May 8, 2025 • 29 mins
Dr. Khalilah Brown our Chief Medical Officer at Southern Research joins us to talk about the Catalyst program they are launching in Birmingham too help include people from Alabama in research that can benefit not only them but their community. Then Dr. Jocelyn Wittstein an Orthopedic Surgeon joins us to talk about prevention of Arthritis and Osteoporosis.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Living better through scientific advances that are achieved right here
in our state. Hello, and welcome to Viewpoint Alabama on
the Alabama Radio Network. My name is John Mounts, and
I'm always excited to tell good news stories about businesses
and research organizations in our state making a difference. And
one of the ones you might not be familiar with
but you should is Southern Research, located right here in Birmingham, Alabama.
(00:23):
And I'm joined right now by the chief medical officer
at Southern Research, doctor Khalila Brown. Doctor Brown, tell me
first of all, what is Southern Research all about?
Speaker 2 (00:33):
So?
Speaker 3 (00:33):
Southern Research is an eighty three year old translational research institute.
We've been doing great work in Birmingham in the tech space,
mostly the biotech space life sciences space for a very
long time.
Speaker 2 (00:49):
I think a lot of people don't.
Speaker 3 (00:50):
Realize that we're here, and probably a well kept secret,
but fifty percent of the chemo therapy is currently used
in the United States came through Southern Research.
Speaker 2 (01:00):
Point time.
Speaker 3 (01:01):
So really excited that we do a lot of work
that touches not only Alabamians, but people in nationwide and worldwide.
Speaker 1 (01:07):
Do you work with UAB at all? Since you're so close.
Speaker 3 (01:09):
Correct, that's a great thing. So Southern research actually pre
dates UAB, but you AB. I'm a two time graduate
of u A B and super proud that it's here
and that we get to work alongside them. We are
now an affiliate of ua B and so we kind
of sit in the middle zone of the research. So
UAB does a lot of the basic sciences and then
(01:31):
we do that translational part, so everything from when it
becomes an idea before it touches a patient to validate
does it work, how does it work?
Speaker 2 (01:40):
Is it safe?
Speaker 3 (01:41):
And then it goes back to institutes like UAB and
others throughout the world when it hits patient.
Speaker 1 (01:46):
And that way you can let UAB handle all the
messy work with all the paperwork and the patients and
all that kind of stuff.
Speaker 2 (01:51):
When it comes to the trials, yes they have the
clinical trials.
Speaker 3 (01:54):
Once they hit the patient, there's still a lot of
paperwork because it's just it's a highly regular industry.
Speaker 1 (02:00):
The human use forms are very very long and complicated.
Speaker 2 (02:04):
Yes, we want to know that things are very safe.
Speaker 1 (02:06):
Extuctly, and they should I was going to say, and
they should be because I don't want you know stuff
being tested on me unless you know, we know it's
going to actually be safe. So well, doctor Brown, the
reason we're in here specifically to talk is something that
Southern Research is involved in. It's a new project. It's
called the Catalyst Project, and Catalyst is going to I
think be very beneficial to a lot of people. Tell
(02:26):
me what inspired the Catalyst program and what it helps
to achieve.
Speaker 3 (02:31):
So Catalyst is a new foray for Southern Research. Remember
I just told you we've been all about pre clinical
things that really didn't touch patients. But because we are
a nonprofit research institute, we sit at a unique juncture
that allows us to do things that other healthcare institutes
may not be able to do. And so we have
(02:52):
funding from the state of Alabama that really is meant
to increase precision medicine to patients throughout the state, regardless
of their insurance, in order to really impact chronic disease management.
So we know that we've got a lot of uninsured
patients in Alabama. We've got rural patients that have, you know,
issues with access to healthcare. So how do we take
(03:13):
care how do we help those healthcare providers that are
in rural areas, underserved areas, even if you're right here
in Birmingham have information that helps them take better care
of their patient.
Speaker 1 (03:23):
When they first rolled out the human genome map back
in what year was that those about nineties? You know,
over twenty years yeh, it's been at least twenty years.
I thought, you know, this is going to really do
incredible things for science. And then you combine that with
the recent all the recent explosion of AI, because AI
can do all those little tiny tasks that would take
you know, a whole building full of people, you know,
(03:44):
years to do, AI can do it in a matter
of minutes. So you combine the human geno mapping and AI,
you can do some amazing things if we have some
data from individual people. And I think that's kind of
what Catalyst is getting at, right, That's.
Speaker 3 (03:57):
That's definitely it's what it's getting at on two sides
of the same coin. So on the front end, we're
offering this testing that has it's a clinical test. It's
not a research great test. It's a clinical test that
goes back to your health care provider that gives you
three great reports that tells your health care provider one,
what are your risk around type two diabetes coordinator or disease,
and breast cancer for your biological female. It also tells
(04:20):
you about how you handle specific drug medications, common things
that we take every day, where they're there antidepressants, ADHD medications,
heart disease medications, simple things like aspirin, motor and talentol,
all those things.
Speaker 2 (04:33):
How does your body handle those? What does your.
