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Hear directly from leading scientists Dr. Scheperjans and Dr. Auvinen about the intricate dance between gut bacteria and the brain, the potential pitfalls of probiotics, and the hidden dangers of certain antibiotics. Explore how lifestyle choices like diet and exercise forge a path toward potentially mitigating Parkinson's symptoms and discover why the Mediterranean diet might be a key player in delaying the disease's progression. Whether you're seeking answers on preventing Parkinson's or finding hopeful strategies for management, this episode is a crucial listen. Join us to empower yourself with knowledge and proactive steps towards better health through the lens of the latest scientific findings.
Spoiler alert: Turns out the microbiome is controlled by our lifestyle. That's even more reason that now is the time to revamp your daily routines into ones that revitalize your life. Sign up for a discovery meeting at cprhealthclinic.com
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Is it possible that the key to combating Parkinson's disease lies hidden within our own gut bacteria? This episode of 'The Unseen Influencers: Gut Bacteria's Role in Shaping Parkinson's, Part 1,' delves into this intriguing question. With insights from renowned researchers Dr. Scheperjans and Dr. Auvinen, we embark on an extraordinary journey through the latest scientific discoveries at the intersection of neurology and microbiology. Prepare to be enthralled by the evidence pointing to our gut's role in shaping the outcomes of Parkinson’s disease, as we uncover new hopes for diagnosis and treatment. By the end of our discussion, you’ll see the gut-brain connection in a whole new light. Tune in to unlock the mysteries of how microscopic organisms could hold the power to change the lives of millions affected by Parkinson's.
Spoiler alert: Turns out the microbiome is controlled by our lifestyle. That's even more reason that now is the time to revamp your daily routines into ones that revitalize your life. Sign up for a discovery meeting at cprhealthclinic.com
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Dr. Duarte Machado is a neurologist specializing in Parkinson's Disease and has a personal connection with this condition.
This episode discusses the importance of understanding Parkinson's disease, identifying early symptoms such as changes in smell and bowel habits, risk factors including environmental exposures and genetic factors, impact of stress on Parkinson's, potential sources of toxins like microplastics, different treatment options including medications and non-medication therapies, and the importance of building a multidisciplinary team for comprehensive Parkinson's care.
Find out how you can make meaningful, tangible, durable improvements to your health at cprhealthclinic.com
Schedule a free consultation.
(Below is a portion of the AI-generated transcript. If you want the whole thing, check out cprhealthclinic.com)
Dr. Sagar: every single individual is like a different chain of dominoes falling down. Does that sound, so that's, that's difficult. So how would I notice in myself if I was developing Parkinson's? What would I see?
Dr. Duarte: The early symptoms that can be enough to seek attention of a neurologist would be, if you know this change in. Sense of smell. So if you're having difficulties. Smelling things in the same way, or even taste because smell and taste are links of foods on taste the same way. You can't smell odors.
In the same way, if there's a change in your bowel habits so that if you were, someone who had a bowel movement daily and now you're going two to three days without having a bowel movement that could be a change. And then as I mentioned, the one with the greatest predictor of concern is REM behavioral disorder.
So if you notice a change in your sleep, such that you're yelling, talking thrashing falling on the bed, that's a problem. Even early on,
Dr. Sagar: That one's not subtle.
Dr. Duarte: No, that, that was not settled. When I was a neurology resident , one time I was called down to the ER because a person had come to the ER with injury having fallen on the bed.
. The patient was saying, well, why did they call neurology? Like I, I fell out of bed. , what does this have anything to do with neurologists? And I said, well, we know babies can fall out of bed or infants, but adults don't fall out of bed. We know that signals some neurological problem.
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Dr. Duarte Machado is a neurologist specializing in Parkinson's Disease and has a personal connection with this condition. He is a leader in helping care for those with Parkinson's. In this episode, he takes away some of the mystery around this disease. Learn if what you're seeing, or experiencing, might be Parkison's and what that means.
Find out how you can make meaningful, tangible, durable improvements to your health at cprhealthclinic.com
Schedule a free consultation.
(Below is a portion of the AI-generated transcript. If you want the whole thing, check out cprhealthclinic.com)
Dr. Sagar: Thank you everyone for joining us on this new season of CPR for Life. This time we'll be delving into Parkinson's disease.
Unfortunately, it's a growing scourge, but the good news is you do have some control. Joining me today, luckily, is the perfect person. To help us explore this topic, Dr. Duarte Machado is a board-certified neurologist with subspecialty training in movement disorders, aka Parkinson's and other things like that. He committed to a career caring for those with movement disorders while still just a high school student when his grandma was diagnosed with Parkinson's disease. He completed neurology residency and fellowship training at the Yale School of Medicine. He practiced at Yale for some time, but is now the Director of Program Excellence and Recognition at the Chase Family Movement Disorder Center in Hartford, Connecticut.
He's also deeply involved with research, and education, and has extensive experience in deep brain stimulation. On top of all that, he also serves on the Board of Directors of the American Parkinson's Disease Association, Connecticut chapter, in addition to other leadership roles such For other societies, Dr.
Machado, welcome to the program. And thank you for being here.
Dr. Duarte: Oh, thank you so much for having me here.
Dr. Sagar: Yeah. So that's an interesting story that you were just a high school student. That's a rare thing to know what you're going to do with your entire life. When you're still in high school, tell us more about what happened with your grandma and how that impacted you.
Dr. Duarte: Yeah. So my parents are, they're both immigrants and they came to this country to really achieve the American dream of providing opportunities for their children. They both have a fourth grade education only. And they were came here with little skills and so, settled in a blue collar town and did factory work.
And so I didn't have. Much knowledge about what opportunities there were beyond what my parents were doing. And they would only emphasize, please get as best an education you can so that you can do more than the type of work that we're doing. So when my grandmother then was diagnosed with Parkinson's, it was the first major illness that, that we had.
Came to our family and she, , lived just a few houses down from where I lived and we were very close. And at the time I was a high school freshman and started, , went to a visit with her and was just odd at learning more about this condition that now afflicted her. And I said, this is what I want to do this, to learn more about this particular condition and learn how to help her and many others with this ailment.
So, by the time I was a senior in high school, I said, I'm only applying to programs that have neuroscience majors. And then even. Went through 4 years at an undergrad and then went directly to medical school at UConn and knew right off the bat that I wanted to be a neurologist, even though exposed to many other fields and in the 3rd year.
