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Winter Everett has gone on a public weight loss journey since she first appeared on 90 Day Fianc. During the upcoming season of her familys spinoff show, The Family Chantel, Winter takes a dramatic step for her health, undergoing weight loss surgery.

Fans first met Winter when she appeared as a guest in 90 Day Fianc: Happily Ever After? In 2017. Her family later became the stars of their spinoff show after grabbing fans attention with their relatable personalities.

Although Winter got her reality TV start as Chantel Jimenos younger sister, The Family Chantel now revolves around her own life. Season 3 focused on her relationship with former longtime boyfriend Jah. In the shows upcoming season, Winter dives deeper into her weight loss journey.

In a 2016 episode of 90 Day Fianc, Winter took cameras along to a consultation appointment for bariatric surgery. She was 313 pounds at the time. In 2020, Winter lost 50 pounds and has continued to shed weight ever since. During season 4 of her familys TLC show, Winter takes the next step in her health journey and moves forward with the weight loss surgery she contemplated years prior.

Winter underwent gastric sleeve surgery. The procedure, which is also called sleeve gastrectomy, is a type of bariatric surgery that shrinks the stomach for the purpose of long-term weight loss.

However daunting, Winter did not have to face the operation alone. Her mom, Karen Everett, and sister Chantel were there alongside her to offer support.

While comforting her sister before the surgery, Chantel assured Winter that its going to be OK, adding that it is the start of a new beginning for her.

After reassuring Winter, Chantel goes on to explain that the surgeon will be removing 75 percent of her siblings stomach.

The fourth season of the TLC show airs Monday, June 6.

See original here:
90 Day Fiance Star Winter Everetts Gastric Surgery: Everything We Know About the Weight Loss Procedure - inTouch Weekly

Paolo Carpaneto has always been the type of guy who was interested in getting in shape, but he just didn't know where to begin. Like many others in his position, he didn't come from a background of weight lifting or gym training and only briefly practiced sports in his youth.

"I always wanted to start any activity to get back in shape, but I didnt take it seriously," Carpaneto said. "I didnt have the support that I needed to continue and progress on my goals."

But in 2020, when his weight started to balloon and his daily activities began to become hindered, Carpaneto knew that he needed to act, and act now.

"At the time I was 227 pounds. Climbing the stairs, lacing my shoes, and finding clothes were all issues," he said. "I think this was my 'low point', and I said to myself: it's now or never."

Many people have experienced the type of low-point that Carpaneto is describing, and it can be made even more tough by not having someone in your corner to motivate you to get your life back on track. This is what ultimately spurred his decision to contact Ultimate Performance Singapore.

"One day, my boss described the UP Fitness method and suggested I give it a try," he said. "I remember that during the conversation he mentioned: 'Hey, they have a small package of 14 sessions, you can try'. These 14 sessions become 2 years."

Joining a new workout program is not always easy and can be daunting for many people who aren't in great shape. For Carpaneto, this was also certainly the case. He goes on to describe the shape he was in before he started his training plan.

"I think the correct definition is 'unbalanced'," he said. "Physicallybecause there was no diet or any planned activity, I was eating whatever was ready and when was possible, and mentallybecause I was focused only on what was easy for me without challenging myself in new activities or goals."

It's important to recognize that everyone feels a little overwhelmed when starting a new training plan, but the key is to stick with it. With the help of his trainer, Owen, Carpaneto was able to remain consistent in the gym and add strength fast.

"I usually have three sessions with Owen every week and one or two running /jogging alone," he said. "I had several weight programs too. The first was to learn the basic movement, then I had the 5x5 program and then high repetition. We gave them funny names such as Arnold Mode and TROY, but all of them are full body workout."

While Carpaneto found success in his new strength training routines, he also needed to get his diet on track too. This is often the step that people neglect when starting a new workout plan. As they say, six-packs are made in the kitchen, not the gym.

Prior to his transition, he would usually start the day with black coffee and finish it off with high- calorie and carb foods for lunch and dinner. This was something his trainer knew Carpaneto immediately needed to stop.

"It was not easy. Owen put a lot of effort on teaching me how to track the food, the calories and the macros," Carpaneto said. "He started from the basics. He gave me four meals per day and suggested a basic menu with plenty of options. He also sent me a lot of podcasts and articles that explained the importance of nutrition and being consistent to see results."

Having someone like Owen during a weight-loss transformation is vitally important to achieving the desired results. Exercise trainers are often well-versed, experts in all-things nutrition and weight-loss related, so their advice should be trusted.

During his transformation, his diet included the following:

3 large eggs and coffee

Chicken breast, broccoli or cauliflower or any vegetables to reach 150 grams

White fish/salmon or Chicken breast with vegetables.

Protein shakes

This strict diet mixed with multiple days of full-body workouts and cardio per week helped Carpaneto lose unwanted fat and gain muscle in its absence. In total, he lost just under 64 pounds and lowered his body fat percentage from 31 percent to 15.5 percent.

However, not all of the changes he's experienced are purely physical. Carpaneto said that his weight-loss transformation has helped him feel more confident and full of energyeven giving him what he describes as a "Navy Seal mindset." His new life has also spurred his love for a long-lost sportrunning.

"Before the transition, I wasn't able anymore to run for more than 100 meters," he said. "This was something that made me depressed. Now, I can perform a 5K in a reasonable time. I ran in a competition here in Singapore, and I did my 5K in little more than 30 minutes. Not bad for +40-year-old at his first competition."

Despite all the progress Carpaneto has made during his weight-loss transformation, he's not done achieving his goals yet.

"Im not yet finished," he said. "At the moment, I have one session every week with Owen, and we are working to build more muscle in a long term project. This will challenge me more on staying consistent and try to put in place what I learned until now."

This interview has been edited for clarity.

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More:
The Simple Diet and Workout Plan That Helped This Man Lose 60 Pounds in 6 Months - Men's Health

Two decades ago, the Diabetes Prevention Program (DPP) clearly demonstrated that type 2 diabetes could often be slowed or prevented in people diagnosed with early signs of it (prediabetes). One approach tested was a low-calorie healthy diet combined with at least 150 minutes of activity to help participants lose at least 7% of body weight. Another was metformin therapy, a medicine widely used to treat diabetes. Both were compared to a control group given a placebo (fake) pill.

A recent follow-up study has focused on death rates from cancer, cardiovascular disease, and all causes in subsequent years and the findings for the three groups were in some ways unexpected.

Type 2 diabetes is one of the most common long-term illnesses worldwide. Over time, it can cause heart disease, nerve damage, eye problems, and kidney problems, raising risks for disability and early death. If laboratory tests show that a person has prediabetes, well-vetted strategies can help them delay the onset of type 2 diabetes, or prevent it. This could allow people to remain healthier for many years.

The results from the original study show that lifestyle modification and metformin therapy each very effectively lower risk for developing diabetes in people who have prediabetes. The reduction in risk was 58% and 31%, respectively, compared to the control group.

The original DPP cohort of 3,234 participants was invited to remain in the follow-up observation study known as the Diabetes Prevention Program Outcomes Study (DPPOS). Most participants have now been followed for over two decades, providing a unique opportunity to assess a number of important health outcomes.

The recent analysis looked at participant deaths from any cause, cancer, or cardiovascular disease after 21 years, on average. The researchers found no difference in the death rates in individuals originally assigned to the intensive lifestyle arm and the metformin arm of the study, compared with those originally placed in the control group.

Not at all! It is important to put things in perspective to be able to understand these results.

First, all of the original DPP study participants were notified of the benefits of intensive lifestyle modification and metformin, and invited to remain in the observation phase of this program. Since lifestyle modification had the greatest effect, researchers were ethically required to disclose these results to every participant and motivate people to implement these strategies. In fact, lifestyle modification sessions were offered to all participants after the DPP study ended.

Its likely that many participants in the follow-up study incorporated some beneficial changes into their meal plans and physical activity. This would limit the ability to distinguish the effect of intensive lifestyle modification on subsequent health outcomes.

Second, in the initial study only one group took metformin. In the follow-up study, any participant who developed type 2 diabetes was referred to their primary care physician to decide how to manage their blood sugar.

Metformin is the first-line therapy for type 2 diabetes. Therefore, those who developed diabetes were commonly prescribed metformin even if they happened to be in the control group or intensive lifestyle modification group. Over time, the three groups became less well differentiated from one another. In this recent analysis, statistical tests were performed to eliminate this bias without affecting the main results, but some remaining bias cannot be totally dismissed.

The people who took part in these studies were a fairly healthy group of individuals, and 50 years old, on average, when research began. That helps explain lower than usual death rates compared with findings from international diabetes prevention studies, or even other US studies, on type 2 diabetes.

Its also interesting that cancer not heart problems, strokes, or other forms of cardiovascular disease was the leading cause of death in the follow-up study. In the general population, cardiovascular disease has topped the chart for many years.

Widespread strategies to reduce cardiovascular disease in adults may play a role here. Yet this advantage also may diminish the ability to see significant differences in death rates when researchers compare the three groups in the DPPOS.

The best course is to continue to work toward preventing or delaying diabetes. Thats healthy for us as individuals, and for our country collectively. Heres what we know based on research.

If you have prediabetes:

Lets not forget that many factors may also play a role in determining the best approaches to prevent type 2 diabetes for each person. Age, race and ethnicity, other medical conditions, overall type 2 diabetes risk, and what types of approaches an individual is able to follow are all important factors to consider. If you have diabetes in your family, or have prediabetes or concerns about developing diabetes, talk to your health care team to decide on the best combination of preventive strategies for you.

Read this article:
Diabetes: Does a long-term study reinforce or change approaches to prevention? - Harvard Health

It was 6:30 A.M., and I was getting ready to head down to the operating room (OR) for the first case of the day: an abdominal wall hernia repair. In preparation for the case, I logged on to the electronic health record portal and read through the patients medical history and the preoperative notes written by the surgical team. In many of the physician notes, the first line noted the patients body mass index (BMI) of 41. The patients ventral hernia was estimated to be 30 centimeters by 20 cm, one of the largest hernias ever repaired by the surgeon I was working with. The CT scan showed sections of the large intestine protruding through the hernia, which posed a high risk for bowel twisting, which can lead to perforation and sepsis or tissue deoxygenation and necrosis. The patients condition had reached a critical point.

