Arthritis isn't just about wear and tear of the joints; it's now being seen as a metabolic disease, affecting more than just where it hurts. Treating it effectively means considering both joint health and as well as blood sugar and metabolic health.

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Research:

Mobasheri, A. et al. The role of metabolism in the pathogenesis of osteoarthritis. Nat. Rev. Rheumatol.13, 302–311 (2017).

Kong, H., Wang, X.-Q. & Zhang, X.-A. Exercise for Osteoarthritis: A Literature Review of Pathology and Mechanism. Front. Aging Neurosci. 14, 854026 (2022).

Show Notes:

00:00 Osteoarthritis has metabolic origins.

00:30 Exercise and a low carb diet support joint health.

02:20 Exercise more, if you have arthritis.

03:50 Inflammation and body weight are involved in the breakdown of joints.

05:00 Leptin, released from fat tissue, triggers chronic inflammation.

07:05 Glucose and insulin parallel with leptin levels.

08:45 Compress your feeding window.

Scientists explored how dietary patterns impacted a number of brain health areas in 184,000 people, including: mood, cognitive function, and brain structure measured using MRI.

They found individuals who preferred a vegetarian diet (lower protein diet) and diets high in sugary beverages and snacks had the worst mental and cognitive health scores.

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Time Stamps:

0:00 Intro 0:20 Foods impact the health of your brain 0:50 Vegans have higher scores of anxiety, depression, and mental health issues 1:10 Processed meats and sugars have poorer cognitive health and higher levels of anxiety and depression 2:24 Whole foods style diet is linked with better cognitive health 3:39 Berberine for metabolic health 5:34 Protein enhances executive function and working memory 6:00 Unhealthy diets and anxiety, depression 6:53 Food categories in this study 7:37 Sugar sweetened beverages  8:00 Diet impacts brain structure  8:55 Structure equals function  9:56 Diet impacts the structure and function of your brain  11:25 Vegetarian diets and mental health

Dr. Amy West, a Sports Medicine Physiatrist, is at the forefront of a paradigm shift in understanding the root causes of joint pain, tendon issues, and other musculoskeletal problems.

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Show Notes:

02:00 CrossFit trains all three energy pathways: glycolytic, anaerobic, and aerobic. It is based on function. Physiatry and CrossFit focus on function and living better. 08:00 Metabolic health impacts recovery, injury propensity, pain levels and physical function. Leptin worsens osteoarthritis and pain issues. 12:15 Osteoarthritis is from the dysfunction of chondrocytes within the joint from inflammation and fragility of cartilage within the joint. Metabolic disease causes a downward spiral. There is more inflammation and more cartilage damage and more boney hypertrophy. 14:00 Trigger finger is often a first sign of metabolic disease. Tendons are also impacted by the inflammation of metabolic disease. Healing process is impacted by the chronic inflammation of metabolic disease. 14:54 Bone and bone density are impacted inflammation. This can appear as stress fractures. Treat the fracture and the reason why. 17:00 Hemoglobin A1C is a marker of overall glycation in the body. Non-painful things become painful with increased glycation. 17:30 The burden of age-related changes is dependent upon your metabolic state and physical wellbeing. 96% of American adults have some sort of metabolic dysfunction, making them predisposed to accelerated aging and physical decline. 23:00 Time is a major reason for not exercising. Short 20-minute bouts of more intense exercise are easier to fit in and you get the same metabolic benefits in a shorter time. 23:40 Functional movement training increases strength and supports life functions. It uses multiple joints and practices coordination. 24:30 Heavy resistance training induces the benefits of bone density and muscle integrity. 24:45 Osteosarcopenic obesity: as you gain weight, you lose muscle mass and bone. 26:00 Weakened tendons, tendonitis, and fibrosis are often a result of chronic inflammation from metabolic dysfunction like diabetes. Arthritis is the leading cause of disability in the US. 27:25 Cortisone is a potent anti-inflammatory that brings short-term pain relief. It can raise blood sugar. Repeated cortisone injections can further degrade cartilage, worsening arthritis. You can build up a tolerance to it. 29:00 Hormones affect joint pain. Menopausal decreased estrogen levels correlate to increased joint pain. 29:40 Turmeric, omega 3s, vitamin D anti-inflammatory effects can be effective in a person with a small amount of inflammation. 31:00 PRP can be beneficial in the right patient with mild arthritis or chronic tendinopathy. It is only as good as whatever is attached to it. PRP efficacy depends upon your metabolic health. 34:10 Athletes have more muscle mass around the joints making the joint more functional and eases the load bearing on the joint. Muscle secretes myokines, which affect pain perception. 34:50 Chronic inflammation from metabolic disease around your joints can affect levels of inflammation and how the inflammation is received by your brain. It can affect brain serotonin signaling. 36:00 Low carb diets produce less leptin signaling which reduces pain and inflammation signaling. 39:50 Dr. West prioritizes protein. Traditional medicine protein recommendations are just enough to keep you alive. Protein helps with satiety and powers workout gains. 41:25 Animal protein, over plant protein, can help you feel stronger. It is challenging to get enough plant protein without eating a lot of carbs. Chronic vegan/vegetarian dieting can cause collagen and bone breakdown. 50:30 Eccentric loading of the Achilles tendon can help build capacity and be more effective than chronic stretching. Tight hamstrings can be addressed with hip extension, pelvic tilting, and hip adduction. 55:25 There can be some risk to doing isolated heavy bicep work. You can develop bicep tendonitis. Over time, it can result in rupture of the bicep tendon. 58:36 Shoulder: Drill down on technique before adding load or intensity. 01:00:10 Hanging is important for grip strength and being able to manage your own body load. 01:01:10 Deadlift/hip hinge can be done using a platform to limit range of motion to maintain form. Push with your legs rather than pulling with your back. 01:02:30 Have a physical biomarker. Do an annual measure of functional movement or movements to track your strength and fitness, along with your labs. Continue to improve. Physical goals are important. 01:06:30 Coca Cola/Gatorade has invested heavily in healthcare, exercise science and exercise guidelines. Fitness professionals are pressured not to make nutritional recommendations. Coca Cola is involved in the American Cancer Society and American College of Cardiology.  

