis and ketoacidosis is a frequent question done by patients and medical providers. The main difference is that in ketosis your glucose level is normal or low and your pH is still physiologic, but in ketoacidosis, the pH is lower than 7.35 and glucose is above 250 mg/dL. So, when a person is in ketosis, you will not see the, for example, Kussmaul's breathing pattern, but in ketoacidosis, you will see that breathing pattern. If you want more info about the keto meal plan, you can listen to our episode 59, done by a great medical student Constance. S: Finally, the Mediterranean meal plan.The hallmark of this meal plan is simple…minimally processed foods. The main characteristic of a Mediterranean meal plan includes a low-moderate protein intake (very low consumption of red meat, moderate consumption of fish and shellfish), moderate-high fat (rich in unsaturated fats, lower in saturated fats), and moderate to high carbohydrates (legumes, unrefined grains). A very different take from the previous two meal plans.D: What is the hype all about? Why year after year does the Mediterranean meal plan come out on top? Well, the reason why it's one of the better options is because of the style of eating. It encourages vegetables and good fats (limiting bad fats) and discriminates against added sugar. No preservation, no packaging, no processing. This style of eating plays a big role in preventing heat disease, and reducing risk factors such as obesity, diabetes, high cholesterol, or high blood pressure.S: In fact, numerous studies have shown that the Med meal plan promotes weight loss and prevents heart attacks and helps with type 2 diabetes by improving levels of hemoglobin A1c, blood sugar levels, and decreasing insulin resistance. No wonder why out of all these meal plans, it's the only one that meets the AHA dietary recommendations.D: In a meta-analysis of randomized trials including the large PREDIMED trial, a Mediterranean meal plan reduced the risk of stroke compared with a low-fat diet (HR 0.60, 95% CI 0.45 to 0.80) but did not reduce the incidence of cardiovascular or overall mortality. By contrast, in observational studies, a Mediterranean meal plan was associated with lower overall mortality and cardiovascular mortality.Following a Mediterranean meal plan may lead to a reduction in total cholesterol. For example, in a 2011 meta-analysis of six randomized trials comparing the Mediterranean approach with a low-fat diet in 2650 individuals with overweight or obesity, a Mediterranean meal plan led to a greater reduction in total cholesterol (-7.4 mg/dL, 95% CI -10.3 to -4.4) but a nonsignificant reduction in LDL cholesterol (-3.3 mg/dL, 95% CI -7.3 to +0.6 mg/dL [5]. A Mediterranean meal plan may also decrease LDL oxidation.S: Additionally, in observational studies, a Mediterranean meal plan was also associated with a decreased incidence of Parkinson disease, Alzheimer disease, and cancers, including colorectal, prostate, aerodigestive, oropharyngeal, and breast cancers. Comment: I am excited to try the Mediterranean meal plan when I visit Spain this coming summer. It will be my first time in Valencia. Keep in mind, with any meal plan, it will work differently for everyone. Just because it worked for an individual doesn't mean it'll work for you. And vice versa. Besides, everyone has different goals we want to achieve, like all of us here.What do you call someone who can't stick with a meal plan? A deserter. ProteinFatCarbohydratePaleo Meal HighModerateLow-ModerateKetogenic Meal planModerateHighLowMediterranean Meal planModerateModerate-HighModerate-High Conclusion: Now we conclude our episode number 92 “Paleo vs Keto vs Mediterranean.” The take-home messages are: Paleo is a style of eating that encourages unprocessed foods, mainly lean meats, fruits and vegetables in their natural state; Keto consists of eating less than 50 carbs a day and encourages high-fat foods; and the Mediterranean plan promotes good quality fats from vegetable sources, moderate protein and low to moderate carbs. These meal plans have a main goal in common: help your patients lose weight, improve their overall health, and decrease mortality. Even without trying, every night you go to bed being a little wiser.This week we thank Hector Arreaza, Sapna Patel, Danish Khalid, and Shantal Urrutia. Audio edition: Suraj Amrutia. Thanks for listening to Rio Bravo qWeek Podcast. If you have any feedback, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Weight Loss Industry Analysis 2020, Cost & Trends, franchisehelp.com, https://www.franchisehelp.com/industry-reports/weight-loss-industry-analysis-2020-cost-trends/. Accessed on May 2, 2022. Masood W, Annamaraju P, Uppaluri KR. Ketogenic Diet. [Updated 2021 Nov 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.Taylor B, Rachel M, Adrien B, et al. The Paleo Diet For Health Professionals. In: University of California, Davis - Nutrition. 2018.Miguel A. Martínez-González, Alfredo Gea and Miguel Ruiz-Canela, originally published on 28 Feb 2019, https://doi.org/10.1161/CIRCRESAHA.118.313348. Circulation Research. 2019;124:779–798.Gerber, M., & Hoffman, R. (2015). The Mediterranean diet: Health, science and society. British Journal of Nutrition, 113(S2), S4-S10. doi:10.1017/S0007114514003912. Colditz, Graham A. “ Healthy Diet in Adults.” UpToDate, 11 Dec 2019, https://www.uptodate.com/contents/healthy-diet-in-adults.Fitó M, Guxens M, Corella D, Sáez G, Estruch R, de la Torre R, Francés F, Cabezas C, López-Sabater MDC, Marrugat J, García-Arellano A, Arós F, Ruiz-Gutierrez V, Ros E, Salas-Salvadó J, Fiol M, Solá R, Covas MI; PREDIMED Study Investigators. Effect of a traditional Mediterranean diet on lipoprotein oxidation: a randomized controlled trial. Arch Intern Med. 2007 Jun 11;167(11):1195-1203. doi: 10.1001/archinte.167.11.1195. PMID: 17563030.
Los frutos secos siempre han tenido "mala prensa" cuando lo que pretendemos es perder peso. Un estudio reciente rompe con este mito y habla de su consumo diario. Aclaramos dudas con el doctor Jordi Salas, investigador de Ciberobn y coordinador del proyecto Predimed+. See omnystudio.com/listener for privacy information.
Los frutos secos siempre han tenido "mala prensa" cuando lo que pretendemos es perder peso. Un estudio reciente rompe con este mito y habla de su consumo diario. Aclaramos dudas con el doctor Jordi Salas, investigador de Ciberobn y coordinador del proyecto Predimed+. See omnystudio.com/listener for privacy information.
El Dr. Miguel Ángel Martínez-González lleva más de 30 años investigando la relación entre nutrición y salud y ha liderado el mayor estudio realizado hasta ahora sobre los beneficios de la dieta mediterránea en la salud, el Predimed. Es epidemiólogo y Catedrático de Salud Pública de la Universidad de Navarra, y también catedrático visitante en Harvard, desde donde ha realizado diversas investigaciones y ha contribuido a importantes asesoramientos en diversos programas para la mejora de las políticas de salud pública y alimentación. Por toda esta importante contribución, el Dr. Miguel Ángel Martínez-González, ha recibido el Premio Instituto Danone a la Trayectoria Científica en Alimentación, Nutrición y Salud. En el Podcast hablamos de alimentación, y una de sus publicacions el libro ¿Qué Comes? Ciencia y consciencia para resistir, escrito junto a Marisol Guisasola.@conbdesalud @dra.nuriaroure @marivichacon
Gary Null Show Notes 02/08/21 CDC: Over 500 Deaths Now Following mRNA Experimental Injections – “Vaccine Hesitancy” Increasing Invasive Insects and Diseases Are Killing Our Forests How ExxonMobil Uses Divide and Rule to Get Its Way in South America How the Pandemic Left the $25 Billion Hudson Yards Eerily Deserted Bayer makes new $2 billion plan to head off future Roundup cancer claims Billionaire capitalists are designing humanity’s future. Don’t let them Citizen scientists are filling research gaps created by the pandemic After COVID, Davos Moves to The “Great Reset” COVID-19: Here’s why global travel is unlikely to resume ‘till 2024 The Acute and Chronic Cognitive Effects of a Sage Extract: A Randomized, Placebo Controlled Study in Healthy Humans Northumbria University (UK), January 31, 2021 The sage (Salvia) plant contains a host of terpenes and phenolics which interact with mechanisms pertinent to brain function and improve aspects of cognitive performance. However, previous studies in humans have looked at these phytochemicals in isolation and following acute consumption only. A preclinical in vivo study in rodents, however, has demonstrated improved cognitive outcomes following 2-week consumption of CogniviaTM, a proprietary extract of both Salvia officinalis polyphenols and Salvia lavandulaefolia terpenoids, suggesting that a combination of phytochemicals from sage might be more efficacious over a longer period of time. The current study investigated the impact of this sage combination on cognitive functions in humans with acute and chronic outcomes. Participants (n = 94, 25 M, 69 F, 30–60 years old) took part in this randomised, double-blind, placebo-controlled, parallel groups design where a comprehensive array of cognitions were assessed 120- and 240-min post-dose acutely and following 29-day supplementation with either 600 mg of the sage combination or placebo. A consistent, significant benefit of the sage combination was observed throughout working memory and accuracy task outcome measures (specifically on the Corsi Blocks, Numeric Working Memory, and Name to Face Recall tasks) both acutely (i.e., changes within day 1 and day 29) and chronically (i.e., changes between day 1 to day 29). These results fall slightly outside of those reported previously with single Salvia administration, and therefore, a follow-up study with the single and combined extracts is required to confirm how these effects differ within the same cohort. In conclusion, we have observed a consistent significant benefit of a sage combination intervention in healthy adult humans on working memory and accuracy of performance cognitive domains. This significant activity was observed both acutely (after just 2 h following consumption) and chronically (after 29 days of administration). The pattern and magnitude of significance points towards an increase in product efficacy over the administration period and, taken together, suggests that future trials should focus on disentangling the working and spatial memory effects of this intervention in humans with an extended timeframe of perhaps several months. Validating the CaMKII mechanism in humans would also be advantageous. Blink! The link between aerobic fitness and cognition University of Tsukuba (Japan), February 3, 2021 Although exercise is known to enhance cognitive function and improve mental health, the neurological mechanisms of this link are unknown. Now, researchers from Japan have found evidence of the missing link between aerobic fitness and cognitive function. In a study published in Medicine & Science in Sports & Exercise, researchers from the University of Tsukuba revealed that spontaneous eye blink rate (sEBR), which reflects activity of the dopamine system, could be used to understand the connection between cognitive function and aerobic fitness. The dopaminergic system is known to be involved in physical activity and exercise, and previous researchers have proposed that exercise-induced changes in cognitive function might be mediated by activity in the dopaminergic system. However, a marker of activity in this system was needed to test this hypothesis, something the researchers at the University of Tsukuba aimed to address. “The dopaminergic system is associated with both executive function and motivated behavior, including physical activity,” says first author of the study Ryuta Kuwamizu. “We used sEBR as a non-invasive measure of dopaminergic system function to test whether it could be the missing link between aerobic fitness and cognitive function.” To do this, the researchers asked healthy participants to undergo a measure of sEBR, a test of cognitive function, and an aerobic fitness test. They also measured brain activity during the cognitive task using functional near-infrared spectroscopy. “As expected, we found significant correlations between aerobic fitness, cognitive function, and sEBR,” explains Professor Hideaki Soya, senior author. “When we examined these relationships further, we found that the connection between higher aerobic fitness and enhanced cognitive function was mediated in part by dopaminergic regulation.” Furthermore, activity in the left dorsolateral prefrontal cortex (l-DLPFC) during the cognitive task was the same or lower in participants with higher sEBR compared with lower sEBR, even though those with higher sEBR appeared to have greater executive function, and thus higher neural efficiency. “Although previous studies have indicated that aerobic fitness and cognitive function are correlated, this is the first to provide a neuromodulatory basis for this connection in humans. Our data indicate that dopamine has an essential role in linking aerobic fitness and cognition,” says first author Kuwamizu. Given that neural efficiency in the l-DLPFC is a known characteristic of the dopaminergic system that has been observed in individuals with higher fitness and executive function, it is possible that neural efficiency in this region partially mediates the association between aerobic fitness and executive function. Furthermore, physical inactivity may be related to dopaminergic dysfunction. This information provides new directions for research regarding how fitness affects the brain, which may lead to improved exercise regimens. For instance, exercise that specifically focuses on improving dopaminergic function may particularly boost motivation, mood, and mental function. Vegan diet better for weight loss and cholesterol control than Mediterranean diet Physicians Committee for Responsible Medicine, February 5, 2021 A vegan diet is more effective for weight loss than a Mediterranean diet, according to a groundbreaking new study that compared the diets head to head. The randomized crossover trial, which was published in the Journal of the American College of Nutrition, found that a low-fat vegan diet has better outcomes for weight, body composition, insulin sensitivity, and cholesterol levels, compared with a Mediterranean diet. The study randomly assigned participants–who were overweight and had no history of diabetes–to a vegan diet or a Mediterranean diet in a 1:1 ratio. For 16 weeks, half of the participants started with a low-fat vegan diet that eliminated animal products and focused on fruits, vegetables, whole grains, and legumes. The other half started with the Mediterranean diet, which followed the PREDIMED protocol, which focuses on fruits, vegetables, legumes, fish, low-fat dairy, and extra virgin olive oil, while limiting or avoiding red meat and saturated fats. Neither group had a calorie limit, and participants did not change exercise or medication routines, unless directed by their personal doctors. As part of the crossover design, participants then went back to their baseline diets for a four-week washout period before switching to the opposite group for an additional 16 weeks. The study found that within 16 weeks on each diet: Participants lost an average of 6 kilograms (or about 13 pounds) on the vegan diet, compared with no mean change on the Mediterranean diet. Participants lost 3.4 kg (about 7.5 pounds) more fat mass on the vegan diet. Participants saw a greater reduction in visceral fat by 315 cm3 on the vegan diet. The vegan diet decreased total and LDL cholesterol levels by 18.7 mg/dL and 15.3 mg/dL, respectively, while there were no significant cholesterol changes on the Mediterranean diet. Blood pressure decreased on both diets, but more on the Mediterranean diet (6.0 mm Hg, compared to 3.2 mmHg on the vegan diet). “Previous studies have suggested that both Mediterranean and vegan diets improve body weight and cardiometabolic risk factors, but until now, their relative efficacy had not been compared in a randomized trial,” says study author Hana Kahleova, MD, PhD, director of clinical research for the Physicians Committee. “We decided to test the diets head to head and found that a vegan diet is more effective for both improving health markers and boosting weight loss.” The authors note that the vegan diet likely led to weight loss, because it was associated with a reduction in calorie intake, increase in fiber intake, decrease in fat consumption, and decrease in saturated fat consumption. “While many people think of the Mediterranean diet as one of the best ways to lose weight, the diet actually crashed and burned when we put it to the test,” says study author Neal Barnard, MD, president of the Physicians Committee. “In a randomized, controlled trial, the Mediterranean diet caused no weight loss at all. The problem seems to be the inclusion of fatty fish, dairy products, and oils. In contrast, a low-fat vegan diet caused significant and consistent weight loss.” “If your goal is to lose weight or get healthy in 2021, choosing a plant-based diet is a great way to achieve your resolution,” adds Dr. Kahleova. Study finds childhood diet has lifelong impact University of California at Riverside, February 3, 2021 Eating too much fat and sugar as a child can alter your microbiome for life, even if you later learn to eat healthier, a new study in mice suggests. The study by UC Riverside researchers is one of the first to show a significant decrease in the total number and diversity of gut bacteria in mature mice fed an unhealthy diet as juveniles. “We studied mice, but the effect we observed is equivalent to kids having a Western diet, high in fat and sugar and their gut microbiome still being affected up to six years after puberty,” explained UCR evolutionary physiologist Theodore Garland. A paper describing the study has recently been published in the Journal of Experimental Biology. The microbiome refers to all the bacteria as well as fungi, parasites, and viruses that live on and inside a human or animal. Most of these microorganisms are found in the intestines, and most of them are helpful, stimulating the immune system, breaking down food and helping synthesize key vitamins. In a healthy body, there is a balance of pathogenic and beneficial organisms. However, if the balance is disturbed, either through the use of antibiotics, illness, or unhealthy diet, the body could become susceptible to disease. In this study, Garland’s team looked for impacts on the microbiome after dividing their mice into four groups: half fed the standard, ‘healthy’ diet, half fed the less healthy ‘Western’ diet, half with access to a running wheel for exercise, and half without. After three weeks spent on these diets, all mice were returned to a standard diet and no exercise, which is normally how mice are kept in a laboratory. At the 14-week mark, the team examined the diversity and abundance of bacteria in the animals. They found that the quantity of bacteria such as Muribaculum intestinale was significantly reduced in the Western diet group. This type of bacteria is involved in carbohydrate metabolism. Analysis also showed that the gut bacteria are sensitive to the amount of exercise the mice got. Muribaculum bacteria increased in mice fed a standard diet who had access to a running wheel and decreased in mice on a high-fat diet whether they had exercise or not. Researchers believe this species of bacteria, and the family of bacteria that it belongs to, might influence the amount of energy available to its host. Research continues into other functions that this type of bacteria may have. One other effect of note was the increase in a highly similar bacteria species that were enriched after five weeks of treadmill training in a study by other researchers, suggesting that exercise alone may increase its presence. Overall, the UCR researchers found that early-life Western diet had more long-lasting effects on the microbiome than did early-life exercise. Garland’s team would like to repeat this experiment and take samples at additional points in time, to better understand when the changes in mouse microbiomes first appear, and whether they extend into even later phases of life. Regardless of when the effects first appear, however, the researchers say it’s significant that they were observed so long after changing the diet, and then changing it back. The takeaway, Garland said, is essentially, “You are not only what you eat, but what you ate as a child!” Turns Out Maple Syrup Is Anticarcinogenic Kindai University (Japan), February 2, 2021 Darker coloured syrup is suggested as healthier than lightly coloured syrup. Maple syrup is a classic natural sweetener that has been making a comeback recently as an alternative to refined sugar. The syrup is tapped from different species of maple trees, with the Canadian province of Quebec being a top producer. Along with a rich and complex flavor, maple syrup offers an abundance of amino acids, manganese and zinc, as well as phenolic compounds, including lignans and coumarin. A new study called “Inhibitory effect of maple syrup on the cell growth and invasion of human colorectal cancer cells” was guided by Dr. Tetsushi Yamamoto, a molecular and cell biologist from the Faculty of Pharmacy at Kindai University in Osaka, Japan. The research evaluated the effect of three different types of maple syrup. The main objective was to identify if maple syrup could be used as a phytomedicine within cancer treatment. Dr. Yamamoto and his research team classified the different types of maple syrup according to colour, as well as cell proliferation, and migration and invasion capability for colorectal cell cancer (CRC). Results showed that CRC cells administered maple syrup showed lower rates of carcinogenic cells when compared with cells administered only sucrose. Additionally, the study suggests that maple syrup should not only be classified by its sugar content, but also according to its nutritional and physiochemical components. This study showed that maple syrup, particularly when coloured darker, might be suitable as a phytomedicine, which may offer a more gentle alternative to traditional chemotherapy. This outstanding revelation is in contrast to other studies, which support the idea that sugar perpetuates cancer and other chronic diseases. However, this disparity might concern diverse types of sugar, including sucrose, fructose and glucose. Also, sugar behaves differently when consumed in diverse nutritional contexts. In this context, researchers experimented with different sucrose concentrations, ranging from 0.1% to 10%. Results showed that only maple syrup with a 10% concentration of sucrose inhibited colorectal cancer cell growth. The study explained that this is because higher concentrations might have cytotoxic effects due to high osmotic pressure. Brains are more plastic than we thought McGill University, January 31, 2021 Practice might not always make perfect, but it’s essential for learning a sport or a musical instrument. It’s also the basis of brain training, an approach that holds potential as a non-invasive therapy to overcome disabilities caused by neurological disease or trauma. Research at the Montreal Neurological Institute and Hospital of McGill University (The Neuro) has shown just how adaptive the brain can be, knowledge that could one day be applied to recovery from conditions such as stroke. Researchers Dave Liu and Christopher Pack have demonstrated that practice can change the way that the brain uses sensory information. In particular, they showed that, depending on the type of training done beforehand, a part of the brain called the area middle temporal (MT) can be either critical for visual perception, or not important at all. Previous research has shown the area MT is involved in visual motion perception. Damage to area MT causes “motion blindness”, in which patients have clear vision for stationary objects but are unable to see motion. Such deficits are somewhat mysterious, because it is well known that area MT is just one of many brain regions involved in visual motion perception. This suggests that other pathways might be able to compensate in the absence of area MT. Most studies have examined the function of area MT using a task in which subjects view small dots moving across a screen and indicate how they see the dots moving, because this has been proven to activate area MT. To determine how crucial MT really was for this task, Liu and Pack used a simple trick: They replaced the moving dots with moving lines, which are known to stimulate areas outside area MT more effectively. Surprisingly, subjects who practiced this task were able to perceive visual motion perfectly even when area MT was temporarily inactivated. On the other hand, subjects who practiced with moving dots exhibited motion blindness when MT was temporarily deactivated. The motion blindness persisted even when the stimulus was switched back to the moving lines, indicating that the effects of practice were very difficult to undo. Indeed, the effects of practice with the moving dot stimuli were detectable for weeks afterwards. The key lesson for brain training is that small differences in the training regimen can lead to profoundly different changes in the brain. This has potential for future clinical use. Stroke patients, for example, often lose their vision as a result of brain damage caused by lack of blood flow to brain cells. With the correct training stimulus, one day these patients could retrain their brains to use different regions for vision that were not damaged by the stroke. “Years of basic research have given us a fairly detailed picture of the parts of the brain responsible for vision,” says Christopher Pack, the paper’s senior author. “Individual parts of the cortex are exquisitely sensitive to specific visual features – colors, lines, shapes, motion – so it’s exciting that we might be able to build this knowledge into protocols that aim to increase or decrease the involvement of different brain regions in conscious visual perception, according to the needs of the subject. This is something we’re starting to work on now.” Higher Fiber Intake May Improve Lung Function University of Nebraska, January 28, 2021 Eating a fiber-rich diet may help protect you against lung disease, a new study suggests. “Lung disease is an important public health problem, so it’s important to identify modifiable risk factors for prevention,” study author Corrine Hanson, an associate professor of medical nutrition at the University of Nebraska Medical Center, said in a journal news release. “However, beyond smoking very few preventative strategies have been identified. Increasing fiber intake may be a practical and effective way for people to have an impact on their risk of lung disease,” she added. The findings were published recently in the Annals of the American Thoracic Society. Researchers looked at federal government data from almost 2,000 American adults. They were between 40 and 79 years old. The researchers found that 68 percent of those who had the highest fiber consumption (about 18 grams or more daily) had normal lung function compared to 50 percent for those with the lowest fiber intake. And, only 15 percent of those who ate a lot of fiber had airway restriction, but 30 percent of those with the lowest fiber intake did, the study showed. People with the highest fiber consumption also did better on two important breathing tests. They had larger lung capacity and could exhale more air in one second, the study said. Although the study found a link between fiber consumption and better lung health, it wasn’t designed to prove a cause-and-effect relationship. But, if the findings are confirmed in future studies, public health campaigns may one day “target diet and fiber as safe and inexpensive ways of preventing lung disease,” Hanson said. Previous research has suggested a diet high in fiber protects against heart disease and diabetes, and that fiber reduces inflammation in the body, the researchers said.
