The findings don’t suggest laughter is a cure-all. What they do suggest is something more useful for everyday life: laughter is a low-cost, low-risk way to nudge the nervous system out of threat mode and back toward regulation — especially when it’s shared with other people.

How Laughter Works

When you laugh, you’re not only reacting emotionally — you’re recruiting multiple systems at once. Your breathing changes (often becoming deeper and more rhythmic), your face and core muscles contract, and your autonomic nervous system (the system that controls “fight-or-flight” and “rest-and-digest” can shift gears. That matters because so many stress-related problems — poor sleep, tension, irritability, rumination — ride on chronic activation of the stress response.

One of the most consistent biological signals researchers track is cortisol, a stress hormone that tends to rise with ongoing strain and can affect sleep, immune functioning, and mood. A meta-analysis found that spontaneous laughter was associated with greater reductions in cortisol than usual activities, suggesting a genuine stress-regulation effect rather than just a subjective feeling of relief.

This is important because it ties the “I feel better” experience to a measurable stress marker. So it’s not all in your head because it is biologically measurable. If you want to think of it another way, laughter is the non-prescription medication that you should take as often as possible. I’ve written about this before and have recommended it to all my college students and my patients.

I am a great believer that laughter plays a significant role in our lives. And you don’t need to wait to be in a group to laugh, because laughing even while alone serves a superior purpose in health maintenance. Does that mean you spontaneously laugh out loud for no reason? It could be so, but you could also use things like TV shows, films, things you’ve read, or anything that is humorous and makes you laugh.

Laughter can also influence brain chemistry linked to mood and pain. While the exact pathways are complex, reputable clinical education sources point to laughter’s relationship with endorphins and other neurochemicals involved in well-being and reward. That doesn’t mean laughter replaces medication or therapy when those are needed. But it helps explain why, in the moment, laughter can feel like a small reset — less tightness in the chest, a clearer head, a slight loosening of emotional grip.

There’s also a social pathway that may be just as powerful. Laughter is contagious for a reason: it signals safety and shared understanding. When people laugh together, they often feel more connected, and that sense of belonging can buffer stress. A 2023 Harvard Gazette feature — grounded in clinical expertise — highlights laughter’s role in lifting spirits and strengthening connection, which aligns with what many mental health clinicians see in real life: isolation amplifies distress, and connection softens it.

What Current Studies Say

The strongest modern evidence comes from controlled “laughter-based interventions.” These include laughter therapy, humor interventions, and laughter yoga (which combines intentional laughter with breathing and simple movement). These approaches are especially useful for research because they can be delivered consistently and compared with control conditions.

Mental health outcomes are promising, though not uniform across every study. A 2024 meta-analysis of randomized controlled trials examined laughter and humor interventions in adults and found improvements in outcomes such as depression and sleep, with more mixed findings for anxiety depending on the population and the type of intervention. That pattern — clearer benefit for mood and sleep than for anxiety — shows up elsewhere too.

For example, a 2022 randomized study on online laughter therapy in first-year nursing students reported reductions in depression, while anxiety effects were less consistent. This doesn’t mean laughter can’t help anxiety. It suggests that anxiety may require either longer interventions, more targeted techniques, or additional supports (like cognitive strategies and exposure-based tools), whereas mood and sleep may respond more readily to the stress-relief and social “unclenching” that laughter provides. There are benefits, and there are limitations, but I suggest the benefits are worth trying.

On the physical side, one area getting attention is cardiovascular functioning. A well-known line of research has explored how laughter may influence blood vessel function and circulation — factors linked with heart health. A British Heart Foundation article discussing this body of work describes findings such as improved arterial function and reduced inflammation markers following laughter-based approaches. Even when studies are small, the direction of effect is noteworthy because cardiovascular health is so closely tied to stress physiology. Worried a bit about your heart health? Okay, then you have to try laughing.

Workplace and burnout-related outcomes have also been studied. A 2024 systematic review focused on nurses and nursing students reported that laughter yoga interventions were associated with reductions in stress and burnout measures, along with improvements in mood-related outcomes in several included studies. These are high-stress groups, so the fact that laughter-based practices can move the needle at all suggests they may be a helpful “adjunct” — a supportive add-on rather than a standalone solution.

One caution that shows scientific maturity in this field is that researchers are increasingly clear about limits. A review on laughter and longevity argues that laughter is biologically plausible as a supportive factor — through stress modulation, social connection, and healthier behavioral patterns — but also emphasizes that the science is still developing and needs stronger, larger trials. That’s the responsible takeaway: laughter looks beneficial, especially for stress and mood, but it’s not magic, and it’s not a substitute for medical or psychological care.

Making Laughter a Health Habit

If laughter is “medicine,” it’s not a pill — it’s a behavior. And like most health behaviors, it works best when it’s realistic, repeatable, and emotionally safe.

Start by letting go of the idea that you must feel joyful first. Some laughter-based methods use intentional laughter that can become genuine once the body loosens up. This can be useful for people who feel flat, burnt out, or socially guarded. In a sense, it’s similar to other behavioral activation ideas: you don’t wait for motivation; you create conditions that make a better mood more likely. Research on structured laughter interventions suggests that even planned laughter can improve well-being.

Next, focus on the social dose. Watching something funny alone can help, but shared laughter adds warmth, belonging, and the quiet reassurance of “I’m not doing life by myself.” If someone is depressed, grieving, or chronically stressed, that social signal may be part of the benefit, not just the joke itself.

Finally, keep it grounded. Laughter is not appropriate in every moment, and forcing it in the face of serious pain can feel invalidating. A helpful guideline is to use laughter as a release valve, not a way to deny reality. It can sit alongside hard feelings rather than replacing them. And if laughter triggers discomfort — some people feel vulnerable when they laugh freely — gentle exposure is fine: smaller moments, safer people, and content that doesn’t leave you feeling ashamed afterward.

Taken together, the current research implies something simple: laughter is a meaningful stress-buffer with measurable biological signals, credible mental health benefits (especially mood and sleep), and potential cardiovascular upside — most effective as a complement to good care and good habits, not a replacement for them.

The post Laugh and Learn to Live This Year appeared first on Medika Life.

I have seen this before in other nations enduring conflict: people preserve continuity by compartmentalizing. They create pockets of normalcy to shield their families, their children, and themselves from the constant strain of danger. Ukrainians do the same. They cling to routines not because they are blind to what is happening, but because this is how life goes on under extraordinary circumstances.

During the day, life unfolded with striking steadiness. Shops were open, schools held classes, and cafés filled with conversations. Nothing closed. War was present, but it did not dictate the cadence of daily life. People pressed on with remarkable resolve, refusing to let conflict consume their hours.

At night, however, the balance shifted. Air raid warnings pierced the darkness. Ambulance sirens cut through the silence. The curfew, from midnight to 5 AM, made those sounds echo loudly, a stark reminder of vulnerability as streets fell quiet. This contrast, between calm days and anxious nights, was a reminder that compartmentalizing is not the same as escaping. Shutting out “the other reality” allows life to go on, but it exacts a quiet toll. Beneath the surface of resilience, the weight of “what if” is relentless.

I recall when Ukraine’s major roads were narrow and potholed, marked by unofficial checkpoints and police randomly checking documents. Over time, they became modern highways, a symbol of progress and a nation moving forward. Russia’s invasion reversed that progress overnight. What had been a country pressing ahead was thrust back into a state of survival.