Still neurology was number one and movement disorders in particular. So I never missed a beat in my path to get to where I am now. Yeah,
Dr. Sagar: were called to it and you're a man on a mission. Even still, we're just talking about how you just finished seeing some patients. As soon as we're done, you're still going to see some more patients. There was no, no rest.
Dr. Duarte: right.
Dr. Sagar: tell me more about what you saw in your grandma and use that to help us understand what the heck Parkinson's disease actually is.
Dr. Duarte: Yeah, so Parkinson's the diseases whereby there is a loss over time of. Cells that make a neurochemical called dopamine and dopamine is the main neurochemical necessary for initiation of movement. So the main cardinal feature of Parkinson's is slowness of movement that people just take longer to initiate that motion.
So there's slowness in their ability to. to move that in conjunction with other symptoms such as tremor or stiffness or what's called postural instability or change in posture. Those four motor features constitute the primary symptoms of Parkinson's. So not everyone has to have tremor. So there are subtypes of Parkinson's depending on the, what motor symptoms are present.
Certainly I saw this, that slowness of movement and some postural change with my grandmother that initially as is seen often, is attributed to aging. But certainly there, one can differentiate between what's normal aging and what's abnormal aging. And with her she also had some other symptoms that, pointed to this being abnormal, and for her to seek the care of a neurologist.
Dr. Sagar: What do you mean by postural changes? How does a person look different?
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Coming up this season: Parkinson's Disease.
By 2040, about 13 million people are expected to be diagnosed with Parkinson's.
Odds are that you'll know someone with this illness, and it might be you.
What is Parkison's exactly and what can you do about it?
In the meantime, if you're having trouble breaking into good habits, then you may need a health coach. See one that knows what you're experiencing and how to prioritize.
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Can stress really contribute to a heart attack? If so, is the answer to eliminate stress?
Join me as I take the mic to delve into a topic important to my own survival: stress and heart disease. I have a special interest in stress; I work in a field where most people burnout and have a family history of heart disease. There's a course at CPR all about stress available here.
Also, this is the last episode for this season. Keep an eye out for the next season of episodes, when the weather is warm.
Find out how you can make meaningful, tangible, durable improvements to your sleep and health at cprhealthclinic.com
Schedule a free consult.
What if I told you that you could rewrite your genetics? That just because your parents died early, doesn't mean that you will. This is the science of epigenetics. Today we talk with leading expert Dr. Shimul Chowdhury about our genes NOT being our fate.
Find out how you can make meaningful, tangible, durable improvements to your sleep and health at cprhealthclinic.com
Schedule a free consult.
(Below is a portion of the AI-generated transcript. If you want the whole thing, become a site member for free.at cprhealthclinic.com)
Dr. Sagar: Welcome back everybody to what is going to be the last planned episode for the series on heart attacks. I want to get into something that we haven't touched on yet, but it's still vitally important when talking about heart and blood vessel disease, cardiovascular disease, and that is. Stress.
It's just going to be me today. So to set things up, I want to give you two examples of patients. I had come into the emergency department one, we're going to call it Bonnie. She's a 60 year old woman that came into the emergency department. The ed. Via ambulance after an argument with her sister, a very heated argument. And during that. Her chest started to hurt the pain, went up to her neck, down her arm, and it felt like a heart attack in the past. She's already had one. Another patient is an 80 year old man that will call Clyde. He had his wife bring him to the emergency department and he was having chest pain too. It doesn't move anywhere to get short of breath with it. And it's happened before. He's also had a heart attack before, and he's not sure if they feel similar or not. Also, he just found out that his son is in prison. So the question is. Are these heart attacks. Neither of these people was even shoveling the driveway. So most people would say, nah, Can stress really have an effect on the heart. It's been said by some that stress isn't real or that it's all in your head. Frankly, the entirety of reality is our head. But more on that later. It's also been said that stress is dangerous and so we should do everything we can to reduce it. --Is that true?
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What if I told you that you could rewrite your genetics? That just because your parents died early, doesn't mean that you will. This is the science of epigenetics. Today we talk with leading expert Dr. Shimul Chowdhury about our genes NOT being our fate.
Find out how you can make meaningful, tangible, durable improvements to your sleep and health at cprhealthclinic.com
Schedule a free consult.
(Below is a portion of the AI-generated transcript. If you want the whole thing, become a site member for free.at cprhealthclinic.com)
welcome to CPR for Life, everyone. I often meet people who think they are screwed because of their family history. They say things like, everyone in my family dies early from heart disease. So why shouldn't I just enjoy my Big Mac and cigarettes? They feel powerless against their genetic destiny.
Today's guest is going to help us realize that we have much more control of this destiny than we might think, both for ourselves and maybe even for our kids.
He's an incredibly smart guy using his knowledge to help improve lives, particularly those of children. But before I introduce him, And we start talking to them. I wanted to give a little bit more introduction to epigenetics because probably most people haven't heard of it. It's relatively new, only been around for about 40 plus years.
And we'll go into exactly what it is for when we talk to our guests. But before that, I just wanted to give some examples. Of what it means. Some cool examples of epigenetics playing a role. Or that fruit lies. We'll change the shape of their bodies and their wings. And response to different environmental factors like temperature.
These epigenetic changes can even be passed down. Two children.
There was an unfortunate time called the Dutch hunger winter. During world war II. Where Germany cut off food to the Netherlands. And so people were starving, including pregnant women that were malnourished. And so the children. We're born . Had a much higher risk of developing obesity and other metabolic diseases. Because that malnutrition. Changed expression and genes.
And then literature is showing that their relationships between how genes are expressed and things like high blood pressure, aging, diabetes. , high cholesterol, for example, there've been discoveries of certain genes. That when epigenetically changed, affect how atherosclerosis. Develops that's the plaque inside the blood vessels that can lead to heart attacks. That can also change how high your cholesterol levels are.
as another example, chronic stress, particularly traumatic stress. Can alter the expression of genes and can make a person even more sensitive to stress. It's like a vicious loop and of course everything's connected to everything. And one example of that is that stress can alter the microbiome and then the resulting changes in what those bacteria in the gut produce can change gene expression. So after
That I really do need to mention two things. Number one, take the CPR stress course. You'll find it at www.cprhealthclinic.com/stress, and two… eat your vegetables. And your fruits and your whole grains and your legumes.