There’s a common misconception that you need to run expensive advanced biomedical tests to fix your health. Over the years we’ve found just the opposite, that you can learn much of what you need to know from basic blood chemistry. Perhaps the best example is the information gained from a Complete Blood Count (CBC) with Differential. As the most common blood test, it is widely used to assess general health status, screen for disorders, and to evaluate nutritional status. On this podcast, NBT Scientific Director Megan Hall and I are talking about leukocytes, also known as white blood cells (WBCs), as critical elements of the CBC blood test. Megan discusses the various types of leukocytes and what it means when your count is outside the reference range. We talk about what leukocytes tell you about your nutritional status, why some people “never get sick” as well as signs you’ve got chronic inflammation or physiological stress. Megan also discusses how to use this information to determine the next steps in your health journey. Here’s the outline of this interview with Megan Hall: [00:01:04] Forum post: Chronically Low White Blood Cell Count. Get access when you support us on Patreon. [00:01:45] Leukocytes = White Blood Cells (WBCs) found on CBC with differential blood test. [00:02:58] Different types of white blood cells. [00:04:18] Phagocytosis video. [00:06:10] Absolute vs relative counts of WBCs. [00:09:15] Optimal range of WBCs in relation to all-cause mortality. [00:11:25] Baltimore Longitudinal Study on Aging: Ruggiero, Carmelinda, et al. "White blood cell count and mortality in the Baltimore Longitudinal Study of Aging." Journal of the American College of Cardiology 49.18 (2007): 1841-1850. [00:12:57] Study: Shah, Anoop Dinesh, et al. "White cell count in the normal range and short-term and long-term mortality: international comparisons of electronic health record cohorts in England and New Zealand." BMJ open 7.2 (2017): e013100. [00:15:30] bloodsmart.ai. [00:18:00] Why WBCs might be high: Leukocytosis. [00:18:45] Paper: WBCs are predictive of all cause mortality: Crowell, Richard J., and Jonathan M. Samet. "Invited commentary: why does the white blood cell count predict mortality?." American Journal of Epidemiology 142.5 (1995): 499-501. [00:20:00] Podcast: Air Pollution Is a Cause of Endothelial Injury, Systemic Inflammation and Cardiovascular Disease, with Arden Pope, PhD. [00:21:57] Association of leukocytosis with metabolic syndrome; Study: Babio, Nancy, et al. "White blood cell counts as risk markers of developing metabolic syndrome and its components in the PREDIMED study." PloS one 8.3 (2013): e58354. [00:22:15] Megan's outline for this podcast. [00:22:41] What to do if you have elevated WBC counts. [00:22:54] Impact of stress; Studies: 1. Nishitani, Naoko, and Hisataka Sakakibara. "Association of psychological stress response of fatigue with white blood cell count in male daytime workers." Industrial health 52.6 (2014): 531-534. and 2. Jasinska, Anna J., et al. "Immunosuppressive effect and global dysregulation of blood transcriptome in response to psychosocial stress in vervet monkeys (Chlorocebus sabaeus)." Scientific reports 10.1 (2020): 1-12. [00:23:32] Dr. Simon Marshall and Lesley Paterson; Podcast: How to Manage Stress, with Simon Marshall, PhD. [00:24:08] Reasons WBC counts might be low; Leukopenia. [00:27:57] "I never get sick". [00:30:40] What to do if your WBCs are low. [00:30:56] Effects of low energy availability: Studies: 1. Johannsen, Neil M., et al. "Effect of different doses of aerobic exercise on total white blood cell (WBC) and WBC subfraction number in postmenopausal women: results from DREW." PloS one 7.2 (2012): e31319. and 2. Sarin, Heikki V., et al. "Molecular pathways mediating immunosuppression in response to prolonged intensive physical training, low-energy availability, and intensive weight loss." Frontiers in immunology 10 (2019): 907. [00:31:44] Articles by Megan on energy availability and underfueling: 1. Why Your Ketogenic Diet Isn’t Working Part One: Underfueling and Overtraining; 2. How to Prevent Weight Loss (or Gain Muscle) on a Therapeutic Ketogenic Diet; 3. What We Eat and How We Train Part 1: Coach and Ketogenic Diet Researcher, Megan Roberts; 4. How to Carbo Load the Right Way [00:31:52] Podcast: How to Identify and Treat Relative Energy Deficiency in Sport (RED-S), with Nicky Keay. [00:33:03] Ranges may slightly differ by ethnicity; 1. Haddy, Theresa B., Sohail R. Rana, and Oswaldo Castro. "Benign ethnic neutropenia: what is a normal absolute neutrophil count?." Journal of Laboratory and Clinical Medicine 133.1 (1999): 15-22; 2. Palmblad, Jan, and Petter Höglund. "Ethnic benign neutropenia: a phenomenon finds an explanation." Pediatric blood & cancer 65.12 (2018): e27361; 3. Grann, Victor R., et al. "Neutropenia in 6 ethnic groups from the Caribbean and the US." Cancer: Interdisciplinary International Journal of the American Cancer Society 113.4 (2008): 854-860. [00:34:39] Absolute Neutrophil to absolute Lymphocyte Ratio (NLR) as indicator of systemic inflammation; Studies: 1. Gürağaç, Ali, and Zafer Demirer. "The neutrophil-to-lymphocyte ratio in clinical practice." Canadian Urological Association Journal 10.3-4 (2016): 141-2; 2. Fest, Jesse, et al. "The neutrophil-to-lymphocyte ratio is associated with mortality in the general population: The Rotterdam Study." European journal of epidemiology 34.5 (2019): 463-470. [00:36:19] Elevated NLR associated with poor outcomes in COVID-19 patients. Studies: 1. Yang, Ai-Ping, et al. "The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients." International immunopharmacology (2020): 106504; 2. Ciccullo, Arturo, et al. "Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line." International Journal of Antimicrobial Agents (2020); 3. Liu, Jingyuan, et al. "Neutrophil-to-lymphocyte ratio predicts critical illness patients with 2019 coronavirus disease in the early stage." Journal of Translational Medicine 18 (2020): 1-12. [00:37:41] NLR predicts mortality in medical inpatients: Isaac, Vivian, et al. "Elevated neutrophil to lymphocyte ratio predicts mortality in medical inpatients with multiple chronic conditions." Medicine 95.23 (2016). [00:38:21] What to do if NLR is out of range. [00:39:23] NLR on bloodsmart.ai (found on the Marker Detail View page). [00:40:01] NLR as a marker of physiological stress: 1. Onsrud, M., and E. Thorsby. "Influence of in vivo hydrocortisone on some human blood lymphocyte subpopulations: I. Effect on natural killer cell activity." Scandinavian journal of immunology 13.6 (1981): 573-579; 2. PulmCrit: Neutrophil-Lymphocyte Ratio (NLR): Free upgrade to your WBC. [00:41:59] Schedule a 15-minute Starter Session.
PREDIMED is a landmark trial that put the Mediterranean diet firmly on the map for primary prevention of cardiovascular disease. However, the initial publication faced enormous scrutiny that sent team PREDIMED scrambling to retract and revise. Listen in to find out what happened next, and what you need to know about the PREDIMED trial.The PREDIMED trial website can be found here and the revised paper can be found here.Support the show (https://cash.app/$PasstheTurmeric)
IT'S HERE! Learntruehealth.com/homekitchen Use coupon code LTH for the listener discount! Check out IIN and get a free module: LearnTrueHealth.com/coaching Dr. Gundry's site: www.drgundry.com The Plant Paradox https://www.learntruehealth.com/the-plant-paradox-dr-steven-gundry Highlights: Importance of removing lectins from beans Leaky gut causes leaky brain All diseases come from the gut Why nightshades are bad for us Why we should consume olive oil Go-to foods to eat that support our gut Hippocrates mentioned thousands of years ago that all diseases start from the gut. Now we’re finding out that his statement is true based on different researches on health and nutrition. In this episode, Dr. Steven Gundry talks about which foods harm the gut and which foods heal the gut. He also shares why we need to remove lectins from our diet and how we can destroy lectins. Intro: Hello, true health seeker and welcome to another episode of the Learn True Health podcast. I’m so excited you’re here. Today is our interview with Dr. Gundry. He wrote the book The Plant Paradox, and I have to say, it was quite controversial. I know you’re going to love today’s interview. Dr. Gundry talks about removing anti-nutrients from your diet. If you, as you listen, want to learn how to do that, come join the Learn True Health Home Kitchen. Go to learntruehealth.com/homekitchen. I’ve been filming for several months. There are many videos in there, and I teach you how to remove these anti-nutrients from your diet—the oxalates, the lectin, the gluten, and how to eat a whole foods diet filled with nutrient-dense foods that heal the gut, prevent heart disease, reverse disease, and nutrify the body. Go to learntruehealth.com/homekitchen, sign up, and start cooking food that heals the body. Awesome. Thank you so much for being a listener. Thank you so much for sharing this podcast with those you love. Enjoy today’s interview. [00:01:06] Ashley James: Welcome to the Learn True Health podcast. I’m your host, Ashley James. This is episode 431. I am so excited for today’s guest. We have, this is going to be such an interesting interview, Dr. Steven Gundry. Your book is The Plant Paradox, and from everything I’ve seen, people either love it or hate it. There’s no in-between. I’ve not met someone who’s lukewarm about your book. People are either passionately for what you do or passionately against what you do. I think it’s going to be fun to have you on the show today and share what happened for you to discover and create The Plant Paradox, and how your system is helping people reverse disease and heal their body. Welcome to the show. [00:02:03] Dr. Steven Gundry: Thanks for having me. [00:02:05] Ashley James: Absolutely. I have interviewed several whole food plant-based doctors that reversed disease with plants. They are up in arms about what you do. They say it’s just ridiculous that someone would cut out legumes, beans, and plants that contain lectins. They think that these are very healthy foods. I’d love for you to start by sharing. Obviously, there’s so much controversy around that, especially with doctors who claim that the opposite of what your diet is healthy. How do you handle that kind of criticism? [00:02:50] Dr. Steven Gundry: I just show them the data that I show in my book and it’s subsequently published. There’s actually no getting around the fact that the harm of lectins has been known about for actually well over 100 years. In fact, just to use an example, there are three papers in the literature in monkeys showing that the lectin in peanut oil is a major cause of the hardening of the arteries—of coronary artery disease in monkeys. When you remove that lectin from peanut oil and give it to monkeys they don’t get coronary artery disease. Recently, I published a paper in circulation showing that lectins are a major cause of an autoimmune attack on the inside of blood vessels. That when you remove lectins from human’s diets, that they’re markers for an autoimmune attack on their blood vessels minimizes. We can say I’m telling people falsehoods but in fact, this is all published data that I write about. [00:04:20] Ashley James: How does one go about removing lectins from their diet? [00:04:25] Dr. Steven Gundry: That’s actually pretty easy. Recently, I had, on my podcast, Dr. Joel Fuhrman who actually I am a big fan of. A few years ago, when The Plant Paradox, came out, I believe he was pretty vocal that how dare I take beans away from people. I don’t take beings away from people, I merely ask them to destroy the lectins with the pressure cooker. While I had him on the podcast and we were chatting, it turns out that he actually pressure-cooks his beans. He does not eat his beans unpressured-cooked. Sometimes, the noise gets in the way. I had beans three times last week. Believe me, they were pressure cooked. I have nothing against beans, but we have to know our enemy, and we have to know how the plant decided to protect itself. The good news is, for the most part, you can neutralize the enemy by some simple tricks. [00:05:41] Ashley James: You brought up a really good point that plant protects itself. Explain what lectins are. How does the plant create it, and how does our body react to lectin? [00:05:51] Dr. Steven Gundry: Lectins actually were discovered almost 150 years ago now. We use lectins to blood type. There was a very famous lectin diet, it was well-hidden, called the Blood Type Diet. Lectins are used by plants as a defense mechanism—one of the defense mechanisms—against being eaten and of having their babies—their seeds—from being eaten. Lectins are proteins. They’re what are called sticky proteins because they actually look for sugar molecules to stick to—specific sugar molecules. Those sugar molecules line the inside of our gut, they line the inside of our blood vessels, they line the inside of our joints, and they line the space between our nerves. The theory is if lectins can break through the wall of the gut and they’re very good at this, Dr. Fasano from Johns Hopkins a few years ago proved that gluten, which is a lectin, causes leaky gut by binding to the sugar molecules in the gut and breaking the tight junctions. There’s no question that this happens. Why do they do that? Because quite frankly if you can cause an animal to not feel well, to not thrive, then a smart animal says every time I eat these particular plants or these plant babies I don’t do very well. I think I’ll go eat something else. The animal wins, the plant wins, and everybody’s happy. Then humans arrived. As most of us know, we’re not very smart. When we eat something that bothers us, let me give you an example, heartburn is caused by lectins. Instead of avoiding lectin-containing foods, like for instance, a hot pepper, which is loaded with lectins, we instead take Prilosec or Nexium and we keep eating these things. That’s really dumb because, actually, there’s a beautiful paper in humans that shows that in normal human beings who were asked to take one of these proton pump inhibitors for one week—one week only—they had dramatic changes in their ability to remember things, process—one week. I can’t believe Larry the Cable Guy thinks that not being very smart is worth a corndog. [00:09:03] Ashley James: How do lectins cause heartburn? [00:09:05] Dr. Steven Gundry: Lectins actually break down the mucus lining, that mucus is a mucopolysaccharide—a sugar molecule, and exposes the covering of our esophagus. The mucus is used up by a lectin attack and then the acid irritates it. I used to have horrible heartburn. I used to eat Tum’s left, right, and every day. I haven’t had heartburn in 20 years now. [00:09:36] Ashley James: Amazing. Tell us a little bit about your story. Your background is so extensive. Reading your biography, it’s amazing what you’ve accomplished through the years and what you have given to the medical space. You have helped so many children and so many cardiac patients around the world, but you yourself had health issues. You uncovered this particular way of eating to heal yourself. Tell us a bit about your personal journey with recovering your health. [00:10:15] Dr. Steven Gundry: I was a very famous heart surgeon, children’s heart surgeon, and transplant surgeon. Very famous for inventing devices to protect the heart during heart surgery, but I was 70 pounds overweight despite running 30 miles a week, going to the gym one hour a day, and eating a healthy low-fat, primarily, vegetarian diet. I had high cholesterol, pre-diabetes, and arthritis. I used to operate with migraine headaches doing baby heart transplants, I don’t recommend it, but somebody had to do it. I thought this was normal because I was assured it was normal because my father was very much the same way. It wasn’t until I met a fellow I described in my books by the name of Big Ed from Miami Florida who in six months’ time following a diet, very much like what I described and taking a bunch of supplements from a health food store, he cleaned out 50% of the blockages in his coronary arteries in six months’ time. He had inoperable coronary artery disease. I was totally shocked that that could happen. I was taught, as most doctors are taught, that coronary heart disease is progressive. Yes, we could maybe slow it down, but eventually, it’s going to get you. To watch an individual—now many individuals—reverse coronary artery disease with food and supplements changed my life. I was ready to discover this. Believe it or not, as an undergraduate at Yale, I had a special major in human evolutionary biology—basically epigenomics. I had a big thesis that my parents had. I’m actually staring at it in my bookcase right now. I actually put myself on my thesis and I lost 50 pounds in my first year, another 20, and kept it off for over 20 years. I started treating patients that I operated on with my program to try and keep them from visiting me again. Lo and behold, not only did they not visit me again, but their diabetes went away, their arthritis went away, their high blood pressure went away, and their autoimmune diseases went away. That’s what I’ve been doing for the last 20 years. [00:13:10] Ashley James: I love it. Lectins, are they proteins? [00:13:15] Dr. Steven Gundry: Yes, they’re proteins. [00:13:16] Ashley James: They’re proteins. Everyone’s heard of gluten at this point. I’ve been gluten-free since 2011. So many people have heard that gluten can cause leaky gut. There’s also this new thing that we’re hearing about called leaky brain. Have you heard of this? [00:13:37] Dr. Steven Gundry: Have I heard? What do you mean? I’ve been studying and writing about it. [00:13:40] Ashley James: Tell us more about leaky brain. [00:13:43] Dr. Steven Gundry: It turns out, there is an incredible gut-brain connection that is being elucidated, actually, with every passing day. I wrote quite a bit about it in The Longevity Paradox but my next book, which is entitled The Energy Paradox, gets even more into that. What we found, we now have some pretty nice sophisticated tests that look at the breakdown of the blood-brain barrier. The blood-brain barrier is basically a barrier that keeps everything out of the brain. For instance, if you had a malignant brain tumor, we can’t give you chemotherapy by swallowing it or through your veins because the chemotherapy won’t get past the blood-brain barrier. We actually have to inject chemotherapy into your spinal fluid. That’s how impenetrable the blood-brain barrier is. In people with leaky gut, a great number of people actually have a breakdown of that blood-brain barrier. There is more and more and more evidence that conditions like Parkinson’s, like Alzheimer’s, and like plain old everyday dementia is in large part coming from leaky gut and causing leaky brain. You don’t have to look very far to realize we have an epidemic of dementia, and we have an epidemic of leaky gut. In fact, this certainly was known for a very long time. Hippocrates 2,500 years ago, the father of medicine, said all disease begins in the gut. He didn’t have a human microbiome project, but he knew this. The fascinating thing he was absolutely right. All disease does begin in the gut, and the good news is, all disease can be reversed by reversing leaky gut. [00:16:03] Ashley James: How do we heal the barrier for our brain? How do we heal leaky brain? By focusing on the gut? [00:16:11] Dr. Steven Gundry: Correct. Leaky brain comes from leaky gut, not the other way around. [00:16:15] Ashley James: Got it. How do we heal the gut? Is it as simple as removing lectins from our diet? [00:16:20] Dr. Steven Gundry: It’s not as simple as that. For instance, I just gave a paper at the American Heart Association Lifestyle and Epidemiology meeting in March where we looked at people who were gluten intolerant, who did react to gluten. These people were gluten-free and yet they still had leaky gut. We found that 70% of people who are gluten-sensitive also react to corn vigorously. Sadly, most gluten-free products have corn in them. We also found that in this report, taking away other major lectin-containing foods like brown rice, like peas for instance, like legumes, like the nightshade family—tomatoes, peppers, eggplants, and potatoes—then and only then did these people stop their leaky gut. It was not only just being gluten-free, but it was also actually being lectin-free. In fact, as I wrote about The Plant Paradox, you can take people with celiac disease, which is the extreme form of gluten intolerance, and you can put them on a gluten-free diet for a year and a half and 70% of those people on a gluten-free diet will still have celiac disease by biopsy, which is the gold standard, even though they’re on a gluten-free diet. My premise is it’s because most of the gluten-free foods that they’re eating have lectins other than gluten. This is what I just showed in that paper I gave in March. [00:18:11] Ashley James: So many people who are gluten-free don’t avoid oats and oats getting gliadin, which is such a similar protein. I always tell people to try to avoid oats and then try to avoid them for a month. Avoid them for a month and then add them back and see what happens. Very quickly people notice a difference once they’ve been abstinent from it. [00:18:31] Dr. Steven Gundry: Yeah, there’s no such thing as gluten-free oats because you’re right, they could cause reactivity of those proteins. As my daughter who’s a horsewoman always reminds me, the only purpose of oats is to fatten a horse for winter. [00:18:50] Ashley James: Wow. That’s interesting. It reminds me of looking into the idea of eating chicken. People who want to bulk up at the gym are told to eat chicken. People who want to lose weight are told to eat chicken. That’s paradoxical in and of itself. It’s like wait a second, one person wants to bulk up and they’re told eat a bunch of chicken like the bodybuilders, and then people who are on Weight Watchers and stuff are told to just eat chicken, it’ll help you lose weight. But it doesn’t. That’s a paradox. There are foods that people think are really healthy, but they have to look deeper