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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Link to Video Interview, Research and Show Notes: https://bit.ly/3U5RIaS

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.