Anyway, that's enough of my long introduction to the topic. Let's get to our guest. Dr. Shimul Chowdhury is a board certified clinical molecular geneticist who's also the vice president of lab operations for Clear Note Health and also works closely with the Rady Children's Institute. for genomic medicine. Additionally, he's a researcher with many peer reviewed publications. Welcome, Dr. Chowdhury.
Thanks, Dr. Thanks for having me.
So tell us, Shimul, what's your background? How did you get into genetics? What do you do?
I've always had a lot of interest in genetics from an early age, even just working in laboratories. The first lab I was in was a genetics lab where they were looking at DNA and making diagnoses of genetic diseases from the tests that they were running in the laboratories.
So my career has really been focused on Genetics and epigenetics will be talking about today and its impact on human health and kind of the role that I have is I have a PhD background, so I spent a lot of time in the lab, but really trying to be a bridge between the laboratory. And physicians and clinical practice.
So taking some of these technologies to look at genetics and epigenetics, how we can use them to improve human health, either through diagnosis or risk prediction things like that and trying to take some of this, these complex scientific concepts and make it understandable for physicians and for patients.
So I've been. involved in, developing multiple tests that are used clinically. Now talk to a lot of different physicians and been part of different clinical studies to make sure we're doing it responsibly and doing it right. So yeah, it's been a passion of mine for a long time and, been able to apply it into pediatric setting as well as in the adult oncology setting that I'm sure we'll.
Touch base on a little bit as the podcast goes along. So yeah, it's an exciting concept, exciting field. And , yeah, I'm very excited to talk more about it.
, and as people learn what the genetics, epigenetics is, I think they'll get more excited too. But first question for you, I ask everybody, what's your definition of health?
Oh, that's a good question. My definition of health is being in balance in all aspects of your life. I guess that's physical is a big part of it. Mental, social, spiritual, and they all play off of each other. And yeah I think they all can influence each other. So trying to. To maintain a balance of that is I think something we're all trying to strive for.
I would agree with that. So tell me, Now, take us into epigenetics, first off, describing what the old paradigm of just genetics is or used to be, and how epigenetics adds to that.
Yeah, , so I would think of it this way for folks. Again, people may or may not be aware of just like the fundamentals of genetics. We have these four letters that are our genetic code, A's, C's, T's, and G's. And we have 3 billion letters pairs of letters in our DNA sequence. And that's the, and that's the code of life.
So these strings of letters. Code for genes, which code for proteins that do all the functions of our body help develop our organs, determine our appearance things like that. And we have these trillions of cells in our bodies that all have the same. DNA, right? The same genetic code, but obviously they do different things.
They have different functions. And one of the main reasons for that is the epigenetics side of things. So epi, like the prefix of it, the EPI part literally means on top. So upon the DNA. And so what is happening in epigenetics is basically you have these modifications that are happening on top of the DNA sequence that impact the expression of genes.
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By this point, you know that physical activity is essential -- but how do you start?!
Let's tackle the thing many people avoid or do wrong - strength training. Today we talk with Kevin Cory who is the owner of Experienced Fitness gym and a professional trainer.
Here are Kevin's recommended sources of information ( I have not vetted them):
Brad Schoenfeld, PhDwebsite: https://www.lookgreatnaked.com/Twitter: https://experts.mcmaster.ca/display/phillisTwitter: https://www.billcampbellphd.com/Find out how you can make meaningful, tangible, durable improvements to your sleep and health at cprhealthclinic.com
Schedule a free consult.
(Below is a portion of the AI-generated transcript. If you want the whole thing, become a site member for free.at cprhealthclinic.com)
Kevin Cory: I feel like there's no single person who would not benefit by having more strength and working out with weights.
Dr Sagar: Hello everyone. Today we're gonna do something a little different for this podcast. I've been hearing from people, and it seems like many folks have trouble with the actual initiation of a physical activity program, and on top of that, they're a bit intimidated by it, especially when it comes to resistance training or strength training.
We had a prior episode with Dr. Franklin, a renowned
exercise physiologist, and he thought that cardio was priority number one, and strength was priority number two, but even he. Had trouble doing the ladder. So I've brought someone in that I've known for many years and who has spent the last 14 years helping people of all walks improve physical performance.
His name's Kevin Cory Corey, and he owns the boutique gym in Westville, Ohio, known as Experience Fitness. He's also a personal trainer thanks for being here today.
Kevin Cory: Thank you. I appreciate Thanks for having me.
Dr. Sagar: Of course. first off, I'd like to ask people, what is your definition of health?
Kevin Cory: Yeah, so I think of health , as various biomarkers, various health biomarkers, cholesterol, blood pressure, A one C, your risk for
Dr. Sagar: I.
Kevin Cory: but also I think of it as strength and muscle mass as well. We've all heard about blood pressure, cholesterol. These are risk factors for disease, for dying early. But when it comes to strength, that's a rarely talked about subject. If you, as we all age, we all lose strength and muscle mass unless we intervene with strength training. And as you age, you lose muscle mass. You also lose bone density. lose the ability to control your body as well. So having more
Dr. Sagar: Mm.
Kevin Cory: allows you to move your body easier. It allows you to have denser bones. So should you actually ever fall, may not your femur or your hip. you may just merely get, a bruise, hopefully. so strength is one of those things. , I'm very passionate about that, that people should be doing more often.
I feel like there's no single person who would not benefit by having more strength and working out with weights.
Dr. Sagar: Yeah, and that's a really good point. We don't typically talk about strength. Anytime a person talks about exercise, number of one thing they're talking about is walking or running, possibly bicycling, maybe even swimming. And it's hardly ever talked about resistance training. That's an interesting take on things.
So I gotta ask you, how did that become a focus of yours? what's the role of fitness in your life? And then how did that transition into bringing that passion to other people?
I.
Kevin Cory: I grew up in a household where fitness was a high priority. My mother stayed in shape. My father was a bodybuilder. He was the amateur bodybuilder here in Ohio.
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Sleep expert, Dr. Imran Shaikh of the American Academy of Sleep Medicine, pulls back the covers on how sleep affects your heart health.