I ventured down to the OR and located the CT and MRI images, as part of my medical student role of assisting the nursing and scrub technicians in prepping the OR prior to surgery. I projected the scans onto the large screen TVs hanging in the OR to help the surgeons better visualize the anatomy and their approach. As I pulled up the images, the team in the room erupted in shock. How could someone let a hernia get this bad before seeking medical consultation, they wondered. And others couldnt believe that someone could live with such a large defect and not want it fixed for cosmetic purposes. After rolling the patient into the OR and moving her onto the operating table, the team began to prep the surgical site. As she drifted off into a state of sedation, medical staff in the room could not stop talking about her BMI. The comments were unrelenting throughout the five-hour procedure, as people took turns gawking at the gaping hole in the patients abdomen. Two of the largest pieces of Strattice biologic mesh made by the supplier were sewn together to repair the hernia. The estimated cost of the mesh alone was $30,000.

As the surgery ended, I couldnt stop thinking about the obvious, yet ironic, connection between the weight comments from the health care team and why the patient procrastinated before getting the surgery. Why would anyone want to interact with a medical system that looked at them in such a derogatory way?

Antifatness is socially ingrained and virtually inescapable. Pop culture idolizes thinness. The Centers for Disease Control and Prevention created an alarmist obesity epidemic based on exaggerated data that havent held up. Like everyone else in society who is socially conditioned to this bias, clinicians are not exempt from harboring antifatness. In a recent study, 24 percent of physicians stated they were uncomfortable having friends in larger bodies, and 18 percent admitted they felt disgusted when treating a patient with a high BMI. This is upsetting, yet unsurprising considering that few programs actively train health care providers against this cognitive bias.

Abundant research demonstrates that obesity is not really a choice and is often a product of systemic inequity. The crux of this research explores the multiple systems that underpin weight: food insecurity, housing insecurity, poverty-induced scarcity mindset, medications, diseases, lack of education, mental health issues and chronic stress among them.

Many researchers and scholars have exposed the pervasiveness of antifatness culture, but some of the most prominent actors in maintaining this culture have not been discussed. Surgeons are central to dismantling the problems of antifat bias in health care, and that requires addressing aspects of surgeons training and day-to-day tasks that may make them more prone to this cognitive bias.

Weight bias is heightened and reinforced in the surgical setting, where surgeries on higher BMI individuals take more time, cost more money and have an increased risk of complications. Antifatness attitudes and behaviors may be higher among surgeons partly as a result of the lack of filter people may have when the patient is sedated. The increased time and care required in these cases can be difficult for surgeons, whose time and care are already strained given staff shortages. Together, these factors may lead surgeons to express their frustration through comments about the patients body.

In addition, professional culture and training are different for surgeons. Primary care physicians training may focus more on upstream factors contributing to care, including being taught about social determinants of health and multifactorial causes of the patients conditions. In contrast, surgeonswho on average spend 3,963 hours of training honing a complex motor and visuospatial skill may naturally focus more on the procedural task at hand rather than the factors contributing to their patients condition. Ultimately, the everyday demands of a surgeons job may make them less likely to think critically about antifatness when providing their day-to-day care. Yet, to provide optimal patient care, it is equally important for surgeons to work against weight stigma.

Surgeons are often the physicians who spend the most time in the hospital. As such, they play a vital role in forming the culture in the OR and hospital at large, and their understanding of weight bias and its associated behaviors is critical to counteracting pervasive weight stigma among health care providers. Post-surgery, many higher-weight patients will require intensive care, continual follow-up and long-term treatment adherence. Patients with a higher weight are also 12 times more likely to have a complication requiring extended hospitalization and continued interface with their surgical team. Surgeons must confront their own weight bias to build positive ongoing partnerships with patients.

A culture of antifatness among surgeons leads to compounding negative impacts on individual patients and the health system. Studies show weight bias from providers is palpable for patients. Patients can sense the lack of dignity and respect in providers attitudes and, in turn, may choose not to interact with the system that degrades them. Many clinicians turn weight loss into an ultimatum for patients rather than focusing on building their trust, understanding contributing factors and partnering with them to make incremental lifestyle modifications possible. Altogether this can harm patients self-worth and rapport with providers.

When providers alienate patients who first touch the health care system, through poor care or rapport, these patients are more likely to not resurface until reaching a critical health point, as with the hernia repair case discussed above. Research suggests that providers spend less time with larger patients, provide a lower quality of care and misdiagnose larger patients more frequently.

Antifatness is often a more socially acceptable masquerade for anti-Blackness. The Department of Health and Human Services reports that about four out of five African American women are overweight or obese, and Black Americans were 1.3 times more likely to be obese compared to white Americans. This intersection allows covert ways to harm Black and brown bodies.

Ultimately, the biases and behaviors that maintain antifatness need to change. Potential avenues for change include creating systemwide education, amending medical documentation, reframing patient conversations and advocating for upstream policies that increase access. A health providers goal should be healthvital statistics, lab results, symptom reduction, time spent exercising, mental healthnot thinness. There are health consequences to obesity, but the current BMI-focused approach is not the best way to capture a persons current health status. Lack of education among medical professionals is perpetuating antifatness. A health systemwide training should be developed to educate health care providers and shift conscious and unconscious attitudes.

Providers should also make a habit of noting diet and exercise in social history, as opposed to collapsing these factors into BMI. They could partner with patients and connect them with community resources to enable them to meet their health goals of lower blood pressure or better cardiovascular health. Providers can also focus on evidence-based methods, such as educating patients about nutrition, increasing access to food or exercise, discussing weight-loss surgery or medication and employing motivational interviewing. Understanding the multifactorial nature of weight and taking a patient-centered approach early on can ensure patients feel supported and empowered to achieve optimal health outcomes. This affirmative type of partnership will encourage patients to return to the health care system and invest in the provider-patient relationship and health goals. Providers must internalize the complexity of weight, learn how to utilize alternative health markers and even advocate for policies that reduce food deserts. Surgeons may read the above action items and write them off as tasks reserved for primary care physicians. But practicing unbiased medicine is possible. In one promising model, hospitals in Canada have recently launched a surgical prehabilitation program and toolkit that helps surgeons and their patients work on hypertension, hyperglycemia, hyperlipidemia and cardiovascular health.

Recent movements around self-love and body acceptance are important, but they cannot replace the work that needs to be done by the people who manifest antifatness bias. America does not have an obesity epidemic; it has an unhealthiness epidemic. Yet the worse health outcomes compared to countries with similar economies are just as much a product of antifatness as they are of fatness. Through shame and blame, antifatness may be contributing to obesity and exacerbating poor health. Until surgeons and other health care providers choose to be a part of the solution to antifatness, then they will be part of the problem.

This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.

Read more:
Antifatness in the Surgical Setting - Scientific American

I have spent most of my career working with cardiac patients with various related heart conditions, some of which include high cholesterol, coronary artery disease, and Ankylosing Spondylitis (AS). While there are many risks for heart disease which we cannot modify, there are various modifiable risks that can affect the heart as well. Since we are able to control these modifiable risks, it will be important to make the best choices in regard to them to promote optimal heart health. Read on to find out moreand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Diet is so important for helping my patients overcome, manage or in some cases even prevent high cholesterol which can, in turn, help them maintain their overall health and well-being. There are many aspects of diet that can promote not only a healthy lifestyle but also help maintain one's cholesterol.

Oftentimes when we think of preventing high cholesterol, we think of foods we shouldn't eat. While there are some foods that if we limit, we can see improvement in cholesterol there are some foods that if we consume daily, we see positive effects on our blood work. One of these foods is fiber.

Fiber will help to transport "bad cholesterol" to the liver where it will then be broken down. Fiber typically comes from fruits and vegetables as well as grains (such as bread, pasta, rice, and cereal). When speaking about fiber and grains it is important to make sure we are choosing whole wheat grains to ensure they are fiber-rich. Examples include whole-wheat bread/pasta/rice. Other fiber-rich grains include oatmeal, quinoa, and barley.

By choosing these fiber-rich items you will also be limiting refined sugars this can have another added benefit on lab work as refined sugars increase the risk for elevated triglycerides. High triglyceride levels are associated with coronary heart disease. Beans, lentils, and legumes also contain fiber. When looking at the food label it is a good idea to attempt to choose foods with 6grams of fiber per serving. Daily fiber intake for women should be around 25grams, and daily intake for men should be able 30grams.

Staying away from saturated fat can also help to show improved cholesterol levels. You may hear saturated fat is referred to as "bad fat." The reason for this is that it can increase your bad cholesterol, also known as LDL (low-density lipoproteins). It can also lower your "good cholesterol" otherwise known as HDL (high-density lipoproteins). Common sources of saturated fat are full fat/whole fat milk/cheese, red meat/pork, butter/margarine, tropical oils, and the skin of poultry. Alternatives to the items mentioned above include low fat/skim dairy products, almond milk, skinless poultry, fish, olive oil, or vegetable oils. If red meat is consumed opt for mostly lean red meat or a choice/select cut of meat. If pork is consumed aim for a center lion cut. Look out for some kinds of butter and mayo which replace the bad fat with good fat some of these products are now made with soybean oil, avocado oil, or olive oil. When buying such products trans fat should be 0 grams and Saturday fat should be 2.5grams or less per serving. In total, The American Heart Association recommends aiming for a dietary pattern that achieves 5-6% of calories from saturated fat per day.6254a4d1642c605c54bf1cab17d50f1e

Consider limiting your daily cholesterol intake. While the body does need some cholesterol too much can result in negative health effects. The body does naturally make cholesterol, while we also can get cholesterol (or rather dietary cholesterol) from various foods. Too much cholesterol can increase the risk for stroke and Atherosclerosis. People will respond differently to dietary cholesterol and unfortunately, there is no way to determine who will respond in which way. For this reason, it may be wise to err on the side of caution and limit cholesterol intake if you personally have high cholesterol, or if you have a family history of cholesterol. Aim to consume no more than 200mg/day of cholesterol. Foods that contain cholesterol include egg yolks, organ meat (such as liver), and shellfish (such as shrimp, lobster, oysters, or mussels). Consider eating egg yolks no more than 2-3 times per week and limiting shellfish intake to 2 times per week.