like you do. What about resistant starch? So many of these foods you’ve mentioned, which contain lectins, are also full of resistant starch, which helps to feed the good gut bacteria. This is the paradox. It’s something that could help us but also is harming us at the same time? [00:19:45] Dr. Steven Gundry: The good news with most of these resistant starches is that you can destroy lectins with the pressure cooker. The only lectin that has not been capable of being destroyed is gluten. You can pressure cook gluten for an hour, two hours and it will not break. All the other lectins, in general, will break. Oats is also a problem. We’ve had a number of people try it and it won’t work, but there are two grains that don’t have lectins because they don’t have hulls and that’s sorghum and millet. I have a lot of sorghum of millet recipes. The other great news is that the best resistant starches are tubers like sweet potatoes, taro root, yucca, or green bananas. They’re fantastic sources of resistant starches, and they don’t have any lectins in them. [00:20:47] Ashley James: I noticed that you didn’t mention any nightshades. What are nightshades, and why are they so bad for us? [00:20:55] Dr. Steven Gundry: Two reasons, the nightshade family that we think of have pretty impressive lectins in their peel and their seeds, the flesh doesn’t. Traditional cultures have always peeled and deseeded tomatoes or peppers before they eat them. The nightshade family came from America and, believe it or not, even goji berries are nightshades. They actually came from America and were taken to China and trade. They were called wolfberries in America. Even goji berries are pretty nasty little lectin sources. If you go over to Italy and talk to chefs, which I do all the time, they will tell you that you cannot make tomato sauce without peeling and deseeding your tomatoes. If you go talk to the Southwest American Indians, you know that you have to peel and deseed peppers before you eat them or grind them in chili powder. In fact, what’s really hilarious, is those chili pepper flakes and seeds that we put on our pizzas we’re actually the byproduct of making peppers safe to eat. [00:22:14] Ashley James: Oh my gosh. [00:22:15] Dr. Steven Gundry: Oh, yeah. That’s why they exist because they were thrown away. [00:22:19] Ashley James: That’s so funny. What about peeling a potato, just a regular Yukon potato, would that make it safe? [00:22:27] Dr. Steven Gundry: Yeah but there has recently been discovered a new class of lectins, which are called aquaporins. There is an aquaporin in potatoes, there is an aquaporin in green bell peppers, there’s an aquaporin believe it or not in spinach. I have, sad to say, a number of, particularly, women who have autoimmune diseases and leaky gut who we’ve been befuddled as to why they get better but not all the way. These women, for the most part, react to the aquaporin lectin in spinach. When we take their spinach way, and they’re usually big spinach eaters, they finally get better. Why haven’t I had a podcast on that? Because I don’t want to have mass panic. Most people don’t react to the aquaporin in spinach, but those that do it’s pretty impressive. [00:23:34] Ashley James: It’s like if you’ve tried everything and it’s not working, try this one thing, but not everyone. Does aquaporin become destroyed by pressure cooking it? [00:23:47] Dr. Steven Gundry: Probably, nobody has actually done the experiment but I do have people that eat potatoes and I do ask them to pressure-cook it. So far so good. [00:24:00] Ashley James: Because they’re discovering new lectins, what can we do to stay on top of this information? Is your book updated? Does your book have the aquaporin information in it, or should they follow your podcast? What’s the best way to make sure we stay on top of this information? [00:24:21] Dr. Steven Gundry: My podcast covers these subjects. For instance, between my Plant Paradox book and The Plant Paradox Cookbook, it was discovered that pecans have a lectin that in some people it actually causes an autoimmune attack on the pancreas. We put that into The Plant Paradox Cookbook that probably pecans are not your best not to eat, particularly if you have an autoimmune disease or if there’s any question of diabetes. [00:25:03] Ashley James: Are there any nuts or seeds that are safe? [00:25:07] Dr. Steven Gundry: Oh, yeah. For instance, walnuts are quite safe, pistachios are safe, macadamia nuts are safe, for the most part, hazelnuts are safe, and Brazil nuts are safe. You notice I’m not mentioning almonds. There is a lectin in the peel of almonds that a number of my patients with rheumatoid arthritis react to. That’s why we recommend either blanched almond flour and/or Marcona almonds—the peeled almonds. Again, it’s very interesting that there are a number of cultures, particularly Spain and Portugal, where the mothers teach the daughters how to soak and peel almonds before they’re eaten. Again, you start looking at cultures and say why do they do this? Because it’s kind of a lot of work. Why not just eat the skin? [00:26:13] Ashley James: When I was six years old my mom took me to a Naturopath. He put us on a specific diet, and it turned out that Naturopath was Dr. D’Adamo. I grew up on the O blood type diet. It changed my life. I was very sick. I was just sick all the time, and my mom was sick too. He had a practice in Toronto. Overnight, my life changed. It was phenomenal. One day I was sick, the next day I was healthy. That’s how quick it was shifting my diet to the O blood type diet. Then, of course, when I was 13 I got incredibly rebellious and started eating everything my mom didn’t want me to eat. I got to develop sickness again. Then through my 20s, I was very sick, and in my late 20s and through my 30s I spent trying to get my health back and reversing all the diseases I gave myself by eating the wrong foods. I’ve lived this several times. Eat the wrong foods, get sick. Eat the right foods, get healthy. The waters can be muddy for many of us especially those with autoimmune because, like you said, some people react to this but not to this, some people react to this, not to this. Where do we start? Should one do an elimination diet? What’s a good place to start? Because not everyone reacts to all the lectins like you mentioned. [00:27:41] Dr. Steven Gundry: I’ve published a paper of 102 people with biomarker-proven autoimmune diseases whether they’re lupus, rheumatoid arthritis, Crohn’s, ulcerative colitis, or MS who were put on my program for six months. At the end of six months, 95 out of 102 or 94% were biomarker negative and off of all immunosuppressive drugs. That’s not a bad result. My first principle, The Plant Paradox, is it’s not what I tell you to eat that matters, it’s what I tell you not to eat. It really is. That’s an elimination diet. Interestingly enough, the carnivore folks, have taken my recommendations to the extreme. Since all plants are out to get us one way or another, that total elimination of plants is a rather impressive elimination diet. I happen to think that they’re going to be sadly mistaken because there are some really great things, particularly the soluble fibers in plants that our gut microbiome is dependent on. As people found in The Longevity Paradox, and they’re going to learn more in The Energy Paradox, we are absolutely positively dependent on messages and transmitters that our gut microbiome makes that keeps our mitochondria working properly, that keeps our brain working properly. Taking away the known causes of leaky gut, and that includes more than just changing the type of plants you eat. It’s primarily trying to eliminate, for the most part, antibiotic overuse, which is rampant, not only in us but in the animals that we eat. Eliminating the non-steroidal anti-inflammatories like ibuprofen for instance like Naprosyn. One ibuprofen is literally like swallowing a hand grenade. Eliminating the antacid drugs like the proton pump inhibitors like we mentioned earlier. They totally changed the bacterial flora. Eliminating artificial sweeteners like Splenda, just as an example, completely changes your gut bacteria. Something that many of us are passionate about trying to get glyphosate roundup out of our lives. It’s probably not doable, but glyphosate is a major disruptor by itself of our gut ball—really good at causing leaky gut. [00:30:59] Ashley James: You said that ibuprofen is like swallowing a grenade. Can you elaborate on that? [00:31:06] Dr. Steven Gundry: I could give you an hour lecture. Long ago, the original nonsteroidal anti-inflammatory was aspirin. Aspirin was used extensively in our arthritis and rheumatoid arthritis. Of course, people know that it cause stomach bleeding. A class of drugs in the same family were developed that wouldn’t cause stomach bleeding, but the drug companies knew that the bleeding wouldn’t actually be caused in the small intestine. You couldn’t see down into the small intestine with gastroscope so you would never know it was there. Believe it or not, when these drugs came out, they were prescription only. Things like Motrin was a prescription, things like Naprosyn was a prescription. There was an FDA black box warning that you could only use these for two weeks at a time because they were so dangerous. Now, of course, they are the largest over-the-counter drug there is. There is children’s Advil for instance. What these do, and this is documented and google it sometimes, great fun. These are drug company research that shows that these destroy the lining of the small intestine causing leaky gut. I can’t tell you the number of people that I see, young women and men who were athletes, who suffered an injury and were put on high-dose non-steroidal anti-inflammatories by very well-meaning orthopedic surgeons, and they, in turn, developed autoimmune diseases. I write about some of them in my books. When we stopped these medications and sealed their gut, lo and behold, their autoimmune disease went away. [00:33:07] Ashley James: How quickly can one recover their gut? How quickly does it take to seal the gut once they have eliminated the foods that have been causing holes in it? [00:33:22] Dr. Steven Gundry: Great question. We’ve seen it turn around as early as three months. One of my more troublesome patients with multiple autoimmune diseases all her life took about nine months, but there are other things that are part and partial with healing the gut. The vast majority of people have very low vitamin D levels. As I write about in The Longevity Paradox, vitamin D is essential to tell stem cells that help repopulate the gut to grow and divide. Without vitamin D, they just kind of sit there and twiddle their thumbs. The vast majority of people I see with autoimmune disease and/or leaky gut, they have very low vitamin Ds when I see them. I’ll give you an example of a woman I just saw today from Southern California. She’s in her 40s. She developed ulcerative colitis five years ago, out of the blue. We think we know why but she was put on an immunosuppressant and then came to see us a year ago. She was positive for antinuclear antibody, which is an autoimmune disease marker that most people associate with lupus—very positive form. She had a very low vitamin D. We’ve now been seeing her for a year. She stopped her immunosuppressant a year ago. She’s had no episodes of ulcerative colitis since. She is negative for antinuclear antibody and has been actually since we started the program. She’s a pretty happy camper. [00:35:28] Ashley James: I love it. The idea, for those suffering from autoimmune, that they can completely go into remission—I mean, that’s a dream come true. There are so many people suffering. They’re told by the average doctor that they’re going to be on medication for the rest of their life and this is their new norm. It’s so frustrating that so many doctors are still in this old way of thinking that once you’re in a diseased state you’re going to always be in the diseased state. They don’t look to nurturing the body through food and shifting diet and lifestyle to heal the body. You must be really waking a lot of doctors up showing them that there’s a way to heal. You’ve obviously published so many articles on helping people to reverse autoimmune. Are you starting to see that doctors are listening and prescribing your diet? [00:36:29] Dr. Steven Gundry: Particularly in functional medicine, I don’t do functional medicine, I do what I call a restorative medicine. I’m not quite sure what functional medicine means. I have good friends like Mark Hyman and Jeffrey Bland in functional medicine, and that’s fine. But I think there are more and more people interested in the fact that Hippocrates was right. That all disease comes from the gut, and that we really ought to be looking at the gut as to where we need to do our work. Somebody tell Kelly Clarkson that you can’t reverse Hashimoto’s thyroiditis. Kelly found my book. She had Hashimoto’s thyroiditis, she was on thyroid medication, now she doesn’t have Hashimoto’s thyroiditis, and she’s off of medication. Her doctors told her hey, you’re going to be on thyroid for the rest of your life. [00:37:35] Ashley James: I love it. I love hearing stories of success of people being able to reverse diseases and get off of medications. [00:37:44] Dr. Steven Gundry: I’ll tell you another funny Hashimoto’s story. Usually, we’re so busy that the first visit in our office they see my PA and then the next visit they see me. That’s usually three months or six months after the first visit, depending on the severity. I’m seeing a woman in her late 50s for the first time after she had seen my PA. I say, “Why’d you come here? She said, “Well, I have Hashimoto’s thyroiditis.” I said, “Oh is that a fact?” She said, “Yes, I’ve had it all my life.” I had seen her new results and when we first saw her she in fact did have both markers for anti-thyroid antibodies and Hashimoto’s. This time they were negative and I said, “Well, that’s interesting you should say that because you don’t have Hashimoto’s.” She said, “What kind of quack are you? Of course, I have Hashimoto’s that’s why I’m here.” I said, “Well, yeah. You used to Hashimoto’s but you don’t now.” I flipped her lab results open and she said, “Oh my God. It is true. You can get rid of this.” I said, “Yeah, look at that.” [00:38:59] Ashley James: I love it. Once her antibodies go down do the hormones restore themselves? I know of some people who have completely eliminated—the antibodies are virtually non-existent in their labs but their thyroid is still not functioning optimally. Are the lectins causing harm still to their thyroid levels? [00:39:24] Dr. Steven Gundry: A lot of times, people who have had it for a long time, they’re immune system has destroyed—their thyroid gland. For instance, type 1 diabetes, the immune system destroys the beta cells in the pancreas. But having said that, we always, once we get these antibodies turned off, start weaning off thyroid medication. We actually just started this weekend with a woman from San Francisco, a fairly young woman, who we now have negative for anti-thyroid antibodies and we’re starting to wean her thyroid know, and we’ll see. The good news about thyroid medication is that you can take both T4 and T3 and do a good job of replacing what the thyroid does, but that doesn’t mean we should actively allow Hashimoto’s thyroiditis to continue. Because one of the things that got me interested in this in the first place is this autoimmune attack takes many forms, and you could have multiple autoimmune diseases at the same time. Recently, there’s increasing evidence that Parkinson’s disease is actually an autoimmune disease, which to me makes a great deal of sense since I and others are convinced that Parkinson’s disease comes from the gut, not from the brain. [00:41:05] Ashley James: Fascinating. I have heard there’s a relationship between MS and Parkinson’s and MS is autoimmune, so that doesn’t surprise me. Have you seen someone reverse Parkinson’s through healing their gut? [00:41:19] Dr. Steven Gundry: We’ve seen it stop. My father had Parkinson’s for 20 years without changing his medication at all. If you know anything about Parkinson’s that’s impossible, but we got to him early. My mother was a very good person about denying him the foods that he loved. He made it to 91 and then actually died suddenly of a bladder infection. Getting to 91, 20 years with Parkinson’s pretty doggone good run. [00:42:01] Ashley James: Very cool. We’ve talked about gluten and lectins, are phytates or phytic acid, I know they’re anti-nutrients, are they also lectins? [00:42:11] Dr. Steven Gundry: No. Again, the plant has lots of tools to prevent itself from being eaten, or to warn the predator that you really don’t want to eat me, or try to make the predator not thrive. Phytates are one of these methods. I actually think and agree with some of my vegan colleagues that there’s a lot to like about phytates, but this is all part of the anti-nutrient system. One of the things that we have to realize, for instance, since lectins are proteins, rats and rodents are primarily grain predators. Rats and rodents have 10 times the amount of proteases that are enzymes that break down proteins than we have. They’re very well equipped to go after these lectin proteins in the food that they eat. When people point out we look at these great rat and mice experiments where whole grains are really good for them. That’s great. They have a great protease system that breaks down these proteins, we don’t. [00:43:50] Ashley James: Are you suggesting that we shouldn’t get our protein primarily from plants? [00:43:58] Dr. Steven Gundry: Oh, no. Are you kidding? I am a plant predator. I tell my patients that we should actually be gorillas who live in Italy. By that I mean we should be eating huge amounts of leaves and pouring olive oil on them. [00:44:21] Ashley James: Very interesting. Why consume olive oil? [00:44:26] Dr. Steven Gundry: Great question. As I wrote in The Longevity Paradox, there are three groups of people who live in blue zones, and blue zones are those areas of the world that Dan Buettner, the journalist, described as having incredible longevity. I’m actually the only nutritionist who has ever spent most of his career living in a blue zone and that was Loma Linda, California where I was a professor. When people talk to me about blue zones and say I don’t know anything about blue zones, I said, “Well, I guess I didn’t live in one for most of my life.” Anyhow, three blue zones use a liter of olive oil per week. That’s about 10 to 12 tablespoons a day. There are some fascinating head-to-head studies done in Spain called the PREDIMED study making 65-year-old people use a liter of olive oil per week versus a low-fat Mediterranean diet. Lo and behold, at the end of five years, people who used the olive oil had actually gained memory compared to when they aged 65, while the low-fat group lost memory, the people in the olive oil group had a reversal of our disease, whereas the low-fat diet group increased their heart disease, and we could go on and on. [00:46:02] Ashley James: Could we gain the same benefit from eating olives instead of drinking or consuming olive oil? [00:46:10] Dr. Steven Gundry: Yeah, and I actually ask people to do both. I actually have a product that I sell that is the combination of incredibly high polyphenol-rich olive oil, olive leaves, and olives that are pressed into little pearls that look like caviar. They’re called polyphenol olive oil pearls. It turns out, interesting fun fact, there are far more polyphenols in the leaves of fruiting plants than there are in the fruit. For instance, there are far more apple polyphenols in apple leaves than in apples, there are far more polyphenols in black raspberry leaves than there are in black raspberries, and so on. [00:47:03] Ashley James: It’s nettle season right now so we can go out in nature and harvest nettles, which the leaves are rich in polyphenols. I learned recently that if you grow sweet potatoes or yams, you can harvest some of the leaves and eat them much like spinach. That is such a delicious thing to grow in your own backyard. I know a lot of people are looking into growing their own food given that they’re all at home and want a new hobby and that they’d like to have some sustainability and have some healthy food. I know you tell us what not to eat, what are some of your go-to foods to eat that are very supportive of our gut and just are very healthy overall? [00:47:51] Dr. Steven Gundry: Great question. Avocados are a great choice to start with. The family of chicories: radicchio, chicory, Belgian endive, and curly endive are some of the best foods you can possibly eat to help your gut buds. Jerusalem artichokes and artichoke hearts are just loaded with a type of sugar molecule that we can’t digest called inulin but our gut buddies think it’s the best food that they could possibly eat. That along with the cruciferous vegetables: broccoli, cauliflower, arugula, bok choy, and Swiss chard. All of these actually have some pretty fascinating compounds that actually tell the immune system in your gut to calm down and relax a little bit. They’re called the AHR receptors if anybody wants to look them up, but pour olive oil on them, please. [00:49:10] Ashley James: Interesting. I think the olive oil thing—it’s so controversial depending on who you talk to. There’s a handful of doctors that say that we shouldn’t consume any oil. That any oil, no matter what kind of oil, even if it’s cold-pressed virgin olive oil, raw cold-pressed coconut oil or all the kind you could buy in the supermarket, that they’re all bad for you and that they cause damage to the endothelial lining of the cardiovascular system. Once the oil is exposed to oxygen, it creates free radicals, so you’re actually absorbing free radicals into the body. What do you say to that? Are the benefits of olive oil outweigh those negatives? [00:50:01] Dr. Steven Gundry: All I say is why don’t you look at the actual human controlled trials where that has been tested, and the results are exactly the opposite. One of the most famous trials was the Lyon Heart trial where they looked at a diet that