Before the war, Ukrainians knew Volodymyr Zelensky as the star of Servant of the People, a television satire in which a schoolteacher rants about corruption and becomes an unlikely president. It was comedy, but with an edge of truth. Today, in a cruel twist of fate, that fiction became prophecy. Zelensky is no longer acting out politics; he is leading a nation through crisis and resilience.

As I walked the streets this year, I noticed how persistence and resilience stand side by side. Markets were crowded with produce, yet older residents stood nearby, selling small baskets from their gardens to make ends meet. Soviet-era uniforms lay for sale on blankets placed on sidewalks, while new BMWs sped past rattling Soviet-era buses. In town squares, there were endless billboards featuring photographs of fallen soldiers, each bearing a QR code that linked to their stories. Schools mounted plaques on building walls to honor graduates who died in battle. I paused as a funeral procession passed, an ambulance leading with a soldier’s photograph in the windshield, shopkeepers leaving their stores to stand in silence. Grief is not an occasional occurrence here. It is part of the rhythm of life.

Living in this reality has unleashed a mental health crisis. According to Ukraine’s Ministry of Health, the number of people seeking psychological help in 2024 has more than doubled compared to the previous year. Antidepressant sales have surged nearly 50 percent since 2021. A Lancet study reports that more than half of Ukrainians, including refugees, live with PTSD. Twenty-one percent struggle with severe anxiety. Eighteen percent live with constant stress. And in 2023, more than one in four reported feeling depressed or very sad, up sharply from before the invasion.

These figures are not abstractions. They are lived experiences. Teachers steady students while suppressing their own fears. Parents comfort children when sirens interrupt dinner. Shopkeepers greet customers with smiles while wondering whether loved ones will return from the front. This is the cost of war: invisible wounds carried behind the routines of daily life.

Remember People’s Stories

Western headlines are increasingly focused on politics, with questions about whether U.S. and EU leaders will sustain aid, how long support for Zelensky will last, and what future negotiations might bring. These debates matter. But when politics dominates the narrative, the human story – our emotional connection – risks fading from view. The United Nations recently passed a resolution recognizing “the profound and long-lasting effects on the mental health of people, in particular children.” This acknowledgment is important, but it is not enough. Policies and political platitudes cannot replace storytelling.

The war’s reach was evident even at the border. My crossing into Moldova took five hours.  Two years ago, it was 30 minutes. Officials pried into spare tire hubs, emptied luggage, and rechecked passports repeatedly. For me, it was an inconvenience. For Ukrainian men between 18 and 60, it was absolute – they cannot leave. Guards studied every face, determined to grab draft dodgers. War demands not only weapons, but people.

Moldova itself carries the strain. Refugees continue to arrive, its economy is stretched, and its stability depends in no small measure on Ukraine’s endurance. Trauma does not stop at borders; it ripples outward, reshaping the region.

What impressed me most was the people’s adaptation. Ukraine is doing more than enduring; it is investing in its future. I saw new multilingual historic heritage signs supported by EU restoration funding, featuring markers that honor the intertwined contributions of Ukrainians, Poles, and Jews. Even if history is more complicated than the inscriptions suggest, these symbols point toward unity. They reflect a nation determined to acknowledge its difficult past while striving to shape a different tomorrow.

That is what struck me most this year. Ukraine is not allowing the conflict to dominate its aspirations. While global headlines debate the scale and length of Western support, Ukrainians are already laying the foundations for what comes next. Their resilience is not simply about surviving the present; it is about declaring that there will be a future, and they will build it.

Ukraine is more than a battlefield. It is a nation of teachers, farmers, doctors, and entrepreneurs who rise each morning to live, to work and build. The war, directed mainly at Kyiv and the East, has scarred Ukraine. It has not broken this nation. Instead, it has revealed a strength of spirit that unites remembrance with renewal.

That is why their stories must remain on our front pages, not only to remember their sacrifices, but also to honor their hope. Ukraine’s struggle is not just for sovereignty, but for the promise that even in the hardest of times, a nation can adapt, unite, and invest in a future worth both believing in and living.

The post Ukraine: Worn Hearts, Steeled Resolve appeared first on Medika Life.

I came to Borneo to let the ground fight back.

This morning, outside Kota Kinabalu, Malaysia, my boots slipped on a tangle of wet roots.

The air smelled of earth and rain.

A quiet hum of life surrounded me.

In that awkward, humbling stumble, I felt something rare:

My body woke up.

The Comfort Trap That’s Making Us Weak

In Seattle, I walk sidewalks and treadmills — smooth, safe, and sterile.

For most of human history, humans moved across shifting ground.

Forests. Fields. Hills.

Every step required micro-adjustments.

Your feet, ankles, and hips worked together without your conscious effort.

But today?

Flat concrete. Cushioned shoes. Escalators and elevators.

The result?

• Weak stabilizer muscles in the feet and ankles
• Poor balance and slower reaction times
• A brain that tunes out during your most basic movement

Comfort stole our strength.

What Science Says About Uneven Ground

Clinical studies confirm what my jungle stumble reminded me:

Walking on uneven terrain:

✔️ Activates foot and ankle stabilizers
✔️ Improves proprioception (your body’s sense of position in space)
✔️ Sharpens reaction time
✔️ Reduces fall risk in older adults
✔️ Boosts mood and cognitive performance

A 2021 study found that older adults walking on rough paths improved their gait stability by 22%.

A separate trial revealed that rugged walking improved working memory and decision-making speed.

In other words: Your steps train your brain.

→ Your feet aren’t the only part of your body that’s asleep. Want to wake up your mind, too?

Join the 100,000 readers who have enjoyed → 10 Tiny Habits That Make You Healthier, Calmer, and Harder to Kill

Orangutans, Cobras — and the Gift of Paying Attention

I paused beneath the jungle canopy.

An orangutan swung overhead, effortless in its grace.

It stared at me as if to say, “You humans forgot how to move.”

A rustle in the underbrush.

Was it a cobra? A monkey?

Or just the wind reminding me to stay alert?

Either way, I wasn’t scrolling my phone.

You can’t walk distracted when the jungle might bite back.

Uneven ground forces presence.

And in a world addicted to autopilot, presence is a rare medicine.

Rough Terrain Rewires Your Brain for Survival

I used to think walking was the ultimate autopilot activity.

But neuroscience says otherwise.

Rough terrain lights up your prefrontal cortex — the part of your brain that handles attention and planning.

Your cerebellum and sensory nerves work overtime to keep you upright.

This sparks:

• Lower cortisol (stress hormone)
• Improved heart rate variability (a marker of resilience)
• Faster reflexes when life throws you off-balance

One landmark study found these brain benefits last long after the walk ends.

So the next time your foot meets uneven ground, know this:

Your brain is rebuilding itself, one step at a time.

Flat Surfaces Make Life Easy — and Make You Fragile

Modern life has flattened our world.

We walk in shoes that numb the sensation.

On surfaces designed to eliminate surprise.

And then we wonder why our balance fades with age.

Falls are the leading cause of injury-related death in people over 65.

However, the danger begins decades earlier, when our feet stop adapting and our brains stop noticing.