Hormones play a pivotal role in every aspect of a woman's life, from mood to fertility and beyond, understanding how to optimize their function is paramount. Dr. Elena Zinkov shares actionable strategies and insights that empower women to take control of their hormonal health and thrive.

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Show Notes:

0:00 Intro 4:50 Hormonal birth control and xenoestrogens from our environment push women into perimenopause and premature ovarian failure. 6:30 Women who come off birth control may experience early perimenopause. 9:30 Bioidentical hormones can help women coming off hormonal birth control to recuperate. 11:30 Women have more testosterone than estrogen. 13:40 PCOS is an insulin and low progesterone issue. 15:40 Women’s estrogen and progesterone are produced in the ovarian follicles. Adrenal glands also produce estrogen, progesterone, and testosterone. 18:25 AMH levels reflect the ovarian reserve. 18:50 Egg quality depends upon balanced levels of estrogen and testosterone. 21:30 DHEA is important for energy, healthy estrogen levels, blood sugar metabolism, immune system, muscle mass, and post workout recovery. 29:05 All hormones are at their peak between 8 and 10 am. 29:45 Blood/serum testing is the most accurate. 32:30 Follicle-stimulating hormone FSH helps the egg to mature and stimulates the release of estrogen and progesterone. 34:15 We are starting to see late perimenopause and menopause levels of FSH in young women. 34:40 Optimal estradiol is between 70 to 150. 35:00 The follicular phase starts on day one of bleeding and luteal starts with ovulation. 37:15 Body temperature and cervical fluid are effective ways to determine if you are ovulating. 42:00 Signs of low progesterone 46:50 Bioidentical oral progesterone 50:00 Helps with sleep: valerian root, CBD, magnesium, GABA, and L-theanine (am and pm). 53:30 Growth hormone peptides can help you sleep through the night. 58:45 Oxytocin nasal spray is neuroprotective and can help with stress management and resilience, anxiety, and depression. 59:50 Women should consume 30 to 40 grams of protein at least 3 to 4 times per day, with a minimum of 120 grams/day.

A Cochrane review of randomized controlled trials finds saturated fat doesn't clog arteries or impact your risk of heart disease.

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Research Cited:

Hooper, L. et al. Reduction in saturated fat intake for cardiovascular disease. Cochrane Database Syst. Rev. 5, CD011737 (2020).