was supplemented with alpha-linolenic acid oil from purslane and compared that to the low-fat American Heart diet. It was a 5-year study, it was randomized. They stopped the study at three years because the group given the Mediterranean diet with the alpha-linolenic acid oil, and large amounts of it, did so much better in new episodes of MIs and unstable angina that it was not fit to continue the trial. Anybody can look it up—the lean Lyon Heart diet—and anybody can look up the PREDIMED trial and see a head-to-head of high-oil versus no-oil or low-oil and the results always come out that it wins. The olive oil wins, the alpha-linolenic acid wins. People say this becomes rancid. Yeah, olive oil could become rancid. That’s why you want to buy it from a high-volume source, and you want to use it quickly. Interestingly, olive oil is the least capable of oxidizing of any oil. It even beats coconut oil as not being oxidized with cooking. We’ve had two of the world’s oil experts on my podcast and they both confirm that olive oil is the safest cooking oil. People say no, no. It smokes and that means it’s oxidizing. That’s not true at all. It has a low smoke point but smoke has nothing to do with oxidation. People have been cooking with olive oil for over 5,000 years and the results speak for themselves. [00:52:16] Ashley James: I don’t think when you burn olive oil it tastes that good anyway. If I were to eat olive oil, I’d eat it raw anyway. The idea of cooking with oil just concerns me, especially it doesn’t particularly taste good when you burn it. Very, very interesting. Where would one buy oil that is very high quality? Where’s the place to buy oil in the highest quality form? [00:52:45] Dr. Steven Gundry: They can come to my website Gundry MD. We have an olive oil list that has 30 times more polyphenols than any oil that’s ever been tested. Having said that, you’re not all going to come to gundrymd.com. Believe it or not, Costco has an excellent olive oil. It comes in at a tall square bottle. It says Toscana on the label, and I use it as my everyday oil. That’s a good source. There’s another very good company out of California called Bariani. Again, I have no relationship with these companies. They just have a very high-quality oil. There’s a company out of Napa and Sonoma Valley called O, just a big O olive oil company. All small producers, all organic. Those are good choices. [00:53:38] Ashley James: Very cool. You had touched on mitochondria. Obviously, you’re coming out with your book The Energy Paradox. Can you give us a little bit of preview into this book? How does your method help our mitochondrial health? [00:53:55] Dr. Steven Gundry: Well, it turns out, we’ve done just the best job of destroying our mitochondrial function. You couldn’t design a better lifestyle, a better diet than the standard American diet for destroying mitochondria. In the book, I talk about how—and I talked about this actually in The Plant Paradox as well. Mitochondria are the energy-producing organelles in our cells. They’re actually ancient engulfed bacteria. They carry their own DNA, but they are bacteria that live inside our cells. If you think of them as workers on an assembly line, they have periods of time where they’re going to do one shift, but currently, in the United States, we’re asking them to do three shifts with no time off. They actually produce a labor slowdown because they don’t want to work that hard. That labor slowdown is the cause of pre-diabetes, insulin resistance, and cancer. We got to have them have some time off. That’s why fasting, intermittent fasting time, restricted feeding actually gives our workers some much-needed rest and recreation. The more we do that the more work they’re able to do for us and do it better. That’s a little teaser. [00:55:52] Ashley James: I am such a big fan of fasting, and I love that you brought that up. Since mitochondria are bacteria, when we take antibiotics, do antibiotics harm our mitochondria? [00:56:11] Dr. Steven Gundry: Indirectly because it turns out, as I write about in The Longevity Paradox, that the bacteria in our gut actually talk to their sisters in the cells. They actually tell the mitochondria how things are going in the outside world. The more diverse those bacteria are and the happier those bacteria are, then the better the mitochondria function. We used to conjecture that there were text messages that we hadn’t been able to measure, but they had to be there. It turns out, we’ve discovered a large number of those text messages—they are real things that we can measure. The book is about we ought to have a diverse group of bacteria in our gut, we ought to give them what they want to eat, and they need to tell their mind everything’s great. [00:57:21] Ashley James: Since researching and writing The Energy Paradox, what changes have you made to your lifestyle or diet? [00:57:31] Dr. Steven Gundry: Actually not a whole lot because The Energy Paradox is where The Longevity Paradox would naturally take me. If you actually look at the people who enter my office, fascinatingly, fatigue is one of the biggest complaints. At least 50% of the people I see are fatigued for apparent no reason. The Energy Paradox grew out of that. Believe it or not, there are really good reasons why most normal people are fatigued. [00:58:25] Ashley James: Since the last few months have been really crazy with the COVID-19, have you done anything to change your lifestyle or diet to give extra support to your immune function? [00:58:41] Dr. Steven Gundry: As most people know, I’m a huge fan of vitamin D. I’ve never seen vitamin D toxicity, neither is my friend Dr. Mark Hyman. There are now four human papers showing that people with low vitamin D are much more susceptible to the COVID-19 virus and are likely to do poorly with it—that is die. Whereas if you have an adequate or high vitamin D level, you’re much likely not to contract it and/or much likely not to die. That’s number one. Number two, sugar dramatically suppresses our white cells’ ability to engulf bacteria and viruses. I’m releasing a podcast about that. The less sugar or things that we turn into sugar the better. What’s really fascinating is a paper from 1973 showed that white blood cell function dramatically increased daily during five-day water fast and that the longer you fast the better your white blood cells work and aggressively ate bacteria and viruses. Additionally, that same study showed that even orange juice, even fructose would dramatically suppress your white cells ability to engulf bacteria for up to six hours after you had that beverage—even orange juice. The idea that drinking orange juice right now is going to help you fight these viruses is actually exactly wrong. [01:00:35] Ashley James: You said that foods that convert to sugar, which would be plants, would be carbohydrates. Are you saying that we should look at more of a low glycemic diet right now? [01:00:48] Dr. Steven Gundry: Right. Here’s the problem with a lot of my well-meaning patients. You can take a resistant starch in its natural forms like say yucca, taro root, turnip, or even almonds for instance. You can grind it up into a fine powder and make a flour out of it. Unfortunately, and I’ve seen this much too much, those will rapidly turn into sugar even though what you originally started with isn’t sugar. For instance, I had Dr. David Kessler who was the head of the FDA when the food labeling law came into effect back in the Reagan era. The food labeling law was incorrectly made because of food lobbyists and not tell the truth about how much sugar. One of the things I have people do is on the back of the label read total carbohydrates, subtract the fiber, and that will give you the amount of grams of sugar per serving in that product and it will shock you. It will have nothing to do with what they put has the sugar content on the label. For fun, since there are four grams of sugar per teaspoon of sugar, divide the number by four and you will see the teaspoons of sugar per serving. You will shudder when you see it. [01:02:36] Ashley James: Right. You can take a healthy food, if you dehydrate it and turn it into flour, it reacts totally different with the body. You could eat chickpeas—pressure-cooked chickpeas—or you could eat something like a chickpea pasta. Chickpea pasta is going to convert much quicker to sugar, give you a larger sugar spike in the blood. Even for those who are not diabetic, they still will have that. Whereas if you ate pressure-cooked chickpeas, it’s a slow steady release of sugar. [01:03:08] Dr. Steven Gundry: Covered in olive oil. [01:03:10] Ashley James: Covered in olive oil. [01:03:13] Dr. Steven Gundry: And throw some mushrooms in. [01:03:15] Ashley James: Oh, man. Mushrooms are so great for the immune system. Get your vitamin D. Let’s just clarify that. What form of vitamin D is best, and how many international units should someone be taking a day? [01:03:30] Dr. Steven Gundry: Vitamin D3. The bare minimum should be 5,000 IUs a day. For me, my 5.000 gets me vitamin D level above 120 nanograms per ml, but during this season, I’ve doubled my vitamin D to 10,000. If I think I’m coming down with something, and I’ve said this before, I actually take 150,000 international units of vitamin D3 three days in a row. Now I’m not telling people to do that. I’m telling people that’s what I do. For instance, when this all started and I decided to keep seeing patients, even though I wasn’t feeling anything, I took on a Sunday, 100,000 international units, on a Monday 5,000, on a Tuesday 25,000, and then I continued on 10,000. I just load up with it. I just saw one of my patients in Santa Barbara last weekend. Her vitamin D level is 244. I assure you, she’s not vitamin D toxic, and she doesn’t have an elevated calcium level. I think we’ve underestimated what a normal vitamin D level is. The Cleveland Clinic Lab now says that a normal vitamin D level can be up to 150. [01:05:08] Ashley James: Amazing, amazing. I know people whose vitamin D level is 10. [01:05:15] Dr. Steven Gundry: I know, it’s really scary. [01:05:17] Ashley James: I have known MDs to say they don’t want to see it above 30. They’re scared if you’re above 30. They want you to stop taking your supplements. Whereas NDs want you at least to be 60, but many NDs I’ve met don’t want you above 90. They’re afraid that if you get above 90 that that could cause toxicity. You’re saying that you’ve never seen toxic levels. Because of course, the worst-case scenario is vitamin D toxicity could cause kidney failure. At that point, it’s almost too late. We definitely don’t want to harm ourselves with supplements, but you’ve never seen that happen in prescribing large amounts of vitamin D. [01:06:01] Dr. Steven Gundry: I measure vitamin Ds on people every three months. I’ve been doing this for over 20 years. I’ve never seen vitamin D toxicity. I have some patients who taught me in their late 70s they run their vitamin Ds in the high 200s and have all of their lives. When I first met these people I couldn’t believe they weren’t dead, they didn’t have kidney failure, or they didn’t have calcifications and kidney stones. They didn’t. When I was researching The Longevity Paradox, it turns out that people with the highest vitamin D levels have the longest telomeres. If you like the telomere theory of aging, and it’s a good one, why wouldn’t you want long telomeres? [01:06:54] Ashley James: That’s exciting. What form of vitamin D is best? Obviously, you said D3, but I’ve seen supplements where it’s like a dry capsule, and then I’ve seen the liquid form as drops. [01:07:06] Dr. Steven Gundry: Great question. Turns out that Dr. Michael Holick from Boston University, probably the most famous researcher in vitamin D, showed that vitamin D is absorbed whether or not there is any fat around. So a dry vitamin D is perfectly fine. Most vitamin Ds in capsules or gel caps. Interestingly, I see a number of people who use vitamin D drops. As a general rule, those people have much lower vitamin Ds than people who swallow the little gel caps. Most of my liquid folks I change over and I’m delighted to see that their vitamin D goes up. [01:07:53] Ashley James: I was using a liquid and my vitamin D went down and down and down and I kept using more and more and more. I got so frustrated I switched to a capsule even though I heard from a Naturopath how could that work? There’s no fat in it. I was like well I’m going to try this now. My vitamin D went up. I was told it’s not going to work but my labs say it worked. [01:08:18] Dr. Steven Gundry: Dr. Holick showed that it has nothing to do with fat even though it’s a fat-soluble vitamin. [01:08:25] Ashley James: Should we take it on an empty stomach, with food, or does it not matter? [01:08:28] Dr. Steven Gundry: It doesn’t matter. [01:08:30] Ashley James: Love it. What did you eat in the last 24 hours? [01:08:35] Dr. Steven Gundry: Let’s see. When did I eat? Last 24 hours I had nothing for breakfast, I had nothing for lunch, and I had some sautéed calamari and a Chinese cabbage salad with olive oil and rice vinegar on it. That’s what we had. [01:09:08] Ashley James: Very interesting. Now your diet has helped people to reverse autoimmune conditions. You’ve also helped people to reverse cardiovascular issues and weight loss. Weight loss is the biggest industry out there. You look at all the diets and people are just yo-yoing. Every diet seems to work for a short amount of time. They blame themselves. The diet stops working, they blame themselves, they fall off the bandwagon, and they go back to eating the state American diet, but people are left feeling broken, right? They failed. What we’re looking at is it’s not their fault, it’s the diets fault because there are so many wrong diets out there. You’ve had great success in helping people with weight loss. Why does removing lectins help with weight loss? [01:10:09] Dr. Steven Gundry: As I write about in The Plant Paradox, there are actually some very interesting data looking at one of the lectins called wheat germ agglutinin (WGA), which is present in whole grains, whole wheat. It binds to the insulin receptor on muscle cells and also on fat cells. In muscle cells, it actually blocks insulin from letting sugars and protein into the muscle cell, but in fat cells, it actually continues to pump sugar into fat cells. I go into more of this in The Energy Paradox. We’re set up with our diet to literally starve our muscle cells and feed our fat cells with lectins are a big chunk of that. Also, it turns out, that it starves the brain and so your brain is constantly hungry despite how much you eat or not eat. [01:11:19] Ashley James: Wow. So when someone removes that, they’re all of a sudden not feeling so starved? They’re not feeling hungry all the time? [01:11:28] Dr. Steven Gundry: Yeah. [01:11:29] Ashley James: Very cool. [01:11:31] Dr. Steven Gundry: The other thing that we have to make sure we understand is that we took over the world because of our ability to go prolonged periods of time without eating. Where the fat ate for a good reason. It is absolutely normal to go periods of time without eating. In fact, do you really think our ancestors crawled out of their cave and said what’s for breakfast? There wasn’t any. There was no storage system. We had to go find breakfast. If breakfast occurred at lunch, or breakfast occurred at dinner that’s when we found food. I actually tell my patients, when we get into this, to embrace the hunger. There is nothing horribly wrong with going a period of time without eating. In fact, just the opposite. It’s really one of the smartest things that we can do for long-term health. [01:12:32] Ashley James: Actually, I haven’t eaten today, and I’m not going to eat today. I love fasting. Hunger is probably the hardest part about fasting, but hunger goes away. [01:12:44] Dr. Steven Gundry: It goes away quickly, very quickly. [01:12:45] Ashley James: It’s kind of like going to the gym. Just get your shoes on and go to the gym. The hardest part is actually getting your shoes on. Once you’re there, it’s easy. Starting a fast is the hardest part, and then following through is the easiest part. I love all the science that’s coming out about fasting. What resources could you point us to for those who haven’t really dived into fasting yet? [01:13:14] Dr. Steven Gundry: There’s a lot of good ways to learn about it. I certainly spend a lot of time talking about it in The Longevity Paradox, one of my New York Times best-selling books. My friend Jason Fung has some good books about it. I think Dr. McCullough and I would agree that for most people who have been following the standard American diet that a prolonged water fast of 3 to 5 days is probably the dumbest thing to do because heavy metals and organic pesticides are stored in fat. They’re released into our circulation and we do not have a good detoxification system. I’ve got a lot of podcasts out on that, so please be cautious. [01:14:05] Ashley James: Right. Always proceed with caution when fasting, especially if someone’s on medication. I agree. I like some of Jason Fung’s work—easy to digest. I particularly like—he has a video on YouTube called the 2 compartment syndrome. I think that’s a great place to start. Intermittent fasting is something where it’s gentle enough that people can ease into it. I actually did a whole series with a man who has invested his own personal money into labs doing fasting to show the heavy metals and pesticides being released in the body and how to best remove them while fasting. He found that, dramatically, if you were to use a sauna while fasting and also consume activated charcoal while fasting throughout the day, they saw a dramatic decrease in heavy metals and pesticides being released from the fatty tissue into the bloodstream. There are ways to combat it but we have to be aware of it. Thank you so much for coming on the show. It’s been such a pleasure having you on. I definitely would love to have you back to talk more about your next book when it comes out. It’s been such a pleasure having you on the show today. [01:15:28] Dr. Steven Gundry: Thank you for having me. Appreciate it. [01:15:31] Ashley James: Awesome. Thank you so much. It’s been a real pleasure, and I can’t wait to read your new book when it comes out. [01:15:37] Dr. Steven Gundry: All right. It’ll be out right after the first of the year, 2021. [01:15:43] Ashley James: All right. Sounds great. Terrific. Thank you so much. Have a great day. Take care. Bye [01:15:46] Dr. Steven Gundry: Take care. [01:15:48] Ashley James: I hope you enjoyed today’s interview with Dr. Steven Gundry. Did you know that the Learn True Health podcast has a Facebook group? Come join us. It’s a very supportive community. Just search Learn True Health in Facebook. Come join the Facebook group, or you can go to learntruehealth.com/group. That’ll redirect you straight to our group. It’s a free group, a very supportive community to support you in your holistic health success, support you in your true health journey. Come join the Facebook group, and please, go to the website learntruehealth.com. You can find all my episodes there—all 431 of them now and counting. You can find free wonderful resources. You can find my course. I have a month-long program where I teach you all the techniques—the NLP techniques—for eliminating anxiety, decreasing stress, and increasing focus on productivity in your life. Go to learntruehealth.com, and on the menu, you’ll see where it says free your anxiety and click on that. There’s a great video there for you. Lots of resources to explore. I have a search function on my website. You can search for topics that you are interested in learning about. You can also go to the Facebook group and search for topics there. There’s a search function on Facebook as well. There are so many resources that I provide through my membership, the Learn True Health Home Kitchen membership, through my free your anxiety program, and free resources at learntruehealth.com. If you have any questions for me, please feel free to reach out to me. Just ask questions in the Facebook group. I love helping, I love supporting you guys in achieving optimal health. If you’re interested in becoming a health coach just like me, check out IIN, the Institute for Integrative Nutrition. That’s the program I took. I absolutely love it. It’s 100% online. If you’re quarantined at home right now you could be becoming a health coach. Go to learntruehealth.com/coach. That’s learntruehealth.com/coach and there, it’ll give you access to a free module of IIN, the Institute for Integrative Nutrition’s online programs so you could see if health coaching is right for you. It’s a free course so go ahead and take it and see what you think about it, experience it for yourself. Learntruehealth.com/coach. Awesome. Thank you so much. You are so wonderful, and you so deserve true health. I’m really glad that you took the time today to honor your body and honor your mission for achieving optimal health through learning more about what you can do naturally to support your body’s ability to heal itself. Have yourself a wonderful rest of your day. Get Connected With Dr. Steven Gundry! Website Supplements Line The Gundry Podcast Twitter Facebook Instagram
Tenemos el honor de recibir en nuestro pódcast al Dr. Miguel Ángel Martínez-González, médico, epidemiólogo e investigador español, uno de los mayores expertos mundiales en la dieta mediterránea y responsable del estudio PREDIMED publicado en el British Medical Journal y que tras evaluar a casi 20.000 participantes, concluía que un mayor consumo de alimentos ultraprocesados provoca mayor riesgo de mortalidad. El Dr.Martínez-González, autor del libro superventas "Salud a Ciencia Cierta", responde con toda claridad sobre los 5 alimentos clave de la dieta mediterránea y los alimentos que deberían desaparecer hoy mismo de nuestra despensa. Además, nos aclara si es peor el azúcar o las grasas y nos argumenta por qué considera el pan blanco como uno de los peores alimentos en nuestra alimentación diaria. Os va a sorprender lo directo que es a la hora de explicar cómo la industria alimentaria trata de influir en nuestra dieta, algo que todo el mundo calla.