How I Brought This Home

Back in Seattle, I made some simple shifts:

✔️ I walked forest trails instead of smooth streets.
✔️ Hiked on pebble beaches where every step shifted.
✔️ Walked barefoot on grass during morning routines.
✔️ Kept a wobble board under my standing desk.
✔️ Balanced on sidewalk curbs instead of staying in the middle of the path.

Small, daily friction makes your body strong again.

And one more thing — stay safe.

Choose trails appropriate for your skill level, watch your footing, and skip barefoot walking where sharp rocks or hidden hazards could cause injury.

How to Start (No Jungle Required)

Here’s how I coach patients and friends to rebuild strength and balance:

✔️ Choose uneven surfaces: dirt trails, grassy parks, rocky beaches, or mulch paths.
✔️ Go barefoot (when safe): start on grass, packed earth, or soft sand.
✔️ Slow your pace: give your body time to adapt.
✔️ Add balance drills: balance on logs, low curbs, or balance cushions indoors.

You don’t need to overhaul your life.

But you do need to stop walking only on flat, predictable ground.

Adaptation is the Goal — Not Perfection

The real danger isn’t falling.

It’s losing your ability to adapt.

On uneven ground, your body learns to adjust.

Your brain stays alert.

Your nervous system sharpens.

It’s not about avoiding every stumble.

It’s about responding better when you do.

What Happens If You Ignore This?

If you wait until your balance is depleted, regaining it becomes harder.

The loss happens slowly:

• Your stabilizer muscles atrophy.
• Your reaction time slows.
• Your confidence erodes.

But rebuilding is simple.

Step off the pavement.

Find a trail.

Let the ground challenge you again.

Of course, be safe and don’t take unnecessary risks.

Final Thoughts: What the Jungle Taught My Feet

By the end of my hike, my legs were burning, and my boots were caked with mud.

But my mind felt clearer than it had in months.

Maybe this is what we’re wired for:

Not flat streets. Not endless comfort.

But uneven steps that challenge and strengthen us.

Modern life has made our paths smooth.

But with a little intention, we can rebuild what we lost — balance, strength, awareness.

And maybe, in the process, discover something deeper than comfort:

Vitality.

→ Ready to take the first step toward a stronger, sharper you?

Follow me on Medium for science-based habits to help you thrive in a chaotic world.

One more thing — My best-selling ebook: Extending Life and Healthspan

The post The Surprising Health Benefits of Walking on Uneven Ground — And Why You Should Start Today appeared first on Medika Life.

The first thing that comes to my mind is not working, turning on (or off) light switches, no television, avoiding cooking, etc.

Chores should be finished before sundown on Friday night and paused until Saturday’s sun has set.

A practitioner’s time is focused on family, catching up on sleep, and perhaps a stroll in the neighborhood.

The World Seems to be Always “On.”

I sometimes feel that I live in a world that is always “on.”

You probably do, too.

The relentless hum of notifications, scrolling through reams of information, and the constant stream of notifications can sometimes leave me feeling frazzled and disconnected.

Pausing, reflecting, and renewing help me immensely.

Welcome to my piece on embracing the Shabbat spirit.

And no, I am not just talking to those who observe religiously, but to anyone, regardless of their religious background, seeking a deeper connection to themselves, loved ones, or the world around them.

Exiting the High-Speed Race With No Finish Line

I recently learned about Shabbat, the Jewish Sabbath.

Followers observe 25 hours of rest and rejuvenation from Friday sundown to Saturday nightfall.

I am not Jewish, but take this lesson away: I need time to disconnect from the world’s demands.

I want to focus on relationships and simply be.

But Michael, you ask, what are you turning to Torah teachings when you are not Jewish?

Shabbat has no deep religious significance for you, right?

But here’s the thing: Its core principles resonate with me, given my desire to lead a more balanced and meaningful life.

I want to build a pause in my life’s rhythm, reclaiming time for what is truly important to me.

You may or may not be religious, but a designated period of reflection may give you a much-needed respite from your always-on world.

Creating a Pause to Uplug and Reconnect

I constantly engage with technology at work and home.

I read a book every week or two on my Kindle. I blog most Fridays and Saturdays. I subscribe to the Seattle Times, New York Times, and Washington Post. I use my computer to study Japanese and Italian languages. You get the picture.

One of the most striking things about Shabbat is unplugging from technology.

Will I put away my phone, laptop, and other devices for 25 hours?

Frankly, no.

But can I do it in the morning or the evening on a weekend? Sure.

Disconnecting has made me realize how constant streams of information and notifications can leave me a little overwhelmed and anxious.

There is always one more blog to read or one more cancer management article to read.

Without digital distractions, I create space for deeper inner connections and better connections to my loved ones and the world around me.

No devices means sharing a meal with my family or walking in nature. It can also be a moment for quiet reflection.

Without digital distractions, we create space for deeper connections with ourselves, our loved ones, and the world around us.

Whether it’s sharing a meal with family, spending time in nature, or simply enjoying a quiet moment of reflection, Shabbat encourages us to cultivate meaningful experiences that nourish our souls.

Embrace the Beauty of Simple Being Present

Shabbat invites us to embrace the beauty of slowing down and simply being present.

It’s a time to release the pressure to be productive and to allow ourselves to rest and recharge.

“To gain control of the world of space is certainly one of our tasks. The danger begins when in gaining power in the realm of space we forfeit all aspirations in the realm of time. There is a realm of time where the goal is not to have but to be, not to own but to give, not to control but to share, not to subdue but to be in accord. Life goes wrong when the control of space, the acquisition of things of space, becomes our sole concern.”
― Abraham Joshua Heschel, The Sabbath

I have written about how a leisurely walk helps me find stillness. Quiet contemplation promises greater perspective, clarity, creativity, and a renewed sense of purpose.

Let’s examine some practical ways to pause your life’s rhythm. I guarantee you will cultivate a deeper sense of peace, joy, and connection.

Creating A Pause (How I Embrace the Shabbat Spirit)

Here are a few simple ways to incorporate its principles into your own life:

• Designate a rest day. Choose one day a week to unplug from technology, slow down, and focus on what truly matters. I am not there yet, but trying to carve out a morning or afternoon.
• Create rituals. Whether lighting candles, sharing a meal with loved ones, or spending time in nature, establish meaningful rituals that mark your day of rest.
• Practice mindfulness. Take time each day to be present and fully engage in whatever you’re doing, whether eating, walking, or simply breathing. Yes, mindfulness eating!
• Connect with others. Make time for meaningful interactions with loved ones, friends, and community.

In a world that often feels chaotic and overwhelming, the spirit of Shabbat offers an oasis of stillness.

By embracing the wisdom of this ancient practice, regardless of our religious orientation, we can reclaim our time, nourish our souls, and cultivate a more balanced and meaningful life.

Thank you for reading “Pause, Reflect, Renew: Embracing the Shabbat Spirit.” I hope you have a joy-filled day.

The post More Than Just Matzah Balls: Finding Meaning in the Modern Shabbat appeared first on Medika Life.

Significant change is needed. But what change? Lowering drug costs will not lower total spending on health so long as pharmacy benefit managers (PBMs) continue to profit from the “spread.” Access to care will not improve so long as we ponder the future of essential telehealth services. Patient adherence will not be supported if formularies can call upon “non-medical switching” as a go-to negotiating tool. The US percentage of GDP will not align with other developed nations’ investments in health if we don’t redirect effort to emotional and physical preventive and value-based care. Fixing one piece of the healthcare puzzle is helpful – but is it transformational?

