Gas Station Heroin

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I have to admit that I’d never heard the headline’s words strung together like that until I read about the banning of several products that contained an anti-depressant called tianeptine, which is approved in some countries (not the U.S.) as a prescription drug for the treatment of depression. It is a tricyclic antidepressant; in some cases, it has a mood elevator effect. I can’t confirm that it is a high similar to fentanyl as claimed in some articles. While the products have been pitched as dietary supplements, they most definitely are not.

Here are three rules to follow when considering a dietary supplement:

  • Know the active ingredient you’re looking for, whether it’s a vitamin, mineral, herb, or other supplement like glucosamine. If you’re not sure, don’t make an impulsive purchase because a friend recommended it.
  • Check the label for a certification from a legitimate testing company like NSF or the USP, the two most prominent certification companies.
  • Most important, don’t buy dietary supplements from convenience stores or gas stations. What are you thinking? That area around the cash register can be a minefield of promises from energy to libido. Don’t fall for it!

The Managing Pain webinar is a week from tomorrow. Reserve your spot for the live webinar; spaces are limited and going fast. I hope to see you live. I’m ready to teach!

What are you prepared to do today?

        Dr. Chet

Managing Pain

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Quick: what’s the location of pain that’s experienced by most adults in the United States, regardless of age?

Pain afflicts everyone at one time or another, but the older we get, research shows that we’re more likely to experience chronic pain. That time you twisted your knee when you played a pick-up game of basketball? When you rolled your ankle playing tennis? That time you were rear-ended in a car? How about when you slipped and fell on the ice? You may have had pain then and recovered, but all of those things could have caused micro-tears in connective tissue and now the bill has become due.

In this webinar, I’m going to cover the most common forms of pain experienced by people of all ages. By the way, the most common type? It’s lower back pain. While the focus is going to be joints and extremities, the approach can be used with other forms of pain such as migraines and fibromyalgia.

The objective of this webinar is to give you a step-by-step approach on how to deal with chronic pain. The goal is that you can use it to help yourself in the future. Every known modality will be discussed.

The Managing Pain webinar will be held Sunday, February 25, at 3 p.m. Eastern Time. If you’re not available at that time, no worries. The replay will be available later that day and for the next six months. The cost of the webinar is $13.95; Member and Insider discounts apply.

There are many places you can be on a Sunday afternoon, but this is an opportunity to help yourself for years to come. Spend a little while with me and learn to change your life. Sign up today.

What are you prepared to do today?

        Dr. Chet

Coffee to Go

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The health benefits of tea are substantial, and in some ways, coffee is even better. They both have substantial amounts of  phytonutrients, but this isn’t about the benefits to your heart, your liver, or your brain. This is about the comparative benefits to your digestive system of coffee and tea. While the fiber approach wasn’t really significant, one of the nutrients in both drinks was.

While I’ve never given it much thought, some people feel the urge to defecate shortly after drinking a cup of coffee, and to a lesser extent, tea as well. With all those phytonutrients, researchers selected a nutrient common to both to test: caffeine. That appeared to be the only study done to directly test the impact of caffeine on bowel movements.

The subjects were required to insert an anorectal manometer into their rectum to test the pressure of the anal sphincter muscles. (Let’s pause here to say a thank you to all the people who volunteer as subjects in these health studies.) There was no response to drinking plain water, but after caffeine ingestion there was a significant increase in pressure at 10 minutes and even greater pressure at 15 minutes. In short, the increase in pressure indicated the ability to “go” once the muscles relaxed.

The only issue I see is the amount of caffeine: the researchers tested at 3.5 mg/kg body weight. For a 180-pound person, that would be almost 300 mg caffeine in one dose, or almost four cups of coffee at one sitting. It would have been nice to see the lowest dose that worked, because not many people would tolerate that much caffeine in one dose. Then there is the issue of genetics, comparing fast metabolizers versus slow caffeine metabolizers.

The Bottom Line

That’s the scoop on poop from a coffee versus tea perspective. You probably never thought about it, but that morning cup of Joe just might help you go. Enjoy the Super Bowl—or not. But if you only watch it for the half-time show, you might want to consider your timing on what you drink, when you drink it, and how much caffeine you get.