(*Unfortunately, there is the sound of a creaky chair and some other background noise in this episode; sorry about that! I like to imagine it as a purring cat :-)
Find out how you can make meaningful, tangible, durable improvements to your sleep and health at cprhealthclinic.com
Schedule a free consult.
(Below is a portion of the AI-generated transcript, if you want the whole thing sign up for the newsletter at cprhealthclinic.com)
Dr. Sagar: That's a good description of how we can figure out our sleep is in need of help. Let's shift gears and talk about treatment. Obviously the treatment depends on what the cause is, but if the person has other medical conditions too, for example, Cardiovascular disease. Does that treatment then change?
Dr. Shaikh: Yeah. So definitely it will play a factor in, into what the actual treatment would be.
. You would definitely have the same options, but I just might push one option more than the other. When it comes to treatment, it is I do tend to really try and get good feedback from the patient as well, just to overview what the treatments are , for sleep apnea.
There are a couple things that you can just do on your own. And that's what I always start with is one is working on the weight. We know weight is directly linked to sleep apnea, so getting your weight down the best you can, and it's not easy, it's not gonna happen overnight, but it's a lifestyle change.
You wanna change your lifestyle to work on ways to control your weight. And then position, we know that sleeping on your back is notoriously worse for sleep apnea. So we recommend actually sleeping off your back, , for sleep apnea purposes alone. And if you find that you are on your back more than doing things to either try and get your head, your bed elevated, if you have an adjustable bed or like a wedge pillow or can find some way to get it elevated one way or another, or finding ways to just stay off your back, sometimes they have these devices that you can use that basically are like our bump on the back, that it's a belt that you wear so that if you roll over onto your back, then you naturally will roll back over.
Dr. Sagar: uncomfortable.
Dr. Shaikh: Yeah. You just make
yourself uncomfortable. weights and positional therapy, those are the two most important things that are really recommended for. That's for everybody, and things you can stop right away. And I tell you just that's things to just focus on right away. Then in terms of actual treatments, you're looking at
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Sleep expert, Dr. Imran Shaikh of the American Academy of Sleep Medicine, pulls back the covers on how sleep affects your heart health.
(*Unfortunately, there is the sound of a creaky chair and some other background noise in this episode; sorry about that! I like to imagine it as a purring cat :-)
Find out how you can make meaningful, tangible, durable improvements to your sleep and health at cprhealthclinic.com
Schedule a free consult.
(Below is a portion of the AI-generated transcript, if you want the whole thing sign up for the newsletter at cprhealthclinic.com)
Dr. Sagar: The time when you lay your head down on your pillow may feel like downtime. But for your brain and body, it's just a different kind of go-time. How do you know if your sleep is good enough to protect your heart and how can you get it better?
Dr. Sagar: I'm lucky to be joined today with Dr. M Ron shake. He's a sleep medicine and obesity medicine specialist, as well as an internal medicine physician. He works in both hospital and primary care in Illinois. He did his training at SLU or the St. Louis university. And a sleep fellowship at rush university in Chicago.
He's currently an active member of the American academy of sleep medicine, particularly in public awareness.
Welcome to the show. Thank you for being here.
Dr. Shaikh: Well, thank you so much for having me.
so many problems with sleep, so many problems with weight that just leads to so many other problems. So, Happy to discuss more with you today.
Dr. Sagar: Yeah, so right as we get in, just one question I like to ask people is, what is your definition of health?
Dr. Shaikh: So I'd like to think of health as a big component of multiple things, but the main components I think are your physical health, your mental health, your social wellbeing, and your sleep. So those are a lot of the topics that I tend to pick on a lot and try and review as much as how are you doing physically, what are you eating?
What are you drinking? Are you exercising? How's your mood? Are you in a good mental state? How are you in society? Do you have a job? Are you connected with your community? And then sleep, which a lot of people don't pay enough attention to, but is essentially one of the biggest pillars of a good, healthy lifestyle.
Dr. Sagar: Yeah, foundational.
Dr. Shaikh: it is very foundational. Yeah,
Dr. Sagar: Oh, so let's start right there. What is sleep? Is it the same thing as a coma?
Dr. Shaikh: No, not the same thing as a coma, but sleep is essential. It is what we use to keep ourself healthy and functioning. It allows your body basically the ability to repair, restore, re-energize. It helps us reset and really helps us balance a lot of things in our body, including, like our hunger and appetite.
It helps us improve concentration, productivity. Productivity reduces issues in mental health. Helps relieve like stress and anxiety and it even improves our immune system. So it's really a very, very critical part of time in our day-to-day life that really allows us to reenergize again.
Dr. Sagar: It sounds like you are passionate about it, which is fantastic. How did you actually find that passion for sleep medicine while you were in internal medicine? How did you choose to get into that particular field?
Dr. Shaikh: So it's interesting, I definitely, from the get go, didn't wanna do sleep medicine initially. I didn't even know anything about it. Honestly, you don't really get too much exposure to it in training, I actually initially wanted to do cardiology. I wanted to be a cardiologist. But then the more time I spent in my training, I realized that I didn't want to be the person who had to step in when something severely bad was already happening.
I wanted to be more of that person who's helping you prevent that from happening. And I think that's one of the biggest shifts in medicine nowadays, is that we're really trying to take more of a preventative approach rather than a reactive approach.
I did an elective in my training and I just loved it at that point. And I realized how related it is to so many other medical problems.
Really, every other organ, every other body system is somehow affected by sleep.
There's just such a correlation between sleep and obesity that they really went hand in hand. And that's kind of how I ended up getting into both of those.
Dr. Sagar: trying to complete the picture to help people the most with their prevention.
Dr. Shaikh: Exactly, exactly.
Dr. Sagar: so what does sleep have to do specifically with cardiovascular disease? Heart and blood vessel disease. I.
Dr. Shaikh: So multiple things, it is, there are multiple different sleep disorders, so you kinda have to break it down a little bit. But in general, poor sleep quality and , poor sleep duration has been linked to quite a few cardiometabolic risk factors. Most commonly things like high blood pressure, obesity, diabetes, coronary artery disease where you're having artery buildup and there is a high rate of death among patients with heart disease who are having sleep problems as well too.
Dr. Sagar: What do you mean by that? The higher people with heart disease, if they start sleeping worse, they end up dying more or...
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World expert cardiologist Dr. Tang of the Cleveland Clinic, takes us into the universe of the gut microbiome and describes the little-known ways that food impacts the heart.