There are changes afoot that we need to make happen sooner rather than later by moving minds, systems and behaviors so that life-sustaining and life-saving approaches to patient care may eventually tip the scale of human survival toward health and wellness. However, we see data through the lens of a human perspective – sometimes self-interests or emotional needs for control.

Here are 10 possibilities that are not dreams – they can happen – if the health ecosystem leaders think beyond cost, reimbursement or authoritative voice and focus on people’s healthy longevity:

1. Artificial Intelligence (AI) — A future of engagement and collaboration:

AI has been around since the Gutenberg Bible! In 1899, medicine made a giant leap into AI by publishing the Merck Manual — a handbook that collected all known medical advice and gave physicians a compendium of diagnoses and treatments. No expert can remember the vast canon of medical information within their specialty, and books became a source of “augmented knowledge.”

Too many health systems and physicians view AI as “novel.” Addressing the obstacles to implementation within their health systems is critical to enhanced decision-making benefits offered by AI. Concerns about cybersecurity and training are valid! However, the value of implementing artificial intelligence is not about embracing technology — it’s about amplifying human wisdom to address patient urgencies effectively.

Human intelligence can be augmented by uniting data, patient files and other health professionals’ patient-care experiences, channeled through this technology platform. We must now rally to address questions about data quality, emotional resistance to change and cybersecurity. As innovation theorist, John Nosta writes about the emerging importance of aligning IQ and EQ with TQ (technology quotient).

“The battle of man versus machine might be ending where cooperative engagement provides transformative solutions to a wide variety of problems and opportunities.”

2. Behavioral Health — America does not lack a supply chain to manufacture chronically ill citizens:

We are killing ourselves slowly…with poor nutrition. We continue to add belt notches to our waistlines. The added weight also increases risks for heart disease, diabetes, cancer, mental health stressors, and more. Who pays those sickness bills? Employers foot a large percentage of the nation’s workforce health insurance. It’s time to look beyond providing an expected workplace benefit. Physicians, employers, payers and the people they seek to help must reduce the waistlines of people tipping toward the obesity border! Helping consumers shed unnecessary pounds and meeting their corresponding medical priorities offers immediate life-saving and personalized health benefits.

The best option for corporations footing a large part of the health bill is to intervene with payers and recognize benign neglect in tackling the obesity epidemic only adds to suffering and expense. Louis J. Aronne, M.D., who founded the breakthrough patient-centered health-tech Intellihealth along with Weill Cornell Medicine physician colleague Katherine Saunders, MD, notes:

“Obesity is a very complex chronic disease with a number of causes from diet to underlying medical conditions, medications and genetics. “Through our extensive research and applied medical model, we have incorporated all of our practice methodologies into a single software platform, which delivers a blueprint for treating obesity with supervision and continued oversight. Evaluation of our approach demonstrates 3x the number of patients reaching the key outcome measure of 5% or greater weight loss compared to programs that incorporate behavioral interventions alone.”

3. Decentralized Clinical Trials — Democratize drug development:

Even before COVID-19 appeared, traditional clinical trial recruitment models were being reconsidered. Drug development was almost sidelined during the pandemic, and clinical research organizations (CROs) recognized that they needed to reinvent patient recruitment. Operation Warp Speed showed how to put the pedal to the metal for COVID-19 vaccines; systems developed now can be applied to other high-priority, clinical urgencies such as treatments for rare diseases and often-fatal cancers.

Collaboration to advance the process is working. Science and research pioneers such as Amir Kalali, MD, and Craig Lipset, who co-lead the industry-wide DTRA.org group, show the sector’s readiness to change direction collectively. Innovators like Michelle Longmire, MD, CEO of Medable, and Irfan Khan, MD, CEO of Circuit Clinical, demonstrate that an industry known to advance new medications from bench to bedside can innovate how and where patients are invited to participate in urgently needed therapeutic discoveries. Innovation is based on finding new paths to address unmet needs.

To accelerate drug discovery and development possibilities, biopharma and medical device companies need to find a new set of allies – patient advocacy organizations and their communities; primary care centers with access to people in rural and inner-city communities. They must recognize that in working with government, sector companies, and those that seek to serve – people with health needs – they can go farther, faster.

4. Digital Health — Physicians and patients need coverage clarity:

Food and Drug Administration approval for life-sustaining innovations does not necessarily sway payer access decisions. “Claim denied” is the all-to-often refrain when physicians and their patients seek access to a 510 K-approved medical device or digital therapeutic.

Payers may have sufficient justification to deny coverage. But what are the criteria for those “dead-on-arrival” reimbursement decisions? What are the guidelines to secure formulary approval? If more data are needed to ensure access for patients — insurance customers — payers must become partners in the sector’s and patient-care success. Adding bricks to the walls patients must circumvent to secure care for themselves and their families does little to improve care or customer relationships.

Digital health analyst and author Artur Olesch outlines a challenge for the coming year in a question many more should be asking:

The COVID-19 pandemic has accelerated the implementation of telecare and telemedicine. Individuals are increasingly using mobile health apps. What can be done not to waste this potential?

5. Ecohealth — We need a healthy planet or else:

Where you live impacts how long and how well you live. Thousands of U.S. communities are ticking time bombs. The harsh reality is that 26% of Black Americans and 29% of Hispanic Americans live within three miles of a toxic landfill site, exposing these communities of color to dangerous levels of lead and other heavy metals and chemicals. We must face the harsh reality that while planet earth can do just fine without humanity; humanity needs a healthy planet. This was the striking call-to-action by Meharry Medical College President and CEO Dr. James E.K. Hildreth.

The longer we wait, the harder it will be to course-correct. The shift to a healthier world requires other innovative superpowers — courage and collaboration. According to Bob Martineau, senior partner FINN Partners, a former Federal and State government official focusing on environment issues: 

Though we breathe, eat and live in the environment, we often forget just how interconnected all aspects of our health are with the world around us. Exposure to dangerous levels of air, soil and groundwater pollution is proven to cause a cascade of life-threatening woes that include cancers, nervous system disorders, respiratory diseases, and premature births.

6. Tackle older patients’ care and adherence challenges:

When people are diagnosed with a chronic or severe medical condition, we must ensure that the patient-physician relationship guides care and that the medical ecosystem prioritizes medication adherence. The National Health Institute reports that 40% of patients sustain significant risks by misunderstanding, forgetting, or ignoring healthcare advice. We don’t need to invent or create new care challenges. Let physicians already seeking to do good oversee clinical-care decisions.

Age discrimination and comfort with using technology to access the health system are barriers to access and understanding medication use and adherence. Age bias is often attached to health conditions often experienced in older persons. While older Americans often are the health system’s most significant customers, they face continued discrimination. We must see continued innovation in earlier detection of illnesses that impact seniors, such as loneliness, Alzheimer’s and even sexually transmitted diseases.