Speaker 3 (04:35):
Genome say about that? And so it may or may
not be the right medication for you. So we're hopefully
helping people understand what medications work best for them, rather
than them having to try them and see they have
side effects or they don't work right. And then there's
a rare disease report, and I need people to understand
that rare disease isn't always as rare as you think.
So it's eighty four genes that translates to about forty
(04:57):
four disease states that we we deal with every day.
So familiar hypercholesterolemia long QT syndrome, which is a cardiac
a rhythmia defect that can cause you to you know,
have an rhythmia and delight cap collapse and die very quickly.
Marphin syndrome, brackaging, for breast cancers. On there, they're screening
(05:18):
for prostate cancers. So just making sure people understand not
just what their clinical risk is, but now what is
my genetic risk? And so how does that help my
healthcare provider have an insight into a window that they
typically don't have access to because it's not typically something
that's paid for by insurance unless you're looking for a
specific disease state.
Speaker 1 (05:38):
And that's so important. You know, your doctor always wants
to know your family history, and sometimes we don't have
complete family history. Maybe our you know, we were born
late in life, and you know, we don't know our
grandparents or our great grandparents. We have no idea what
they die from, and so that's a mystery to us.
So something like this could be very helpful not only
to us, but to our children, to our nieces, our nephews,
(05:59):
other family members, because they could very well benefit from
this information as well, right, correct.
Speaker 3 (06:04):
And that's the great thing about one put it in
the hands of your health care provider who can help
you understand it. But on the back end of this program,
every participant in every healthcare provider has free access to
genetic counselors. So now we have the information, but how
does that translate not just to my health, but to
my family's health. We want to make sure that we
understand how it's inherited, and so who would impact Should
(06:25):
I call my sister, Should I call my brother or
my cousin or my aunt? Who are the right people
that I should be talking to about this, because so
often we just don't have a clear picture of our
family history. Even when we have history, it's not always correct.
You know, We've had ten men in our family collapse
and everybody thought it was because they were obese and
they smoked, but really we had some type of familial
(06:47):
cardiomyopathy that was missed, and so we don't know those
types of things just because you know, again we didn't
pass down the right name of it, or maybe we
didn't know the right name of it. We never got
an autopsy. And so we're trying to make sure that
people have a window into those things. And then on
the back end of that, we can use that data.
So now, as you say, with AIAI only spits out
(07:07):
things that's already.
Speaker 1 (07:08):
In the system, garbage in, garbage out, correct.
Speaker 2 (07:11):
So we need good data in.
Speaker 3 (07:12):
We need data that's representative of Alabama, and so when
you look at the data set, we're not there, We're
not represented. Nobody's come into Alabama really to do research
and make us part of their data set. They're going
to California and Texas and New York, and so we
get things on the back end. Our medications aren't always
built for us here in Alabama. And we're a unique
(07:33):
data set, we really are. We're a non transient state,
so about seventy percent of people born in the state,
say in the state. So we've got generations of data.
We've got significant chronic disease. So we're a great place
to make sure that these medications work properly, and so
we want the data to prove it on the front
end before it ever hits our bodies.
Speaker 1 (07:53):
That's a great point, the fact that we are so
insular and we don't have a lot of people who
move to Alabama, and we don't have a lot of people,
especially not a lot of people leave because Alabama's a
great place. Why would you want to leave here? But
that makes sense why it is that we do need
research very specific to our region. And I would imagine
this information not only as helpful to individuals and their families.
But also as you amass all of this data, it
(08:14):
kind of goes into larger database, so we're better able
to understand whole populations of people. Are you able? Can
you talk some about that how it's able to help
individual populations of people.
Speaker 3 (08:24):
So people who consent, are able to consent to have
us have access.
Speaker 2 (08:28):
To their de identified information.
Speaker 3 (08:30):
So we take away your name, your data, birth, all
the things that would be somebody would be able to
identify you as a person from now. Granted your genome
identifies you who you are, but being able to take
that information in a more global perspective. So in Alabama
we have a high rate of breast cancer and heart disease.
Can we look at that from a population level, right,
(08:54):
and then decide are there certain treatments that work better
for us here based.
Speaker 2 (08:58):
On you know, is there a gene variant?
Speaker 3 (09:01):
Is there some type of target that we can use
a lot of times what you see as people and
different pharma companies repurposing medication. So a thing was originally
designed for one thing and it didn't work, but I
had a side effect that as a side effect that
worked for something else, Right, So now we have data
and we can say, oh, maybe we can try this.
(09:21):
So this is how we pull in things that have
already the billions of dollars have already been spent and
it's sitting in a vault somewhere. But now we realize
it can be used for something else. Like we have
medication meant for diabetes, but now we know it works
for weight loss. So how do we repurpose that for
a completely different subset of the population to benefit them
as well. So there's lots of things that can be
(09:42):
done with those data sets, but we want to make
sure first that Alabama is represented.
Speaker 1 (09:46):
Now you mentioned this a little touch on a little bit,
but I wanted to go into it a little deeper.