Find out how you can make meaningful, tangible, durable improvements to your health at cprhealthclinic.com
(Below is a portion of the AI-generated transcript, if you want the whole thing sign up for the newsletter at cprhealthclinic.com)
Dr. Tang: Nowadays there is a lot of option for us to actually get people to live their full lives and even for some of the sickest patients , who, had a really rough time after a heart attack,
Dr. Sagar: We're back with Dr. Tang. Renowned cardiologist and researcher to continue the conversation on the effect of the gut on the heart.
We left off talking about nutritionally deprived populations.
Dr. Sagar: When you say nutritionally deprived populations, I think a lot of people are gonna be thinking of areas where there is no food at all. But are you talking about that or are you talking about our modern day world where all the food is coming from a gas station?
Dr. Tang: Well, I think that that is an evolving trend. But for example I'm talking about in the 1930s, forties, fifties, that there are some people that have some nutritional deficiency that we actually fortified many of the foods and all that. So we actually did put in a lot of nutrients for the assumption of , benefit.
But I think it is okay if we know what we put in. The problem is there's a lot of things that we don't know is in the food right now. Particularly things that are, highly processed and , and there are studies out there, we don't know what they are, but I think we know that some of them may not be.
So there are people who have isocaloric food with crossover study that look at processed foods versus not processed food, and they have certainly see, you know, problems with, metabolic or weight change or whatnot. So that's actually, , puzzling because if you have the same type of food, but yeah, it's processed versus not, , why would they be different?
Certainly something made them different. And so that's why I'm trying to say , it's, we still have a lot to learn because I think it would guide us in our public health efforts to try and, you know, at least advise our patients what to do. Right now we as clinicians are not very good at understanding what they are eating and even.
Explaining to them what they should eat. Many people are very motivated to actually change their diet. There are many very excellent organizations and many very vocal clinicians and many pathways, but the research on this is challenging. It's very challenging to study diet because it's such a complex intervention.
And, and there's a lot of really strong cultural beliefs in, in food, , if I actually ask all these people, ask everybody, how is your diet, , even quantifying the amount is difficult, let alone qualifying what they are eating. And there's a lot of strong beliefs out there about whether some things are good or bad.
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World expert cardiologist Dr. Tang of the Cleveland Clinic, takes us into the universe of the gut microbiome and describes the little-known ways that food impacts the heart.
Find out how you can make meaningful, tangible, durable improvements to your health at cprhealthclinic.com
(Below is the AI-generated transcript, if you want the whole thing sign up for the newsletter at cprhealthclinic.com)
Dr. Tang: the small molecules that float in our body and we know of course we've got cholesterol and sugar, but there are many other things
Dr. Sagar: I am honored to have with us Dr. W h Wilson Tang, to share just a portion of the knowledge that he has with us. Dr. Tang is a leading researcher and cardiologist practicing at the Cleveland Clinic and the Lerner Research Institute. He studied neural and molecular sciences prior to attending medical school at Harvard, and then did residency training at Stanford and a cardiology fellowship at the Cleveland Clinic with further fellowship there into heart failure and cardiac transplantation.
His research work focuses on finding and understanding the underlying mechanisms that lead to heart disease, and for his significant work, he was awarded the Distinguished Scientist Award from the American College of Cardiology in 2022 . So thank you for coming on today.
Dr. Tang: Thank you for having me.
Dr. Sagar: Before we get into. The real details. This is a very specialized area of research, or at least it seems that way to me, being on the outside. How did you get from just thinking about going to medical school, to finding yourself here doing cardiac transplantation, medicine, and researching poop?
Dr. Tang: Well if you say it that way, it's kind of interesting, but truly it was just like most things is serendipity. I've always long to , be a good doctor and be a good cardiologist. And I was fortunate enough to come here to the Cleveland Clinic where I learned a lot, and I stayed here as staff and specialized in heart failure transplant.
That's my day job. But as we continue to see our patients they are more questions than answers. I think most doctors would recognize that and is really the patients that got us to think about, , or rechallenge what we are doing and what are the things that get them sick and continue to let the disease progress.
And if you think about a heart failure transplant is really the, the common final pathway to, , progressive heart diseases, whatever you've got, coronary disease or valve disease or arrhythmia, or the heart just get weak got hit by a virus or whatnot. And what we have continued to really struggle with is, How the different organs interact with each other in terms of promoting disease.
So I had the fortunate to work with many very brilliant minds both in terms of people working with me , and people that we trained and have explored various different ways. I was I jokingly called a closet nephrologist before. I wanna, I've always liked the physiology of kidney so as most trainees and so, and one of my favorite areas also endocrine.
So what would combine cardiology, endocrine and nephrology? We heart failure. And so what we have is a lot of people who are continually congested, patients with progressive cardiorenal problems. And one of the well known, you know, facts of renal dysfunction is progressive accumulation of uremic toxins.
Dr. Sagar: To translate from science to English. Heart failure is linked to not just the heart and vessels, but hormones and the kidney. Cardio means heart renal means kidney nefro also means kidney. You remove toxins are things that will do harm. If not eliminated by the kidneys. Also you're about to hear the term metabolite and that's just a tiny molecule made in the process of metabolism.
Dr. Tang: And that area actually got us interested early on in look at metabolites that are accumulating in the body that causes problems that lead to cardiovascular disease.
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Part 2! Nutritionist Heather Borders (former astronaut trainer and engineer) takes us into the nuts and bolts of how to eat when heart disease is a concern.
Find her at Kailo Nutrition
Find out how you can make meaningful, tangible, durable improvements to your health at cprhealthclinic.com
(AI generated transcript below, so there may be errors; for the full transcipt, join the email list at cprhealthclinic.com)
Heather Borders: No one really prepared me for how much of it it's gonna have to talk to people about carbohydrates,
C p r. It's what happens after someone dies as a last ditch high intensity effort. Unlike the movies, it usually fails. What if we used that drive while we're still alive to heal ourselves? Welcome to C P R for life where we help you understand how to reclaim your health by changing your everyday life.
I'm Dr. Sagar Doshi, board certified in both lifestyle and emergency medicine and Certified Health Coach.
Our health is like a vehicle. I've seen too many people, including my own family, crash their health because they don't realize they are the ones driving. This podcast aims to help each of us take the wheel and learn where to go. But even though these conversations are evidence-based, they are just for your education.