7. Health disparities — The most vulnerable need access to care now:

Decades of racism place people of color in harm’s way from COVID-19 more than any other community. Blacks are dying at a rate of 50.3 per 100,000 people, compared with 20.7 for whites. In New York City, the most densely populated place in America, 19% of residents, many people of color, live in poverty, while 17% live in overcrowded conditions. We seem unable to come to grips with the reality that health disparities cause multiple public health disasters and cost lives and dollars.

We must reach the communities that seek information in ways that speak to their interests and needs. What groups such as Hip Hop Public Health creatively use the power of music with health-specific messages to mobilize and change mindsets.

America is among the few developed nations that deny good healthcare services to those most in need. Neglect and racism are morally counter to the health mission of medical leaders. The changes of senior citizens to access health networks easily must be addressed. Policymakers, corporate leaders and citizens must raise their voices to enact change. A cultural shift is needed to rally communities for awareness and education. According to Yele Aluko, MD, MBA, chief medical officer at EY:

The current conversation going on nationally about societal justice, about health equity, drives a moral imperative. This conversation is going on across health systems, big business, government, and philanthropic organizations. Everybody’s talking about how we need to fix this wrong, so the time is now. We have a convergence of goodwill that drives my optimism. But we must seize the moment and translate it into actionable solutions.

8. Metaverse — Smart technologies channel our imagination toward curative possibilities:

Do you have an imagination? Put it to work to heal. After all, medical engineering is a pioneering effort that connects people’s ideas with human biology to overcome sickness. We entered the “Matrix” the first time we imaged a therapeutic stent, LVAD and 3D-printed artificial limb; complex operations became possible when expert hands drew upon technology to realize new concepts.

Rafael Grossman, MD, FACS, has been tapping technology to improve patient-centered medical care. Always ready to explore the disruptive power of technology in medicine, Dr. Grossman has been at the forefront of using smart glasses, augmented, virtual and mixed reality to change the way we practice and teach medicine.

Grossman and medical compatriots such as Daniel Kraft, MD, don’t see the metaverse as sci-fi. Artificial reality, virtual reality and wearables are used by leading-edge practitioners to advance patient outcomes.

9. Remote Patient Monitoring and Telehealth — Remote care after COVID-19:

Digital systems are built into beds, furniture and watches. Medical wearables make hospital stays more customer-friendly by delivering patient information straight to providers’ smartphones and central monitoring stations. At the height of the pandemic, there was a dramatic uptick in telehealth and remote care. As reimbursement rates shift, patients worry they will lose the benefits of remote care.

Ever so often, Congress, the Centers for Medicare and Medicaid Services and private payers pump the brakes on continued remote access with life-saving services such as telemedicine. We need to change the culture of conservatism when it comes to remote advancements and access. Groups like the American Telemedicine Association are essential voices for access and a sensible hybrid approach to care.

Medicine is a culture where patients are not yet seen as customers. Cancer survivor, caregiver and health professional Stacy Hurt, a HIMSS Digital Health Influencer and recent participant in a VyTrac-sponsored webinar on remote patient monitoring, writes on the importance of a hybrid approach:

Patients ultimately want two things: hope and options. We’re finally to a point where telemedicine is an option. It for sure shouldn’t replace the in-person encounter and relationship between the healthcare provider and patient, but it is an option we need to preserve.

10. Self-Care — Our health system keeps us alive — it doesn’t keep us well:

Our health system is not built around sustaining “health.” We have invested mightily in national illness management, a sick-care structure that offers no return on investment regarding a better path to healthy longevity. Value-based and preventive care to keep the illness at bay is a big win-win-win for households, companies and governments that now foot the nation’s health insurance bill. Employers and payers will find that incentivizing self-care and illness prevention is a more innovative business model.

WebMD Chief Medical Officer John Whyte, MD, an author on bestsellers with life-saving tips to reduce cancer and diabetes risks, writes:

The biggest myth has been that (cancer) is primarily caused by genetics or just bad luck and there is nothing that you can do about it. The reality is only about 30% of cancer is caused by what we would say are inherited mutations or family history. The rest is primarily influenced by lifestyle. I know, although nothing is 100% preventable, we have learned through science that you can reduce your risk by deciding what you eat, how much you exercise, your level of stress, the quality of your sleep. These are all things you have control over.

If this roster of innovations in hand tells us anything, it’s time we put health-system mindset change front and center. There are plenty of great reasons to say, “this won’t work” or “let’s not do it; it adds to costs.” It is understandable that new products, services and approaches take time to implement and cost money. But when we look at people’s well-being, adding complexity to people’s lives that separates them from access to the best quality of care has never been medicine’s intended mission.

We look to changes such as Amazon purchasing One Medical as a pathway to fix that which is broken. We have an abundance of innovative, readily and inexpensive (often generic) medicines. We often can speak with a skilled health professional through our smartphones and tablets. Perhaps the change so sorely needed isn’t another billion-dollar acquisition and “roll-up,” it’s addressing the challenges of collaboration and transparency?

Health providers are at the forefront of confronting our significant societal challenges. They have risen to the task heroically. Health disparities between the haves and have-nots and developed and developing nations have opened our eyes and hearts. Innovation combined with our determination must open the door to fundamental system change.

The post Health Possibilities We Can’t Afford to Block appeared first on Medika Life.

We attended the digital funeral today of an innocent victim, slaughtered in a horrific drive-by shooting. That victim was of course Ivermectin, a wonder drug that has over the last two decades saved countless lives. The vehicle involved was the pandemic and the vehicle’s occupants, none other than individuals from within the medical and wellness sectors.

To understand why people sworn to protect their patients at all costs would cross over to the dark side, we need to highlight facts that have surfaced over the last few months. Understanding motive will I hope also enable those who remain skeptical to accept the truth about Ivermectin.

It is not a treatment or prophylactic for Covid-19 or the SARS-CoV2 virus. It never was.

A small, as yet unvalidated possibility exists that it may offer some benefit to late-stage Covid-19 patients, but that remains inconclusive pending further research. Proving Ivermectin’s efficacy in early-stage Covid or as prophylactic poses very real, and some would argue, insurmountable methodological challenges.

All Ivermectin ever claimed to be, was an anti-parasitic drug. It is as much a victim of the intricate web of deceit and deception spun by certain individuals, as the intended targets, who consume it in the mistaken belief it offers salvation.

Let’s begin by examining how that web has begun to unravel and then we’ll take a closer look at those who engineered the deception and why.

The Preprint

Most of the scientific and medical community speaking up on behalf of Ivermectin used the following pre-print as validation for the efficacy of the drug as a Covid-19 treatment. The paper was called Efficacy and Safety of Ivermectin for Treatment and prophylaxis of COVID-19 Pandemic and the first of four versions was made available to the public on the 13th of November, 2020.

The preprint was published on researchsquare.com and if you click on the link above you will see that the preprint has been removed and an investigation initiated into the content and contributing authors. Why is explained below.

ReasearchSquare posts the following text in red font above the preprints it publishes as fair warning that the content is not peer-reviewed and should not be considered as anything more than an unverified opinion.

This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.

Despite this, the preprint was seized upon, Google scholar showing 43 citations. In case you’re not familiar with publication terms, in scientific journals, a citation is a reference from a published article to a published paper (note, not a preprint) intended to provide confirmation or reference for content.

In short, 43 papers that have done exactly what the warning above suggests shouldn’t be done. Why this warning exists and preprints are broadly unreferenced in the scientific community became apparent as peer review set about validating the integrity of the data in the preprint and claims of plagiarism that had been leveled against the authors.