Make sure to be including plant sterols and plant stanols into your diet. Sterols and stanols are found in plants and can help to block the absorption of cholesterol. They can be found naturally in many foods however in small amounts. They are naturally in vegetable oils, nuts, seeds, and whole grains. Various foods are now fortified (or enriched) with sterols/stanols. These foods include orange juice, cereals, and different breakfast bars. Ideally to get the most benefits one should consume about 2grams of sterols/stanols per day.

It is also important to keep in mind the benefits of an active lifestyle on heart health. Exercise will benefit our overall cardiovascular function. It also will help to promote weight loss which in turn will also positively affect cardiovascular function (safe and effective long-term weight loss usually comes in the form of losing about 1-2 pounds per week, anything more than that is not sustainable for the long term weight loss maintenance). Having a less active or rather sedentary lifestyle can also increase the chances of having raised LDL. The American Heart Association recommends at least 150 mins per week of moderate-intensity aerobic exercise. Aerobic exercise is defined as physical activity that increases the heart rate and the body's use of oxygen often referred to a cardio workout. Examples of this include brisk walking, running, bike riding, swimming, and dancing. For those who aim to have a less sedentary lifestyle, it is a good idea to keep time spent sitting or ideal to about 30 mins this means if you are sitting for 30 minutes get up if possible. And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

Nicole Roach is a registered dietitian with five years of experience. She works at Lenox Hill Hospital.

Nicole Roach

Read the original here:
Ways to Lower Your Cholesterol Fast Eat This Not That - Eat This, Not That

Researchers will delve into the latest research in diabetes, obesity, thyroid and other endocrine conditions during the Endocrine Societys ENDO 2022 news conferences June 11-14.

The press conferences will feature select abstracts that are being presented at ENDO 2022, the Endocrine Societys annual meeting. The event is being held at the Georgia World Congress Center in Atlanta, Ga. News conferences will be livestreamed for those who are unable to attend in person.

To register to view the news conferences, visit http://www.endowebcasting.com.Journalists can register to attend and learn more about the meeting on our website.

News Conference Schedule:

Saturday, June 11

Endocrine-disrupting Chemicals (noon EDT): Researchers will discuss how chemicals in hair care products affect breast cancer cells in Black women and how chemical exposure in the womb affects fear and anxiety behavior in rats.

Sunday, June 12

Diabetes (10 a.m. EDT): The Society will unveil its Clinical Practice Guideline on Management of Hyperglycemia in Hospitalized Patients in Non-Critical Care Settings. In addition, researchers will explore diabetes effect on metastatic breast cancer outcomes, regional variations in hospitalization for diabetes complications, and prediabetes as a risk factor for heart attacks.

Obesity(11 a.m. EDT): Featured studies will examine long-term weight loss maintenance with medications, how childhood obesity can contribute to male infertility, and the impact of wireless device overuse on obesity.

Monday, June 13

Reproductive Health (9 a.m. EDT): Researchers will discuss the COVID-19 pandemic stresses impact on womens ovulatory cycles, the results of the year-long phase 3 study on hot flash medication fezolinetant, the economic costs of treating mental health disorders in women with polycystic ovary syndrome, and a mouse model of in vitro fertilization in transgender men undergoing active testosterone treatment.

Thyroid Health (11:30 a.m. EDT): Studies will delve into artificial intelligences value for ruling out thyroid cancer, how soon individuals with thyroid conditions can take levothyroxine solution after drinking coffee, and the safety of COVID-19 vaccinations among individuals with hypothyroidism.

Register to attend the news conferences at http://www.endowebcasting.com. Credentialed journalists will be given priority to attend. Recordings will be available on the Societys website following the event.

# # #

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the worlds oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Originally posted here:
Hybrid ENDO 2022 press conferences to highlight emerging diabetes, obesity, reproductive research - EurekAlert

Research has begun to emerge showing a causal link between COVID-19 and diabetes. In a study published in The Lancet Diabetes & Endocrinology in March, researchers found that people who suffered from COVID-19 were40% more likely than controls to eventually develop Type 2 diabetes.

Dr. Brian Fertig, M.D., founder and president of the Diabetes & Osteoporosis Center in Piscataway, New Jersey, told BioSpace that the increased risk of diabetes can be added to the list of Long COVID effects.

In addition to the 40% increased risk of diabetes type 2 within 12 months, another recent study reported a significant increase in incidence of type 1 diabetes after 30 days from a diagnosis of COVID-19, highlighting pleiotropic mechanisms in physiology, he said. The additional study was released by the Centers for Disease Control and Prevention in January of this year.

Fertig said that insulin deficiency caused by COVID-19 in cases of type 1 diabetes could be related to a direct destructive effect of the virus on the insulin-producing beta cells of the pancreas. Another explanation could be that protein components of the virus may molecularly mimic proteins of the beta cells with destruction mediated by an autoimmune process, he continued.

As to why COVID-19 increases the risk of type 2 diabetes, Fertig drew parallels to other Long COVID symptoms, including the sleep/wake cycle disruption and neuropsychological effects which drive chronically activated hormonal and autonomic nervous system branches of the stress response.

He explained that in this case, cortisol and adrenaline stimulated states promote increased glucose production from the liver as well as other antagonistic effects on insulin secretion and its suppressive effects on blood glucose and lipid levels.

Fertig originally became interested in the growing endocrinology field during his medical training. Three decades later, I published a two-volume book series, Metabolism & Medicine, which spotlights hyperinsulinemia and insulin resistance as core to the metabolic decline that occurs with aging, including important links not only to diabetes and obesity but to all chronic diseases, including heart, vascular, Alzheimers diseases and cancer, he said.

In his personal practice, Fertig shared that some of his patients with pre-existing controlled diabetes saw their conditions worsen due to COVID-19. Some (a small minority) of these patients have long term more aggressive therapy requirements to maintain glycemic and lipid levels in a safe range. Dexamethasone almost predictably worsens glucose levels in known diabetics, and often results in steroid-induced diabetes in preexisting non-diabetics, the vast majority of whom revert to normal glucose (and lipid) levels following discontinuation of steroids, he said. In congruence with the study, Fertig has also treated patients who developed new cases of type 2 diabetes post-COVID-19.

Fertigs typical recommendation for management of type 2 diabetes involves a low dosage of pioglitazone, metformin and a Glucagon-like peptide-1 (GLP-1) agent. He said that GLP-1 antagonists aid in weight loss, which improves insulin sensitivity and reduces blood glucose levels. Both pioglitazone (a direct insulin sensitizer) and metformin (an indirect insulin sensitizer) prevent the transformation of lipofibroblastto myofibroblasts, thus having an apparent important protective effect on COVID-19-related complications and mortality.

In his Metabolism & Medicine series, Fertig details a scientific approach for predicting and preventing disease as well as predicting patient responses to therapeutic interventions. His model, called the Physiological Fitness Landscape (PFL), uses bioinformatics to make these predictions.

When asked what he imagines diabetes treatment will look like a decade from now, he said I believe that type 1 diabetes will be cured by an injection of pancreatic insulin-producing beta stem cells that will seed and remain in the liver. Blood glucose levels will likely be higher than normal range per se, but low enough to be safe (complication-free) and not require insulin or other therapeutic interventions.

In terms of the management of type 2 diabetes, he predicts that a single oral drug containing the properties of pioglitazone, metformin and the GLP-1 antagonist will replace the triumvirate approach to treatment. It will likely be able to modulate the amount of insulin production and fat mass and distribution, he said, adding that the ideal future drug would be personalized according to the guidance presented in his PFL model.

For both COVID-19 patients and others, Fertig said that the best way to reduce the risk of developing diabetes is to commit to a healthy lifestyle which incorporates nutrient dense foods, regular exercise and quitting or reducing bad lifestyle habits.

He pointed out that though genetic predispositions to diabetes exist, living under stress, foregoing exercise and not prioritizing sleep and diet can be damaging. A poor micronutrient diet impairs the function of metabolic machinery also causing insulin resistance, thus predisposing to diabetes.

The doctor explained that insulin resistance and high insulin levels in the blood, present in up to 50% of the adult population in the U.S., contribute not only to diabetes but to all the major chronic diseases of aging including Alzheimers disease, heart and vascular disease and cancers.

Though type 2 diabetes cannot be cured, Fertig said that complete and partial remission are possible. In this case, the patients glucose levels would return to normal. Yes, beta cells have been damaged and the underlying genetic factors remain intact, he said, but individuals can control the damage by maintaining a healthy weight, an active lifestyle and a positive mental outlook.

More:
Exploring the Causal Connection Between COVID-19 and Diabetes - BioSpace

People with insomnia have a higher risk of getting into depression and people with depression and anxiety have trouble sleeping. As per a John Hopkins report, "People with insomnia , for example, may have a tenfold higher risk of developing depression than people who get a good nights sleep. And among people with depression, 75 percent have trouble falling asleep or staying asleep. "

Sleep patterns have been disturbed during COVID pandemic, no doubt. The immediate switch from office to work from home; exposure to more screen time, and limited outdoor activities hampered the normal sleep pattern of individuals.

But years later, sleep disturbance is still one of the major issues people face. In long COVID, in which the long term effect of the COVID is seen in people weeks and months after the infection, sleeping issues is a major symptom.

Post-traumatic stress disorder after recovery from COVID has been correlated to sleep problems in many individuals.