The safety of the data, this being you know, there's
a lot of concern about anything from my financial information too.
I could even see stuff like this where if it
were to it out to say my insurance provider that
I have a proclivity for certain illness, they might not
(10:06):
cover me. They might say, well, that's actually pre existing.
How do we protect the safety of the data from
getting out there and actually harming those people who participate.
Speaker 3 (10:15):
So first and foremost, there is a law called the
GENA Act. The Genetic Information Non Discrimination Act. That means
that your healthcare provider or your health care insurance entity
does not have any right to your genetic information. You
have to share it with them and what your risk
are from that, and so we don't supply any of
that to any type of health care institution or anyone
(10:37):
doing anything like that. We've also hired an amazing chief
data officer who's done this for many many years at
m D. Anderson and at Baylor College of Medicine. This
is what he's built his career on and so we
were really lucky to get him here to Alabama to
help us build this data set. So we've built in
a lot of security from a lot of different ways.
(11:00):
So the information that a patient fills out on what
we call their patient portal, which would be their identifying information,
their name, their address on their phone number that lives
in one system, right, they.
Speaker 2 (11:11):
Take their surveys there.
Speaker 3 (11:12):
So we do social determinants of health because we understand
that Robert what Johnson says eighty percent of your health
outcomes actually come from your social determinants of health, not
from your clinical care. So we want to make sure
that healthcare providers know that about their patients. So all
of those things live in this data set that is
your patient portal. Your genetic information again is deidentified from
(11:34):
that and housing a completely different set. And so we've
made this structural segregation for a lot of different ways.
We don't want somebody to be able to have access
to one system and know everything about you.
Speaker 2 (11:46):
So even if someone somehow.
Speaker 3 (11:48):
Got access to this super lockdown system, they would then
have to be able to have access to both systems
and then figure out what the crosswalk is to put
you together with this other data set to figure out
that it's you. And that's something that we've learned from
missteps that of other programs, not here in Alabama, but
they're like.
Speaker 1 (12:06):
You've heard about twenty three and meters how they're about
ready to go belly up, and so there's a concern
that well wears all that data going to go that
they've amassed. So that's why I guess, you know, you
guys have been more careful with it, which makes a
lot of sense because you're you're smart, there's Southern research,
you know what you're doing.
Speaker 3 (12:20):
Yeah, we're doing our best to make sure that people
feel confident that what we're doing keeps them safe. And
that's a great thing about us being in Alabama based nonprofit.
It's not like you're having a drive to New York
or call somebody in California. We're right here. So if
you have questions, we're homegrown. We're home home based, and
so we're built here for Alabama, serving Alabama, and so
(12:41):
you can show up on our front doorstep if you'd
like and ask about your data. There's a way to actually,
you know, pull your data out if you would like to.
You know, you've consented, you've participated, and now you said, hey,
I really don't think I'm comfortable with this anymore, or
I don't want to be a part of this anymore.
There's always a way to say, Okay, I no longer consent.
And that's part of what you know. People don't we
(13:01):
hear a lot about what's gone on in research in
our states, specifically in Alabama, because we do have a
lot of mistrust.
Speaker 2 (13:07):
We've made a lot of missteps.
Speaker 3 (13:08):
In our history, but we are we are also much
like civil rights.
Speaker 2 (13:13):
I don't think people will realize that the.
Speaker 3 (13:15):
Pioneering of consenting and ethical medical treatment was born right
here in Alabama.
Speaker 1 (13:20):
Well after that civilist thing. I'm sure that's what you're
referring to. Yeah, Ever since that, I'm sure there's a
lot of people who are very concerned about that in Alabama,
and so we led.
Speaker 2 (13:29):
The charge for that.
Speaker 3 (13:30):
We have the Center of Bioethics that now lives at
Tuskegee who make sure worldwide that we're doing ethical research.
So we have learning from our past and we're getting better.
We're being better, we're being ethical. And that's the great
thing about having Tuskegee and the UABS that's you know,
fourth and nih is funding and doing all the great
work that they do. That we're all committed to doing
(13:52):
things and doing them the right way and making sure
that Alabama stays at the top of that research. So
we're informing not just Alabama, but nationwide and worldwide. We
really are pioneering treatments that help people worldwide.
Speaker 1 (14:04):
So, doctor Brian, you've given us a lot of good
reasons why you should participate in this project. So how
do people participate?
Speaker 3 (14:11):
So you can go to Catalysts by Southern Research dot
org or googling to get more information. We've got a
website there. What we're doing right now is really trying
to get the information out to healthcare providers so that
they know what their patients are eligible for.
Speaker 2 (14:28):
Again completely free.
Speaker 3 (14:29):
We don't take any insurance information from beginning to end,
from your testing all the way through to your genetic
counseling appointment. All that information goes back to the patient
and their healthcare provider, and there's no charge for that.