So please talk with your physician before making changes.
Let's pick up where we left off in our last conversation.
Heather Borders: this isn't a no fat lifestyle. This is a low fat lifestyle.
Dr. Sagar: So two
questions based
on that
Track 1: Mm-hmm. Mm-hmm. ...Yeah.
Dr. Sagar: and then go ahead, answer that. And then I
Track 1: So I would say that the average American probably being generous here, is probably getting in 30 to 40% of their calories coming from fat. It, there may be other sources that say it's more, but that's usually what we're seeing. And for most people, weight loss, we need to get under 20% of calories coming from fat.
and in some of the more extreme or stricter plant-based interventions, you'll see them get down to 10% calories from fat. And so that is a situation where not eating out much of all, you're not getting any oils. and you're getting your fats from, avocados and nuts and seeds and not too much
So
So that is a very plant, you can't get that, you can't do 10, 15% with much animal protein in your diet and with much processed foods , that's a pretty plant forward diet. Yeah.
Dr. Sagar: Yeah, and so that less than 10% is for people that have real concerning heart disease and don't want it
Track 1: Yeah.
Dr. Sagar: progress
Track 1: I use this analogy for a lot of GI issues, but it goes, it goes a long way with other things too. But if someone has a broken leg, like a really bad broken leg, they have to get it realigned. They gotta go put a cast on it, and they're gonna hang out in a cast for six to eight weeks, if not longer, for it to heal.
And some of the direction that the doctors are gonna tell you is don't put weight on it, don't walk on it, don't get it wet. And for the average person who is ambulatory and doesn't have a broken leg, walking is a healthy activity. and swimming, if you wanna get it wet, showering, it's a good idea.
So it is a very unique situation when someone has a very, a broken leg that they have to follow certain protocol for a while so that it heals.
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Nutritionist Heather Borders (former astronaut trainer) takes us into the nuts and bolts of how to eat when heart disease is a concern.
Find her at Kailo Nutrition
Find out how you can make meaningful, tangible, durable improvements to your health at cprhealthclinic.com
Partial Transcript Below (AI-generated, so there may be errors - if you want the whole transcript sign up for the newsletter at cprhealthclinic.com)
Nutritionist Heather Borders: we have our whole life ahead of us. I don't wanna be controlled by, the clinical world. I don't wanna have to be chained to a doctor. I don't wanna have to be chained to medication.
C p r. It's what happens after someone dies as a last ditch high-intensity effort. Unlike the movies, it usually fails. What if we used that drive while we're still alive to heal ourselves? Welcome to C P R for life where we help you understand how to reclaim your health by changing your everyday life.
I'm Dr. Sagar Doshi, board certified in both lifestyle and emergency medicine and Certified Health Coach.
Our health is like a vehicle. I've seen too many people, including my own family, crash their health because they don't realize they are the ones driving. This podcast aims to help each of us take the wheel and learn where to go. But even though these conversations are evidence-based, they are just for your education.
So please talk with your physician before making changes.
Sagar: Welcome everybody today with me. We have a wonderfully interesting and knowledgeable guest. Her name is Heather Borders. She's a culinary dietician and the founder of Kylo Nutrition, a culinary nutrition practice in Florida. Her focus is on chronic diseases such as diabetes, heart disease, and autoimmune disease.
Sagar: She became a Food for Life instructor with P C R M, which is the Physician's Committee for Responsible Medicine and has a certificate in plant-based cooking from ru, and she's also done the plant-based Nutrition course from E Cornell. She's collaborated with Dr. Michael Clapper with the Moving Medicine Forward Initiative and starting in 2023.
Sagar: She's helping with building the nutrition curriculum for a new lifestyle medicine program in Texas called New Me Health. In addition to her degree in nutrition, she has degrees in aerospace engineering, mechanical engineering, and business. You have an unusual entry into healthcare. I see on your website there's a picture of you floating in an airplane in a zero G plane. Tell me how you made your way from the engineering world, even into the engineering world, and now are a plant-based nutritionist.
Nutritionist Heather Borders: Thank you again for having me. Basically fell in love with space science , I was really young. I, I remember the, the challenger accident. I was, watching it in school and I just, I lo I, it, it kind of perverse, but that really got me started. I really was very fascinated with the space shuttle program and. I went to space camp every year from seventh grade to 12th grade, and I
Nutritionist Heather Borders: program they had at Huntsville, Alabama. And I just knew, as soon as I understood what college was and how it worked, I knew I was gonna major in aerospace engineering and I had my eyes set on working for nasa.
Nutritionist Heather Borders: I didn't know what I was gonna do, but I knew that that was the direction so, I, I just loved it and I thought, I just think, I still think space science is the coolest thing ever I love watching video and footage from space and looking back at earth and and things like that. So I graduated from Auburn University with my degree in aerospace engineering and I made my way to Johnson Space Center in Houston. And I was just one of those incredibly fortunate souls to get a position in what they call Mission Operations Directorate. And I was part of the crew training team. And so that is NASA speak for astronaut trainers. So 22 year old engineering majors are training your astronauts and it is quite
Nutritionist Heather Borders: job ever.
Dr. Sagar: Yeah.
Nutritionist Heather Borders: and so I landed in. The and thermal, systems department. So that's what I trained and I was assigned to the International Space Station astronauts. At that time it was divided into shuttle and is s and so I was is S trainer specific to electrical and thermal systems. So you show up to the Johnson Space Center and they put you into NASA school and you learn what you're about to teach.
Nutritionist Heather Borders: So it's a train the trainer program and you learn about the systems on the space station and you, and then you get further training on what you need to know so that you can train the new astronauts coming in.
Nutritionist Heather Borders: And then I did that actually only for about a year in change. And then I switched. I found this group that focused on. The health side and the medical side of, of training for the crew members. And I switched over to what was called the countermeasure systems instructor. So I got to train the astronauts on the exercise hardware that they used and how to
Nutritionist Heather Borders: and how to fix it when it broke, how not to break it, and then how to fix it when they did break it.
Dr. Sagar: Step one, don't break it. Step two, after we know you're gonna break it,
Nutritionist Heather Borders: fix it and. that was an introduction to space medicine. my introduction to life sciences came from the body responded to space flight and I was hooked. I just thought that was the coolest thing ever. I really thought it was very unique and just cool your, your spine kind of grows and you have headaches and you might get nauseated and how your blood shifts and your fluid shifts and, the, the bone loss that you get from extended time in space.
