Episode Transcript
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(00:01):
Initially seen coming to you live fromHouston, Texas, home to the world's
largest medical center. Use everything we'regoing to lead. This is your Health
First, the most beneficial health programon radio with doctor Joe Glati. During
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the next hour, you'll learn abouthealth, wellness and the provention of disease.
Now here's your host, doctor JoeGlatti. Well look good Sunday evening
to everybody. I'm doctor Joe Glatti. Thanks very much for tuning into the
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program to nights. If you doto the program, it is your health
first, and that is exactly whatwe do. We want to put your
health first, making you better consumersof healthcare, having you understand better how
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the body works, keep you outof the hospital, keep you out of
the doctor's office, and have along, happy, healthy life. That
is simple. It sounds like atall order, but I think we are
ready to share that mission and thatpassion with all of you. Our website
doctor Joe Glotti dot com, DoctorJoe Glotti dot com, signer Frown newsletter.
(01:40):
Find out about all that we do, past episodes, podcasts, our
practice website which is Liver Specialists ofTexas. That's what we do. We
take care of people with live adisease, every facet of liver. If
there's anything wrong with your liver,we are there to care of it,
Doctor Joe Glati dot com. Allright, so we've been away for a
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couple of weeks. I was travelingto Ireland. I'll try to give you
an update on that. And it'sgood to be back here on Sunday night.
So what I want to get intotonight sort of a revelation. And
these are kinds of things that almoststew on my mind, especially when I
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see patients, and it has todo with alcohol. Now we talk about
alcohol alcohol related liver disease, Iwould say a fair amount. I don't.
I wouldn't say we talk about itall the time. But as a
hepatologist, a liver disease specialist,no matter how you cut it, liver
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disease and alcohol go hand in hand. Just a little bit of trivia.
Cirrosis of the liver, which isscarring of the liver, is due to
alcohol only in about forty nine percentof the cases. When I pull my
patients, or sometimes when I'm ata party, such a fun guy that
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I am, I will pull individualsthe lay public and say hey, what
percent of the cases of cerrosis doyou think or due to alcohol? And
most people say seventy eighty percent,very high percent, but it's only forty
nine percent. But still that's alot of people that have alcohol related liver
disease. But anyway, the pointthat I want to make here is that
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so many of us lead a doublestandard life. You have the intentions of
one thing, and then you endup doing the exact opposite. So this
is what I mean, and hopefullythis may resonate with some of you.
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So in the population of patients thatI see, it's a very mixed group
of men and women, wide degreeof nationalities and races, and even an
international group of patients that we see. We're in Houston, Texas, and
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of course it's a very diverse cityin the United States and around the world,
and there are people that will comein that are absolutely committed to their
health. They exercise, they eatright, they are very very keen on
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eating only organic food, certain typesof meat, or they eliminate meat,
and they go to various let's justsay, alternative healthcare practitioners because a they
have the money, be they havethe knowledge and know how and resources to
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go to all these different types ofpractitioners. I won't get into the detail
of who they are or the kindof practice, but let's just say it's
not your typical MD physician that youwould go see under a normal circumstance.
Some of them are not even physicians. They may be chiropractors, they may
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be homeopaths, holistic specialists, peoplethat are nutritionists or dietitians, some sort
of nutritional training. They might noteven be certified in anything, but they
hang up a shingle and that's enoughfor them to open the door and they're
open for business. And so thesepatients of mine or other people that I
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know, they have the means,they have the money, they have the
time. They have the time toresearch out the latest and greatest type of
therapy. Now, even though thistherapy has not been proven with any kind
of meaningful clinical research study. Itis all me against you, my advertising
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to say, if you come tome and if you take this fistful of
vitamins, herbs, supplements, nutritionalconcoctions, your erectile dysfunction will go away,
your fatigue will go away, yourwrinkles will go away, your pancreas
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will function better. Your libera willfunction better. Whatever the case may be,
a little bit of selling snake oil, all right, something you may
have seen a turn of the centuryat a carnival, all right. And
they buy into this, they buyinto that. This, you know,
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the multiple bottles of vitamins and supplementsand herbs and these drinks and these teas.