So we're really lucky in the state that our state
understood the impact from this, not just from a medical standpoint,
(14:49):
but there's also an economic impact. We saw that during
COVID when small businesses had to shut down because of
the health of their staff, and so how do we
redirect that to chronic disease? As our population gets older
and older Americans are working, how can we help them
be healthier so that they can go out and fuel
(15:10):
our economy. They can keep their jobs, they can keep
putting dinner on their table because they're healthier. Health really
is wealth, So how do we help Alabamians really have
a window into their health and help their health care providers?
Speaker 1 (15:23):
When you actually talk about the participation process, because we
have listeners not only in Birmingham but also in Mobile,
so it's about a three and a half hour drive
from Mobile, So do you need to go to Birmingham
or can you do these? Can you actually participate from
you know, three hours away?
Speaker 3 (15:38):
Yeah, right there with your health care provider in your
clinic where you've already established trust. That's the whole thing
is that it's put in the hands of your health
care provider who can make it actionable in your care.
We know from lots of different studies that people are
more likely to do something if their primary care provider
recommends it, and so we want to make sure that
(16:00):
the person that they trust with their day to day
care has this information, has reviewed it, has talked to
the specialist, and can now say hey, I think this
is what's right for you, or this is a variant
that we've found, this is a problem with this medication,
and they help you make that actionable in your care.
So it puts it in your health care provider's hands
to help you make an informed decision about what's best
for your care.
Speaker 1 (16:20):
So they take samples like blood and the usual samples
they would take.
Speaker 3 (16:24):
Correct So we're taking two small purple top tubes, just
like you would if you were getting a CBC or
a LIMPID panel during a regular clinic visit. So when
you're going for your regular clinic visit, you tell us
that you're going, we'll send a kit and we just
make sure that the providers have what they need and
then we do that sequencing and get it back to
get it back to healthcare providers through their provider portal.
Speaker 1 (16:46):
So in other words, not even an extra stick, just
you know, whyle, they've already got the needle in. You
just draw an extra tube. Correct, That's always very important.
I have minimum sticks is always the best thing. Well,
let's talk about where what's on the horizon. What's next
for cat List Once all this data is a mass
what we already know what's going to benefit me and
my family, But what about the Alabama and the world
(17:08):
at large? What does Catalyst see the future.
Speaker 3 (17:11):
As So Number one, as you talked about with AI,
we want to make sure that Alabama is part of
that data set. AI only spits out what's in there
right now, we aren't represented. So we want to make
sure that Alabama is represented there because lots of companies
are using that to design drug targets, to design the
drugs and the treatments for the future. And so we
(17:32):
want to make sure that we're involved in that, that
we're not secondary or on the back end of that.
So often that happens when you're outside of the University
of Alabama at Birmingham or USA and Mobile. If you
live in you know, rural and Dealusia or Florence, are
you getting access to those clinical trials? Usually not, And
(17:52):
so we want to a make sure you're part of
a data set. So we're bringing it to you, but
we're also going to let patients know when they're eligible
for clinical trials, because clinical trials is treatment is.
Speaker 2 (18:02):
A real thing.
Speaker 3 (18:03):
It is a life saving thing for many many people.
So based on the data that you provide, what clinical
trials are you eligible for?
Speaker 2 (18:11):
And again, we want.
Speaker 3 (18:12):
You to go back to your primary care provider and
say is this right for me? We don't want to
tell you what we think is right for you or
even what your data says is right for you, because
there's a human component to that. You should be able
to make your health care decisions with your health care provider.
So we give you the information and then say, hey,
sit down with your healthcare provider and talk about whether
or not participation in this is what's right for.
Speaker 1 (18:33):
You also as somebody who has participated in some of
those things. Usually there's a little bit of compensation, not always,
but usually so to defray the cost of travel or
whatever else. So you know, it's not just you know,
your time, you're giving up for nothing, you're helping others,
you're helping yourself, and you might actually get a few
bucks on the side.
Speaker 2 (18:49):
Correct.
Speaker 3 (18:49):
And our hope is as we build this information and
we show that Alabamians participate in research that we want
to know more about our health care, that we want
to be at the forefront. That farmer companies now come
in and they do research with Alabama as opposed to
what's happened in the past doing research on Alabama.
Speaker 2 (19:07):
We want to say, hey, come here, be our partners.
Speaker 3 (19:09):
Invest in Florence, invest in Coleman, invest in Aniston, invest
in Andalusia, wherever you may be, Dothan, there's great research
being done in small, community based areas.
Speaker 2 (19:20):
How do we build that up.
Speaker 3 (19:21):
We've got the Health Sciences Academy come into Demopolis, Alabama.
Speaker 2 (19:25):
How do we put that there.
Speaker 3 (19:26):
We'll have students who are working on this from high
school up. There'll be a nursing school there. So how
do we build a long clinical trials there to provide
access now for patients in Demopolis in Tuscaloosa.
Speaker 2 (19:37):
That's the infrastructure we want to build.
Speaker 1 (19:39):
So one more time people, We've given them all the
reasons to participate. Where do they need to go and
what do they need to have ready to supply when
they fill out the online forms.
Speaker 3 (19:49):
So, if you want to get more information about catalyus
again catallus by Southernresearch dot org.