Examining the Data

Much like forensic auditors check for cooked books, forensic data analysts exist to sniff out anything fishy in sets of data. Nick Browne was tasked with examining the data used in the preprint to validate claims made relating to the efficacy of Ivermectin as a treatment for Covid-19. You can read a full breakdown of his analysis here if the summation below is insufficient.

The data file for the research was made available as a locked Excel spreadsheet, rather than an SPSS 21 file, the tool the preprint authors purported they had used for their analysis. Browne was forced to pay for access to the file and then had to manually guess at the password (1234) before gaining access to the Excel data. From there, things rapidly progressed from bad to worse.

Many of the patients who died appear to be duplicates. According to the original data, there were ‘four’ patients with the initials NME, NEM, and NES (twice), who were all males aged 51 years old, all suffered from diarrhoea(sic), had the same blood hemoglobin levels, were all diagnosed on the 22nd of May, and all died on the 29th of May 2020. They also all share identical values in at least four other data columns.

At least a further ten deceased patients also display evidence of being duplicated. Duplicates make up around half of the recorded deaths. Much of the patient data is identical, but minor changes exist, proving that a simple copy and paste error cannot be the cause of the duplicates.

In no particular order, and again, please refer to the linked report for specifics, Browne also identified issues with;

• Formatting
• Numbers containing non-numeric characters
• Confusion around date formats
• Repeated or cloned sequences of data
• Apparent failures of randomization
• Descriptive statistics that did not match the preprint
• Table results that do not match the preprint
• Other issues included age distribution, trailing digits of numerical variables, study entry and exit dates, and last, but not least, the lack of the SPSS file.

In summation, Browne arrived at the following conclusion;

In view of the problems described in the preceding sections, most notably the repeated sequences of identical numbers corresponding to apparently “cloned” patients, it is difficult to avoid the conclusion that the Excel file provided by the authors does not faithfully represent the results of the study, and indeed has probably been extensively manipulated by hand.

We aren’t limited by Browne’s proclivity for professional restraint so we’ll call it as he saw it. The data provided for the preprint are a largely concocted fairy tale, an ambitious con designed to mislead. Manipulation of the data was not accidental but rather intentional, engineered to support very specific predetermined outcomes, for reasons we will examine below.

Plagiarism

Lead-authored by Dr. Ahmed Elgazzar, a Professor Emeritus at the University of Behna, the preprint claimed to represent the results of a multi-center, 600-patient study evaluating the use of ivermectin in preventing and treating COVID-19.

The author’s claims centered around the following;

• Ivermectin significantly reduced both the number of deaths and the length of patient’s hospital stay compared to standard Egyptian treatment protocols
• Ivermectin exhibited a substantial effect in preventing the onset of the disease in the first place, in other words, it acted as a prophylactic against the virus.

The article by Jack Lawrence we will reference with regards to the above can be read in full here, and again, we have provided a summation of his findings below. There are numerous instances in the preprint of text being lifted directly from an original source and not credited. In a schoolboy fashion, the authors have tried to obfuscate the plagiarism by changing a few words in each extract.

Plagiarized Elgazzar et al 2020

“This novel virus infection has incapacitated the world’s medical services framework as well as the political and financial relations [2. As another section in human life opens

up [3, the world is by all accounts divided into two sections pre-and post-COVID19 time.”

Original Heidary & Reza Gharebaghi 2020

“This novel virus has paralyzed not only the world’s health care system but also the political and economic relations [13]. As a new chapter in human life opens up [14], the world seems to be divided into two parts pre- and post-COVID19 era.”

Note: Elgazzar even used the same sources

https://www.nature.com/articles/s414290200336-z

A schoolboy could be chastised and excused for similar behavior, but there can be no excuse offered by the preprint author, Elgazzar, who would be intimately familiar with protocols surrounding scientific publications. The preprint is littered with further examples of plagiarism and Larence uncovered further unethical actions pertaining to the study.

While the disclosures above may shock some, they pale in comparison to what is to follow, namely acknowledging the extent of duplicity and malintent by members of the medical community across the globe. Doctors, scientists, pharmacists, alternate health practitioners, and individuals from the wellness sector have teamed up to exploit vulnerable patients for financial gain in the midst of a pandemic.

That is the only logical and unavoidable conclusion that can be drawn from the Ivermectin fiasco and avoiding confronting this unpleasant reality prevents us from protecting vulnerable patient populations.

Acknowledging the Grift

Medika first became aware of Ivermectin and its ability to kill the SARS-CoV2 virus in a paper in Nature, released in mid-2020. We published an article, highlighting the results, achieved in vitro, and suggested, like others, that immediate trials should be undertaken to see if the effects could be replicated in vivo.

The pandemic was gaining momentum and there would be no shortage of willing trial candidates. The problems though were obvious at the outset. Ivermectin had successfully killed the test tube sample in a laboratory, but achieving similar dosage levels in human subjects was highly inadvisable and patently unachievable without endangering the patient’s health.

Conducting broad-scale trials at tolerable dosages should have been a priority for either the FDA or a recognized European health authority. No one stepped up to conclusively prove or disprove the potential of Ivermectin as a Covid treatment. The lack of credible trials was potentially driven by an industry-wide skepticism of the drug’s ability to impact viruses (it is an anti-parasitic) and although this rationale made sense to scientific circles, the public was unable to make the connect.

A potential ‘treatment void’ had been unintentionally created for Ivermectin and it was into this void, as is so often their want, that the grifters stepped, seizing an opportunity to co-opt the pandemic for profit on a global scale.

Plumbing the dark depths of deception

India was one of the countries that fully embraced the grift. Provincial authorities distributed Ivermectin as a Covid treatment to residents and other countries, notably South American populations, followed suit.

Proving the efficacy of a treatment is often far simpler than disproving its efficacy and the grifters took full advantage, distributing their ‘Covid treatment’ via the global digital conspiracy network surrounding the pandemic. They assured the public that the drug was being intentionally withheld and the rest is history. Across the internet, both the public and many from within the medical community bought into the Ivermectin lie.

A lie that was cemented in many minds as fact by anecdotal evidence, falsified data and manipulated trials like the one conducted by Elgazzar and his colleagues. It is far easier to believe a convenient lie than face an unpleasant truth.

Doctors (the term is used loosely) have taken advantage of a vulnerable patient population to sell them drugs and in case you think this deplorable behavior was limited to non-western countries, the evidence suggests the west drove the trend. This is not simply supposition but fact.

In the US, rapidly formed organizations like America’s Frontline Doctors, a despicable congruence of dishonest doctors, pharmacists, and marketing individuals set about creating the ultimate pill mill for not only Ivermectin but the other darling of Covid conspiracies, hydroxychloroquine. You can read more on that here, including comments from exploited patients, shown below the article.

This pattern of profiting by deception from the sale of Ivermectin and other Covid cures continues unabated. We have unintentionally created the environment where large sums of money can be made from misleading the public in the midst of a pandemic. The fact the public’s health may be forfeit is irrelevant to the quacks and charlatans claiming to be healers.

These individuals are doctors, nurses, pharmacists, caregivers, and individuals of science. The lie could not exist without their duplicity and in many instances, the lie exists at their instigation. It is a hard truth to face and one we look away from. We need to openly acknowledge this and develop effective methods to prevent future occurrences.

