Intelligent Medicine Radio for September 26, Part 2: Dry Fasting

Cholesterol Beyond the Basics: ApoB, Lp(a), Stress, and Aged Garlic Extract for Cardiovascular Risk: Dr. Ronald Hoffman interviews clinical pharmacist and nutritionist Jim LaValle about cardiovascular risk factors beyond total cholesterol, emphasizing that blood tests measure lipoprotein particles and subfractions rather than cholesterol itself. They discuss limitations of relying on surrogate markers, the role of lifestyle (diet, exercise, sleep, stress, glucose control), and advanced markers such as ApoB, Lp(a), oxidized LDL, and Lp-PLA2, noting that lowering Lp(a) or improving markers doesn’t always improve outcomes. LaValle highlights ApoB as a key risk barometer, reviews evidence for aged garlic extract lowering ApoB, slowing coronary artery calcification, regressing vulnerable plaque, and improving vascular function, and supports combining supplements with appropriate medications. They address lean-mass hyper-responders on ketogenic diets, debate broad statin use in seniors, and cover stress/cortisol dysregulation, hormone effects, and appropriate use of GLP-1 drugs for weight and metabolic risk.

Dr. Hoffman continues his conversation with clinical pharmacist and nutritionist Jim LaValle about cardiovascular risk factors beyond total cholesterol.

We take the keys away from older drivers—why not older doctors? Nearly 3 in 4 Americans battling this health problem—fatigue! What super-agers over 100 have in common—a hyper-vigilant immune system guarding against cancers and infections. How does “anabolic resistance” contribute to frailty—and what to do about it? Recurrent bouts of “burning sensations” on the face—diagnosis please?

Deadline looms for ban on hemp-derived CBD/THC products—while legal pot proliferates; Scientists disclose IBD benefits of urolithin A; “Dry-fasting” is a new fad—is it healthy? Short “exercise snacks” to break up prolonged inactivity benefit attention and cognition; Kimchi and designer probiotics show promise for flushing out microplastics; LSD soon to be approved as a prescription for anxiety.

Sleep, Growth Hormone, and Autophagy: How Rest, Diet, and Fasting Support Metabolic Health and Longevity: Nutritionist Leyla Muedin discusses how deep, early non-REM sleep boosts growth hormone for muscle, bone, fat burning, and metabolic health, and reviews a Cell study in which UC Berkeley researchers mapped hypothalamic circuits and feedback through the locus coeruleus showing a tight balance between sleep, growth hormone release, and wakefulness, with implications for metabolic disease and neurodegeneration. She connects poor sleep to higher blood sugar, insulin, and cortisol, which can suppress growth hormone, and advises avoiding sweet post-workout foods (e.g., smoothies, bananas, fruit yogurt) that stimulate insulin and blunt growth hormone, recommending protein and fat instead. She then explains autophagy and mitophagy as cellular cleanup processes linked to longevity, noting autophagy peaks after 12 hours of fasting, highlighting roles in mitochondrial quality control, immunity, and neurodegenerative disease, and mentions interventions such as fasting, exercise, ketogenic diets, and investigational inducers like rapamycin and urolithin A.

America's food fight and dietary guidelinesMy son-in-law suffers from bloating and abdominal pain. Any suggestions?I have positive but low anti-gliadin antibodies. Should I embark on a gluten-free diet?

I'm a 70-year-old woman with hip arthritis. Any recommendations?A treatment on the horizon for high Lipoprotein (a)?After chemotherapy to help shrink a tumor near my husband's spine, he now has numbness and neuropathy in his legsAnother study implicates meat, and now poultry and fish, in causing cardiovascular diseaseWhat do you think of Consumer Lab's recommendations on supplements?I take CoQ10, but I just heard about PQQ. What are your thoughts?

Understanding Pelvic Floor Health: Dr. Sarah Reardon, a board-certified pelvic floor physical therapist and author of "FLOORED: A Woman's Guide to Pelvic Floor Health at Every Age and Stage," delves into pelvic floor disorders, highlighting their prevalence, symptoms, and the importance of proper diagnosis and treatment. Dr. Reardon explains the anatomy and function of the pelvic floor, common misconceptions about Kegels, and the impact of life events such as childbirth and menopause. She also touches on the relevance of pelvic floor health for men, particularly in relation to prostatitis and other urinary issues. Practical advice on addressing these issues, including biofeedback, exercises, and lifestyle modifications, is provided. The episode emphasizes the need for greater awareness and proactive measures to prevent and treat pelvic floor dysfunction.

Dr. Hoffman continues his conversation with Dr. Sara Reardon, author of "FLOORED: A Woman's Guide to Pelvic Floor Health at Every Age and Stage."

Teaching Nutrition to Doctors: Dr. Nate Wood, MD, inaugural director of Culinary Medicine at Yale School of Medicine, discusses the persistent lack of nutrition education in medical training. Wood defines culinary medicine as combining nutrition science, medicine, education, and culinary skills to help patients and trainees cook health-promoting food. He reviews diet’s broad impact on chronic disease (cardiometabolic disease, dementia, cancer, mental health, MS), challenges in nutrition research, and Yale’s approach emphasizing plant-forward, minimally processed foods while addressing controversies. Barriers to adoption include crowded curricula, lack of trained faculty, unclear competencies, and limited exam coverage, though nutrition is being added to Step exams. Wood describes free patient classes, community outreach, research showing culinary training boosts counseling confidence, GLP-1s as complementary to lifestyle change, and his upcoming book, “Food Figured Out,” due in 2027.