Speaker 2 (19:54):
If you want to learn more, all the information is there.
There's learn more button.
Speaker 3 (19:58):
If you're a healthcare provider, you can sign up to
offer the clinical tests to your patient. We want to
make sure that anybody who wants access has access.
Speaker 2 (20:06):
And that's how you can get more information.
Speaker 1 (20:08):
And once the research is kind of amassed and completed,
I assume that Southern Research, you guys are probably going
to put some stuff on your website. People want to
find out how we're doing because I'd like to see
the report. You know, do we have more of this
and less of that? I think it'd be great for
you know, just just general knowledge.
Speaker 4 (20:23):
Yes.
Speaker 3 (20:24):
So I spent fourteen years in public health at Jefferson
County Department of Public Health and I know how important
it is to inform what we do in public health
in our state, and so our goal really is to
be able to work with you know, adph.
Speaker 2 (20:37):
These local public health.
Speaker 3 (20:38):
Departments are federally qualified health centers to say, hey, these
are the things fluence looks different from SELMA, right, these
are the things that maybe we should be focusing more
on influence. We want to make sure that not just
people have benefit from their data.
Speaker 2 (20:52):
How do their.
Speaker 3 (20:52):
Communities build programs around what's going on? If we've got
more brackup patients in one area, how do we get
the Susan g Coman's of the world to say, come here,
let's invest Let's do a study here, let's invest some
money here to help these patients.
Speaker 1 (21:08):
Invest in Alabama. I love a chief Medical Officer Southern Research,
doctor Khali Brown. Thank you so much for joining me
this week on Viewpoint Alabama.
Speaker 2 (21:14):
Thank you for having me.
Speaker 1 (21:15):
This is National Arthritis Awareness Month and also National Osteoporosis
Prevention Month. Anyone over the age of fifty has an
increased risk of arthritis in osteoporosis, but everyone should be
concerned about preventing it. Hello, I'm John mountsin This is
Viewpoint Alabama on the Alabama Radio Network. Joining me right
now is Joshlyn Witstein. She is a board certified orthopedic
(21:36):
surgeon and the Associate Professor of Orthopedic Surgery at Duke
University School of Medicine. She's also the co author of
the Complete Bone and Joint Health Plan. Jocelyn, Welcome to
Viewpoint Alabama.
Speaker 4 (21:46):
Thank you for having me, Jocelyn.
Speaker 1 (21:48):
I always say an ounce of prevention is worth a
pound of cure, but easier said than done. First question,
how do we prevent these things?
Speaker 5 (21:56):
Yes, we would all love to escape these problems, wouldn't
we First maybe to think of the scale of the problem,
which is that twenty percent of adults will experience arthritis,
and one in three women will experience osteoporosis related fractures.
One in five men will as well, so it's extremely common,
(22:17):
and of course it's an age related process. And well,
we really can't entirely prevent arthritis. There are so many
things we can do to make this less symptomatic and
maybe progress lower. And then when we think about osteoporosis
that is actually quite preventable through dietary choices and specific
(22:41):
exercises and for women actually use of hormone therapy.
Speaker 1 (22:45):
We'll talk about arthritis. I always consider that there is
two major areas. There's osteoarthritis and rheumatoid arthritis. Can you
explain the fundamental difference between those two.
Speaker 5 (22:56):
Yes, there's actually more than two types, but I like
to use those two types as an explanation for you know,
variations and types of arthritis because they're kind of at
the opposite.
Speaker 4 (23:07):
End of the spectrum.
Speaker 5 (23:08):
But when we think about osteoarthritis, this is your classic
wear and tear, you know, age related arthritis that is
from just overload of the joint like a you know,
just mechanical like you're just using these joints over the
course of your lifetime. And at the opposite end of
the expect of the spectrum is rheumatoid arthritis, which is
an inflammatory condition. This is an autoimmune condition where inflammation
(23:33):
and your joints is literally destroying the surface or what
we call the cartilage of the of the joint. There
are other types actually in between. I would say there's
something called post traumatic earthritis. Like if you have an
injury like tear your acl you get some inflammation in
your need, you're more likely to develop arthritis. And there's
also menopause arthritis, which is arthritis related to the inflammation
(23:55):
that occurs in women as their estrogen levels drop.
Speaker 1 (23:58):
So it sounds like inflammation is an issue. And then
also just as you mentioned, wear and tear, because that
cartilage that makes it to where our bones can slide
at best each other easily eventually wears down and there's
not much you can do, I guess to I mean,
things wear out through time, but there's ways that we
can prevent them from I guess wearing as quickly from
(24:20):
And I've heard all sorts of like things that might
go in the category of old wives tales like oh,
you shouldn't you shouldn't run on concrete, or you should
get better shoes or that kind of thing. And then
I've also heard where you should take this medicine or
that medicine. What are some of the I guess, the
clinically proven things we can do from a lifestyle standpoint,
and then we can talk about a pharmacologic standpoint.
Speaker 5 (24:39):
There are a lot of myths about arthritis.
Speaker 4 (24:41):
This is true.