Did you know that nutrition plays an important role in contributing to your better quality of health and overall well-being? According to research, about 700,000 deaths and 15% disability cases have a correlation to poor nutrition. It’s not just diseases, but the pain that you’re feeling right now in your back and other parts of the body may be because of high levels of inflammation. And as clinics are not operating at full-capacity with the COVID-19 pandemic still underway, you can make a difference in managing your pain with the food that you eat. In this episode of Back Talk Doc, Dr. Sanjiv Lakhia dives deep into the anti-inflammatory diet and how it can help with pain. He debunks certain misconceptions about inflammation and the role food plays in exacerbating this condition, and affecting our body. One type of diet he highly recommends is the Mediterranean diet, which is more of a pattern and way of eating rather than specific recipes. It’s one that’s backed up by studies that have shown positive results to one's health. Dr. Lakhia further breaks down the Mediterranean diet, and the different food groups that you can consume while following it. He further specifies the type of food you can and cannot eat, such as nuts, the type of protein, fats and carbohydrates, to name a few. You can also tweak the Mediterranean diet and make adjustments to your meal plans, for as long as you follow the basic principles it espouses. Improving your nutrition is a great way to supplement pain management, especially if you’re already taking medicine to lower inflammation levels. If you start providing your body with good nutrition and being consistent with it, then you’re going to see the results and benefits in the long run. Key moments in the episodeImportant statistics 03:56 The truth behind inflammation 04:49 How food contributes to inflammation 05:54 Determine existence of high levels of inflammation in your body 06:53 The Mediterranean diet 08:05 The Mediterranean diet as a pattern of eating 09:44 PREDIMED trial on the Mediterranean diet and cardiovascular disease 11:07 Debunking fats 12:13 On nuts 14:09 On carbohydrates 15:09 On fruits and vegetables 16:57 The importance of spices 19:40 Consumption of alcoholic beverages 20:39 16 top food sources for the anti-inflammatory diet 22:12 Links mentioned in the episode Back Talk education booklet (https://www.backtalkdoc.com/store/p1/Back_Talk_Booklet.html) Integrative Medicine by Dr. David Rakel (https://www.amazon.com/Integrative-Medicine-Rakel/dp/1416029540) PREDIMED trial (https://www.nejm.org/doi/full/10.1056/NEJMoa1800389) What Is The Anti-Inflammatory Diet And Food Pyramid? by Dr. Andrew Weil (https://www.drweil.com/diet-nutrition/anti-inflammatory-diet-pyramid/what-is-dr-weils-anti-inflammatory-food-pyramid/) 16 Top Sources for the Anti-Inflammatory Diet by Dr. Andrew Weil (https://www.drweil.com/diet-nutrition/anti-inflammatory-diet-pyramid/dr-weils-anti-inflammatory-food-pyramid/) Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to (http://www.carolinaneurosurgery.com/) .
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. Dr Greg Hundley: And I'm Dr Greg Hundley, associate editor, director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Well, Carolyn, our feature article this week relates to an international multi-center evidence-based reappraisal of genes reported to cause congenital long QT syndrome. But, before we get to that, how about if we grab a cup of coffee and start on our other papers? Do you have one you'd like to discuss? Dr Carolyn Lam: Yes. My favorite part of the week. So this first paper really asks the question, "What's the association between HDL functional characteristics, as opposed to HDL cholesterol levels, and acute coronary syndrome?" The paper comes from Dr Hernáez from IDIBAPS in Barcelona, Spain and colleagues who conducted a case control study nested within the PREDIMED cohort. Originally a randomized trial where participants followed a Mediterranean or low-fat diet. Cases of incident acute coronary syndrome were individually matched one is to two to controls by sex, age, intervention group, body mass index, and follow-up time. The authors measure it the following functional characteristics, which were HDL cholesterol concentration, cholesterol efflux capacity, antioxidant ability, phospholipase A2 activity and sphingosine-1-phosphate, apolipoproteins A1 and A4, serum amyloid A and complement 3 protein. Dr Greg Hundley: Wow Carolyn, a detailed analysis. What did they find? Dr Carolyn Lam: They found that low values of cholesterol efflux capacity, and levels of sphingosine-1-phosphate and apolipoprotein A1 in HDL or all associated with a higher risk of acute coronary syndrome in high cardiovascular risk individuals, irrespective of HDL cholesterol levels and other cardiovascular risk factors. Low cholesterol efflux capacity values and sphingo-1-phosphate levels were particularly associated with an increased risk of myocardial infarction, whereas HDL antioxidant or anti-inflammatory capacity was inversely related to unstable angina. Now this is significant because it's the first longitudinal study to comprehensively examine the association of several HDL function related biomarkers with incident acute coronary syndrome beyond HDL cholesterol levels in a high-risk cardiovascular risk population. Greg Hundley: Very nice. Carolyn. It sounds like function over just the levels is important. Dr Carolyn Lam: Exactly, you summarized it well. Well Greg, I've got another paper and I want to pick your brain first. Is it your impression that type 2 myocardial infarction, the type that occurs due to acute imbalance in myocardial oxygen supply versus demand in the absence of atherothrombosis, do you think that this type of MI is on the rise? It seems more and more common in my country. Dr Greg Hundley: Do we want to say it's on the rise? Certainly by measuring all these high sensitivity troponins, et cetera, we're finding, I think, more evidence of type 2 MI. So, all in all, yeah it probably is on the rise, but likely related to some of our measurement techniques. Dr Carolyn Lam: Oh, you are so smart, Greg. Because this paper that I'm about to tell you about really addresses some of these issues and it's from corresponding author Dr Gulati from Mayo Clinic in Rochester, Minnesota. And they really start by acknowledging that despite being frequently encountered in clinical practice, the population base incidents and trends of type 2 myocardial infarction is unknown and long-term outcomes are incompletely characterized. So they prospectively recruited 5,640 residents of Olmsted County, Minnesota who experienced an event associated with cardiac troponin T greater than 99th percentile of a normal reference population, which is greater than or equal to 0.01 nanograms per milliliter. And this was between 2003 and 2012, so very careful to talk about which Troponin T assay exactly to the point you discussed earlier, Greg. The events were retrospectively classified into type 1 versus type 2 MI using the universal definition. Dr Greg Hundley: So Carolyn, what did they find? Dr Carolyn Lam: They found that there was an evolution in the types of MI occurring in the community over a decade with the incidence of type 2 MI now being similar to type 1 MI. Adjusted long-term mortality following type 2 MI is markedly higher than after type 1 MI and that's driven by early and non-cardiovascular deaths. Mortality of type 2 MI is associated with a provoking factor and is more favorable when the principle provoking mechanism was an arrhythmia compared with postoperative status, hypotension, anemia or hypoxia. And these findings really underscore the healthcare burden of type 2 MI and provide benchmarks for clinical trial design. Dr Greg Hundley: Very nice, Carolyn. Well, my paper comes from type 5 long QT syndromes and an analysis. And it's from Dr Jason Roberts from Western University. Through an international, multi-center collaboration, improved understanding of the clinical phenotype and genetic features associated with rare KCNE1 variants implicated in long QT 5 was sought across 22 genetic arrhythmia clinics and four registries from nine countries that included 229 subjects with autosomal dominant long QT five. So there were 229 of those subjects. And then 19 individuals with the recessive type 2 Jervell and Lang-Nielsen syndrome. The authors compared the effects of clinical and genetic predictors on a composite primary outcome of definite arrhythmic events, including appropriate implantable cardioverter defibrillators shocks, aborted cardiac arrest, and sudden cardiac death. Dr Carolyn Lam: Wow. What did they find? Dr Greg Hundley: Well, several things, Carolyn. First, rare loss of function KCNE1 variants are weakly penetrant and do not manifest with a long QT syndrome phenotype in a majority of individuals. That's a little bit of a surprise. Second, QT prolongation and arrhythmic risk associated with type 2 Jervell and Lang-Nielsen syndrome is mild in comparison with the more malignant phenotype observed for type 1 Jervell and Lang-Nielsen syndrome. And then number three, all individuals possessing a rare loss of function KCNE1 variant should be counseled to avoid QT prolonging medications and should undergo a meticulous clinical evaluation to screen for long QTS phenotype. And then finally, Carolyn, the last finding, in the absence of a long QTS phenotype, more intensive measures, such as beta blockade and exercise restriction, may not be merited. Dr Carolyn Lam: Oh, very interesting. Well, I've got one more original paper and in this, authors describe a new cellular mechanism linking ischemia-reperfusion injury to the development of donor specific antibody, a pathologic feature of chronic antibody-mediated rejection, which mediates late graph loss. This paper is from corresponding author Dr Jane Witt from Yale University School of Medicine and colleagues who use humanized models and patient specimens to show that ischemia-reperfusion injury promoted elaboration of interleukin 18 from endothelial cells to selectively expand alloreactive interleukin 18 receptor 1 positive T peripheral helper cells in allograph tissues and this promoted donor specific antibody formation. Dr Greg Hundley: Carolyn, here's the famous question. What does that mean clinically for us? Dr Carolyn Lam: Aha, I'm prepared. Therapies targeted against endothelial cell derived factors like interleukin 18 may therefore block late complications of ischemia-reperfusion injury. Dr Greg Hundley: Very nice. Sounds like more research to come. Well, how about other articles in the issue? Dr Carolyn Lam: Well, I'd love to talk about a white paper from Dr Al-Khatib, and it's about the research needs and priorities for catheter ablation of atrial fibrillation and this is a report from the National Heart, Lung, and Blood Institute Virtual Workshop. Dr Greg Hundley: Well, I've got another arrhythmia paper, so this is from Professor Michael Ackerman at the Mayo Clinic and its minor long QT gene disease associations by coupling the genome aggregation database. It's a harmonized database of 140,000 or more exomes and genome derived in part from population-based sequencing projects, with phenotypic insights gleaned from a large long QT syndrome registry to reassess the strength of these minor long QT syndrome gene disease associations. Next, Carolyn, in an on my mind piece, Professor Gerd Heusch from University of Essen Medical School discusses, how can the many positive preclinical and clinical proof of concept studies on reduced infarct size by ischemic conditioning interventions and cardioprotective drugs be reconciled with the mostly neutral results in regard to clinical outcomes. The author discusses the important differences between animal models that have been used a lot in this ischemia reperfusion and infarct size reduction science, and then the clinical scenarios of STEMI in humans as well as the many aspects of coronary reperfusion. How is that affecting the myocytes? How is that affecting the microcirculation, et cetera, that must be addressed? And then finally Carolyn, there is a series of letters, one from Professor Oliver Weingärtner from Universitätsklinikum Jena and another from Professor Yasuyoshi Ouchi from Toranomon Hospital. They're exchanging letters debating the utility of lipid lowering with Ezetimibe in individuals over the age of 75 years. Dr Carolyn Lam: Very nice, Greg. Thanks so much. Shall we now move to our future discussion. Dr Greg Hundley: You bet. Well, welcome everyone. This is our feature discussion and today we're going to hear more about long QT syndrome. We have Dr Michael Gollob from University of Toronto and our own associate editor, Dr Sami Viskin from Tel Aviv Medical Center. Good morning. Good afternoon, gentlemen. Before we get started with a discussion of some of the study findings and results, Michael, could you tell us a little bit about why you performed the study and what were some of the hypotheses you wanted to test? Dr Michael Gollob: As you know, long QT syndrome is probably the most recognized channelopathy associated with sudden cardiac death in young individuals and adults. And at the present time, there are 17 genes available for clinical genetic testing in cases of suspected long QT syndrome. We simply ask the question, "Is there sufficient scientific evidence to support that each of these genes are single gene causes of long QT syndrome based on our contemporary knowledge of genetics and the human genome? Dr Greg Hundley: Great, Michael. So, can you tell us a little bit about your study population? How did you go about this and what was your study design? Dr Michael Gollob: We designed a methods approach that would assure that any conclusions that were made from our working group were not based on the opinions of one or two individuals. We wanted to ensure that this was a consensus conclusion with multiple experts in the field including genomic scientists, genetic counselors, inherited arrhythmia experts, and researchers in the field. We created three independent teams of genetic experts to curate the genetic evidence reported in the medical literature for each of these 17 reported causes of long QT syndrome. This was essentially an evidence-based approach using a pre-specified evidence-based matrix or scoring system depending on the level of evidence, genetic primarily, in the reported literature for each gene. Each of these curation teams worked independently of each other and they were blinded to each other's work and they were tasked with concluding whether a gene, based on the medical literature and the resource methodologies, had sufficient evidence for disease causation. Their classifications would be one of disputed evidence, limited evidence, moderate evidence, strong or definitive evidence for claims towards disease causation. Remarkably, independently, all of these teams reached the same conclusion. In the end, their summary data was reviewed by a clinical domain expert panel with individuals with expertise, particularly in long QT syndrome and other channelopathies. So in total 19 individuals reviewed all of the literature and the data presented and came to unanimous conclusions for each gene. Dr Greg Hundley: Out of the 17, were there some that were more important than others or was it uniformly all 17 were relevant? Dr Michael Gollob: Well, I think the most relevant conclusions of our study are that nine of these genes, more than half of these genes, were felt not to have sufficient evidence to support their causation as a single gene cause for typical long QT syndrome. So nine genes that are currently tested by clinical genetic testing providers do not have enough evidence to support their testing in patients with suspected long QT. And to us, that is the most relevant observation because testing genes that do not have sufficient evidence for disease causation poses a significant risk to patient harm and family harm. We concluded that only three genes had very definitive evidence for causation of long QT syndrome. Those three genes were KCNQ1, KCNH2, and SCN5A. There were another four genes that were concluded to have strong or definitive evidence for unusual presentations of long QT syndrome. And by that, I mean presentations that typically occur in the neonatal period and are associated with heart block seizures or developmental delay or in the case of one of these genes, Triadin, an autosomal recessive form of the disease. Dr Greg Hundley: So helping us perhaps what types of genes to screen for when we have someone with this condition or suspected. So Sami, can you help us put this into perspective? How does this study help us in management of this clinical situation. Dr Sami Viskin: In Circulation, we immediately recognize the importance of the manuscript, the importance of the study because unfortunately, there are too many physicians all over who will accept the results of genetic testing essentially like gospel. Now it's in the DNA, it's in the genes, so whatever you find must be true. And too often, clinical decisions on treatment including ICD implantation have been undertaken based on results of genetic testing’s; thus are wrongly interpreted. So we recognize immediately the importance of this paper. We already had a different study by Dr Gollob and his associates. Again, reassessing the role of genes in Brugada syndrome. So we were familiar with this type of analysis. We recognize the importance and we moved ahead to accept this paper, it went fairly easily, I think only one revision. At the same time, we were getting additional paper by other groups. So in the same issue, we have two more papers, one from Jason Roberts with the International Long QT Registry of long QT 5, reaching similar conclusions that this is a gene with very limited penetrants and another study by the Mayo clinic also showing that many of the genes who are not the major genes are overrepresented in the healthy population. So we put all these three papers together with a very nice editorial by Chris Semsarian in the same issue. So everything is put in the right perspective of how we should be looking at all the genes of these disease in a different way. Dr Greg Hundley: So as a clinician quickly, how can I use this information in the issue, perhaps this paper and all three, in management of patients with either suspected or long QT syndrome? Dr Michael Gollob: First off, I would emphasize that the diagnosis of long QT syndrome or any genetic base disease for that matter, should be based on clinical phenotype and not the observation of a genetic change, particularly if genes are being tested that do not have strong evidence for disease causation, as is the case for the nine genes that we've pointed out in this manuscript. So I think clinicians need to be wary of the genetic testing panels that they are requesting be screened or used in the assessment of their patients and be knowledgeable that at this point in time, we really only have three genes with very strong evidence to support disease causation of the typical form of long QT syndrome. And that for the most part, these other genes should not be tested or should only remain in the realm of research. I think that responsibility extends further than just the clinician taking care of the patient, but also clinical genetic testing providers, companies that offer these genetic testing services. I think they should assume a responsibility to ensure that they are only offering services for genes that have strong evidence for disease causation because when they report results in genes that are not valid for the disease, that only confuses the care of the patient and that creates a risk of harm to them if that information is misinterpreted by a physician. As Dr Viskin or Sami pointed out, we do see patients who are inappropriately diagnosed. We remove the diagnosis of roughly 10 to 20% of cases in our own clinic. And unfortunately, many of these patients and their families have suffered undue anxiety. Some of them have ICDs in place that should not have been there. So I think overall, the field needs to be aware of what genes are relevant and what genes still are within the realm of research. Dr Greg Hundley: Can you tell us just quickly Michael and then also Sami, what do you see as the next study in this field? Dr Michael Gollob: We're taking a step back now. The first decade of this century saw an exponential growth in reported gene disease associations. And now in the last five or six years, we've learned a lot about human genetic variation, which has provided us an opportunity to reflect back on some of these previous and reported genes as causes for long QT and other diseases. So I think many individuals in our field may say, "Well, you know, this is disappointing. We believed in these genes. We really thought these genes were causes of long QT." And to that point I would say, we need more research. If you believe in some of these genes that have now been considered to have limited or disputed evidence, research should continue if these remain plausible candidates for the disease. So I think future research has to continue. There are probably still a few other genes that have not yet been discovered. I think we've got the vast majority. I think in most cases, at least in our experience, 90 to 95% of cases are explained by the top three genes. But there are probably other genes out there and it's always fascinating to learn or discover new genes, but those sorts of studies have to be done with the correct methodologies and rigid protocols. Lastly, I think in the future us clinicians and geneticists and genetic counselors need to work closely with genetic testing providers to ensure that they are offering responsible genetic testing services. Dr Greg Hundley: Sami, do you have anything to add? Dr Sami Viskin: Just congratulate the authors. I think they did a very great service to the medical community by pointing out the limitations of the genetic testing and the way we interpret the results, and they deserve to be applauded for reminding us that we have to be careful when we read papers about genetic results or when we get genetic testing results ourselves. Dr Greg Hundley: I want to thank Michael from University of Toronto and Sami from Tel Aviv Medical Center for participating. And on behalf of both Carolyn and myself, wish you all a great week and look forward to chatting with you next week. This program is copyright, the American Heart Association 2020.