Read: Here's how your food plate should look like when you are on a weight loss mission

Read the original here:
Coronavirus: Here's how long COVID depression looks like; these are the key symptoms to know - Times of India

Coughing up blood can be a terrifying experience, even if it's just a few drops.

While coughing up blood isn't always cause to go straight to the hospital, you should seek immediate attention if you're experiencing:

Coughing up blood can be caused by anything from drinking alcohol to experiencing severe heart failure . It can also be from a short-term condition, such as pneumonia , or a lifelong condition like cystic fibrosis.

Here are some of the most common causes of a bloody cough and an overview of what you should know.

What is it? Chronic bronchitis refers to long-term inflammation of the bronchi, your breathing tubes and is the most common cause of hemoptysis the medical term for coughing up blood from your respiratory tract.

With chronic bronchitis, you might only cough up a red streak of blood one time. However, some people with chronic bronchitis experience several episodes of coughing blood that happen sporadically over a handful of years.

You are most at risk for chronic bronchitis if you are a cigarette smoker, but other risk factors include:

Chronic bronchitis is one of the most common conditions contributing to chronic obstructive pulmonary disease (COPD).

Is it serious? Unlike acute bronchitis, which often comes from a standard cold and goes away in a week or two, chronic bronchitis is a serious condition that develops over time. While your symptoms might get better or worse, they never entirely disappear.

These long periods of inflammation can cause sticky mucus to build up in your airways, leading to long-term breathing difficulty.

Do I have it? If you have a cough-producing mucus most days for at least three months in a given year for at least two years in a row, you might have chronic bronchitis.

Other common symptoms include:

How to treat it: While chronic bronchitis does not have a cure, there are a handful of treatments to help you live more comfortably through controlling symptoms.

Your doctor can diagnose chronic bronchitis and recommend the best treatments to open your airways. These may include oral medications, inhaled steroids, and pulmonary rehab to help you live more comfortably with your breathing problems.

If you smoke, quitting is widely considered the most essential to alleviating symptoms.

What is it? Pneumonia is an often serious infection that can occur in one or both of your lungs. With pneumonia, the air sacs in your lungs fill with pus or other fluid, which can give you trouble breathing.

Is it serious? This condition ranges from mild to severe, depending on its cause and your overall health. Pneumonia can affect you at any age, but it's more common (and serious) in certain groups.

See your doctor immediately if you or a loved one may have pneumonia and is:

Do I have it? Symptoms of pneumonia can develop in 24 hours, or they may come on slowly over several days.

You may cough up blood-stained phlegm that is thick and dry in consistency. This phlegm may be yellow, green, or brown in color.

Common symptoms also include:

How to treat it: Some cases of pneumonia can go away on their own if you get plenty of rest and fluids. However, this depends on the cause and severity of your symptoms.

There are over 30 different infections that can cause pneumonia including bacterial, viral, and fungal. Therefore, your treatment will depend on the type of infection.

For example, treatment may require oral antibiotics for a bacterial infection, antivirals for a viral infection, or antifungals for a fungal infection, so it's best to reach out to your doctor if you think you may have pneumonia.

Severe cases may also require a hospital stay for intravenous (IV) antibiotics or oxygen therapy.

What is it? Lung cancer is a type of cancer that starts in your lung tissue, typically in the cells lining your airways. It is the second most common form of cancer in the United States.

People who smoke have the highest risk of developing lung cancer. Smoking tobacco, specifically, causes 90% of cases in men and 80% of cases in women.

Other common causes of lung cancer include inhaling secondhand smoke, a family history of lung cancer, and exposure to certain chemicals like radon or asbestos.

Is it serious? Lung cancer is the leading cause of cancer deaths worldwide. Moreover, relative survival rates for lung cancer are low, making this a serious condition.

Note: A relative survival rate compares people with a certain type or stage of cancer to the overall population. For instance, if the five-year relative survival rate for one kind of lung cancer is 40%, people with that cancer are about 40% as likely as those without cancer to live for at least five years after being diagnosed.

The five-year relative survival rate for non-small cell lung cancer is 26%, while the five-year relative survival rate for small cell lung cancer is 7%.

Do I have it? Coughing up blood is one of the most common symptoms of lung cancer. Lung cancer is more likely than other conditions to produce large amounts of blood in your cough (massive hemoptysis), sometimes leading to hospitalization.

Other symptoms include:

How to treat it: If you think you might have lung cancer, you should see your doctor as soon as possible. When lung cancer is found earlier, it is more likely to be treated successfully.

Common treatments for lung cancer include:

You and your provider will choose a treatment plan based on your overall health, the type and stage of your cancer, and your preferences.

What is it? Congestive heart failure is a chronic condition where your heart doesn't pump blood as efficiently as it typically does. It's sometimes just referred to as "heart failure."

As a result, your heart can't keep up with your body's demands, and blood returns to the heart faster than it can be pumped out. This creates a pumping issue that prevents oxygen-rich blood from flowing to your other organs including your lungs. As a result, your lungs fill with fluid.

Is it serious? Congestive heart failure is a serious condition. Over time, your heart can't keep up with its normal ability to pump blood to the rest of the body, which can be life-threatening.

Do I have it? You may experience a chronic cough with pink blood-tinged mucus if you have congestive heart failure. Symptoms like coughing blood happen as your heart weakens and loses its usual ability to pump blood successfully through your body.

Other common symptoms include:

How to treat it: If you're experiencing heart failure, seeing a doctor as soon as possible for proper treatment can help you reduce symptoms and live longer.

Call 911 if you're experiencing any of the following:

Treatment typically includes medication and lifestyle changes like exercising, reducing sodium and caffeine intake, losing weight, and managing stress. Your doctor may also recommend surgery and additional therapies in severe cases.

What is it? Cystic fibrosis (CF) is an inherited disease that affects around 35,000 people in the United States. It causes persistent lung infections that eventually limit your ability to breathe.

Is it serious? With CF, your lung function can gradually worsen until it becomes life-threatening.

CF creates dangerously thick and sticky mucus that blocks airways, damages your lungs, and increases your risk of infection. CF can also prevent proteins your body needs for digestion from reaching your intestines, which decreases your ability to absorb essential nutrients.

Do I have it? The combination of airway damage and frequent infections that may occur with CF can cause you to cough up a small amount of blood.

Other symptoms of CF may include:

While most people with CF are diagnosed in early childhood, some don't receive a proper diagnosis until adulthood.

How to treat it: Even coughing up a small amount of blood can be life-threatening and a sign to seek immediate medical care if you have CF.

Cystic fibrosis requires consistent care from your provider, at least once every three months.

If you or your child has symptoms of CF, or if someone in your family has CF, discuss testing with your doctor as soon as possible.

While there is no cure for CF, treatment can ease symptoms, reduce complications, and improve quality of life.

Treatment may include stool softeners, antibiotics, bronchodilators, and more based on your symptoms. CF symptoms and their severity can differ widely, so treatment plans are tailored to your unique needs.

"If you're coughing up bright red blood, the blood is likely new or fresh. This type of blood is usually from the throat, lungs, or upper gastrointestinal tract and can have any number of causes," says Jenna Liphart Rhoads, a registered nurse at NurseTogether. These causes can range from moderate to severe.

Here are a few other conditions to consider, according to experts.

Endometriosis is another, less frequent, culprit for coughing up blood.

"If endometrial tissue develops around the lungs, it can get inflamed and bleed during the woman's normal cycle. The only way out would be through coughing out sputum, a mixture of saliva and mucus that may include blood," says Nancy Mitchell, a registered nurse at Assisted Living Center.

Tuberculosis is a serious disease caused by bacteria. This condition usually attacks your lungs and is highly contagious through coughing and sneezing.

"A fever is enough reason to call coughing blood an emergency because high body temperatures can be a sign of tuberculosis, which is highly contagious," Mitchell says.

Mitchell adds that you could also be protecting others by protecting yourself from severe causes of coughing up blood. "Your diligence in reporting symptoms could prevent a massive outbreak if your health provider sees a need to perform contact tracing," Mitchell says.

Lupus is a lifelong autoimmune disease, which causes your body to attack its own healthy tissues. This can have serious consequences, including kidney failure, blood clots, and heart attack.

About 50% of people with lupus will experience lung issues during the course of their disease. Acute lupus pneumonitis is a severe lung condition that affects up to 10% of lupus patients and is characterized by chest pain, shortness of breath, and a dry cough that may bring up blood.

It's important to speak with your doctor right away to reduce your risk of lung scarring.

Goodpasture syndrome is a rare autoimmune disease in which your body mistakenly attacks your lungs and kidneys, which may cause your lungs to bleed. Other symptoms include respiratory issues, blood in your urine, anemia, chest pain, nose bleeds, and kidney failure.

"In addition to coughing up blood, a patient with Goodpasture syndrome may also present with kidney failure," says Dr. Jyoti Matta, a pulmonologist, and Medical Director at the Center for Sleep Disorders at Jersey City Medical Center.

Goodpasture syndrome can be fatal if left untreated, so it's important to bring up any symptoms to your doctor if you're concerned.

"However, this is a very rare condition and not the first that comes to mind when a patient is coughing up blood," Matta says. There are between 300 and 3,000 cases of Goodpasture syndrome in the United States.

Antineutrophilic cytoplasmic antibody (ANCA) associated vasculitides are a group of uncommon autoimmune conditions that cause inflamed blood vessels and affect approximately 1 in 50,000 people.

This group includes three main diseases:

Previously called Wegener's granulomatosis, granulomatosis with polyaniitis is a rare but serious condition that causes inflammation of the blood vessels in your sinuses, throat, lungs, nose, and kidneys.

"Wegener's may cause a patient to cough up blood intermittently. People in their 30s on can be diagnosed with this rare condition," Matta says. Besides coughing up bloody phlegm, you might also experience joint pain, pus-like drainage from your nose, sinus infections, fatigue, and coughing with bloody phlegm.

"Low-dose steroids may help keep these conditions under control when there are flare-ups. Typically, when a person coughs up blood, they usually have a bout of bronchitis, pulmonary edema, infection, and inflammation, and not ANCA-associated vasculitis," Matta says.