Speaker 5 (24:42):
Even the wear and tereror type of arthritis does have
some component of inflammation. So you know, lowering your inflammation
in your body. Eating a diet that is anti inflammatory
can help. Maintaining a healthy body weight can help. Obest
people are more likely to have arthrit and not even
just in their weight brain joids, just in general and
(25:04):
all joints in their body. So losing weight can help
and also help slow the progression of earthritis. If you
have some mild arthritis, choosing activities that are not as
high impact or load on your joint, like running and jumping,
can help minimize the symptoms of arthritis. As you mentioned,
(25:24):
running is often blamed for you know, we blame running
on you know, causingthis, but it actually doesn't cause earthritis.
Runners are not more likely to have arthritis. They are
less likely to have arthritis. However, if you already have arthritis,
running may exacerbate it. And then there are supplements that
(25:44):
help support our joint health.
Speaker 1 (25:46):
So it sounds like inflammation is an issue from a
systemic standpoint, and also there's just general wear and tear.
Things wear out over time, and then you have to
think about like these old wives tales you always hear,
like you shouldn't run on concrete, you'll develop authritis, or
you shouldn't pop your knuckles or all of these things
that you hear. What are some proven treatments at clinically
(26:07):
proven treatments for prevention and treatment Author Authritis. We'll talk
about both lifestyle and then we'll talk about pharmacologic treatments.
Speaker 5 (26:16):
Well, I think certainly a good diet that includes you know, calcium,
vitamin D, micronutrients that you need for bone health, like
magnesium and you know, vitamin K, vitamin C, things like
that all important for bone health. But activity that includes
strength training and some impact is extremely important for establishing
that you know, base of your peak bone density, which
(26:38):
peaks at age thirty. And then after the age of thirty,
we do start to gradually lose bone density about one
percent per year and then, unfortunately for women, when they
reach menopause with estrogen withdrawal, that becomes.
Speaker 4 (26:51):
A two percent per year loss.
Speaker 5 (26:52):
And then the thing that we really, I think don't
give enough credit to is hormone therapy. So when women
go through menopause doesn't have estrogen withdrawal, they can be
treated with hormone therapy that includes estrogen and this significantly
reduces risk of osteoporosis and reduces risk of hip fractures
by thirty percent.
Speaker 4 (27:11):
So there is so much that we can do.
Speaker 5 (27:14):
It's not like once you have it, you know it's
doomsday and there's nothing you can do.
Speaker 4 (27:17):
But it's best to be proactive and doctor Wistein.
Speaker 1 (27:20):
One of the things that I've heard throughout my lifetime
for my mother, my grandmother, is you shouldn't slouch, you
should have better posture. It's better for you so you
won't develop you know, poor posture and arthritis and all
these other things. Is there any truth to that?
Speaker 5 (27:34):
Well, I think good posture is extremely important. It's basically
exercise all day for your core muscula sure, and it
does help your back for sure as well. Not to
be in the slouched posture unfortunately, and today's landscape, everyone's
on their tablet or iPad or phone or whatever, and
I think there's even worsening posture and slouching even in teenagers.
(27:58):
But you know, I think being more active, being more
engaged in strength training and using.
Speaker 4 (28:02):
Your core, thinking about your poster those are all good things.
Speaker 1 (28:05):
It's true we do seem to spend a lot of
time looking down, and I know that's going to cause
some problems at least in your cervical spine, if not
in your spine as a whole. Plus, just by being
on your devices, you're not as active as we used.
Speaker 4 (28:16):
To be, right, Yeah, that's true, Jocelyn.
Speaker 1 (28:19):
In your book The Complete Bone and Joint Health Plan,
are there some simple steps that you lay out that
people should take every single day. I'm not discouraging them
from going out and buying the book, but right now
some simple steps they can take every day to help
them prevent developing these problems later in life.
Speaker 5 (28:36):
Absolutely. In The Complete Bone and Joint Health Plan, we
try to make this really easy for people. Basically your
own you know what. The actions that you can take
are in the form of educating yourself about what causes
arthritis and osteoporosis so that you can know how to
attack this problem. There are dietary choices you can make,
and we outline how to follow a diet that meets
(28:59):
both anti and slamsy needs and bone health needs. We
provide recipes that allow people to combine ingredients that nourish
both their bones and their joints, and we provide the
exercises that you can incorporate several days a week to
be proactive about maintaining your muscle mass, maintaining your bone density.
And then lastly, I think the most helpful section may
(29:20):
be the frequently asked question section, where my co author,
Sitney nur Skorsky, who's a registered dietitian and fitness instructor,
and myself include all of the things that her clients
and my patients ask me every day.
Speaker 1 (29:33):
Doctor Jocelyn Witstein, thank you so much for joining us
this week off Viewpoint Alabama.
Speaker 5 (29:37):
Thanks for having me.
Speaker 1 (29:38):
You've been listening to Viewpoint Alabama, a public affairs program
from the Alabama Radio Network. The opinions expressed on Viewpoint
Alabama are not necessarily those of the staff, management, or
advertisers of this station.