Nutritionist Heather Borders: Cuz again, the ISS crew members spend six months up there, whereas shuttles, they might spend 10 to 21 days up there. It's totally different. That was, that was kind of my introduction to being interested in life sciences where I'd never really been interested in that before. And that got me started, down the path of wanting to learn more about how does the body work on earth. And and so, at that time, which I was there from 2000 to 2005. With every new administration you get a new NASA administrator and it's , I don't know. I always felt it was like getting a new c e o every four or eight years and they were changing you. You might be on a program that gets cut because the new administrator and administration doesn't wanna do that. And I survived several layoffs. Not just layoffs, but just program cancellations. And I
Dr. Sagar: Oh, wow.
Nutritionist Heather Borders: Again, at that time there was no Elon and there was no sort of Richard Branson. Where else can I train astronauts? This is, I felt
Dr. Sagar: Mm-hmm.
Nutritionist Heather Borders: actually. And I just said, well, I wanna go back to school and I wanna get a business degree and I want to learn about. biomedical engineering. I thought, well, it's still life sciences, still it's engineering. And and that's kind of where I was in Houston. So I went to Rice and I did the dual degree program where it was a master's of engineering and a master's of business, and you just do it at the same time. And so at the time I tech, my degree is technically in mechanical engineering, but I took all biomedical engineering classes and so, so that that time my eyes were set on medical devices.
Nutritionist Heather Borders: So now I was kind of just
Nutritionist Heather Borders: So I moved from Houston to Jacksonville, Florida to work for a large medical device company called Medtronic and it was the ear, nose throat division. So yeah,
Dr. Sagar: Okay. I didn't even know that went that high. I really just know Medtronic from the heart. That's it.
Nutritionist Heather Borders: Yeah.
Dr. Sagar: Pacers, defibrillators,
Nutritionist Heather Borders: So so it was great. It was kind of intense actually, now I felt like it was science. There was this an undercurrent, it was very sciencey, but at the same time it was really just a business job. It was a marketing job. so,
Dr. Sagar: Huh.
Nutritionist Heather Borders: yeah, that was kind of my introduction to, to business. It was product manager role, so I managed the product. I, I was managing all things tonsils and adenoids. so
Nutritionist Heather Borders: all
Dr. Sagar: Okay. That's really close to the mouth though. So I see where this is going.
Nutritionist Heather Borders: So it's actually a good point in my world at that time, The big question was, or, or desire, I guess you could say, was how do we decrease the pain from a tonsillectomy? Because if you look at across the board how much pain a tonsillectomy causes, it's right up there with childbirth.
Nutritionist Heather Borders: And I've actually talked to women who's given birth and they're , I'll go through birth before I go through a tonsillectomy again.
Dr. Sagar: What
Nutritionist Heather Borders: it's really especially if you're an adult. Now most cases are with kids, but even with kids, it's horrible. It's a very painful procedure. And and so it was all about which device is gonna cause less thermal damage and which device is gonna harm the nerves less.
Nutritionist Heather Borders: And, recovery from say, six days to three days, that, I mean, it was literally that that's what we were doing. And you look at the data in, in past, I'd say 30, 40 years ago, most people got a tons ectomy due to strep throat. But if you look nowadays, it's usually cuz of obstructive sleep apnea. And I always felt like, why isn't anybody asking why that happened? And why are we bothering with trying to decrease pain from six days to three days? Why don't we start asking ourselves, do we need to do this procedure?
Dr. Sagar: Yeah, go a little further back.
Nutritionist Heather Borders: it, it started to really resonate with me. And this, to be fair, this was after I had found a plant-based diet, I'd found the plant-based diet in the middle of my time there. that was what really made me start to feel a little, more interested in nutrition and preventative, well, health and wellness and, started me ask, it's just I started asking questions, and one's really at that time in the circles that I was in, was really trying to decrease the number of procedures.
Nutritionist Heather Borders: They were just trying to decrease the amount of pain from the procedure. And I
Dr. Sagar: Yeah, they're focused.
Nutritionist Heather Borders: backwards.
Dr. Sagar: So how did you discover that plant-based diet?
Nutritionist Heather Borders: my husband and I met in, in college And I haven't known him to have low cholesterol so throughout our twenties it was, it was not even kind of high. It was two fifties and above, through our twenties.
Nutritionist Heather Borders: in the beginning we didn't really do anything about it cuz you're young and dumb. And then it just kept getting higher and higher and higher and it would bounce around two 30 s, 2 50, 2 70, 2 80. And finally we just kind of said, okay. I, I don't even remember when, but at some point we started to pretend to care and I think we tried to eat well and exercise and, and,
Dr. Sagar: what did that mean for you at at that time?
Nutritionist Heather Borders: I think it meant no obvious junk food and possibly focusing on the chicken and fish.
Nutritionist Heather Borders: Right. So a lot of ate and we were total Americans and we were totally young. We were eating out a lot. So I think we tried to not eat out as much, but I really feel like it was, it was not a very deliberate, thoughtful strategy. It was okay, we're just gonna say we're,
Dr. Sagar: Yeah, I'd say that's a very common people can identify with that. I would say
Nutritionist Heather Borders: So at, when I was at Medtronic, and this was about 2011, we had one of those biometric screenings, and my husband's cholesterol was the first time it had gone over 300, so it was three 11 and his triglycerides were 3 0 5. And....
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Make your heart younger and stronger- even if you've had a heart attack. Dr. Franklin is an internationally renowned exercise scientist and he breaks down the relevant science into usable chunks.
Check out his newest book, GPS for Success, at DrBarryFranklin.com
If you need help turning knowledge into action get a free consultation at cprhealthclinic.com
Transcript (for the whole transcript, sign up for the newsletter at CPRHealthClinic.com):
(This transcript is auto-generated and may have errors)
Dr. Franklin: Number one, I say to all patients, what are the 10 most empowering two-letter words?
Dr. Sagar: In the last segment, we left off talking with top exercise scientist and cardiac rehabilitation expert Dr. Barry Franklin about overdosing on exercise.