This is what's going to keep myheart, my lungs, my kidney,
my skin, my brain healthy.And I'd like to say they fall
for that. But when we getdown to the real basics, and this
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is where the alcohol story comes in, We'll take a full history. I'll
have a chat with them. I'llgo through all of these supplements that they're
taking. I'll go through the listof various practitioners that they're seeing, try
to understand what that practitioner is doingfor them. We then get around to
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alcohol, and they will tell me, yeah, look, I'm a businessman,
I travel abroad, I'm in oiland gas. I have a couple
of cocktails at lunch, I'll havea few glasses of wine at dinner,
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maybe more on the weekends. Andthey'll admit, yeah, could I could
overdo it on the weekend. Butyet they are taking all of these supplements,
all of these herbs, all ofthese elixirs that have no proven value.
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Plus they're using alcohol. So onone end, they are doing all
kinds of things. They are goingout of their way to take care of
themselves. They want that fountain ofyouth. But at the same time,
they do not see anything wrong withconsuming excess amounts of alcohol beer, wine,
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spirit, distilled products, etc.And I'll talk to them about that.
I say, look, you're drinkingtoo much alcohol. That is why
your liver is in large, thatis why you have a fatty liver.
That is why you have these elevatedliver chemistries. And they don't want to
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hear it. They'll say, comeon, my father lived to eighty five
years old, and he had threehigh balls in the morning and three old
fashions at night. I said,well, you know, I don't know
about your father. All I knowis that you're sitting here with me and
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you've got something wrong with your liver. And so we go to extreme lengths.
And all I am looking for inmy patience in the public, in
our radio listeners, is a certaindegree of consistency. If you're going to
be committed to your health follow thatpathway the full way. You can't be
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healthy part of the time. Youcan't be cautious in how you're treating your
body part of the time. Nowyou may say to yourself, well,
you're you're asking for too much here, you're asking for too much of people.
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Well, I would say, it'sjust it is mind boggling that you're
spending hundreds or thousands of dollars aquarter some a month going to all these
other practitioners, legitimate or not,buying all these products, doing all these
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crazy things. But yet you wantto have your liquor, you want to
have your cake and eat it too. And I would say it's it's I'll
say it's disturbing to see, butit's frustrating when we want to try to
ensure the best pathway for health andwellness that there are those that pick and
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choose sort of like a you know, a menu. I'll have two of
these, I'll have one of thosethree of these in that column to say,
I'll take my vitamins, I'll takemy supplements, i will take my
elixirs, I'll go to these doctors, I'll go for all kinds of less
than proven therapies. But I'll justdrink whatever I want. It does.
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It doesn't make sense and at theend of the day, you're going to
be hurting yourself. That is thetruth. So with that said, we're
gonna take a quick break Doctor JoeGlotti. That is me. Your Health
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First is the name of the program, every Sunday between seven and APM.
Don't forget doctor Joe Glotti dot com, sign a friend newsletter. You can
pick up a copy of my book, Eating Yourself Sick. It's on Amazon,
and you know what, We'll beback in the second. Stay tuned,
Welcome back, everybody. Hope yougiving a great Sunday evening. The
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daylights is a little bit longer thistime of the year, so hopefully you're
getting out there, spending time withyour family, spending time in the garden,
walking, playing golf, playing pickleball. I have to get somebody
here too talk about pickle ball.I've got a very good friend, George
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Joseph. He's been on the radiowith me before and he is a pickle
ball maniac, and I think gettinghim on to say, how does somebody
that's fifty or sixty get into pickleball? Maybe a good little tutorial for everybody.
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All right, enough is easy.Top, Okay, don't forget Doctor
Joe Glotti dot com is our website, sign a friend newsletter. I am
going to post an article on theFacebook page and the Facebook candle is at
doctor Joe Gallotti and it's out ofthe Wall Street Journal. And it's a
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very simple article. It's the healthtests you need at age thirty, forty
and fifty. And the subtitle isit's hard to keep track of when to
start getting screened for health issues?And then here is a guide. So
I would say that for everybody youwant to have a sense based on two
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things. One is your age thirty, forty, fifty, sixty, seventy.