Living better through scientific advances that are achieved right here
in our state. Hello, and welcome to Viewpoint Alabama on
the Alabama Radio Network. My name is John Mounts, and
I'm always excited to tell good news stories about businesses
and research organizations in our state making a difference. And
one of the ones you might not be familiar with
but you should is Southern Research, located right here in Birmingham, Alabama.
(00:23):
And I'm joined right now by the chief medical officer
at Southern Research, doctor Khalila Brown. Doctor Brown, tell me
first of all, what is Southern Research all about?
Speaker 2 (00:33):
So?
Speaker 3 (00:33):
Southern Research is an eighty three year old translational research institute.
We've been doing great work in Birmingham in the tech space,
mostly the biotech space life sciences space for a very
long time.
Speaker 2 (00:49):
I think a lot of people don't.
Speaker 3 (00:50):
Realize that we're here, and probably a well kept secret,
but fifty percent of the chemo therapy is currently used
in the United States came through Southern Research.
Speaker 2 (01:00):
Point time.
Speaker 3 (01:01):
So really excited that we do a lot of work
that touches not only Alabamians, but people in nationwide and worldwide.
Speaker 1 (01:07):
Do you work with UAB at all? Since you're so close.
Speaker 3 (01:09):
Correct, that's a great thing. So Southern research actually pre
dates UAB, but you AB. I'm a two time graduate
of u A B and super proud that it's here
and that we get to work alongside them. We are
now an affiliate of ua B and so we kind
of sit in the middle zone of the research. So
UAB does a lot of the basic sciences and then
(01:31):
we do that translational part, so everything from when it
becomes an idea before it touches a patient to validate
does it work, how does it work?
Speaker 2 (01:40):
Is it safe?
Speaker 3 (01:41):
And then it goes back to institutes like UAB and
others throughout the world when it hits patient.
Speaker 1 (01:46):
And that way you can let UAB handle all the
messy work with all the paperwork and the patients and
all that kind of stuff.
Speaker 2 (01:51):
When it comes to the trials, yes they have the
clinical trials.
Speaker 3 (01:54):
Once they hit the patient, there's still a lot of
paperwork because it's just it's a highly regular industry.
Speaker 1 (02:00):
The human use forms are very very long and complicated.
Speaker 2 (02:04):
Yes, we want to know that things are very safe.
Speaker 1 (02:06):
Extuctly, and they should I was going to say, and
they should be because I don't want you know stuff
being tested on me unless you know, we know it's
going to actually be safe. So well, doctor Brown, the
reason we're in here specifically to talk is something that
Southern Research is involved in. It's a new project. It's
called the Catalyst Project, and Catalyst is going to I
think be very beneficial to a lot of people. Tell
(02:26):
me what inspired the Catalyst program and what it helps
to achieve.
Speaker 3 (02:31):
So Catalyst is a new foray for Southern Research. Remember
I just told you we've been all about pre clinical
things that really didn't touch patients. But because we are
a nonprofit research institute, we sit at a unique juncture
that allows us to do things that other healthcare institutes
may not be able to do. And so we have
(02:52):
funding from the state of Alabama that really is meant
to increase precision medicine to patients throughout the state, regardless
of their insurance, in order to really impact chronic disease management.
So we know that we've got a lot of uninsured
patients in Alabama. We've got rural patients that have, you know,
issues with access to healthcare. So how do we take
(03:13):
care how do we help those healthcare providers that are
in rural areas, underserved areas, even if you're right here
in Birmingham have information that helps them take better care
of their patient.
Speaker 1 (03:23):
When they first rolled out the human genome map back
in what year was that those about nineties? You know,
over twenty years yeh, it's been at least twenty years.
I thought, you know, this is going to really do
incredible things for science. And then you combine that with
the recent all the recent explosion of AI, because AI
can do all those little tiny tasks that would take
you know, a whole building full of people, you know,
(03:44):
years to do, AI can do it in a matter
of minutes. So you combine the human geno mapping and AI,
you can do some amazing things if we have some
data from individual people. And I think that's kind of
what Catalyst is getting at, right, That's.
Speaker 3 (03:57):
That's definitely it's what it's getting at on two sides
of the same coin. So on the front end, we're
offering this testing that has it's a clinical test. It's
not a research great test. It's a clinical test that
goes back to your health care provider that gives you
three great reports that tells your health care provider one,
what are your risk around type two diabetes coordinator or disease,
and breast cancer for your biological female. It also tells
(04:20):
you about how you handle specific drug medications, common things
that we take every day, where they're there antidepressants, ADHD medications,
heart disease medications, simple things like aspirin, motor and talentol,
all those things.
Speaker 2 (04:33):
How does your body handle those? What does your.
Speaker 3 (04:35):
Genome say about that? And so it may or may
not be the right medication for you. So we're hopefully
helping people understand what medications work best for them, rather
than them having to try them and see they have
side effects or they don't work right. And then there's
a rare disease report, and I need people to understand
that rare disease isn't always as rare as you think.
So it's eighty four genes that translates to about forty
(04:57):
four disease states that we we deal with every day.