In this episode I bring you my conversation with Ted Kyle, RPh, MBA. Ted founded ConscienHealth in 2009. He is a pharmacist and healthcare innovation professional who works with health and obesity experts for sound policy and innovation to address obesity. He serves on the Board of Directors for the Obesity Action Coalition, advises The Obesity Society on advocacy, and consults with organizations addressing the needs of people living with obesity. His widely-read daily commentary, published at conscienhealth.org/news, reaches an audience of more than 15,000 thought leaders in health and obesity. His peer-reviewed publications focus upon weight bias and policy related to health and obesity. As such, Ted is perfectly positioned to share with us his list of the Top 10 Milestones in Obesity and Health over the past 10 years. Discussed in this episode, # 10-# 1: 10. The Rise of ObesityWeek: We discuss what is ObesityWeek and why does this conference matter. 9. The Mediterranean Diet Hits a Speed Bump: In 2018 the original authors of the PREDIMED study audited the study’s data and execution and they found problems. For about 14 percent of the study’s 7,447 subjects, assignment to a treatment group was not random. Taking those problems into account, they still found lower rate of cardiovascular events for people in the Mediterranean diet groups (compared to a lower-fat diet). But the bold claim of cause and effect evaporated. The original conclusions said the diet “reduced the incidence” of cardiovascular events. The new conclusion says “the incidence was lower.” This difference might seem small but it’s the difference between causality and association. 8. Plants Are IN, But Carbs Are OUT: As demonstrated by the new Dietary Guidelines for Americans in 2020. 7. Vibrant Support and Advocacy for People with Obesity: The rise of the Obesity Action Coalition. 6. Sugar Is Poison: Dr Robert Lustig's Sugar-is-Toxic video 5. A Whole New Specialty for Obesity Care: American Board of Obesity Medicine came into existence. 4. Surgery for Diabetes: Understanding that Bariatric Surgery is an endocrine surgery that changes the hormonal communication between the gut, adipose (fat) tissue, and the brain. The logic is inescapable. Type 2 diabetes is a cruel, progressive disease that slowly, but surely destroys a body from the inside out. Strokes, heart disease, amputations, organ failure – they’re all part of a bleak picture. Intensive medical care can slow it down. But metabolic surgery can put it into remission. Three years ago (2016), a remarkable consortium of 45 expert organizations endorsed metabolic surgery for type 2 diabetes. And yet, 97 percent of people who might benefit still don’t receive metabolic surgery. 3. New Drugs for Obesity Treatment: Liraglutide (Saxenda), Naltrexone & Bupropion (Contrave), Phentermine & Topiramate (Qsymia), and Lorcaserin (Belviq), with more coming. 2. Sleeves Take Over from Bands: Bands peaked in 2007. As of 2018 Vertical Sleeve Gastrectomy is the #1 procedure of all bariatric surgeries. 1. Less Explicit Bias: Bias comes from selective blindness to facts. Explicit bias refers to attitudes and beliefs we have about a person or group on a conscious level. Implicit bias refers to thoughts and feelings we hold without conscious awareness regarding a person or group. Some of the more common biases we can hold against a person are based on their weight, sexuality, race, age, skin tone, or disability. The risks of implicit and explicit bias is that people become sicker because of denial and inaction. Less (NONE!) of both types of biases would be better but less explicit bias is certainly a start. Thanks for Listening! Support the podcast at either: Patreon or PayPal Connect with Ted Kyle: ConscienHealth.org, LinkedIn, Twitter, Facebook, Instagram, email: Ted.Kyle@conscienHealth.org Connect with Reeger Cortell: Facebook, Twitter, Instagram, email: reeger@weightlosssurgerypodcast.com
Dr Orlena interviews Doctor and Professor Miguel Ángel Martínez, one of the clinical co ordinations of the PREDIMED study. Find out why olive oil is so great for your health. Show notes: https://www.drorlena.com/blog/health-benefits-of-olive-oil-podcast-episode-31 New me Challenge: https://www.drorlena.com/new-me
One way to protect your heart is to choose the right diet. Discover why Dr. Allen J. Taylor believes the Mediterranean Diet—which relies on foods such as fruits, vegetables and white meat—is the best for preventing heart disease. TRANSCRIPT Intro: MedStar Washington Hospital Center presents Medical Intel where our healthcare team shares health and wellness insights and gives you the inside story on advances in medicine. Host: Thanks for joining us today. We’re speaking with Dr. Allen J. Taylor, Chair of Cardiology at MedStar Heart and Vascular Institute. Welcome, Dr. Taylor. Dr. Allen J. Taylor: Thank you. Host: Today we’re discussing diet choices for heart health, specifically the Mediterranean Diet. With so many ideas online and from well-meaning friends and family, it can be tough to make the best food and beverage choices for on-going heart health. Dr. Taylor, patients hear the recommendation to eat a healthy diet all the time. What does that really mean? Dr. Taylor: Yeah, everyone’s an expert on their own diet, aren’t they? We’ve long known that (quote) “healthy diets” - and those are typically defined, from a heart perspective, as diets that are low in fat, high in fruits and vegetables - tend to be seen more frequently in patients who don’t suffer from heart disease. On the converse, people that eat poor diets are more likely to have heart disease. And that is true. The question is, where is diet science going? And in 2018, what’s the best diet to prevent heart disease? And that’s where there’ve been changes. Host: What questions do your patients often ask about how their diets relate to their heart health? Dr. Taylor: When you talk to patients about diet, there’s usually two things. The first is controlling body weight. And then the second is about controlling specific health problems, such as their blood pressure or their diabetes or their cholesterol. And as you tailor diets to different patients, it often has to be highly customized to the health problems that they have. But overall, it’s about reducing heart risk. And, it can get very confusing to think, “Oh, I have to avoid salt and I have to avoid fat and I can’t eat sugar because of my diabetes.” And the question is, “What can I eat?” And patients get confused. And they get so confused, they can’t make good food choices and they give up. And they eat things which aren’t good for their health. So, how do you bring it all together? There’s so many diets - there’s fad diets, the keto diets, the low carb diets, Atkins diets, South Beach - it’s all over the place these days. And today...tomorrow there’ll be another one. The optimal diet from a heart perspective is one, if you were going to design it, is one that makes good metabolic sense and has been tested. Tested and proven to reduce heart disease risk. Now, when it comes to weight loss, that’s a simple thing. It’s about calorie balance. It’s calories in and calories out. One reason people gain weight as they age is because, they don’t realize it, with every decade they age their daily calorie requirements go down about a hundred kilocalories. Now, the average 20-year-old can probably eat 2,000 or 2,200 calories a day. The average 60-year-old has to eat 400 calories less a day just to stay in balance, 1,700 or 1,800 calories. If you’re eating like you did when you were 20 or 22, you’re gaining weight. So, calorie balance is the most important thing from a weight perspective. But then it’s about what goes in to those calories; what’s making up those calories - how much is fat, how much is sugar, how much is protein? It’s hard to eat like that. It’s hard to eat...how much protein am I going to eat today? How much sugar should I eat today? And, some people can do that. What I try to do with my patients is to make it as simple as possible and to use the best evidence-based diet as possible because we’re trying to reduce the risk for heart disease. And today, that diet is the Mediterranean Diet. Host: What about the Mediterranean Diet makes it so heart healthy and so, quote/unquote, “easy to follow?” Dr. Taylor: Well, the first thing about a Mediterranean Diet, and it’s just simply a name for it, but it’s really a style of eating, it’s food choices. And, it has been rigorously studied, both in people with known heart disease and without known heart disease. Very important study, published about five years ago now, was a study called the PREDIMED study. And, it was a study of about 7,500 individuals who were either asked to eat a Mediterranean Diet or an otherwise really high-quality American diet. The American diet was things like using low fat dairy products, saying that things like pasta and rice were ok, and fruits and vegetables are encouraged, and lean fish and seafood are also okay. That sounds pretty good, doesn’t it? It’s pretty much what a lot of us eat. What was interesting is that the Mediterranean Diet is different than that. It’s a diet that’s, again, rich in fruits and vegetables but includes fish. It includes beans. White meats, such as chicken. Wine is okay with meals and that’s often a good selling point for the diet. And then it can include nuts and supplementation with olive oil - olive oil to cook or even olive oil to simply add to your food, like put it on top of salads. When those two diets - this really good quality American diet and the Mediterranean Diet - were compared, Mediterranean Diet won, hands down. There was nearly a 20 percent lower risk for heart events in people who ate the Mediterranean Diet. There was a 30 percent reduction in heart disease risk in the patients that ate the Mediterranean Diet. So, that’s a large reduction - 30 percent risk - that’s the same risk reduction seen with taking cholesterol pills, for example. So, very impactful. The thing about the Mediterranean Diet that I like in particular - while those are the things you should eat, and again, to repeat them, fresh fruits and vegetables, fish, white meat, beans, nuts are okay, wine is okay, and olive oil supplementation - it discourages certain things like soda drinks, commercial baked goods and sweets, spread fats and red meats. And what I like about it in particular is it doesn’t say you can never have those things. It’s about how frequently. For instance, most of those things should be fewer than one serving per day. And commercial baked goods, less than three servings per week. And so, when you stand in the line at your favorite coffee shop, what you’re tempted with while you’re waiting is nothing but commercial baked goods and sweets. And it’s okay to have one once in a while. Not every day, if you’re going to eat the Mediterranean Diet. And, I ask my patients, is that worth a 30 percent reduction in your risk for heart disease? And most become very interested in this type of diet because it’s about the food choices you make. And it’s not like you can never do certain things because look, eating’s supposed to be fun and eating is a part of life many times a day. It’s a social function; it’s what we enjoy. And so, the Mediterranean Diet, I think, can be compatible with a very healthy diet, a very heart healthy diet, but also one you can sustain. The problem with many of the fad diets is they’re great for a week or a month and people will often lose weight and that entices them into it, but frankly, we don’t know the safety of those diets. We don’t know if they’re heart safe. We don’t know what it does to their cholesterol and their blood pressures. In the end, that’s the most important thing. So, if you really want to follow an evidence-based diet, a diet that’s been proven to work, to reduce heart risk, it’s the Mediterranean Diet. Host: When you give that example, what do you say to those patients who say, “Well, if it’s similar to taking a pill, I’ll just take a pill and still enjoy my cheeseburgers.” Dr. Taylor: That’s great. Well, I say, “You know what? This was in addition to people taking pills.” So, this doesn’t replace pills and lowering cholesterol is not the goal of this diet. It’s about lowering heart risk. So, if you have a cholesterol problem, you probably will need a pill. If you have a blood pressure problem, you probably will need a pill. But this diet reduces heart risk. And it’s the types of food you’re eating and the types of foods you’re not eating that is driving it. So, it’s the diet that, from my viewpoint, we should be following for heart risk in this country. To come back to the diet that it was compared to, it was the previously recommended diet by the American Heart Association. So, those recommendations - and if you grew up through the ‘80s and the ‘90s, you were told, “avoid fat, avoid red meat, and the rest is gonna be fine.” Now, I’m summarizing, but that was what people were trying to avoid. And what do they substitute? They substituted sweets and baked goods and pasta, which are great, but small amounts. And, the Mediterranean Diet is by far a better diet from a heart risk perspective. Host: What about those trendy diets like Atkins or like keto. What do you say when folks are wanting to try those types of diets? Dr. Taylor: The goal of those diets is usually weight loss, and they do work in the short term. You can eat a ketogenic diet, and that’s a fancy term for a diet that is simply carbohydrate poor. So, it takes rice and breads and sweets out of the diet and focuses on vegetables and meats. And so, it’s a high protein diet. And in the short term, people will lose some water weight and they’ll lose water weight very quickly. Then it tails off. And, what the evidence is, is that, in the end, if you eat simply a calorie-restricted diet versus a ketogenic diet, the weight loss is the same. So, there’s no specific advantage of eating a ketogenic diet, when you look at 6 and 12 months out. What we’re talking about with things like the Mediterranean Diet is a diet that is more about prevention of heart disease. It’s not about weight. So, if you want to lose weight, it’s really about ins and outs - how many calories you’re taking in; how many calories you’re burning. Oftentimes patients aren’t quite aware. They’ve got a certain pattern of eating and often there’s some overeating. And, you’ve got to measure it. There’s some great health apps like MyFitnessPal. It’s a free app and you put in all your foods. It tells you exactly what you’re eating and how many calories. And there’s other ones as well. That’s important - to measure where you are and how much you’re eating. And it’ll tell you how much protein and fat and sugars you’re eating. And again, if you want to lose weight, you’ve got to measure your ins and monitor your outs. More exercise, less eating. It’s the only way to lose weight in a stable, long-term way. But from a heart risk perspective, it’s about the types of foods you’re eating. And, the best diet now is the Mediterranean Diet. That diet is better than the best American diet, 30 percent better for heart risk. It’s an easy sell. Host: So, when you’re thinking about all these diets - you have paleo and you have keto and you have Atkins and they have all these flashy names - well, Mediterranean Diet just sounds very fancy and complicated. How do you break that down for people so it’s something relevant to them that they can really do? Dr. Taylor: Yeah, it can sound exotic and it isn’t and that shouldn’t scare anybody away. It’s actually just a diet that changes the quantities of things you eat to one, things that are healthier and away from things we’re probably eating too much of. And nothing in this diet is not freely available to people on a daily basis. So, it’s about the quantities. And the thing I love about this diet is that it’s...you don’t have to go to the Mediterranean to eat it. And you don’t have to eat foods you don’t like. It’s about the choices you make. So it’s about eating lean meats, fruits and vegetables. It’s about eliminating sodas and baked goods and sweets. And the occasional red meat is okay. And people that like red meat will find that really comforting and think that they can really sustain this. Host: What questions should patients ask their doctor if they’re considering trying one of these newer, trendier diets or going on to the Mediterranean Diet? Dr. Taylor: I think it’s important to talk about the goals of the diet and what the risks are or unknown risks are. If the goal of the diet is weight loss, the answer is simple. You’ve really just got to do it a calorie restriction and more activity. It’s hard work. It’s slow going. The fad diets - you’ll lose a little more weight quickly, but it’s a fake-out—it’s usually water. If the goals are other things like you want to improve your blood pressure, well, there are blood pressure improvement diets, such as the DASH diet. It restricts sodium, it supplements potassium, magnesium. It’ll lower your blood pressure. So, if you’re worried about your blood pressure, you’d like to avoid meds, there’s a diet out there for you. Similarly, for cholesterol. You can lower your cholesterol with a diet - somewhat. Restrict fats, eat lean meats. But by and large, cholesterol is pretty unresponsive to diet. And so, we usually use medicines for cholesterol. So as you talk about what diet to eat and fad diets, define your goals. Is it weight loss? Then the answer is ins and outs. And, if it’s a specific health problem, that is a little bit more of an in-depth discussion because there are some diets that are proven to work - the DASH diet is the best example. But I choose, typically, to focus on the global risk for heart disease because, no doubt, the most effective diet is this Mediterranean Diet. We’ll treat the blood pressure and cholesterol with other ways, but reducing heart risk is so important and the Mediterranean Diet is very effective. Host: Could you share a success story from your practice about changing their eating habits and reducing their heart attack risk? Dr. Taylor: Yeah, I can share a few. One is simply weight loss and have had many patients and I’ll describe one that, you know, everyone walks in with their smart phone and they think they’re all app’ed up. And, many patients have turned on to these apps like MyFitnessPal. And I’ve had patients come in and they’ve shown me exactly what they’ve eaten and how they’ve changed what they eat. They found foods that they thought they liked but really are quite unhealthy for them - they have a lot of sodium or a lot of calories. And, have changed their diet and have lost weight. And that’s really gratifying. And they’ve done that simply by more monitoring - and these apps, these health aids can really help. The Mediterranean Diet is a different story. And, a week doesn’t go by where I’m in the hospital talking to some patient, and it’s usually the wife that’s asking the diet question, about how to change a diet to reduce the risk of a future heart event. And, I try to be very optimistic in talking about the Mediterranean Diet - that it is a lifestyle diet. There’s nothing you can’t do, but it’s about food selections and these days, you know, we’re fortunate that the access to fresh foods and to healthy foods can be made without a lot of sacrifice. And so, it’s about shifting the types of foods you eat and usually the wine’s a big seller. People don’t mind a glass of wine with dinner, and that’s in this diet as well. So, people want to know what they can do that’s active to improve their health and eating is such an important part of life. You want to know that you’re eating a diet that’s not just you enjoy but that is healthy for you. So, I think the Mediterranean Diet is really worth a look. You can find simple information online. And even, you know, you can find the study I referenced - the PREDIMED studies - free online. You can go and look that up. And, it’s got the diet simply laid out. So, you can really start to look at the foods you’re eating and choose the right ones. I think diet is an important discussion to have with your doctor, and it’s not a quick discussion. You’ve really got to define the goals and then make a commitment toward changing diet that you can sustain. And, if you can outline a way forward. And I’ll even give patients a copy of the study and a page that summarizes the diet so they can ... somebody can look and say, “I can do that. I like that food. Ah, I’ll just have that once a week. I’ll skip it three times a week.” They sound like they can be successful, and they are. And it’s nice to see that people can make sustainable changes that you know reduce their heart risk. Host: Thanks for joining us today, Dr. Taylor. Dr. Taylor: Thank you very much. Conclusion: Thanks for listening to Medical Intel with MedStar Washington Hospital Center. Find more podcasts from our healthcare team by visiting medstarwashington.org/podcast or subscribing in iTunes or iHeartRadio.