Ivermectin’s lasting legacy should not be as the drug that failed to treat Covid and fooled the world. It should be seen as the drug that taught the world about a bitter pill, one we need to swallow now, lest we repeat history.

The post Ivermectin is Dead and Buried Despite NIH Website Misstep and Twitter Buzz appeared first on Medika Life.

Our white blood cells, including T-cells, are central players in our immune response to infections (such as the flu) and cancer.

Did you know that the infection-fighting T-cells are better able to do their job if you get sufficient sleep?

Sleep: Are you getting enough?

Do you underestimate the importance of getting adequate sleep? The United States Centers for Disease Control offers that adults ages 18 to 60 years should get seven hours or more of sleep, while those 61 to 64 seven to nine hours. If you are 65 or older, the CDC points to 7 to 8 hours as optimal.

The Sleep Foundation points to five key elements to getting sufficient sleep:

• A quiet environment. Consider calming sounds or music. Avoid loud, abrasive sounds.
• A focus of attention. A word, phrase, mantra, breathing pattern, or mental image may draw your attention and reduce thinking about external issues.
• A passive attitude. Accept that it is normal for your mind to wander.
• A comfortable position.
• A comfortable mattress.

In addition, the Sleep Foundation suggests consideration of mindfulness practices such as meditation or controlled breathing. Here’s one option, known as the Andrew Weill 4–7–8 method:

1. Place your tongue tip close to the ridge behind your front two teeth and hold it in this location throughout the breathing practice.
2. Mouth closed, slowly inhale through your nose as you count to four.
3. Hold your breath and count to seven.
4. Open your mouth and exhale as you count to eight. Because of the location of your tongue, exhalation should cause a whooshing sound.
5. Repeat this 4–7–8 cycle three more times.

Here are other suggestions for improving your sleep:What To Do When You Can’t Sleep | Sleep FoundationIf you’re one of the millions of Americans who struggle with insomnia, you may find your mind racing and your body…www.sleepfoundation.org.

Sleep and the immune system

As noted above, good quality sleep can boost your immune system’s T-cells to fight off infection. Sufficient sleep improves by enhancing the T-cells’ ability to adhere to and destroy cells infected by pathogens such as viruses.

To better understand how sleep improves our ability to stave off infection, in 2019, German researchers examined a group of molecules called “Gαs-coupled receptor agonists.” These substances can suppress the immune system. But how?

To better understand the relationship between sleep and immune system-suppressing Gαs-coupled receptor agonists, the scientists obtained samples from volunteers who had had a good night’s sleep.

They also got blood from a separate group that stayed up all night. Here are the findings:

T cells taken from the sleeping volunteers had much higher “integrin activation” levels than T cells obtained from the up-all-night group members. Put in more simple language, the T cells from the sleep group performed better at attacking cells infected with a virus.

Sleep can improve the efficiency of T-cell responses to infection and may also help lower the risks of chronic stress, aging, depression, etc. Get some good sleep; your well-rested pathogen-fighting T cells will thank you.

The post One Trick to Dropping Covid Risk appeared first on Medika Life.

We’ll come back to that awful statistic, but we need to keep such findings in context: Randomized clinical trials show that screening mammograms save lives.

Today, I look forward to exploring breast cancer screening, including the pros and cons of the various imaging approaches.

Mammograms

Mammograms remain central to screening for breast cancer. Systematic reviews of randomized clinical studies for women ages 40 to 69 years show a long-term drop by up to one-fifth in the risk of dying from breast cancer.

Unfortunately, these are primarily historical; most screening mammograms studies began before 1990. Since then, there have been changes in imaging, and there have also been tremendous treatment advances.

Full-field digital mammography

Today, many patients have full-field digital mammograms. These images are similar to traditional film-screen mammograms, except now the image is captured by an electronic detector stored on a computer.

In the United States today, virtually all of the mammography units accredited by the Food and Drug Administration are full-field digital units. Are these newer digital mammograms better than the old film ones?

The most extensive study, the Digital Mammographic Imaging Screening Trial (DMIST), discovered that while the overall diagnostic accuracy of the film and digital mammograms appear similar, digital mammography is more accurate for women less than 50 years of age, for premenopausal and perimenopausal women, and women with dense breasts.

Tomosynthesis

This digital approach produces three-dimensional (3D) images using a moving X-ray source with a digital detector. Multiple studies suggest that tomosynthesis mammograms increase cancer detection rates modestly compared with historical 2D digital mammograms.

A 2018 analysis of a collection of studies showed a gain of 1.6 cancers (per one thousand screening studies) detected with the addition of tomosynthesis, compared with traditional mammograms alone. The tomosynthesis rates also appeared lower.

Alas, no studies have examined whether tomosynthesis cuts breast cancer mortality chances.

Mammograms — Still the gold standard

Mammograms continue to be the primary imaging modality for screening women at average risk of getting breast cancer.

Ultrasound sometimes supplements mammogram screening for those with dense breasts, even though we don’t have high-level evidence to show improved outcomes.

Magnetic resonance imaging (MRI), in combination with mammograms, is being increasingly used for those at high risk of getting breast cancer. However, we have some data that incorporating MRI for those with extremely dense breasts (and normal results on mammograms) results in fewer interval (between studies) cancers than mammograms alone.

Mammograms — New findings

A University of California, Davis-led study, published 25 March 2022 in the Journal of the American Medical Association Network Open, reports these findings:

Half of women will experience a false-positive mammogram after ten years of annual breast cancer screening with 3D mammograms. The risk appears lower for women who have mammograms every other year.

The 3D mammogram approach modestly dropped the odds of having a false-positive result compared with standard digital 2D mammograms.

These groups had a lower false-positive risk:

• Women with non-dense breasts
• Older women
• Those who screened every other year

Writing in sciencedaily.com, the first author Dr. Michael Bissell writes that the “screening technology did not have the largest impact on reducing false positives.”

Dr. Bissell adds that the findings from our study highlight the importance of patient-provider discussions around personalized health. It is essential to consider a patient’s preferences and risk factors when deciding on screening interval and modality.

The researchers analyzed data collected by the Breast Cancer Surveillance Consortium on 3 million screening mammograms for over 900,000 women aged 40–79 years.

I am surprised that the innovative 3D mammogram approach for breast cancer screening did not lower the chances of having a false positive after ten years of screening. Still, mammograms save lives.

The post 3-D Mammograms — Worth It? appeared first on Medika Life.

Lifestyle Changes May Be Better Than Rx Drugs

Let me be clear about this point — There’s a wealth of data that shows when specific healthy lifestyle interventions are performed correctly – with actionable recommendations – the effect can be just as good if not better than some prescription drugs. Take diabetes as an example.  The Diabetes Prevention Program (DPP) evaluated how intensive lifestyle changes might compare to medication in preventing the progression of prediabetes to diabetes. With more than 25 research sites around the country and thousands of participants, this study serves as a landmark trial should change how we think about lifestyle intervention!

Here’s what they did: They split participants into three groups – one received the drug metformin, one received no specific intervention, and the third receives intensive lifestyle coaching that consisted of a low-calorie, low-fat diet and at least 150 minutes per week of moderate intensity exercise. Participants received specific advice on what and how to eat, as well as what types of exercises to do.