You're going to have unique health issuesthat need to be addressed. That's
that's number one. Number two,the screening is going to be in a
sense dictated by your family history.Now, if you're a forty year old
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guy, if you're sixty year oldguy, and you have a very strong
history of heart disease where your father, maybe your mother, your uncle's,
your brother all had heart attacks,they had pacemakers, they had heart failure,
they dropped dead of heart disease.Before let's just say sixty years old.
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You have to look at yourself andsay, I am probably predisposed to
heart disease. I better get inearly and assess my risk factors. Same
thing for diabetes, same thing fordifferent kinds of cancer, be a prostate
cancer, colon cancer, or breastcancer. If you're a woman. So
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but I've said this time and timeagain, you have to really understand your
family history. So the article,like I said, it's going to be
on the Facebook page, but reallywhat you want to do. So,
if you're in your twenties, youwant to check for sexually transmitted disease.
Unfortunately that is a real thing.You want to get check for goneria clamidian
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HIV. People in a twenties shouldget tested for hepatitis C basically with hepatitis
C for everybody listening. Everybody shouldbe test once in your lifetime, regardless
of any risk factors of blood transfusions, needle use, tattoo, sexual promisecuity.
Screening for cervical cancer and women ofaverage risk is recommended to start at
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age twenty one through sixty five.The frequency of the task will depend on
what kind you're doing. Okay,the task Force, the American the Cancer
Task Force and other groups recommend doinga cervical cytology test, also known as
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a pap smeer, every three yearsfrom age twenty one to twenty nine.
Now, if you're in your thirtiesagain, papsmere, you want to get
tests for human papaloma virus, whichyou'll put your risk for cervical cancer.
You want to start thinking about gettingscreened for diabetes. Get your cholesterol checked
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and look for pre diabetes and typetwo diabetes. Okay, if you are
twenty five years old, let's saywhat a BMI of forty and you have
a history of diabetes and cardiovascular disease, you have to be screen now.
Once you get into your forties,women are going to be starting to get
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mammograms every two years at age forty, and colon cancer screening starts at age
forty five. Once you get intoyour fifties, you're going to be starting
to get screened for osteoporosis. Andkeep in mind that men are able to
get and develop osteoporosis as well.This is just not a thing for women.
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Lung cancer screening between fifty and eightyyears old. If you have a
twenty pack year of smoking, currentlysmoke, or you quit smoking within the
past fifteen years, you want totalk to your doctor about getting a chest
X ray for lung cancer screening.And then once you get up into your
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sixties again it's osteoporosis. You're gonnabe checking for abdominal aortic aneurysms. You
may want to go for some cognitivetesting early changes of dementia. So again
this is pretty basic stuff, butagain we want you to be committed to
have a plan on what you're actuallygoing to be doing. All right,
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We're gonna take a break using weathercoming up. I'm doctor Joe Glotti.
Doctor Joe Glotti dot Com, ourwebsite. Stay tuned. We'll right back
every Sunday evening between the hour ofseven and APM. I'm doctor Joe Glotti,
and this is your Health First.Don't forget. Go to your Health
First dot com, sign a fromnewsletter and find out about what we're talking
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about tonight. And as many ofyou know from listening for all these years,
obesity and obesity related diseases and complicationsare so much of what we talk
about, not because I like it, but because this is what is being
researched and the public health problems thatwe're facing every single day and on the
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line. It's an absolute expert.Edward you He's a doctoral candidate at the
Harvard chan School of Public Health inthe wonderful city of Boston, Massachusetts.
Edward, Welcome to the program tonight, and I want to command un your
colleagues for the great article that waspublished in a great journal, the Annals
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of Internal Medicine a few weeks ago. Welcome to your health. First,
it's great to be here. Well, you know, as I had said,
we gravitate to discuss obesity a lot, and when I saw this article
about weight history and all cause mortality, it caught my eye. In reading
through it, I thought it wouldbe interesting to share with the audience tonight.
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But before we get into you know, some of the details on the
article and the research you're doing,tell us about yourself and the research you're
doing in Harvard and obesity and justbringing us all up to speed what you're
interested in. So, I ama doctor candidate in nutrition epidemiology at Harvard.