Análisis pormenorizado del estudio PREDIMED Plus, el ensayo clínico de dieta mediterránea para la mejora de la salud cardiovascular. Acaban de publicarse los resultados del primer año de seguimiento (de los 8 previstos). Participan Julia Alonso, Ana Garcia, Beatriz Yuste, Paula Sanchez-Seco y Javier Arribas. Coordina Raul Piedra.
Análisis pormenorizado del estudio PREDIMED Plus, el ensayo clínico de dieta mediterránea para la mejora de la salud cardiovascular. Acaban de publicarse los resultados del primer año de seguimiento (de los 8 previstos). Participan Julia Alonso, Ana Garcia, Beatriz Yuste, Paula Sanchez-Seco y Javier Arribas. Coordina Raul Piedra.
If you’ve listened to my podcasts, you surely know that I love what I do. And my podcast with Dr. Stephen Sinatra is no exception. One of my most inspiring conversations to date, Dr. Sinatra is, as you know, a pioneer in the field of integrative cardiology. Hear about his remarkable, very early transition to integrative cardiology, including pivotal encounters with patients and scientists that shaped his thinking; his gutsy, hospital grand rounds presentations on the use of CoQ10 for heart failure patients, and the story of my mom working as a cardiac nurse with him during his fellowship. While Sinatra doesn’t maintain an active medical practice anymore, he still goes into his office often “to see how my former heart failure patients are doing. I don’t charge them. I just want to check in” He talked about a 9 year old boy he saw with florid heart failure. That boy is 32 years old now, and doing great. He was involved in designing the treatment plan for the now oldest-living person with tetralogy of Fallot. What did he prescribe? The “fearsome foursome”: CoQ10, magnesium, ribose and carnitine. At 73 years old, the first heart failure patient he prescribed CoQ10 to (10mg TID!) is alive and well. We move through loads of research on nutrients (yes, we discussed K2) diets, fats and what we need to be doing for ourselves, our families and our patients. Update: Dr. Sinatra and I spent a chuck of time on the famous PREDIMED study, published in the New England Journal of Medicine in 2013. PREDIMED garnered much attention by validating the use of a Mediterranean diet supplemented with olive oil or mixed nuts for reducing incidence of cardiovascular disease in persons at high risk. Interestingly, the day we recorded, news broke that the PREDIMED was retracted. However, the study authors re-published the PREDIMED in NEJM June, 2018 with compromising data omitted. The findings remained similar to the original PREDIMED. Listen to Dr. Jeff Bland discuss the details.
Returning from a memorable fishing trip, the boys tackle the evidence behind omega-3s, a group of molecules known as “PUFAs!” (try not to laugh). They talk about the EPA; kinky and bent molecules; carnivorous chickens; cardiovascular disease and brain development. Also: how big trials can go wrong; and an interview with Dr. Emma Jones on palliative care, cultivating quality of life, collaborations in paediatric oncology, and myths about medicinal cannabis! Julia Belluz's article about the PREDIMED trial paper retraction: https://www.vox.com/science-and-health/2018/6/20/17464906/mediterranean-diet-science-health-predimed Vox pop by Ada McVean of the McGill Office for Science and Society. Jingle by Joseph Hackl. Additional music by Seth Donnelly and Kevin MacLeod. Theme music: "Troll of the Mountain Swing" by the Underscore Orkestra. To contribute to The Body of Evidence, go to our Patreon page at: http://www.patreon.com/thebodyofevidence/.
According to the World Health Organization, type 2 diabetes comprises the majority of the more than 400 million people with diabetes around the world. In efforts to better understand the disease, metabolomics measurements have identified tryptophan metabolites as potential biological mediators in the development of type 2 diabetes. The PREDIMED trial was a multi-center trial of Mediterranean-style diets where the primary prevention of cardiovascular events that also included type 2 diabetes as a secondary end point. An original research article published in the August 2018 issue of Clinical Chemistry studies whether tryptophan metabolites in PREDIMED participants were associated with development of type 2 diabetes and insulin resistance.
Denna vecka blir det fyra olika ämnen i Tyngre Rubriker. En av de mest inflytelserika studierna på dagens kostråd har visat sig innehålla flera problem och den fick därför dras tillbaka för att sen publiceras i ny form. Men frågan är hur mycket man kan lita på resultaten nu? En väldigt intressant studie på möss visar att det med stor sannolikhet finns ett ännu okänt system i kroppen som skyddar djur från överätning och får dem att börja äta mindre i fall de ätit väldigt mycket under en tid. Efter detta kommer en kort uppföljning kring Caster Semenya och sen diskuterar vi att TV4 nyheterna tagit upp det faktum att det inte finns några krav på kunskap hos en personlig tränare och att det verkar finnas utbildningar som är oseriösa. Vilka krav ska man ställa på en PT och hur lång borde en utbildning vara? Medverkar i panelen gör Jenny Ågren, Wille Valkeaoja, Jacob Gudiol, Caroline Mellberg & Jacob Papinniemi. Hålltider 00:00:00 PREDIMED dras tillbaka och publiceras igen 00:16:18 Leptin verkar inte skydda mot överätning hos möss 00:29:38 Caster Semenya överklagar till CAS 00:36:09 Inga kunskaper krävs för att bli personlig tränare Följ gärna Tyngre Rubriker på Instagram för att få del av relaterat material till podcasten.
PREDIMED (again), malpractice concerns in CAD testing, alcohol, stroke care in the elderly, and genetic testing are the topics discussed by Dr John Mandrola in this week’s podcast
Nutrition education for docs, PREDIMED retraction, recommendations for ECG screening of healthy adults, and MOC studies are discussed in this week's podcast.
Hoy hablaremos del estudio más potente hasta la fecha sobre dieta mediterránea con el investigador y catedrático Miguel Ángel Martínez. Esta es la entrevista hasta la fecha con más polémica. Veremos cómo se hizo el estudio y qué comían los que participaron en él. También analizaremos en detalle los resultados, que tengo que decir, me han dejado un poco "frío". Pero qué mejor que preguntar a uno de los investigadores del mismo para salir de dudas. ¡Vamos a por ello! Estas son las preguntas que tengo preparadas para Miguel Ángel: ¿Quién es Miguel Ángel Martínez y a qué te dedicas? Haznos una breve introducción de lo que es PREDIMED. ¿En qué tres grupos se dividieron los participantes? En el estudio mandabais 2.000 litros semanales de aceite de oliva ¿Qué tipo de aceite era y por qué elegisteis este tipo? ¿Qué cantidades de frutos secos se utilizaban para ese grupo? ¿Qué más puntos había que cumplir? (Vamos a ir repasando uno por uno). Hay uno de ellos que me llama la atención: "Al menos 3 vasos de vino a la semana." No hay limitación de dulces siempre que sean hechos en casa. Un día a la semana sin carne, ¿al estilo de la Cuaresma? ¿Por qué limitar la carne roja? Hay algo que me llama muchísimo la atención y es que no veo el pan por ninguna parte, ni en lo obligatorio ni en lo prohibido, ¿hay alguna razón? El pan es algo muy arraigado en la alimentación de nuestro país. :-) Hablemos de los resultados. Baja un 30% el riesgo de muerte por infarto, ¿pero sólo de infarto? ¿Y la mortalidad total? Si bajó la mortalidad por enfermedad cardíaca, pero no bajó la mortalidad... ¿Sabéis que tipo de sucesos causó mayor mortalidad? Y no sólo la mortalidad, quizá más importante es la calidad de vida... ¿Qué recomendación o recomendaciones transmitirías a nuestros oyentes en cuanto a alimentación? ¿Dónde podemos encontrarte? Aquí tenéis la web de PREDIMED por si queréis echarle un vistazo. Os dejo también aquí el enlace con el libro que nos ha comentado Miguel Ángel. Habrá segunda parte para intentar resolver con más claridad el tema de las grasas saturadas y la carne roja. Hasta aquí el episodio de hoy, GRACIAS por apuntaros a los CURSOS y PLANES DE ENTRENAMIENTO y por vuestras valoraciones de 5 estrellas en Itunes y comentarios y me gusta en Ivoox. ¡Buen fin de semana y sed felices!
Podcast Azusalud. Información médica para pacientes desde el Centro de Salud de Azuqueca de Henares. Estudio PREDIMED. La dieta mediterránea previene enfermedad cardiovascular. En este episodio hablamos del estudio y sus resultados. Damos recomendaciones sobre cómo mejorar nuestra dieta y hacerla más saludable.
Podcast Azusalud. Información médica para pacientes desde el Centro de Salud de Azuqueca de Henares. Estudio PREDIMED. La dieta mediterránea previene enfermedad cardiovascular. En este episodio hablamos del estudio y sus resultados. Damos recomendaciones sobre cómo mejorar nuestra dieta y hacerla más saludable.
In this episode, Sal, Adam & Justin speak with Max Lugavere. Max is a filmmaker, TV personality, health and science journalist and brain food expert. He is the author of the book, Genius Foods: Become Smarter, Happier, and More Productive While Protecting Your Brain For Life (Harper Wave, March 2018) which was just released. Max has been featured on NBC Nightly News, the Dr. Oz Show, and in The Wall Street Journal. He is a sought-after speaker, invited to lecture at esteemed academic institutions such as the New York Academy of Sciences and Weill Cornell Medicine, has given keynotes at such events as the Biohacker Summit in Stockholm, Sweden. From 2005-2011, Max was a journalist for Al Gore's Current TV. You can find Max on Instagram @maxlugavere and at www.maxlugavere.com. Get a free look at his book at www.geniusfoodsbook.com Also, check out his video series on Mind Pump TV (YouTube) I had a love for storytelling and creating. Max shares his early jobs, working for Al Gore, and how he found his passion for health and psychology. (8:31) When the camera is on, you had to be a higher energy version of yourself. Attention is the new limited resource. How to create respect for your audience and to help people with health literacy. (14:52) Found potions to make me become a superhero. Max explains his nerdiness growing up, passion for comics and how he found a supplement store that sparked his obsession to be a superhero. (20:34) It seems like when I was talking to my mom, I was talking to an elderly person. Max shares the personal story of his mom's early onset dementia, his call to action and the impact it had on him. (24:00) One pill for every ill Diagnosis and adios Medicine becomes worse than the disease. Max describes the medicine prescribed to his mom and the mind-blowing findings he found while researching them. (34:00) My theory was there had to be something related to diet and lifestyle. Ways to protect your brain through prevention, Alzheimer's disease being type 3 diabetes and how Max went down the research rabbit hole to find answers. (37:13) It was hard sell, at first, for my mom. Was there any push back when he started to give her his research and nutrition advice? (45:28) Being guilty until proven innocent. Why we don't need grains in our diet. (49:00) Glucose is the brains gasoline. The pros/cons of putting his mom on the ketogenic diet and the struggles he faced along the way. (52:25) This is something that young people need to talk about. Practices to implement now to not become a slave to your food. (58:15) We have traded acute disease for chronic disease. What is wrong with the current Western Medicine model and how to prevent you from becoming part of the cycle. (1:07:00) Nutritional psychology. The importance of teaching the masses this vital information and gives practical methods how to retain it. (1:14:40) Our brains have lost volume in comparison to our ancestors. The science of why certain foods are optimal for brain health. (1:17:54) Max's daily food journal. A day in the life of the foods he eats on a daily basis to fuel his brain. (1:23:10) The brain is the battery that makes everything possible and we need to protect it. Final thoughts from Max on his new book and how it is written as the “Ultimate guide for dementia prevention.” Related Links/Products Mentioned: Current TV The Ketogenic Diet: A Complete Guide for the Dieter and Practitioner - Book by Lyle McDonald Cleveland Clinic: Every Life Deserves World Class Care Doctors Wasting Over Two-Thirds Of Their Time Doing Paperwork Why Do So Many Drugs for Alzheimer's Disease Fail in Development? Time for New Methods and New Practices? Dr. Terry Wahls - Minding Your Mitochondria - TED - Documentary, Lecture, Talk NUTRITION Vascular Dementia Coconut Oil As an Alzheimer's Treatment - Dr. Mary Newport – YouTube Brain glucose hypometabolism and oxidative stress in preclinical Alzheimer's disease Brain Glucose Hypometabolism, Ketosis, and Alzheimer Disease: From Controversy to Consensus Relations between Executive Function and Academic Achievement from Ages 5 to 17 in a Large, Representative National Sample Babies of mothers with gestational diabetes have more body fat, scans reveal High-intensity interval exercise and cerebrovascular health: curiosity, cause, and consequence The World's Leading Expert on Gluten-Related Disorders, Dr. Alessio Fasano, Sets the Record Straight in His Definitive New Book Plant compounds may boost brain function in older adults, study says Why Diet is The New Antidepressant on the Block – Diet and Depression Ep 725-Mikhaila Peterson's Personal Account of Treating ... - Mind Pump The evolution of modern human brain shape Folic acid, ageing, depression, and dementia B Vitamins and the Brain: Mechanisms, Dose and Efficacy—A Review Extra virgin olive oil consumption reduces the risk of osteoporotic fractures in the PREDIMED trial Collagen May Help Protect Brain Against Alzheimer's Disease Stress and Eating Behaviors Can Food be Addictive? Public Health and Policy Implications Monetary Costs of Dementia in the United States Featured Guest/People Mentioned: Max Lugavere (@maxlugavere) Instagram Max Lugavere Genius Foods: Become Smarter, Happier, and More Productive While Protecting Your Brain for Life – Book by Max Lugavere https://www.geniusfoodsbook.com/ Al Gore (@algore) Twitter Terry Wahls MD (@drterrywahls) Instagram Suzanne de la Monte - Brown University Dr. Mary Newport Richard S. Isaacson, M.D. Dr. Mehmet Oz (@DrOz) Twitter Would you like to be coached by Sal, Adam & Justin? You can get 30 days of virtual coaching from them for FREE at www.mindpumpmedia.com. Get our newest program, MAPS HIIT, an expertly programmed and phased High Intensity Interval Training program designed to maximize fat burn and improve conditioning. Get it at www.mindpumpmedia.com! Get MAPS Prime, MAPS Anywhere, MAPS Anabolic, MAPS Performance, MAPS Aesthetic, the Butt Builder Blueprint, the Sexy Athlete Mod AND KB4A (The MAPS Super Bundle) packaged together at a substantial DISCOUNT at www.mindpumpmedia.com. Make EVERY workout better with MAPS Prime, the only pre-workout you need… it is now available at mindpumpmedia.com Also check out Thrive Market! Thrive Market makes purchasing organic, non-GMO affordable. With prices up to 50% off retail, Thrive Market blows away most conventional, non-organic foods. PLUS, they offer a NO RISK way to get started which includes: 1. One FREE month's membership 2. $20 Off your first three purchases of $49 or more (That's $60 off total!) 3. Free shipping on orders of $49 or more You insure your car but do you insure YOU? If you don't, and you are the primary breadwinner, you will likely leave your loved ones facing hardship and struggle if you die (harsh reality). Perhaps you think life insurance is expensive, but if you are fit and healthy, you can qualify for approved rates that are truly inexpensive and affordable. To find out if you qualify for the best rates in the industry, go get a quote at www.HealthIQ.com/mindpump Have Sal, Adam & Justin personally train you via video instruction on our YouTube channel, Mind Pump TV. Be sure to Subscribe for updates. Get your Kimera Koffee at www.kimerakoffee.com, code "mindpump" for 10% off! Get Organifi, certified organic greens, protein, probiotics, etc at www.organifi.com Use the code “mindpump” for 20% off. Go to foursigmatic.com/mindpump and use the discount code “mindpump” for 15% off of your first order of health & energy boosting mushroom products. Add to the incredible brain enhancing effect of Kimera Koffee with www.brain.fm/mindpump 10 Free sessions! Music for the brain for incredible focus, sleep and naps! Also includes 20% if you purchase! Please subscribe, rate and review this show! Each week our favorite reviewers are announced on the show and sent Mind Pump T-shirts! Have questions for Mind Pump? Each Monday on Instagram (@mindpumpmedia) look for the QUAH post and input your question there. (Sal, Adam & Justin will answer as many questions as they can)
If you had heart disease, wouldn't you prefer advice from a cardiologist who is trying to make themselves heart attack proof? Dr Kim Williams is a vegan cardiologist. Yes you read it right. He adopted a plant-based diet 15 years ago when his cholesterol level was found to be higher than it should have been and he'd recently seen a patient's heart scan improve remarkably with a plant-based diet. He now understands that a whole foods plant-based diet should give him a longer life and should also give his patients the opportunity to reverse their heart disease, one of the greatest killers on this earth. Hence he eats, advises and advocates plant-based nutrition. After graduating from the Pritzker School of Medicine at the University of Chicago, Kim became board certified in internal medicine, cardiovascular diseases, nuclear medicine, nuclear cardiology, and cardiovascular computed tomography. He has worked at the Pritzker School of Medicine, the Wayne State University School of Medicine in Detroit and since 2013 at Rush University Medical Center in Chicago, where he is Professor and Head of the Cardiology Department. He was President of the American College of Cardiology from 2015-2016 and has also been President of the American Society of Nuclear Cardiology. Previously an elite tennis player himself, Kim is now combining his passions of tennis and plant-based nutrition advocacy with a visit to Melbourne this January. Whilst primarily here to watch the professional tennis players at the Australian Open he is also speaking at the "Young at Heart" Nutrition in Healthcare Symposium run by Lucy Stegley of Raw Events Australia on January 23rd 2018 at RMIT University in Melbourne. If you live in or close to Melbourne you won't want to miss what he has to say. As a doctor whose career combines patient care, scientific reasoning, diagnostic testing and health advocacy he has lots to tell us all about the patient stories and the evidence to support his stance that a diet devoid of animal products is the best for our heart health. He was very kind to give us an opportunity for a chat here on the New Normal Project podcast. We covered several important topics from what he eats, what patients with heart disease should eat, to what pro tennis players eat. And lots in between. Live well, feel well, do well! Claire & Andrew ----------------- Links to people, organisations and other resources mentioned in this episode: Dr Kim Williams at Rush University Medical Center: https://doctors.rush.edu/details/1728/kim-williams-sr-cardiovascular_disease-chicago-oak_park Dr Kim Williams on Twitter: @cardio10s Australian Open tennis tournament: https://ausopen.com Blog post by Dr Williams on "Vegan diet, healthy heart": https://www.medpagetoday.com/Cardiology/Prevention/46860 American College of Cardiology: http://www.acc.org Dr Caldwell Esselstyn: http://www.dresselstyn.com Dr Dean Ornish: https://www.ornish.com Portfolio diet (David Jenkins): https://en.wikipedia.org/wiki/Portfolio_diet American College of Cardiology and American Heart Association guidelines on high blood pressure: https://www.ncbi.nlm.nih.gov/pubmed/29133356 Meta-analysis by Dr Neil Barnard’s team: https://www.ncbi.nlm.nih.gov/pubmed/24566947 Adventist health studies: https://publichealth.llu.edu/adventist-health-studies Dr John McDougall: https://www.drmcdougall.com/ Dr Joel Fuhrman: https://www.drfuhrman.com/learn/the-nutritarian-diet Book - The Spectrum by Dr Dean Ornish: http://deanornish.com/books/ Mediterranean diet: https://en.wikipedia.org/wiki/Mediterranean_diet PREDIMED study: http://www.predimed.es/ Happy Cow: https://www.happycow.net/ Tennis Australia: https://www.tennis.com.au/ Rod Lever Arena: https://www.rodlaverarena.com.au/ Professional tennis players mentioned: Donald Young, Roger Federer, Rafael Nadal, Andy Murray, Novak Djokovic, Serena Williams, Venus Williams Raw Events Australia: http://www.raweventsaustralia.com/ Raw Events “Young at Heart” Nutrition in Healthcare Symposium: http://www.raweventsaustralia.com/calendar/ Raw Events Eventbrite link: https://www.eventbrite.com/e/nutrition-in-healthcare-melbourne-symposium-dr-kim-williams-usa-more-tickets-41260790134 New Normal Project website: https://www.newnormalproject.com.au/ New Normal Project podcast: http://newnormalproject.libsyn.com/ New Normal Project on Facebook: https://www.facebook.com/newnormalproject/ New Normal Project on Instagram: @newnormalproject New Normal Project on Twitter: @newnormalproj Email Claire & Andrew Davies: info@livingtheplantpowerway.com Photo credit: Noah Hannibal