Remember, the Aging with a Vengeance: Managing Pain webinar is in two weeks on February 25. Information will be coming soon.

What are you prepared to do today?

        Dr. Chet

Reference: Dis Colon Rectum. 2008 Jun;51(6):928-31.

Fiber, Coffee, and Tea

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Paula’s recovery from her knee replacement is going well. While she’s been rehabbing, she does a lot of reading and recently passed on an article that compared the health benefits of coffee vs. tea. One of the comparisons was about fiber: did either have any? The article suggested that there was 1 to 1.5 grams of fiber per cup of coffee. If true, that would help fiber-lacking Americans reach their RDA of 25 to 35 grams of fiber per day.

I checked it out. In a single study, researchers found that there was about 0.5 g fiber in 3.3 ounces of brewed coffee or just over a gram per 8-ounce cup. If you drink coffee like I do, that could add up. But what about tea? Nothing really, whether brewed black or green tea. Matcha (green tea) does have fiber, but it’s not clear whether it’s just in the residue after brewing or in the liquid itself.

What coffee and tea both have are phytonutrients and plenty of them. While fiber might not be readily available, could there be something else that could help with digestion and especially, elimination? Yes, and I’ll tell you about it on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: J Agric Food Chem. 2007 Mar 7;55(5):1999-2003.

Super Bowl Webinar and a Slip on the Ice

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Now that the snow has almost melted, I’ve taken to walking outside. When I walk, I think. On yesterday’s walk, I was thinking about the Super Bowl Webinar. Without warning, I slipped on a patch of ice and landed on my butt. In the annals of slipping and landing, it was perfect. Legs out, butt first, then elbows. Didn’t hurt a thing. I had no problem getting up and getting moving, but I think it knocked some sense into me.

Paula’s recovering from knee replacement very well, although she’s learned that having gone through one knee replacement doesn’t mean the second will be easy. The problem is that sitting at her desk for hours every day, creating and editing all the graphics and info in enough time to have it ready by February 11 doesn’t make sense for her recovery. Therefore, the Aging with a Vengeance: Managing Pain webinar will be held on February 25. Regardless of age, that’s the number one question I get asked. That’s the topic, so save the date. More information will follow.

What are you prepared to do today?

        Dr. Chet

What Your Body Needs for Bone Repair

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Note: As this email hits your inbox at 6:15 a.m., Paula and I are already at the surgery center where she’s getting her right knee replaced. She had the left one done six months ago, so the recovery routine is familiar. We know we need to concentrate on bone repair, and since it’s slip-and-fall season here in the North, I thought this would be a good time to remind everyone of the nutritional requirements for bones. That’s why we’re rerunning this Memo from last February.

When it comes to broken bones, especially in adults, what can be done to help the healing process? Pain management is always paramount because of the second reason: joint rehabilitation. If any movement is too painful, no one wants to rehab the muscles and tendons surrounding the joint, especially with a dislocation that stretches them beyond their normal capacity. Putting the bone in place is one thing, but getting the tendons and muscles to repair is another. There’s no being brave or gutting it out; rehab is necessary to restore complete joint function.

That raises the question: are there any supplements that can help with the healing process? The research is virtually non-existent, as outlined in a recent article, but there are some nutrients that make sense:

  • Vitamin C: an additional 1,000 to 2,000 mg per day. Vitamin C is involved in building connective tissues; bone, tendon, and ligaments are all connective tissue.
  • Vitamin D: an additional 50 to 100 mcg per day. Vitamin D is known for helping build bone, so it makes sense to increase the amount.
  • Glucosamine: 1,200 to 2,400 mg per day in total. Glucosamine, like vitamin C, is used in making all connective tissue. This appears to be important within the first two weeks after the injury, based on animal studies.
  • Calcium: 500 to 1,000 mg/day in total. The formation of the callus and conversion to bone requires calcium. Taking an extra amount, providing stone formation is not an issue, is important.

The final part of bone repair is patience. We all progress at our own pace. If ever there was a time to be consistent, this is the time.

Manage the pain, perform the rehab once you’ve been given a program, take some nutrients that can benefit bone growth, and don’t stop until you have full function. That’s the bottom line on broken bones.