I am actually a biochemist by training, but I am interested now in
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obesity, diabetes, cardiovascular disease.I'm looking at biomarkers and actually aspects of
diet that six these outcomes. Wow, Now with obesity, how did this
particular article come to be with yourcolleagues in Boston to write about this looking
at who is it that dies andand why being overweight is not good for
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us? So before this publication,the consensus was that obesity was harmful,
but there was always this nagging doubtthat overweight may or may not be harmful
for individuals for early death. Soquite a few reports published reported that overweight
people seem to have paradoxically a lowrisk of death compared to normal weight people.
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So when I say normal weight,I mean a body mass index in
the range of eighteen point five totwenty four point nine. Overweight is twenty
five to twenty nine point nine,and the basis thirty or above. So
you can take your BMI by takingyour weight in kilograms and dividing about your
height squared. And what we foundis that these studies were using baseline measurements
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at one point in time. Sowhat you can imagine is that someone would
be let's say overweight, and theywould get like cancer or something right,
and they would lose weight and bythe time they get measured, they would
actually be in the normal weight group, but they're at a very high risk
of death and so they die veryearly on. This is something called reverse
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causation, and so this is theproblem with a lot of the previous studies.
And in our paper we were actuallyable to replicate this by using the
baseline measurement and when we use weighthistory, by using maximum weight in a
sixteen year period, we actually foundthat those who maintain a normal weight over
time had the lowest weight to death. So it is it fair to say
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that just looking at weight or orweight loss to get back into the normal
normal range is inaccurate and possibly alot of the research may be misleading that
we've seen up to this point.Right, So if you what we found
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is actually that those individuals who lostweight were almost certainly at higher risk of
death. And this is because thatthis weight loss, permanent weight loss in
the United States is actually very difficultfor most people. Most people cannot lose
weight and keep weight off more thana year. So most permanent weight loss
that we see is due to illness, right, And so I want to
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reiterate this point for the listeners,is that weight loss from obese or overweight
into normal weight is a good thingthrough helping me like die in exercise,
right, and so yeah, that'sso what we found is that individuals who
lost weight were at high risk gooddeath. So if you compare people who
had ever been obese or overweight tothose who had always been normal weight,
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that's where we saw lower success,right, normal weight individuals. Right.
So this this really comes down thatin a sense, there is no doubt
that if you have been close toyour normal weight, let's just say the
majority of your adult life, thechance of you having something bad happening is
lower. Is that Is that agood take home tonight? Yes? So
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the take home is that if youwant to minimize your risk of early mortality,
you should try to maintain a weightrange in the normal BMI category.
Okay, okay, that again,I think for everybody listening that it may
be stating the obvious, but ithas to be told now in the article.
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I just want to clarify a pointbecause we've we've in the past,
over the years, we've we've usedthis term and it is all cause mortality,
and how how would you define itfor everybody tonight? What all cause
mortality means and how is it usedin research or sort of in everyday practice.
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So all cause mortality just means adeath from any cause. So this
is in contrast to something like causethe system mortality, where a study might
just look at death from cardiovasc or'sdisease and not look at anything else.
So we look at death from anycause, all right. So to say
someone is obese, they may havediabetes, they may have heart disease,
and that may kill them. ButI guess if they die of Alzheimer's disease
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or kidney cancer seemingly unrelated to theirobesity, it's still going to count.