Show Notes:

00:00 A review of randomized control trials of at least 24-month duration. 00:45 There are nutrients/vitamins in fat. 01:30 There was little or no effect on cardiovascular or all-cause mortality by reducing saturated fat for 2 years. 01:38 Reducing saturated fat possibly reduced cardiovascular events. 04:00 Heart attack risk and saturated fat reduction has no clear correlation. 05:30 Replacing saturated fat with polyunsaturated or monounsaturated fat, carbs, or protein effects did not differ. 06:15 There may be a prevention of second heart attacks with saturated fat reduction. 07:00 Other cardiovascular events and cancer outcomes effects were very small or unclear. 08:00 Carbohydrates and processed foods are often used to replace saturated fat in the diet.

'Intermittent fasting may raise risk of heart disease death,' sensational headlines read.

Not so fast...

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Video, Images and Research Cited: 

Time Stamps:

0:00 Intro 0:03 Sensational headlines

0:57 Statistical details

1:30 Nutritional epidemiology

2:54 Study period was 2003 to 2018

3:22 Only 414 people in 8 hour feeding arm

4:30 Smoking

6:47 20% died, why?

8:41 AHA Conflicts of interest

New evidence suggests fructose and sugar are major drivers of obesity and metabolic disease.

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Show Notes:

0:00 Intro 0:25 The Fructose Survival Hypothesis theory of obesity. 1:10 Fructose reduces the active energy within your cells. 2:50 Table sugar contains glucose and fructose. 2:55 Excessive glucose can be converted into fructose. 4:10 Fructose kinase enzyme is a key initiator of deleterious fructose/glucose effects. 4:55 Leptin causes you to seek more food. Excess fructose/glucose drives hyperleptinemia. 6:45 Fruit sugar increases body fat storage to help you survive the winter. 7:24 Aging pathways are disrupted with high levels of blood sugar. 10:00 Uric acid, and liver enzyme elevation may be biomarkers. 12:10 High carb/high salt diets increase risk of diabetes.

Diets high in seed oils are linked with migraines, chronic pain and developmental delay in children. Here’s the truth about seed oils and their impact on your health. 

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Time Stamps: 

00:00 Linoleic acid oxidizes easily. 00:50 Linoleic acid is stored in your fat tissue with a half life of over 680 days. 01:40 25% of total fatty acids in your fat cells comes from linoleic acid. 02:30 Soy, cotton seed, canola, and sunflower oil are in most processed foods. 03:05 Pain can be influenced by chronic seed oil consumption. 05:30 Adipose tissue linoleic acid has doubled. 06:00 We are eating less beef, pork, butter, and lard, and more chicken and seed oils. 07:25 Adipocytes become inflamed. 08:10 Inflammation from fat worsens metabolic health. 09:20 Oxidation of lipids in LDL is a major risk factor for coronary heart disease. 10:20 High intake of omega 6 fats from seed oils is associated with depression and poor mental health. 12:00 Omega 6 fat is liked to persistent pain, headaches, irritable bowel, low back pain, and rheumatoid arthritis. 12:45 Omega 3 fats are linked with reduced pain.  

Sensational media coverage of a new study claims ‘protein damages your arteries' but upon deeper inspection, the study didn't even look at artery health. 

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Time Stamps: 

0:00 Intro 0:07 Media Coverage 0:44 Actual study 1:34 Junk protein and canola oil 3:44 Graphical abstract  5:00 Immune cells and arterial plaque  6:04 Human arm of study 7:44 Mice prone to heart disease  8:50 Plant VS Animal protein  9:27 mTOR in immune cells 10:02 New mechanism of heart disease?  11:20 Human arm of study 12:13 Protein used in study  14:13 Protein stimulates mTOR 15:40 Study conclusions

A new 27 year study highlights how junk food, not red meat, is the primary driver of heart disease.

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00:00 High consumption of ultra processed foods is the main risk factor in coronary artery disease. 01:20 You can have normal LDL and still have atherosclerotic cardiovascular disease. 01:45 Junk foods negatively impact inflammation and your microbiome. 06:55 7 to 8 servings of junk food increases risk of developing coronary artery disease by 20%. 08:10 Consume real food. 09:00 Most plant-based foods are ultra processed. 09:45 Increased higher all-cause mortality is linked to junk food consumption. 10:40 Intestinal inflammation can be instigated by junk food and its packaging. 12:00 Food processing contaminants and food additives may elevate coronary disease risk. 13:20 Non-calorie sweeteners accelerate atherosclerosis.