However, since these disorders can be fatal without proper care, as the continuous inflammation in your blood vessels and organs can result in kidney or lung failure, it's worth seeing your doctor if you're repeatedly coughing up blood.

Many things could contribute to coughing up blood, so you should see your doctor to find the correct diagnosis and treatment.

"Coughing up blood almost always means there's an underlying condition often a mix of infection and severe inflammation," Mitchell says.

"You should always seek medical attention when coughing up blood and not attempt to treat it at home," Rhoads agrees.

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Coughing up blood: 5 common causes and what to do - Insider

You hear a lot about metabolism. You probably know it has something to do with weight loss. And even if you dont go in for those supposed hacks around speeding up your metabolism, you likely figure you can at least increase it by exercising more.

This isnt actually the case, and my guest will sort through this and other misconceptions around metabolism on todays show. His name is Dr. Herman Pontzer and hes a professor of evolutionary anthropology and the author of Burn: New Research Blows the Lid Off How We Really Burn Calories, Lose Weight, and Stay Healthy. We begin our conversation with an overview of how metabolism powers everything your body does from thinking to moving to simply existing, and how it uses the food you eat as the energy needed to fuel these processes. We then get into Hermans field research which shows that increasing your physical activity doesnt actually increase the number of calories you burn, but why its still hugely important to exercise anyway. He also unpacks whether certain kinds of foods are better for your metabolism, offers his recommendations on how to use diet to lose weight, and answers the common question as to whether its true that your metabolism goes down as you age.

Brett McKay: Brett McKay here, and welcome to another edition of The Art of Manliness podcast. You hear a lot about metabolism, you probably know it has something to do with weight loss, and even if you dont go in for the supposed hacks around speeding up your metabolism, you likely figure you can at least increase it by exercising more. This isnt actually the case though, and my guest will sort through this and other misconceptions around metabolism on todays show. His name is Dr. Herman Pontzer, and hes a professor of Evolutionary Anthropology and the author of Burn. New research blows the lid off how we really burn calories, lose weight and stay healthy. We begin our conversation with an overview of how metabolism powers everything your body does from thinking, to moving, to simply existing, and how it uses the food you eat as the energy needed to fuel these processes. We then get into Hermans field research, which shows that increasing your physical activity doesnt actually increase the number of calories you burn, but why its still hugely important to exercise anyway. He also impacts whether certain kinds of foods are better for your metabolism, offers his recommendations on how to use diet to lose weight, and answers the common question as to whether its true that your metabolism goes down as you age. After the shows over, check out our show notes at aom.is/burn.

Alright, Herman Pontzer, welcome to the show.

Herman Pontzer: Thanks for having me.

Brett McKay: Alright, so your field research has uncovered some counter-intuitive things about our metabolism, and were gonna dig into that today. But before we do, I think it would be helpful to do a short metabolism 101 class for our listeners. Because I think people throw around that word metabolism a lot like, Oh, gotta speed up my metabolism. But they might not know exactly what that means. So what exactly is metabolism? And then well go from there.

Herman Pontzer: Sure, sure. So yeah, I think youre right, people dont always Arent always told the right thing. Your metabolism is all the work that your cells do all day. So youve got 37 trillion cells give or take, and each of them is a tiny microscopic factory thats bringing in raw materials, thats the nutrients in the foods that we eat, and turning them into various molecules, hormones, that kind of thing, burning them for energy. And all of that work that our cells do, each of those little factories do, that takes energy, and so metabolism is all of that, its all the work thats happening. And since work requires energy, we can think about metabolism either as the work itself, so people do focus on things like how molecules get changed around by cells, its called metabolomics, the products that they make. Or you can focus on the energy it takes to do that work, and thats what most people focus on in metabolism research like me, we measure all the work that our cells are doing by measuring the energy that our bodies burn.

Brett McKay: Gotcha, okay, so metabolism is the measurement of energy our body is using to do what it needs to do: Breathe, heart beating, reproduce, get off the couch

Herman Pontzer: Yeah.

Brett McKay: Thats metabolism. Okay.

Herman Pontzer: Yeah, thats right. And most of it, youre only dimly aware of or not aware of at all. So for example, every nerve cell in your body needs to keep a very precisely amount of negative charge inside of its cell relative to the outside of its cell, or else your nerves dont work. And so to do that, its constantly pumping these ions, these sodium and potassium ions in and out to maintain that balance, maintain that negative charge. Your liver is constantly at work, detoxifying all the stuff you ate, helping break down nutrients. Your spleen, your immune system, all of it, theres so many things that are happening. Your brain, your brain runs a 5k every day, your brain burns 300 kilo calories of energy everyday, thats the equivalent of going on a five kilometer run, and none of this youre aware of, youre only aware of the very small amount of energy that you spend Relatively proportionately, that you spend on things like exercise.

Brett McKay: Yeah, so thats an important point, when people typically think about speeding up their metabolism, and well talk about why that actually isnt a thing, they think, Well, I just gotta exercise and move more, and thats gonna burn more calories. But you make the point, no, most of the calories you burn, its just functioning, just sitting there existing, listening to this podcast.

Herman Pontzer: Exactly, yeah, yeah. Even if all you did is binge listen to The Art of Man podcast, all day, youd still burn about 70% of the energy that you would have burned in an active day.

Brett McKay: So, okay So yeah, I think you break it down, theres a chart, the percentage of our calories that we burn throughout a day that are geared towards just existing, and then theres movement. And then theres another one, another criteria of how we burn calories, I think its called NEAT? N-E-A-T.

Herman Pontzer: Oh, yeah.

Brett McKay: What is NEAT?

Herman Pontzer: Well, so NEAT is this concept that youre moving when youre not paying attention to it, so fidgeting, standing up and walking over to get a cup of coffee, that stuff. It stands for Non-exercise activity thermogenesis. And yeah, its a nice acronym for NEAT is a nice acronym for that, and its this idea that not only are you burning energy to move when youre paying attention to it and exercising, but youre also burning energy in these other ways as well. But theres even more than that, because NEATs not Okay, so NEAT was a concept that people developed because they were having a hard time making the numbers add up. When they would try to understand how people are spending their energy, they would look at basal metabolic rate, thats your energy at rest, like 6:00 in the morning when your bodys super calm and still and youre in the nadir or youre in the valley of your energy expenditure for the day. Your organs are as quiet as theyre gonna be, you take basal metabolic rate, you take how much people exercise, you take how much energy it takes to digest food, you add those up and theres missing calories cause people are burning more calories than those three components would suggest.

You add those up, you dont get the same numbers you get when you really measure it as a real empirical measurement, it being total calories burned over 24 hours. And so people thought, well, theres this NEAT stuff too, theres movement when were not paying attention, and thats true, I guess we could add that in it as well. And I would say theres other things as well that we dont always pay attention to that we need to think about as well, which is the circadian fluctuations, the circadian rhythm of our energy expenditure, youre burning more energy in the middle of the day, especially when youre alert, than you are at night while youre sleeping. So even without moving, just the act of being alert and awake and at the peak of your circadian metabolic cycle is gonna be burning more energy than at your lowest point. So we can get into the weeds, we can get into the nuanced weeds about how the body spends energy, but youre right, we can break it down to those components as well.

Brett McKay: But I think the big take away, the majority Like you said, the majority of our calories burned throughout the day is this BMR, this basal metabolic rate, just When were at rest, thinking, breathing, heart beating, liver producing all the hormones that it does, thats where most of our energy is geared towards. Okay.

Herman Pontzer: Thats right.

Brett McKay: So lets talk about how our body takes the food we eat and converts that into energy. So basically, when we consume food, you can categorize the nutrients in that food into three broad categories, theyre called macronutrients. We got protein, carbs and fats. And our body metabolizes these different macronutrients differently. Can you walk us through big picture, and we dont have to get into the Krebs cycle.

Herman Pontzer: Sure.

Brett McKay: But big picture, what are the difference between how our body takes these different macronutrients and turn them into energy so we can power our bodies?

Herman Pontzer: Yeah, sure. So we can start with carbs. So carbs include starches, they include sugars, and no matter whether its a complex carbohydrate, like you get from a potato, or if its a simple sugar like you get from the sugar in your coffee, your body and your digestive tract breaks those down into very simple sugars, things like glucose and fructose. Glucose is by far the major simple sugar, so thats why we talk about blood glucose levels, cause that glucose, its absorbed into your blood, and then really it only has a couple places to go. It can go and get stored as glycogen, which is kind of a short-term savings account for glucose, cause glucose is really just all about energy. It can get turned into fat if your glycogen stores are already full, because glycogen Theres a limit to how much glycogen your muscles and liver can hold. Or, it can get burned as energy. And so, thats what its gonna eventually end up happening, is its gonna get burned as energy. But if youre not using it right now for energy, the glucose, you can store it as glycogen or fat.

The fat that you eat will also get broken down into fatty acids and those get stored as fat or burned. And then the proteins you eat get turned into tissues, like muscle tissue. Youre constantly cycling through muscle tissue cause you break it down during the day and you build it back up at night. And your other tissues need protein as well. Were kind of protein robots walking around. We need a lot of protein to build our tissues. And then when proteins get degraded, when tissues break down, your body will break those down into amino acids and burn those as well. But the main energy supply for your body is the glucose and the fat, and protein is mostly a building block. And we can get into the weeds there, like you say, we can For example, there are sugars that help build your DNA, there are fats that help build your cell membrane. So, things get used for different jobs, but those are the three big jobs.

Brett McKay: Gotcha. Okay, and so I think the big takeaway here is you literally are what you eat. When you eat carbs and fats, that stuffs in proteins, its broken down and its powering every part of your existence. And the idea is, okay, if you eat this stuff, you Say you eat a pizza, use it as an example, if you do pizza pizza, your bodys going to process that, break it down. You might use it right away for energy. If it doesnt need that energy right away, if its glucose or carbs, its gonna store it as glycogen. If the glycogen stores are too full, well then the body is, Okay, well, were gonna save that energy for later. Were gonna turn that into fat. And the same with fat, you eat fat, you either use it right away to power your body. If your body doesnt need it then, then it will store it as fat around your belly.