Well, we don't know if it'sunrelated, and you know, it could
be some causal mechanism. So that'swhy we look at death from any cause,
right, Yeah, And I meanI look at the obesity problem as
just a tip of the iceberg toit's an indicator or a red flag that
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bad things are potentially going to happento you, right. So I think
in our study we found that thosewho are obees had almost a twofold risk
of death compared to people who arenormal weight. Yeah, now, you
know one one point you had inthe study you had mentioned about how when
people got sick their weight went down, and that could skew how some of
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the data was interpreted. Do youhave any evidence or any sense of when
you maybe unrelated to these kinds ofstudies, when people are to report their
weights, they they have some difficultyin telling you their maximum weight at some
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time or anything along the line.Do you find that the reporting of weight
is inaccurate for people? So insome studies the participants will try to recall
their weight from ten years back.The great thing about our studies that this
was a contemporaneous measurement, so peoplewere asked to report their weight at the
time of the measurement. So I'msure a lot of listeners out there probably
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know their own weight to within fivepounds, which is fairly accurate. Right,
And self reported weight has been shownto be very highly correlated with actual
measured weight, So okay, Idon't think that there's a big problem with
accuracy there. Okay, So actuallypeople are recording a pretty decent weight from
memory to us. Yeah, thegreat thing about weight is that people generally
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know what their weight is. Yeah, So what would you say, Edward,
is maybe the biggest take home forwhat the listeners can take away tonight
or society in general, and froma scientific standpoint within the medical scientific community,
I think a really important thing tonote is that if you are overweight
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or obese, you're not condemned riskof early death. If you can lose
weight and get into a normal weightcategory, you will lower your risk of
mortality from that point on, andtry to do that through things like diet
and exercise, I think would bethe message right now. With the research
that you're doing at Harvard and collaboratingwith other experts in the field, where
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would you say the research and obesityis going, either from a public health
standpoint and epidemiology or actually understanding thebiochemistry of it all? Where are we
where are we at? And wheredo you think the next five or ten
years we're going to be? So, I mean, obesity is just so
complex. So I'm actually a nutritionalepibbeologist, so I concentrate on like diet
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and lifestyle factors. So there areso many things that effect obesity and such
a big problem epidemic. It's isrising everywhere. So in the next five
to ten years, I think we'realso going to start seeing things like metaboli
predictors. Probably new therapies and drugsto hopefully treatle these. But in the
end, the most important thing youcan do is keep a healthy diet,
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lifestyle, exercise, don't smoke.Those things would be the biggest things,
right right, What do you whatdo you think about nutrition as far as
the availability of a lot of highlyprocessed foods, and this is more of
a societal problem where we're in asense my take on it is that we're
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we're uh driving away from cooking athome and a lot of fresh fruits and
vegetables and a lot of packaged foods. Are you are you guys looking at
this at all? Right, sowe have been looking at this very closely.
Um So the research in the groupthat I work with sound refined food
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added sugars seem to certainly be associatedwith higher risks, uh, you know,
adverse health outcomes. Right, itseems like the best thing to do
is stick to you know, homecooked meals. If you've ever heard of
the Mediterranean diet that also is verygood for you, Walt nuts, lots
of fish, just avoid things likesoda and highly processed moods exactly that is
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what we try to preach with ourpatients. And in here on the radio,
Edward You with Harvard chan School ofPublic Health in Boston. First again,
congratulations on the research that you're doing, and I think we will continue
to talk with you over the monthsand years and keep nutrition on the front
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burner here for everybody on the radio. All Joe pleasure, all right,
thank you very much, have agreat weekend. Alright, bye bye.
All right, that was Edward Youup at Harvard. And certainly there is
so much, so much research thatneeds to be done in the world of
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obesity, and um, you know, like I said, we talk about
it a lot here on Your HealthFirst, but the researchers are spending their
entire career trying to sort this problemout. All Right, we're gonna take
a break. I'm doctor Joe Glotti. This is your Health First. Don't
forget your Health First dot Com.There'll be information about doctor you in the
(30:18):
article and his research on your HealthFirst dot Com. Stay tuned when we're
right back, final segment of thisweek's Your Health First. I'm doctor Joe
Glotti. Our website is doctor JoeGlati dot com. Signer for a newsletter
send me a message, download acopy free chapter of our audio book,
(30:44):
and there's information about our medical practice, Liver Specialists of Texas. And all
of our social media posts are there, Facebook, Instagram, YouTube, LinkedIn
all there see what we're all upto. Doctor Joeglati dot com is the
(31:06):
place to go. All right,So we were talking about celery juice and
how this is the absolute craze,cure all greatest thing on earth that is
(31:29):
going to save us all from chronicdisease. Now, I have always said
that you first have to have ahealthy dose of skepticism. When anybody comes
off and says this one single product, this one single fruit or vegetable or
(31:55):
vitamin is the cure, all,you have to be bright enough to think
that, wait a second, maybethis just is not right. And so
many, many, many times,especially recently, kal kale is the cure.