What are you prepared to do today?

        Dr. Chet

Reference: J Orthop Res 38:695–707, 2020.

Find Your Way

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How are you doing with your 2024 weight loss efforts? Or your fitness regimen? Eating more vegetables and fruits? Taking your supplements regularly? Is it going smoothly at about three weeks in, or not so much? I know I’ve slipped up. Based on Dr. Barabási’s research, that doesn’t mean you’re doomed to failure. Remember what he found: it isn’t your age that determines your productivity, it’s your creativity.

Not Your First Rodeo

If you’ve been successful at changing a health habit, losing weight or getting fit, particularly when you were younger, you found a way to do it. Over the years, especially with weight loss and fitness, life happens, and your body changes; you go back to old habits and gain back weight or lose fitness.

There’s a tendency to try to recreate that experience again. In other words, you’re going to try the same workout routine, the same way to lower calories, whatever helped you achieve that goal. But life isn’t static and maybe it doesn’t work the same way. You decide to try another type of diet, such as the ketogenic diet, and that worked great—for a while. But you slowly returned to your old habits and gained back the weight. Because you’re older and with the change in metabolism that seems inevitable, you lose the passion for trying.

You just get tired of trying. You may be saying something like, “You’re just not into it,” or you make up some other excuse. But whatever the reason, you quit trying.

Never Stop Trying

At the end of his TED talk, Dr. Barabási’s said: Creativity has no age; only productivity does. What that means applies as much to health as it does to being a successful scientist or attaining any goal. Keep trying to find that one thing, that one way that will work for you. It doesn’t matter what diet you use, what aerobic workout you try, or what method you use to gain strength. The only thing that limits you is not your age but your willingness to keep trying until you figure it out. No matter your age, no matter your limitations, that way exists. You just must find it and make sure it’s sustainable for life.

The Bottom Line

Near the end of the movie “City Slickers” the character played by Jack Palance tells Billy Crystal’s character he knows the secret to life. Billy says, “Well, what is it?” Jack tells him that’s what he must figure out. Find that one thing and nothing else matters.

Whether it’s changing your weight, getting fit, lowering your blood pressure, or any other health goal you want to attain and maintain, that’s what you must figure out. No gimmicks, hacks, or short cuts. Find your way. I remain committed to helping you find it.

What are you prepared to do today?

        Dr. Chet

Reference: Ted Radio Hour. Late Bloomers. 9-1-2023

Can You Still Reach Your Goals?

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As I was working out the other day, I listened to a podcast about different takes on aging from people in a variety of fields. But one stood out to me, so let me tell you a little bit about it.

Dr. Albert-László Barabási is a physicist who studies networks; genetic expression, disease development, and the world wide web are some networks he has studied. But his forte is examining networks in many different areas of study. For example, regardless of your level of competence as an artist, he can look at the network of where you’ve displayed your work and be able to predict whether you’ll be a successful artist or not. The possibility of success wasn’t dependent on ability alone, although that is important.

He decided to look at his own profession: being a physicist. What he found was that if you don’t write that seminal paper that gets your research published by 35 and then referenced by many others, it will never happen. Now that he’s over 50, he decided to look further at the real question. What he attempted to examine is this: is it your actual age that predicts success or is it creativity? If you keep trying, could you ultimately succeed, or was it all over at 36?

You may wonder what this has to do with health. I’ll put it together for you on Saturday and believe me, for your health goals in 2024, it’s one memo you don’t want to miss.

Tomorrow night is the Insider Conference Call. I’ll answer some recent questions about vitamin C as well as the topic for this year’s Super Bowl Webinar. If you become an Insider by 8 p.m. Eastern Time tomorrow night, you can join the discussion.

What are you prepared to do today?

        Dr. Chet

Reference: Ted Radio Hour. Late Bloomers. 9-1-2023

Should You Increase Your Protein Supplement?

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The research paper we’re reviewing demonstrated that there seemed to be a dose-like response to protein intake after intense exercise; that is, the more protein, the more muscle synthesis. And it lasted at least 12 hours instead of the prior four to six hours for a lower dose. Also, the excess protein intake wasn’t used to make energy to any great degree as previously thought; that means less strain on the kidneys, because when protein is broken into individual amino acids, the nitrogen group won’t have to be eliminated via the kidneys.