Britain's leading anti-sugar campaigner and one of the most prolific doctors in the world influencing obesity thinking and highlighting the harms of too much medicine. In addition to being a Consultant Cardiologist, Dr Malhotra is a member of the board of trustees of UK health think tank, The King’s Fund and a member of the Academy of Medical Royal Colleges Choosing Wisely Steering Group Here’s the link to his website: http://doctoraseem.com/biography/ Topics covered include: No association of saturated fats and heart disease in primary or secondary prevention studies. Focus on sugar - • CVD mortality has come via reduction in smoking & trans fats with better acute AMI management. • Statins have a number needed to treat of 1 in 83 for mortality in secondary prevention in men • Stents save lives during heart attacks but not for 'stable' coronary disease • PREDIMED and Lyon heart study • Cholesterol is not the mechanism of action of how diet studies work • Practical explanation-of frying vegetable oils and dangerous omega 6 (high omega 6 to omega 3 is bad) • Butter and coconut oils have saturated fatty acids and are stable in cooking. • Criticism from the Centre for evidence based medicine (Oxford). Here is the editorial (Free) in BJSM: http://bjsm.bmj.com/content/early/2017/03/31/bjsports-2016-097285
Dr. 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 podcast is taking us to Japan today where we will be talking about aspirin for primary prevention in patients with diabetes. First, here's your summary of this week's issue. The first study provides insight into the development of neurologic injury in patients with single ventricles undergoing staged surgical reconstruction. In this paper by Dr. Fogel and colleagues from the Children's Hospital of Philadelphia, the authors recognize that single ventricle patients experience greater survival with staged surgical procedures culminating in the Fontan operation, but experience high rates of brain injury and adverse neurodevelopmental outcome. They therefore studied 168 single ventricle patients with MRI scans immediately prior to bi-directional Glenn, prior to the Fontan, and then three to nine months after the Fontan reconstruction. They found that significant brain abnormalities were frequently present in these patients and that the detection of these lesions increased as children progressed through staged surgical reconstruction. In addition, there was an inverse association of various indices of cerebral blood flow with these brain lesions. This study therefore suggests that measurement of cerebral blood flow and identification of brain abnormalities may enhance recognition of single ventricle patients at risk for poor outcomes, and possibly facilitate early intervention. The next paper uncovers a unique mechanism underlying arrhythmogenesis and suggests that the anti-epileptic drug valproic acid may possibly be repurposed for anti-arrhythmic applications. In this paper by first authors Dr. Chowdhury and Liu and corresponding author Dr. Wang and colleagues from University of Manchester UK. The authors used mouse models and human induced pluripotent stem cells derived cardiomyocytes to discover a new mechanism linking mitogen activated kinase-kinase 7 deficiency with increased arrhythmia vulnerability in pathologically remodeled hearts. Mechanistically, mitogen activated kinase-kinase-7 deficiency in the hypertrophied hearts left histone deacetylase-2 unphosphorylated, and filamin A accumulated in the nucleus, which then formed an association with kruppel-like factor 4 preventing its transcriptional regulation. Diminished potassium channel reserve caused repolarization delays resulting in ventricular arrhythmias, and the histone deacetylase-2 inhibitor, valproic acid restored potassium channel expression abolishing the ventricular arrhythmias. This study therefore provides exciting insights in developing a new class of anti-arrhythmics specifically targeting signal transduction cascades to replenish repolarization reserve, all for the treatment of ventricular arrhythmias. Does the Mediterranean diet improve HDL function in high risk individuals? Well, the next paper by first author Dr. Hernaiz, corresponding author Dr. Fito and colleagues from Hospital Del Mar Medical Research Institute in Barcelona, Spain addresses this questions. The authors looked at a large sample of 296 volunteers from the PREDIMED study and compared the effects of two traditional Mediterranean diets, one enriched with virgin olive oil, and the other with nuts to a low-fat control diet. They looked at the effects of these diets on the role of HDL particles on reverse cholesterol transport, HDL antioxidant properties, and HDL vasodilatory capacity after one year of dietary intervention. They found that both Mediterranean diets increased cholesterol efflux capacity and improved HDL oxidative status relative to the baseline. In particular, the Mediterranean diet enriched with virgin olive oil decreased cholesterol ester transfer protein activity, and increased HDL ability to esterify cholesterol, paraoxonase-1, arylesterase activity, and HDL vasodilatory capacity. They therefore concluded that adherence to a traditional Mediterranean diet, particularly when enriched with virgin olive oil, improves HDL function in humans. The final study tells us that among hospitalized medically ill patients, extended duration Betrixaban reduces the risk of stroke compared to standard dose enoxaparin. In this retrospective sub-study of the APEX trial, Dr. Gibson and colleagues from Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, Massachusetts randomized 7,513 hospitalized acutely ill patients in a double-dummy, double-blind fashion to either extended duration of the oral Factor Xa inhibitor Betrixaban at 80 mg once daily for 35 to 42 days, or standard dose subcutaneous enoxaparin at 40 mg once daily for 10 days all for venous thromboprophylaxis. They found that the extended duration Betrixaban compared with enoxaparin reduced all cause stroke by almost one half with a relative risk of 0.56 equivalent to an absolute risk reduction of 0.43 percent and number needed to treat of 232. The effect of Betrixaban on stroke was explained by a reduction in ischemic stroke with no difference in hemorrhagic stroke. The reduction in ischemic stroke was confined to patients hospitalized with acute heart failure or non-cardioembolic ischemic stroke. This paper is accompanied by an editorial by Drs. Quinlan, Eikelboom, and Hart in which they articulate three reasons that they think these results are important. First, the results demonstrated an unexpectedly high rate of new or recurrent ischemic stroke during the first three months in hospitalized medical patients receiving standard enoxaparin prophylaxis, the rate being even higher in patients presenting with heart failure or ischemic stroke. Secondly, the data demonstrated for the first time that a NOAC reduces the risk of ischemic strokes in patients without known atrial fibrillation. Thirdly, the effects of Betrixaban on stroke were dose dependent, all of the benefits were seen in those who received the 80 mg dose, whereas the 40 mg dose did not provide advantages compared with enoxaparin or placebo. While these results are encouraging, the editorialists also warn that these are based on a post-hoc analysis and should be considered hypothesis generating. Well, that brings it to the end of our summaries. Now for our feature discussion. Today our feature discussion focuses on the exciting 10-year follow up results of the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes, or JPAD trial. I am simply delighted to have with me first and corresponding author Dr. Yoshihiko Saito from Nara Medical University, Japan. As well as a familiar voice on this podcast, Dr. Shinya Goto associate editor of Circulation from Tokai University in Japan. Welcome gentlemen! Dr. Goto: I am very pleased to have this opportunity. I am always enjoy listening your podcast, and this is very interesting topic of aspirin in prevention cardiovascular event in patients with diabetes, type II diabetes. Dr. Lam: I couldn't agree more, because the burden of cardiovascular disease globally is actually shifting to Asia, and the burden of diabetes especially, is one of the fastest growing in Asia. So a very, highly relevant topic indeed. Could I start, Yoshi, by asking you: these are the 10 year follow up results, what inspired you to take a re-look at the original JPAD results and to report this 10 year result? Dr. Saito: The American guidelines said that low-dose aspirin is recommended to the type II diabetes patient for the primary prevention of cardiovascular events who are older than 30 years old, and who are not contraindicated to aspirin. That meant that almost all type II diabetes patients were recommended to low dose aspirin. However, at that time there was no direct [inaudible 00:09:49] evidence for it. So we connected the prospective randomized control trial that examined the effects of the low dose aspirin on primary prevention of cardiovascular events in type II diabetes patients without preexisting cardiovascular disease. The name of this trial, JPAD trial, that stand for the Japanese Primary Prevention of Atherosclerosis with aspirin in Diabetes. We enrolled 2,539 patients who were assigned to the low dose asprin group or the no aspirin group. So we followed them with a median follow up period of 4.4 years. The results of the original JPAD trial were that low dose aspirin reduced CV events by about 20%, but the reduction could not reach statistical significance. So I don't know the exact reason, but one is the reason is low statistical power, because event rate was about one-third of the anticipated. Another reason is that low dose aspirin really could not reduce cardiovascular events. So we decided the extension of the follow up of the JPAD trial to elucidate the efficacy and safety of long term therapy with low dose aspirin in type II diabetes patients. This extension study was named the JPAD 2 study. We followed them up to the median follow up period of more than 10 years. In this time the JPAD trial study, we analyzed the patients in a pod protocol method because the randomized control trial was ended after 2008. Finally, we analyzed the 992 patients in the aspirin group, and 1,168 patients in the no aspirin group who retained the original allocations throughout the study period. The primary endpoint were composite endpoint of cardiovascular events including sudden cardiac death, the fatal and the non-fatal coronary artery disease, fatal and non-fatal stroke, peripheral vascular disease, and aortic dissection. This end point is the same as the original JPAD trial. The main results are the primary endpoints, 15.2% of patients occurred primary endpoints in aspirin group, and 14.2% in the no aspirin group occurred in the primary endpoints. So the primary endpoints rate is singular in both groups, with the hazard ratio is 1.14 with a 95% CI is 0.91 to 1.42 with a p value of 0.2 by log-rank test. So the low dose aspirin therapy could not reduce cardiovascular events in the type II diabetes mellitus. We also analyzed these data by intention to treat analysis, the results is singular. Again, the low dose aspirin therapy could not reduce the cardiovascular event in type II diabetes mellitus. However, I was told the hemorrhagic events, total hemorrhagic events was singular in both groups, but gastrointestinal bleeding of about 2% in the aspirin group but only 0.9% in no aspirin group. That means our gastrointestinal bleeding is doubled in the aspirin group compared with no aspirin group. This is the main outcome of the JPAD and JPAD-2 trials. Dr. Lam: Thank you so much Yoshi, and really congratulations on such a tremendous effort. I completely applaud the idea of looking at the 10 year follow up trying to address the issue of whether or not it was a lack of power that limited JPAD-1, but what you found really reinforced what you found in JPAD-1, which is low dose aspirin did not reduce cardiovascular events in the diabetic group. They're still huge numbers, I'm so impressed that 85% of the treatment assignment was retained. Then furthermore you even showed increased gastrointestinal bleeding with aspirin. So really remarkable results. Can I just ask, are you surprised by the results, and how do you reconcile it with what was found in the general population studies like the Physician Health Study, or the US Preventive Services Task Force, where they really seem to say that primary prevention aspirin works in the general population when your risk is a certain amount? Dr. Saito: I think that we studied only the type II diabetes patients, so it is not clear that our results are applied to the general population, but our results is very much similar to the current European guidelines and American guidelines. Dr. Lam: That's a very interesting point about diabetic versus non-diabetic population and the utility of low dose aspirin. Shinya, you brought this up before. What do you think? Dr. Goto: For the primary prevention population cohort study, aspirin demonstrated 25% reduction of cardiovascular event. We are not recommending aspirin for primary prevention due to the balance of bleeding and cardiovascular protection, absolute risk. In Yoshi's paper, in patients with type II diabetes aspirin evened that [inaudible 00:16:13], and that is very important message he had shown in this long term outcome randomized trial. Dr. Lam: Do you think that there are some pathophysiologic differences when you study a diabetic versus non-diabetic population? Dr. Goto: Yes, that is a very important topic, and we have very nice review paper by Dr. Domenico and Fiorito. In patients with diabetes the platelet time over becomes relatively rapid as compared to general population. New platelets come to blood and COX-1 inhibition by aspirin cannot reach to enough level in diabetes patient. Still, this [inaudible 00:16:57] hypothesis, very interesting hypothesis. Dr. Saito: I think so, I think so. That review that proposed the same concept, their higher dose of aspirin as possibly effective for diabetic patient. Dr. Lam: That's interesting. Are you planning any future studies Yoshi? Dr. Saito: Yeah, maybe two times study. Dr. Goto: But anyway, the event rate is currently very low than the old [inaudible 00:17:28]. So the sample size should be huge. Huge sample size is needed for the primary prevention setting to analyze the effect of aspirin, so the number needed to treat in the primary prevention setting is more than 1000. If diabetes patient, aspirin is resistant to aspirin so the number needed to treat is getting larger. So the sample size is getting larger and larger. That is not practical to perform that clinical trial. Dr. Lam: That's a very good point that the contemporary trials like yours are really challenged by the low event rates because of improved preventive treatment across the board like high dose statins, like very, very low LDL targets, and so on. That's a good point. Actually, could I ask both of you gentlemen, and maybe Shinya you can start, can you let us know what is it like to perform such a large rigorous clinical trial in Japan? It must be a lot of effort. Could you give us an idea? Dr. Goto: In Japan, medical care system is a little bit different from the U.S. Every patient covered by the homogeneous health care system so it means it is rather difficult to conduct a clinical trial. I appreciate the effort by Professor Saito, Yoshi, it is extremely difficult to conduct the study. Japan is relatively small island, patient stick to the clinic so the long term follow up with relatively low follow up can be expected. [inaudible 00:19:15] number of patients is a challenge, and Yoshi did succeed it. We can do that and due to the baseline therapy is quite homogenous, impact of the clinical care like this has very strong impact. Dr. Lam: Exactly, and I share your congratulations once again to Yoshi for really tremendous effort, important results. Thank you so much Shinya for helping with this paper, and for really highlighting how really important it is. Did anyone have anything else to add? Dr. Saito: Yes, I have one thinking, in respect to the Japanese clinical trials. I think the Japanese evidence, as derived from Japanese clinical studies is getting better and better in quality. Almost all Japanese clinical trials enrolled only Japanese patients, so the way the Japanese not so good at to organize the international clinical trial because of the, one is the language problem, and the other is funding problem. In Japanese funding agency, the AMED, that is similar to the NIH in United States, but AMED is not so strong as NIH so that they cannot give a bigger budget to the Japanese clinicians. That is another problem to organize a big clinical trial. The funding [inaudible 00:20:49] apprenticeship without holding investigators are very, very important to be better clinical situation in Japan, I think so. Dr. Lam: Thank you for listening to Circulation on the Run, don't forget to tune in next week.
The role of branched-chain amino acids (BCAAs) in cardiovascular disease (CVD) remains poorly understood. We hypothesized that baseline BCAA concentrations predict future risk of CVD and that a Mediterranean diet (MedDiet) intervention may counteract this effect.
Highlights from the November 18th issue, presented by Dr. John Fletcher, editor-in-chief, and Dr. Kirsten Patrick, deputy editor for CMAJ. In this issue: vitamin D levels in non-dairy milk alternatives, research on Mediterranean diet and metabolic syndrome in the PREDIMED trial, C-CHANGE cardiovascular guidelines, nutrition in dementia, hallucinations case, physician-assisted dying viewpoints, and more. Full issue table of contents: http://www.cmaj.ca/content/186/17.toc
DIETA MEDITERRÁNEA Y PREVENCIÓN CARDIOVASCULAR - UMH Prof. MIGUEL ÁNGEL MARTÍNEZ GONZÁLEZ Catedrático de Medicina Preventiva y Salud Pública, Universidad de Navarra. Director del grupo de investigación PREDIMED http://www.predimed.es/ Plan DIVULGA 2014 Servicio de Innovación y Apoyo Técnico a la Docencia y a la Investigación. Vicerrectorado de Estudios. Universidad Miguel Hernández
© 2020-2025 Ivy Podcast Discovery LLC