Herman Pontzer: Thats right. Thats right.

Brett McKay: Thats basically Okay. Okay, so now that we have this basic understanding of how metabolism works, lets get into your research. Because like I said, its counterintuitive what you found, cause I think a common idea out there that people have is that if you move your body around a lot, youre gonna burn more calories, than someone who moves less. And thats exactly why people, when they say, Im gonna start losing weight, what do they do? They sign up for the gym, they start exercising.

Herman Pontzer: Yeah.

Brett McKay: But what youve done with your field research as an anthropologist, you went to a group of hunter-gatherers in Africa, called the Hadza, and you measured their daily caloric expenditure. And the Hadza, theyre hunter-gathers, theyre moving around all the time. They have to move to eat, whether theyre gathering tubers or hunting animals out in the wild, theyve gotta work a lot to get their food. And you figured, well, they probably burn a ton of calories because theyre moving all the time.

Herman Pontzer: Yeah.

Brett McKay: What did your research find?

Herman Pontzer: Yeah, thats right. So we did this project because humans evolved as hunter-gatherers, so our species is Homo sapiens, so were in this genus Homo. The genus Homo is older than us, its 2.5 million years old. And for the last 2.5 million years, the entirety of the genus Homos evolution, weve been hunting and gathering. And then our species, Homo sapiens, shows up about 300,000 years ago, and were just one more hunter-gather group in a hunting and gathering genus. And so if you wanna understand anything about how our bodies evolved or what our bodies are built for, a hunting and gathering community is Thats the best context you can have. Now, theyre not living in the past, theyre not trapped in amber or anything like that, theyre as modern humans as you and I are. But because theyve held on culturally to this hunting and gathering lifestyle, it allows you to ask, How do our bodies work in a hunting and gathering lifestyle? So its one of the best windows youll get into how our bodies were shaped for hunting and gathering.

And like you say, theyre incredibly physically active, they worked with us, the group called the Hadza in northern Tanzania. They get more physical activity in a day than most Americans get in a week. And so going into it, we thought, Well, gosh, we have to understand how many calories theyre burning, because obviously, its gonna be a lot different than you and me. And so we went there. We stayed The first time I went there, I went for about two months, living with them, measuring energy expenditures over the course of a week, with this isotope tracking technique, which is really good, empirical, objective measurement of calories burned per day, and you get it over about a week-long period. So, its a really good look at daily energy expenditure. And yeah, we got back to the States with our samples, cause you use urine samples to track this stuff. We had to get them analyzed in a lab down at Baylor. And we got the numbers back and we were shocked, because Hadza men and women were burning the same amount of energy everyday as people in the US and Europe and other industrialized countries. There was no difference. In fact, Hadza men and women are burning less energy every day, fewer calories every day, than men and women in the West. Once you account for body size, they tend to be a bit shorter. So once you account for body size, its indistinguishable. You cannot distinguish daily energy expenditures between us and them. Its really, really remarkable.

Brett McKay: Oh, yeah, just to be I wanna emphasize this point. They, on average, walk like five miles a day, I think, was like one of the

Herman Pontzer: Oh, at least, yeah, thats the women. The men walk further. Yeah, absolutely.

Brett McKay: And a western like me, I dont Im lucky if I get my 10,000 steps in a day.

Herman Pontzer: Yeah, so thats a fun way to do it. The women get about 13,000 steps a day on average, often with a kid on their back, and men get about 19,000 steps a day on average.

Brett McKay: Alright, so whats going on there? How is it that theyre able to burn the same amount of calories as us not-so-active Westerners. Whats going on?

Herman Pontzer: Yeah. Yeah, well, that was the big puzzle, and so weve been trying to figure that out for the last 10 years. Heres what we know. We know that theres nothing magic about the way that theyre moving, right? So weve measured the energy cost of their walking. Weve taken a system out there that allows us to measure the energy cost to walk, and its the same as you and me. So theres nothing special about their muscles, theyre not more efficient that way. Instead, what seems to be happening is, the energy that they spend on activity is being rather than adding on top of everything else and creating a higher total energy expenditure per day, the energy theyre spending on all that activity is taken away from other expenditures. So basically, theyre reducing other expenditure and other aspects of their bodies to make room for this really large amount of energy spent on daily physical activity.

Brett McKay: Wait, and where do you Have you been able to see where the bodys taking away Whats going on? Wheres the body reducing caloric expenditure, so they can take into account that extra activity?

Herman Pontzer: Yeah, so this has been the focus of research over the last few years. Heres what we know, and part of this is based on what we know from groups like the Hadza, and part of this is what we know from other people, like for example, athletes in the US and elsewhere who are also really physically active, and then sometimes are easier to study, because we can get them into labs here. Heres what we know. When youre really physically active, you have lower levels of baseline inflammation, so things like C-reactive protein and the other stuff that is your immune system kind of over-reacting all the time, theres high levels of inflammation that Westerners tend to have, its lower in people who are really physically active. So, thats your immune system basically dialing it back, spending less energy, if youre really physically active.

Reproductive hormones, testosterone levels, estrogen levels in men and women respectively, are lower in groups like the Hadza and in athletes as well, endurance athletes as well. If you are a Hadza man, or a Hadza woman, your reproductive hormone levels are gonna be 20% lower, 30% lower than an adult your age. Theres an age effect, of course, as well with your reproductive hormones, so were accounting for age with that. Thats your reproductive system spending a little bit less energy on keeping itself up, and thats gonna save energy. Now, that doesnt mean I wanna be really clear, that doesnt mean theres fertility issues, or anything like that, or that theyre any less manly, the men, because they have slightly lower testosterone levels, nothing like that, but just the reproductive system is just taking a little bit less energy per day in really physically active folks.

And then the other big thing, and we dont have measurements of this with the Hadza, but we do with other physically active groups and with athletes, stress levels and stress reaction, stress reactivity, right? So if I stress you out, I accost you on the street and give your heart a bump, and your epinephrine levels go up, your adrenaline levels go up, your cortisol levels go up, or if I do that in the lab and I make you do mathematics in public, thats a really fun way to get people to get stressed out, your heart rate will go up, your cortisol levels go up. But if youre an athlete, or if We think if youre someone like the Hadza whos physically active all the time, that reaction will be not as sharp, not as big, and will Youll go back to baseline faster, youll spend less energy on that stress reaction than if you are a sedentary person who doesnt exercise a lot. So these are all the different various ways, we think, that the bodys able to take energy away from other tasks in ways that actually are really healthy for us, we can talk about that too, and make room for more physical activity.

Brett McKay: I guess to help people understand this, why its going on, basically our bodys regulation system for metabolism, its all geared towards surviving and reproduction, right? And so yeah, it makes sense, like you talk about the reproductive hormones going down. Well, if youre facing extreme physical activity, extreme caloric expenditures just to survive, to get food, your bodys like, Well, were gonna prioritize survival over reproduction a bit more, so were gonna adjust things. So I guess people understand that, your bodys metabolizing energy either to survive and reproduce, its going to modify things to further those goals. And I guess survivals the first goal, and then reproduction is number two.

Herman Pontzer: Well, yeah, I mean, it depends. In some species that are short-lived, its all about reproduction. Theyll throw away the survival piece. Humans, because were long-lived, were evolved to be here for the long term and to get through the tough times. Yeah, thats right, well, in a bad time, well focus more on the survival piece, our bodies will. But yet, we see this kind of a reproductive issue, reproductive effects in the Hadza, so a woman in a Hadza community, they like big families, they dont use contraception typically, but a woman will still have a kid every Between two and three years. So thats without any contraception. In the West, women who have a kid this year, even if that woman decides to breastfeed and is Yeah, so shes nursing, if she doesnt use contraception, is likely to be pregnant again within a year. So its much The reproductive system is actually kind of, its dialed back a little bit in these really physically active groups. And by the way, thats probably more healthy that most guidelines for things like pregnancy say, You should put more time between pregnancies. So thats one Its a good thing. But you can see the impact of how the energys being spent.

Brett McKay: And so what you guys have found, what you researchers found, is that our bodies, all human bodies, have this sort of constrained daily expenditures. Its like the Theres a range, upper limit range of how many calorie you can burn through a day.

Herman Pontzer: Yeah, thats right. So its not just the Hadza. I want to be clear about that. Weve done If youre a scientist and you find this really interesting result, the first thing you assume is that youre wrong, so you go to all the Youve done all the work to try to make sure that thats a really strong A good result for the Hadza and it is. You can use different techniques, different approaches, you get the same answer. So Hadza data are solid, and then you wanna replicate it. You wanna make sure its not just one society where youre seeing this or even one species, and so weve seen this in other human groups, now. Weve looked at other farming and hunter-gatherer groups and mixed groups, you see the same thing. Same daily energy expenditures as Westerners, industrialized communities, even though theyre much more physically active. We see this across species.

So weve done this study where we looked at different species of primates, monkeys and apes, and lemurs and lorises. In the monkeys in a zoo, from the same number of calories every day as monkeys in the wild. You can do this in a laboratory setting. You can get mice, you can take out their running wheel away from them for a while and then give it back, and theyre less active and then theyre more active, and you dont see any effect on their daily energy expenditure. So this is a really robust thing. Our bodies And probably all mammal species, maybe even birds species too, seem to be built to really try to regulate how many calories were burning everyday.

Brett McKay: So in humans, whats the constrained daily expenditure? Whats the range?

Herman Pontzer: Well, its gonna be a function of your body size. Bigger people expend more energy than small people, but women burn about 2400 kilocalories a day. Im saying kilocalories, cause we always say calories, its actually not correct, but you can just replace that with capital C, big calories if you want to, but women burn about 2400 kilocalories a day, men burn about 3000 kilocalories in a day. That can vary a little bit, again, with your body size, thats the biggest factor, but lifestyle has a really small effect on it.