Dr. Franklin: so you're asking, you're saying to me, Barry, is it possible to get too much of a good thing? Yes. Mm-hmm.
Dr. Sagar: how do I know if I'm getting too much of a good thing?
Dr. Franklin: Well I in general if you're sore from one workout to another if you're tired, if you find yourself tachycardic, you're probably getting too much. People who do what we call high volume, high intensity exercise, in our experience and in the literature have two reported mal adaptations.
Dr. Franklin: Things you don't want. Number one, higher levels of coronary calcium. So marathon runners have higher levels of coronary calcium, which as you well know, is a 4runner for cardiovascular disease. Now, that's the bad news. The good news is in those same marathon runners, when we look at their blockages, the coronary artery blockages, They have more stable plaques, they're less likely to rupture, more stable, cuz there's more calcium and less lipid.
Dr. Franklin: Whereas the inactive guy has a thin fibrous cap and a large lipid core, those are vulnerable plaques and they're more likely to rupture so that calcium may not be all that bad. The note is that higher level, higher incidents about heart rhythm, irregular irregularity called atrial fibrillation.
Dr. Franklin: Atrial fibrillation can predispose somebody to transient ischemic attacks little strokes or major strokes, so to speak. Lots of studies now suggest that veteran endurance athletes are two to 10 times more likely to develop atrial fibrillation in older age, two to 10 times more likely to develop that.
Dr. Franklin: You say, gimme the thresholds, one study came out and said over 2000 hours of vigorous to high intensity exercise, and another study said, over 20 years, they're more likely to develop incident atrial fibrillation, which is in irregular heart rhythm irregularity, which people to stroke or transient ischemic attack.
Dr. Franklin: The good news is if you can get those guys to start walking and markedly reduce their exercise dosage and intensity, oftentimes that atrial fibrillation with more modest routines can revert to what we call irregular heart rhythm or normal sinus rhythm. So those are two adverse effects, potentially adverse effects that extreme exercise regimens can confer.
Dr. Sagar: You mentioned soreness and tachycardia. Did you mean after the exercise bout having, still being sore before or rather when you get to your next workout
Dr. Franklin: Yeah.
Dr. Sagar: having a fast heart rate by the time you get, all right, so not during
Dr. Franklin: Not, during, no. That, that's afterward can for days then they're probably doing too much.
Dr. Sagar: Okay.
Dr. Franklin: Yeah. look at it. Look at it this way. If, if you say to me from a standpoint of survival, here's something that people will find astounding. If you're a runner beyond, how many minutes per day do the mortality benefits level off the, the answer is go to when.
Dr. Franklin: And colleagues, Lance, at 2011, I've cited this study a thousand times when, and colleagues Lance, 2011 and basically what they found, looking at all the data, is runners who run more than 40 to 45 minutes per day. The, the survival benefits plateau plateau at about 45%. So that's, that's pretty damn good.
Dr. Franklin: But if you run two hours or three hours a day, you're not any healthier. And there may be some signs that there's what's called a reverse J shaped curve where you're, in general, the more you do, the lower the risk. But if you get to the extremes, the risk starts going up again.
Dr. Sagar: Yeah. If you get to that cumulative 2000 hours or
Dr. Franklin: Yeah.
Dr. Sagar: 20 years,
Dr. Franklin: You, you're more likely to develop atrial fibrillation, so it's possible to get too much of a good thing. Yeah.
Dr. Sagar: Okay. What about in terms of strength training? Is there too much of a good thing there?
Dr. Franklin: My knowledge, no. I mean, you can get huge muscle, muscle mass, and in fact, the studies years ago showed that elite weightlifters had lower aerobic capacities than normal healthy men, to tell you the truth. You know, they'd be bulk bulked up and so on and so forth. So, I suppose it's possible with with, with, with strength training.
Dr. Franklin: I personally think strength training is a great compliment to an aerobic training program. Shouldn't replace it, but should compliment it. It lowers heart rate and blood pressure when you're lifting any given load. So the stronger you are, the lower the heart and blood pressure carrying suitcase or whatever.
Dr. Franklin: It improves muscle strength and muscle endurance to a greater extent than does aerobic training. It maintains or enhances basal metabolic rate. So Payson says to me, geez, I wanna, I wanna lose weight. My answer is, I want you to compliment that aerobic training with some resistance training, because that really doesn't do very much for the basal metabolic rate.
Dr. Franklin: It'll, the, the resistance training will maintain or enhance muscle mass, which will preserve the BA or enhance the basal metabolic rate and burn more calories throughout the day. So those are all good reasons to use resistance training to compliment aerobics.
Dr. Sagar: Yeah. Fantastic. And I'm gonna ask you about all those different kinds of exercises in a little bit........
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Make your heart younger and stronger- even if you've had a heart attack. Dr. Franklin is an internationally renowned exercise scientist and he breaks down the relevant science into usable chunks.
Check out his newest book, GPS for Success, at DrBarryFranklin.com
If you need help turning knowledge into action get a free consultation at cprhealthclinic.com
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Part 2! of the conversation with interventional and preventative cardiologist, Dr. Heather Shenkman.
Find out how heart disease is found and treated; something that applies to most adults in this country.
To find more of Dr. Shenkman's recommendations and explanations, check out her website.
This is the heart risk calculator I mention in the show.
Ready to grab a hold of health and take it back? Schedule a free appointment.
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CPR Health Clinic- Bring Your Health Back to Life.
This starts the heart attack series for this season of podcasts; how to avoid them and heal from them. Dr. Shenkman is a heart doctor specializing in prevention and procedures. We talk about what heart disease is and what we can do to prevent and reverse heart disease. Check out her website and her book here!
www.cprhealthclinic.com - Make a free appointment to bring your health back to life.
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Hi everybody!
My brief hiatus turned out to be a little longer than expected. But good news! I'll soon be releasing the first in a series of podcasts specifically on heart disease and what we can do to prevent and reverse it. Worldwide, cardiovascular disease kills about 28 people per minute!
The first episode of this season will come out within the next several days, and then another one every couple of weeks-ish. Make sure you're subscribed so that you don't miss an episode. Thank you.
www.cprhealthclinic.com
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Hi guys,
Taking a brief hiatus to make sure I publish episodes worth your time.
Sign up for the newsletter at cprhealthclinic.com and also take the stress course, CPR for the Mind.
Take Care!
- Visa fler