The goal was to lose 7% of their baseline body weight.  For most people, that was 15-20 lbs.  Guess who got the most benefit? The lifestyle group did the best of all three groups—it even out-performed the one group that received medication.  As for the belief that older folks won’t make changes (“can’t teach an old dog new tricks”), lifestyle changes for people over 60 years of age resulted in 71% reduction in diabetes risk!  This wasn’t a one-time benefit where participants gained weight when the program was finished.  Even after 10 years, the risk reduction was 34%. 

If you combine social support with lifestyle changes, the results can be even more impressive! A recent study teaching lifestyle changes in a group support setting included patient-centered counseling techniques, motivation to change, social support and assistance with goal setting, action planning and self-monitoring.  Again, the goal was 7% weight loss, 150 minutes per week of moderate-intensity exercise including 2-3 sessions of muscle strengthening, as well as a program for healthy-eating.  All of this was not done in a vacuum – There were 12 hours of educational group sessions. The majority of participants were followed by 2 years.  No medications were prescribed.

Again, impressive results in reversing high blood sugars!  In fact, there was a 40-47% reduction in the risk of developing type 2 diabetes in those who participated in the study.

Lifestyle changes work! Of course, they have to be done properly.  We often like to quip “medications only work in people who take them” – well, lifestyle changes need to be prescriptive with specific advice and results measured consistently over time if you’re going to recommend them.  I find the biggest problem is that physicians don’t encourage patients in a meaningful way to eat healthy, be more active, and focus on quality sleep.  They don’t talk to patients about the benefits, so patients often don’t make a real effort.

Physicians Have Their Limits – Look at Varied Coaching Options

The argument from physicians will be “ I don’t have time” or “I don’t get paid to give that type of advice.”  That should not be a sufficient reason to not provide proven therapeutic interventions.  Yes, we must be practical – most physicians are not equipped right now to do this.

The remedy?  We use consultants all the time as part of our medical training, and now we need to start consulting for help with strategies to address lifestyle. Let’s partner with nutritionists and personal trainers to advise patients with specific information on how to eat healthy, as well as give detailed advice about different exercises.  We need to use digital tools that provide real-time feedback to help patients make healthy choices.  These include apps that can analyze food quality through pictures, continuous glucose monitors to assess blood sugar, as well as devices that tell you whether you are burning fat or carbs in the morning, at bedtime, and before exercise.  And we need insurance coverage to ensure everyone can benefit from it.

Lifestyle changes work!  Sure, there’s still a role for medications for many people – but let’s not jump to them all the time.

*****

[Editor’s Note: Dr. John Whyte is author of the bestselling health guide: “Take Control of Your Diabetes Risk.” From his newest work, you can learn more about ways to reduce your diabetes risk and change your mindset from “I hope I don’t get diabetes to I can prevent diabetes.“]

Perreault L, Kahn SE, Christoph CA, Knowler WC, Hamman RF; Diabetes Prevention Program Research Group. Regression from pre-diabetes to normal glucose regulation in the diabetes prevention program. Diabetes Care. 2009 Sep;32(9):1583-8. doi: 10.2337/dc09-0523. Epub 2009 Jul 8. PMID: 19587364; PMCID: PMC2732165.

Sampson M, Clark A, Bachmann M, et al. Lifestyle Intervention With or Without Lay Volunteers to Prevent Type 2 Diabetes in People With Impaired Fasting Glucose and/or Nondiabetic Hyperglycemia: A Randomized Clinical Trial. JAMA Intern Med. 2021;181(2):168–178. doi:10.1001/jamainternmed.2020.5938

The post The Power of Lifestyle Choices – The Dose of Truth in “Heal Thyself” appeared first on Medika Life.

That’s the view of Dr. Denise Park, the Director of the Center for Vital Longevity at the University of Texas at Dallas (USA).

OUR HABITS CAN HAVE PROFOUND EFFECTS on our cognitive functions. There are many contributants to our brain health, but today I want to focus on a relatively simple way you can lower your chances of suffering from cognitive decline.

First, before we talk about too much sitting, let’s quickly list some brain hacks that may lower your risk of suffering from a cognitive decline.

1. Physical activity may provide some protection for many of us. Dr. Laura Baker, a neuropsychologist at the University of Washington (in my beloved Seattle), discovered that older adults with mild cognitive impairment demonstrated improvements on tests of executive function after six months of aerobic exercise (for four days weekly).
2. Stress is associated with an increase in beta-amyloid protein, a component thought by many (but not all) to be a causal agent for Alzheimer’s dementia, at least in mice brains.
3. Mental stimulation. A 2006 meta-analysis showed fewer years of education associated [emphasis added] with a greater risk of Alzheimer’s disease.
4. Short sleep is associated with brain dysfunction. I have written about the link here:

Short Sleep and DementiaSleep disturbance is associated with a higher risk of dementia.medium.comUse Sleep and Exercise to Drop Your Dementia RiskToo little (or too much) sleep may increase your dementia risk. Optimizing sleep and getting some exercise may reduce…drmichaelhunter.medium.com.

First, full disclosure: I am unaware of any high-level evidence pointing to a clear cause-and-effect relationship between lifestyle interventions and improvements in cognitive impairment risk.

The US National Institutes of Health agrees, with an expert panel concluding that there is not enough evidence to support any particular modifiable factor as reducing dementia risk.

Still, many habits are associated with poorer brain health, and today I want to look specifically at the effects of sitting too much.

Sitting and the brain

“Americans Sit More Than Anytime In History And It’s Killing Us.”

That’s the headline I recently stumbled across. Do you sit too much? In the United States, the average American adult sits more than at any other time in history.

As a radiation oncologist, I have a relatively sedentary job. Do you? According to the American Heart Association, these types of jobs have increased 83 percent since 1950.

We sit. A lot.

Did you know that physically active jobs comprise less than 20 percent of work in the USA? This low number is down from approximately half of jobs in 1960.

And, Johns Hopkins researchers contend that “physically active jobs now make up less than 20% of the U.S. workforce, down from roughly half of jobs in 1960.” The typical office worker sits a remarkable 15 hours daily. And then we sit on our commute home.

And there is this: Too much sitting can offset the health benefits of working out.

All of this sitting can do a job on our brains. A 2018 PLOS One study reports that sitting too much is associated with changes in a brain region central to memory.

University of California, Los Angeles (USA) researchers used magnetic resonance imaging (MRI) scans to peer into the brain’s medial temporal lobe (MTL), a zone that creates new memories. The research subjects ranged in age from 45 to 75 years.

They compared the scans with the average number of hours an individual sat each day. Those who sat for the most prolonged time had thinner MTL regions. Unfortunately, such brain changes can be precursors of cognitive decline and dementia.

Sitting and the brain — An action plan

I recommend moving after 30 minutes of sitting to all of my able patients. Many of us have reminders on our wrists: My FitBit device buzzes periodically to remind me to get up and move.

I recall a New York Times piece that suggested we exercise for three minutes every half hour to counter the harmful effects of sitting too long. Walk around the office or home. Climb stairs. Stretch. Just move. Even as few as 15 steps during mini-breaks can improve our blood sugar control.

The post One Simple Way to Protect Your Brain appeared first on Medika Life.