Brett McKay: Alright, so this is a cross. About 3000 calories, whether youre a Hadza or some guy in New York, your bodys probably burning about three This is total, so this includes This is like BMR, so that resting, basal metabolic rate, on like your activity.

Herman Pontzer: Yep, it includes that, it includes the energy to digest your food, it includes whatever exercise you did, it includes taking that walk to go get a coffee, it includes the stress reaction from your boss throwing extra work at you at 5 oclock, all that stuff.

Brett McKay: Okay, so the implication of this finding is that relying solely on exercise to lose weight is probably not an effective strategy because your body Cause you exercise to burn more calories than youre consuming, but youre Weve discovered our bodys gonna figure out a way to compensate for the increased physical activity so that you stay inside your constrained daily expenditure.

Herman Pontzer: Yeah, theres two reasons that exercise end up being a poor tool for weight loss. One, is what weve been talking about, your body will adjust and youre adding You think youre adding 300 kilocalories a day to your daily routine of exercise, but youre not really because that 300 kilocalories of exercise is at least partially being eaten up by adjustments other places. The other thing is that even if you are able to manage to pump your energy expenditure up a bit with exercise, especially in the short term, cause it takes a while for the body to adjust, youre gonna eat those gains, cause your body is also Part of the system as your body is very well evolved to match energy intake with energy expenditure, and that also happens below our conscious thoughts. So if you are able to increase your metabolic rate by a bit, youre just gonna eat those gains and youre gonna end up right back where you are, where your energy intake matches your energy expenditure and youre not changing your weight at all.

Brett McKay: Alright, so Im sure people are listening to this and is like, Well this is depressing. But were gonna talk about why actually this is so important. Were gonna take a a quick break for a word from our sponsors.

And now back to the show. Okay, so people might hear this and go, Okay, if I wanna lose weight, then exercise doesnt do anything for me, what I need to do is reduce the number of calories I take in by a lot to lose weight. But that doesnt work either, and can even backfire sometimes, so what happens when we significantly reduce our caloric intake?

Herman Pontzer: Yeah, if you go on a crash diet, really cut the calories in half kind of thing, then this is another evolved survival response, your body says, Oh my gosh, were starving, theres no food in the world, and we gotta get through this lean period. And so what itll do is, without your being aware of it, it will reduce your metabolic rate. So all those systems that youre not aware of, your body can take the foot off the gas and spend less energy on those, and all of a sudden you arent burning as many calories as you were before. And not only do you feel miserable because youre starving yourself, but youre actually Your body is actually trying to frustrate those weight loss attempts Weight loss effort because it is reducing the energy expenditure that you had before, so its actually that difference between the energy youre taking in and the energy youre burning gets smaller because your body is saying, Oh my gosh, were starving, turn the energy down.

Brett McKay: And then so weve seen this with Biggest Losers contestants. They go Theyre losing hundreds Like 150 to Like a human, they lose a human off of their body, a full-grown human. And then you do the follow How do they do afterwards? And I think most of them gain the weight back.

Herman Pontzer: They almost all do, and thats really Its sad because of how much effort that you know they put into it and how much it meant to them, but its also kind of predictable because your body doesnt wanna change weight. There have been vertebrates, part of the group of animals called vertebrates, weve been around for half a billion years, and for almost all that time, probably all of it, losing weights been a really bad thing. Youre losing weight, youre on your way to dying, and so there are all these involved mechanisms not to lose weight, which is why its actually the most important that you can do for your health is to try to not get overweight in the first place. And that gets us into discussions about how we think about how we take care of our kids and how we take care of ourselves, especially in our early years, but yeah, its really hard to change once you do Once youre overweight. The best thing you can do is, if youre looking at behavioral strategies, is to try to change your diet, but like you say, if you go too fast, too hard and too fast, too soon, then that can backfire because your body responds to that by, again, reducing energy expenditure and frustrating that weight loss.

Brett McKay: Alright, so yeah, the metabolism, you cant outsmart the metabolism, theres no Its gonna figure things out.

Herman Pontzer: Yeah, one of the biggest frustrations I have when I look at online self-help, Heres how youre gonna take charge of your metabolism and boost your metabolism or whatever. All of this stuff, it all makes people think that theyre in charge of their metabolism. Right? Which is completely not the case. Your metabolism is working behind the scenes. Its smarter than you. And it adjusts to you. You cant really push it around. In a way itll manipulate things behind the scenes in ways that are gonna frustrate what youre trying to do. Now, and I hope were gonna talk about this, you should still exercise, absolutely, and if you do wanna try to lose weight with diet theres some strategies you can take, but I think this idea that were in the drivers seat, revving our engines, our metabolic engines in a sort of really simplistic way. And thats how we burn calories. I wish we could move away from that. Cause its just not the science.

Brett McKay: Right. So you cant speed up your metabolism, like thats

Herman Pontzer: No. Its really hard to do, and basically, yeah, you cant do it.

Brett McKay: Okay. So lets talk about this. So while exercise cant be the sole driver of weight loss, you make it very clear. You devote a whole chapter of this. Like that doesnt mean you shouldnt exercise and you actually make the case that because of humans unique metabolism, maybe we can talk about how it differs from the apes, because of our unique metabolism we actually its really, really important for us to move a lot. Why is that?

Herman Pontzer: Yeah. Well, so like I said, weve been evolving as hunter gatherers for two and a half million years and hunting and gathering takes a lot of work. And so our bodies are actually evolved to expect and require a lot of physical activity every day. Its what our organ As evolved organism, its what were evolved to do. And if we dont do it, we get sick. And so, yeah. Getting all those steps every day is really important. And apes are lazy, right? I mean, Ive done field work with apes. Ive worked with apes in zoos. Theyre impressively lazy, getting 5,000 steps a day maybe, is kind of a typical day for an ape. Even if you count up the climbing and all that stuff. And theyre just fine like that. They dont get sick from being like that. In fact, a chimpanzee in a zoo probably has less than 10% body fat. Thats a typical, thatd be typical for a chimpanzee in a zoo, even though theyre just sitting around. And so we cant do that. If we act on our ape-like impulses just to be lazy all day, yeah, we get real sick.

Brett McKay: Yeah. That was really interesting to me is that apes in captivity dont really get fat, like when they eat more food instead of turning that into body fat, apes just turn that into lean tissue.

Herman Pontzer: Yeah. Isnt that crazy. Humans are Its another evolved piece of our physiology. We are evolved to put on fat really easily. And it probably goes hand in hand with having a faster metabolism. So weve actually evolved a faster metabolism than apes have that allows us to have things like these big brains that we are so energetically expensive, and we have big fat babies more, and we have them more often than apes do that, takes a lot of energy. We are physically more active than apes. So all of this is like were a high energy ape. And as a kind of a backup plan, weve also evolved this propensity to put on fat because if youre always burning a high level of energy, given a high metabolic rate that you cant kind of turn down, you cant adjust much at all as weve been talking about, you need to have a backup in case you have periods where theres not much food and thats where our body pack comes in.

Brett McKay: Right. So, yeah, I get Okay, just to make sure Im getting this right. So apes, they dont have to move around a lot to get their food. So they have a slow metabolism and thered be you no reason for them to put on body fat really, because they would never They would probably wouldnt be long periods of time where they wouldnt go without food. Like, well, Ill just grab this leaf here. Humans, we had to hunter and gather to gather foods that requires a lot of energy. And so we have to If theres instances where we dont have a lot of food available, our bodies are like, Well, we need to have We need to store body fat in case that ever happens so that we have the energy to walk and find tubers and gazelle again.

Herman Pontzer: Yeah. And reproduce and do all those things that were built to do. Absolutely.

Brett McKay: Okay. So we have to move a lot. So our body uses a lot of energy. You also highlight research that exercise while isnt useful to lose weight, its really important in maintaining weight loss. Whats going on there?

Herman Pontzer: Yeah. Thats a really interesting piece of this. So if you go on an exercise program tomorrow, yeah, you might lose a couple pounds over the course of the year, but thats not the big benefit of it. Big benefit is how it kind of makes a lot of our systems more healthy. And if youre able to lose the weight with usually with diet as the big intervention, that exercise helps you keep it off. And we dont entirely know why. What we think is happening is that the exercise, the When you exercise your muscles send all these signals to your body, all these hormones and all these things. So your body knows youre exercising, it affects every part of your body. And one of the things we think it helps do is regulate how hungry and how full we feel. So how much we eat. And so kind of exercise has this effect of keeping our hunger and fullness better regulated. So we dont overeat once weve lost the weight. If you exercise, it helps you keep at that weight and not overeat and gain all that weight back.

Brett McKay: Okay. So, yeah, I think when people Okay, I wanna Theres some interesting things going on here, because our metabolism again is weird, when we exercise more, were gonna eat more because we need more energy, right? But if, I think what youre saying here is that when you exercise, theres a better connection between the calories you need and your hunger levels, right? So its like

Herman Pontzer: Yeah, thats right, yeah, thats right, And once youve lost the weight, the energy that you need is actually less, right? Because youve lost all that weight. And so if your body was just trying to match how much you need and how much youre taking in, youll match that at that lower level and maintain the weight better. Thats what we think is going on. Its actually not entirely well understood why exercise is such a good tool for keeping weight off. But it absolutely is thats what all the data show.

Brett McKay: Okay. So overall, exercise is gonna help you lose a little weight, but its really useful in helping you keep the weight off and maintaining your weight loss. And its probably because it helps match your appetite to your actual caloric needs and its helping control those hunger signals, and something thats interesting with this research is that they found that sedentary people, people who dont move hardly at all they actually eat more than those who are active, and its probably because their bodies have somehow become out of touch with how much food they actually need. And then something else we talk about Biggest Loser contestants, something else thats interesting with the research there is that with all the contestants, their metabolism dropped after the show, and then it stayed low long-term, but among those who exercised, even though their metabolisms were low as well, they actually did the best in keeping the weight off. And again, its probably because of the way exercise regulates appetite. So, yeah, exercise plays a big role in weight maintenance.