(32:15):
Roll well, kal is good foryou, But you shouldn't just eat
kale. If you want a kalesalad, go ahead, but throw in
onions, peppers, tomatoes, greenonions, you name it. Throw some
(32:38):
fruit in there. But there isno one single food that is going to
cure, treat, or retard acertain disease or condition. It's it's it
just doesn't work that way. Sothat's why when something will come out and
they'll say avocado are great for breastcancer, so everybody starts eating avocados.
(33:04):
Well, it's not that. It'sall the other phyto nutrients that you need
to get from a balanced diet.The science stands behind that. You don't
want to eat junk. But yousay, hey, man, I'm eating
my avocados and I'm not going toget breast cancer. That's not the way
it works. And so when yousee this whole celery thing come up right
(33:28):
away, the bells and whistles haveto go off. Now what is it
said to do? Okay? Now, a lot of this is anecdotal,
meaning people just are telling their ownstories without any sort of scientific background.
(33:50):
They had a problem, they hadan ache, they had a rash,
they were depressed. They got oncelery juice and buy goodness, they're better,
Okay. Instagram, Facebook, Twitter, everybody is talking about it.
And some of the remedies are fordigestive disorders, autoimmune disorders, sosiasis,
(34:16):
acne, chronic fatigue syndrome, acidreflux, shingles, strep, bacteria,
and it helps with weight loss.Now, the person behind all of this
is a gentleman by the name ofAnthony Williams. He is the originator of
(34:38):
this celery juice craze. Now,if you look at what has been written
by other scientists researchers University of California, Doctor Rachel E. Shearer, Assistant
(34:59):
Research Science Tish in Nutrition at Universityof California, Davis, there is no
scientific evidence to support any of theclaims made. There aren't large studies in
humans on the topic, and thelittle research that exists on the vegetable has
been cellular or animal. Nothing inhuman, somebody else. Doctor Elizabeth Bradley,
(35:22):
Medical director of Cleveland Clinic Center forFunctional Medicine. There's no proof that
it does what it is claimed todo. Now, it's celery juice is
not bad for you. There arecertain vitamins, as a little bit of
fiber. There are phytonutrients. Itis an antioxidant, but so is spinach.
(35:50):
So is a carrot. Why arewe not mixing celery with carrots and
tomatoes and peppers and spinach. Idon't know. People just want to do
the celery. Okay, Now,in juicing it, you are going to
(36:13):
lose some of the fiber. Nowit's not the greatest source of fiber,
but it does have a little bitof fiber. But by juicing it,
you're going to destroy some of it. And as I said earlier, like
kale, like spinach, like carrots, there are antioxidant properties, so it
(36:34):
may be of benefit as an antioxidant. Now, the biggest problem that I
have with mister Williams is that hehas absolutely no medical or formal training in
nutrition, yet he is making allof these these statements and making people run
(37:00):
wild to juice Celery. Now whathe says is he describes himself as a
medical medium and his process is prettyunconventional. This is a quote spirits start
to talk to me, and Irate every word exactly the way the spirits
(37:22):
want me to write it until Ihave a stack of notepad's many feet high.
It's a gift that was given tome. Now, I think you
have to look at this and say, this guy is getting his medical directions
from a spirit. Some people wouldcall that schizophrenia. And so somebody that
(37:50):
has no scientific training, there isno research, he has not even experimented
personally with this. You have tobe very suspect. So for everybody that
you know without coming after me.All of the medical claims I would say
(38:12):
are anecdotal and there is no scientificproof. Is celery juice bad for you?
No, it is not bad foryou. Should it be part of
your diet? Yes? You couldthrow celery into your morning smoothie, chop
it up into your salad, makea vegetable dish with it, you could
bake it, you could grill it. Of course that is good. But
(38:36):
to think that this is the cureall I think you're going to come up
a little short. It's sort ofsound. I'd like to hear from somebody
that is using the celery juice andhas felt better. I'm sure now there
may be a huge placebo effect.Very tough to tell. All Right,
(38:57):
we will all see you next Sundayevening. I'm doctor Joe Glotti. Hope
you are going to have a greatrest of the evening. Take care,
stay well, eat a well roundedbalanced diet, and exercise. We'll see
you next Sunday night. You've beenlistening to Your Health First with doctor Joe
Glotti. For more information on thisprogram or the content of this program,
(39:19):
go to your Health First dot com