As always, there are more questions to be answered before this study becomes the new normal.

To Be Determined

The obvious issue is that the subjects were all young men from 18 to 40. Would the same results happen in women? And would the same result happen in older subjects, such as those in their 50s or 60s?

Next question: would the extra protein be absorbed and used the same way without the intense exercise session? The subjects did four different exercises using the legs and chest with four sets of ten reps, pushing the subjects to failure on the final three sets. Pushing yourself that hard can be challenging and even dangerous without help. Could someone with known cardiovascular disease push themselves as hard without causing a cardiovascular event? Would metabolic diseases such as type 2 diabetes impact how protein was utilized?

I could go on, but you get the point. One study with fewer than 40 young subjects, using testing procedures that will not be easy to duplicate, isn’t a basis for changing protein intake after exercise for everyone.

What Does It Mean?

The obvious answer is that it provides a new area of research. I would be most interested in how the use of essential amino acids could impact the protein synthesis in addition to additional protein intake. But let’s stick to what it means beyond future results.

On the days that you lift weights, even though perhaps not as intensely as the subjects in this study, add an additional 10 or 25 grams of protein to your post-workout shake. Milk protein was used as the source in this study, but other sources of protein powders would probably obtain the same result. The composition of protein powders doesn’t vary much, so choose whatever appeals to you.

The men began drinking their shake after they completed the exercise session. I recommend drinking extra water for a couple of hours after the shake. Do that for a specific number of weeks and see what happens. Track whether you’re able to increase weight or add muscle.

If you don’t do resistance exercise, you can see how you respond to the additional protein after a long walk or a yoga session. You might feel better with the additional protein.

The Bottom Line

Nutrition is a constantly changing field. Some basic assumptions that developed can now be reconsidered with better technology to test benefits or pitfalls. While it may take years or even decades before we have answers, what’s really important is how you respond. Adding some additional protein such as 10 or 25 grams to your morning or post-workout shake is not unreasonable to see how it benefits you. All the research in the world still comes down to how it affects you and your unique body; for example, certain antihistamines put some people to sleep and keep other people awake. As long as you’re reasonably healthy, you are your own subject.

Just remember: keep track of what you do and find a way to assess the outcome. After that, it comes down to one question: 

What are you prepared to do today?

        Dr. Chet

Reference: Cell Reports Medicine https://doi.org/10.1016/j.xcrm.2023.101324

Reconsidering Protein Supplement Amounts

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One of the basic tenets in sports nutrition is that we shouldn’t consume more than 25 grams of protein in a drink product. The reasoning has been that more won’t help you to add more muscle after a workout. This has trickled down to the point that it applies to anyone who drinks a protein shake. Based on a recent study, that may not necessarily be true.

First, let’s review why you want to build muscle. Obviously, more muscle helps you do more with your body: lift heavier objects or move your body more easily. Muscle is more dense than fat, so it takes up less space; when you are more muscular you look slimmer as well as more fit. Maybe most important, more muscle burns more calories; you can use that fact to lose weight or to eat more food.

Researchers wanted to test how long muscle synthesis would continue after an hour-long intense weight training session. The study was simple in design: take 36 young men who were physically active, test their initial exercise capacity, and then subject them to an hour-long weight training session in a laboratory setting. Afterward, in a randomized way, 12 of them got 100 grams of a protein drink, another 12 got 25 grams of the same protein drink, and the final 12 got a placebo that had no protein.

That’s where the simplicity stopped. The protein had specific quantities of carbon-labelled amino acids including leucine, the amino acid responsible for initiating protein building in muscle. The objective was to monitor whether protein synthesis lasted more than four to six hours, the previous conventional thinking. The other question is whether the excess protein would be used for making energy.

The short answer is that protein synthesis lasts at least 12 hours (and perhaps longer) at the highest intake, 100 grams. There is more to it than that, and I’ll cover it on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: Cell Reports Medicine https://doi.org/10.1016/j.xcrm.2023.101324