Herman Pontzer: The other thing that its doing, all of the other adjustments its doing, keeping your inflammation levels down, reproductive hormones in a healthier place, your stress reactivity down, that is gonna add years to your life. Those are all ways to avoid heart disease, avoid diabetes, the things that were most likely to die from, is by exercising. So, thinking about exercise as a weight loss tool, still kinda misses the point. Its actually really good for all this other stuff thats gonna keep you healthy and active and add not just years to your life, but like healthy good vital years to your life.

Brett McKay: Well, lets talk about diet, because I think thats the way we can lose weight, just reducing calorie intake. But then theres people who have created diets based on how our body metabolizes different macronutrients, and I think the most popular one is like a low carb high fat diet.

Herman Pontzer: Yep.

Brett McKay: And I think the big idea is Gary Taubess idea is like, well, the reason why you get fat is insulin, and when you eat carbs, insulin level spike and it drives the storage of carbs or fat as body fat. And so you cut the carbs, you reduce the insulin, youre gonna lose weight. What does your research reveal about diet and weight loss based on a macro nutrient?

Herman Pontzer: Yeah, the carb idea, its a beautiful idea. It just doesnt fit the evidence, unfortunately. So first of all, we can say, a group like the Hadza, and there are lots of them still that are farming and hunting and gathering and doing that kind of stuff. They eat a lot of carbs, in fact, they eat more carbs as part of their diet than people in the US do. So if it were all about carbs, then folks like the Hadza should be incredibly obese, but of course theyre not. Theyre but healthy weight throughout their whole lives, and they dont ever gain weight in their middle and older age, theyre just fine. And so if its really just about carbs then groups that eat a lot of carbs ought to be overweight, theyre not. Secondly, when you do the control laboratory studies and you put people on low carb diets versus on low fat diets, you dont see any difference in weight loss outcomes. And in fact, depending on the size sometimes you see people do a little bit better on low fat, but thats The main outcome is that you just dont see any difference at all.

If you cut calories by cutting carbs, or you cut the calories by cutting fat, you get the same outcomes. And the third is, if you do a study where you take people and you randomly assign them to a high carb diet or sorry to a low fat diet or a low-carb diet, this has been done a few times now. Theres no difference in outcomes. People, again, lose weight just as easily, just as well on low fat as they do on low-carb diets, and so theres just really no The carbohydrate insulin model of obesity, which is the Gary Taubess idea, its been tested in a lot of different ways, and its a beautiful idea, its very elegant, it just doesnt work. It doesnt fit the data. Now, low-carb diets work for a lot of people, thats a different question. The question is, why are they working? And how do they work? And the answer is, they basically, youre cutting calories but that doesnt mean that the mechanism thats been proposed as insulin-based mechanism is really what its all about, cause that just doesnt bear out.

Brett McKay: Alright, so again, you cant trick your body, your metabolism?

Herman Pontzer: Well, I mean, no, I think this is a different thing about tricking. So, okay, the counter argument from the folks like Gary Taubes would be like, Oh well, youre saying all calories are the same, youre saying, it doesnt matter what you eat. Is that what youre saying? You know, and the answer is Well, no, no, were not saying the 100 kilo calories of broccoli is gonna affect us differently and feel different than 100 kilo calories of potato chips. So, in both those cases, those are very carb-heavy foods. And so the kinds of food you eat matter, but all the evidence says that the way that you feel full on fewer calories, which is really the goal to lose weight with diet, is that we have to think about the way that those calories affect our brains.

So we talked about how your brain is really well adapted to match the calories in and the calories out, to match our fullness and hunger to our weight. The way that you kind of push that system to lose weight without feeling miserable is to find foods that make you feel full on fewer calories, so things like higher fiber foods can help, higher protein foods can help. Thats where low carb diets come in, by the way, you take a whole macro-nutrient group out and you give yourself foods that really have a lot of protein in them, and you feel better. You feel full on fewer calories, thats why low calories work for some people. Yeah, so I mean, thats what were talking about here. So were not saying that theres no That foods dont have different effects, that kind of stuff, of course they do. But do all diets work through the insulin pathway or do they work through manipulating the way our bodies feel, our brains feel that seems to be the more likely mechanism.

Brett McKay: Yeah, we had Steven Guinea on the podcast a while back ago. And he talked about this, right, how our brain How it feels about our food that were eating, and one of the interesting takeaways I got from him was, one thing you can do is just eat less palatable food, cause palatable food you just wanna eat a lot of it. Were talking about Doritos and cheese burgers its like oh I just wanna keep But its like if you look at the diet of the Hadza its the most boring thing. Theres no spices, its just like, well, youre gonna a tuber its kind of burnt, and like some zebra.

Herman Pontzer: Yeah.

Brett McKay: Thats just gross, and so its usually like well, Ill eat enough to get the energy I need to do what I have to do, but Im not gonna So one take away, its just like eat Instead of eating a potato chip, eat a baked potato.

Herman Pontzer: Yeah, thats right, theres actually a great set of, most of it is anecdotal cause nobody No real nutritionists would ever recommend this diet and Im not to be clear, but theres a great anecdotal evidence of people who just eat potatoes and lose lots of weight that weigh hundreds of pounds sometimes, because if all you eat is potatoes, guess what, you are sick of potatoes [laughter] well before you have over-eaten your calories that day, and so thats one way to do it for sure. And I think thats what low carb is doing as well, you take a whole class of foods off the menu and how much steak can you eat? How much spinach can you eat? Youre just gonna feel full before you over-consume and thats the great way to go, for some people that works really well. But its not the only way to go and its not because of this kind of carbohydrate-insulin magic, I think its much more about our brains than that.

Brett McKay: So I think another common idea people have about metabolism Its okay, thats great We kind of debunked a lot of things, exercise isnt gonna do much for you to lose weight, basing a diet on a macronutrient probably is not gonna do anything for you.

Herman Pontzer: Right.

Brett McKay: I think another popular idea people have about metabolism is that as you get older, it slows down, thats why

Herman Pontzer: Oh, yeah.

Brett McKay: People in their 50 or 60 got the belly Is that true? Does their metabolism slow down?

Herman Pontzer: You know man, Im in my 40s and I was really sure that one was true. And then we just recently did this big study, we took measurements from 6400 and some people, and those are people from People who have just been born, 8 days old, up to folks who are in their 90s. And what we did is we were able to use that big, big data set to measure how many calories people burn over the course of a day and ask how that changes over a lifespan. What we found was that your metabolism is really steady and stable between about 20 years old and about 60, and so theres no slow down in your 30s and 40s that we were able to detect at all, yeah, that turned out to be another one of these myths. So thats not to say that it feels the same to be 44 as it does to be 24, I can attest to that. But its not metabolism, its not the energy burning thats changing, its something else, its about stress levels or hormone levels, that kind of thing.

Brett McKay: But it does start slowing down after 60?

Herman Pontzer: At 60, yeah, and thats really interesting because 60 is also that inflection player, people start to People get in their 60s, 70s, 80s, thats when you see your risk of different diseases pick up, heart disease, Alzheimers disease, other Diseases that we associate with aging, those are when those really start to kick in, is after 60, and were seeing your metabolic rate decline too. What does that mean? That your cells are slowing down, thats where your metabolic rate Which we started off by talking about what metabolism is, its all your cells at work, when we see that metabolism is starting to slow down, well thats telling us our cells are doing less work. And man, we would love to know exactly whats happening there, whats changing that it is either promoting or just signaling and telling us about these changes and how our cells work that seem to be related to the disease risk that we see picking up there. Because maybe, maybe we could find a way to keep ourselves burning more energy keep them at a younger state, maybe that would be protective against disease, I dont know. But its Something we need to look into next, is figuring out exactly why that decline happens and is that telling us about healthy aging, I suspect it is, but were gonna have to have more work to figure that out.

Brett McKay: Well, one idea that crossed my mind when you told me that at 60, it starts going down, that would make sense if we understand that metabolism is about survival and reproduction. If youre over 60, especially for women, reproductions off the table, your body doesnt need calories for reproduction.

Herman Pontzer: Yeah, so thats interesting, right? Because menopause typically happens when women are in their 40s, late 40s, so actually from an evolutionary perspective, that last 15 years, if you go to 60, lets say Thats kind of hard to explain. And what that seems to be about is that the elders in our communities And this is true in the Hadza, and this is also true here in the States, and its true historically and across cultures. Folks who are in their later middle age are doing a lot of work and helping out their own kids and helping out the next generation, and that seems to be really important, so we have this evolved strategy to share and to help, its one thing you cannot escape when you go in to work with the Hadza, theyre always sharing, theyre always helping each other out. And its not just being nice, it is baked in to being a human, and I love that about the doors that this kind of metabolism work opened up, Id be like, Oh my gosh, hunting and gathering. Right? Its not just one or the other, you have to do it together.

And that comes out every celebration you ever had, I bet, involves hanging out with other people and sharing stuff, sharing food, sharing birthday cake. Alright, thats whats been so hard about all the social distancing with COVID is were built to be social and together and sharing. Anyway, so getting up to 60 actually gets you past your reproductive years, for most of us, and that makes sense because again, its really We need to work together. Maybe at 60 is around the time that most folks in the hunting and gathering communities, mortality rates kick in at a higher rate there, and maybe thats what were evolved to get to at least 60, and then the rest of that time youre in the bonus if youre in a hunting and gathering group, that would fit the mortality data alright, so thats an interesting idea. But I do think its clearly, is an evolved piece of our physiology, its not something we decide to do is just slow down at 60, its our cells are built to start doing that.

Brett McKay: Alright, so whats a person supposed to do with this information? Alright, someones listening to this, thinking, Well, I need to lose some weight. How should this research guide their approach to losing weight?

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Podcast #793: The New Science of Metabolism and Weight Loss - Art of Manliness

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