So familiar hypercholesterolemia long QT syndrome, which is a cardiac
a rhythmia defect that can cause you to you know,
have an rhythmia and delight cap collapse and die very quickly.
Marphin syndrome, brackaging, for breast cancers. On there, they're screening
(05:18):
for prostate cancers. So just making sure people understand not
just what their clinical risk is, but now what is
my genetic risk? And so how does that help my
healthcare provider have an insight into a window that they
typically don't have access to because it's not typically something
that's paid for by insurance unless you're looking for a
specific disease state.
Speaker 1 (05:38):
And that's so important. You know, your doctor always wants
to know your family history, and sometimes we don't have
complete family history. Maybe our you know, we were born
late in life, and you know, we don't know our
grandparents or our great grandparents. We have no idea what
they die from, and so that's a mystery to us.
So something like this could be very helpful not only
to us, but to our children, to our nieces, our nephews,
(05:59):
other family members, because they could very well benefit from
this information as well, right, correct.
Speaker 3 (06:04):
And that's the great thing about one put it in
the hands of your health care provider who can help
you understand it. But on the back end of this program,
every participant in every healthcare provider has free access to
genetic counselors. So now we have the information, but how
does that translate not just to my health, but to
my family's health. We want to make sure that we
understand how it's inherited, and so who would impact Should
(06:25):
I call my sister, Should I call my brother or
my cousin or my aunt? Who are the right people
that I should be talking to about this, because so
often we just don't have a clear picture of our
family history. Even when we have history, it's not always correct.
You know, We've had ten men in our family collapse
and everybody thought it was because they were obese and
they smoked, but really we had some type of familial
(06:47):
cardiomyopathy that was missed, and so we don't know those
types of things just because you know, again we didn't
pass down the right name of it, or maybe we
didn't know the right name of it. We never got
an autopsy. And so we're trying to make sure that
people have a window into those things. And then on
the back end of that, we can use that data.
So now, as you say, with AIAI only spits out
(07:07):
things that's already.
Speaker 1 (07:08):
In the system, garbage in, garbage out, correct.
Speaker 2 (07:11):
So we need good data in.
Speaker 3 (07:12):
We need data that's representative of Alabama, and so when
you look at the data set, we're not there, We're
not represented. Nobody's come into Alabama really to do research
and make us part of their data set. They're going
to California and Texas and New York, and so we
get things on the back end. Our medications aren't always
built for us here in Alabama. And we're a unique
(07:33):
data set, we really are. We're a non transient state,
so about seventy percent of people born in the state,
say in the state. So we've got generations of data.
We've got significant chronic disease. So we're a great place
to make sure that these medications work properly, and so
we want the data to prove it on the front
end before it ever hits our bodies.
Speaker 1 (07:53):
That's a great point, the fact that we are so
insular and we don't have a lot of people who
move to Alabama, and we don't have a lot of people,
especially not a lot of people leave because Alabama's a
great place. Why would you want to leave here? But
that makes sense why it is that we do need
research very specific to our region. And I would imagine
this information not only as helpful to individuals and their families.
But also as you amass all of this data, it
(08:14):
kind of goes into larger database, so we're better able
to understand whole populations of people. Are you able? Can
you talk some about that how it's able to help
individual populations of people.
Speaker 3 (08:24):
So people who consent, are able to consent to have
us have access.
Speaker 2 (08:28):
To their de identified information.
Speaker 3 (08:30):
So we take away your name, your data, birth, all
the things that would be somebody would be able to
identify you as a person from now. Granted your genome
identifies you who you are, but being able to take
that information in a more global perspective. So in Alabama
we have a high rate of breast cancer and heart disease.
Can we look at that from a population level, right,
(08:54):
and then decide are there certain treatments that work better
for us here based.
Speaker 2 (08:58):
On you know, is there a gene variant?
Speaker 3 (09:01):
Is there some type of target that we can use
a lot of times what you see as people and
different pharma companies repurposing medication. So a thing was originally
designed for one thing and it didn't work, but I
had a side effect that as a side effect that
worked for something else, Right, So now we have data
and we can say, oh, maybe we can try this.
(09:21):
So this is how we pull in things that have
already the billions of dollars have already been spent and
it's sitting in a vault somewhere. But now we realize
it can be used for something else. Like we have
medication meant for diabetes, but now we know it works
for weight loss. So how do we repurpose that for
a completely different subset of the population to benefit them
as well. So there's lots of things that can be
(09:42):
done with those data sets, but we want to make
sure first that Alabama is represented.
Speaker 1 (09:46):
Now you mentioned this a little touch on a little bit,
but I wanted to go into it a little deeper.
The safety of the data, this being you know, there's
a lot of concern about anything from my financial information too.
I could even see stuff like this where if it
were to it out to say my insurance provider that
I have a proclivity for certain illness, they might not
(10:06):
cover me. They might say, well, that's actually pre existing.
How do we protect the safety of the data from
getting out there and actually harming those people who participate.
Speaker 3 (10:15):
So first and foremost, there is a law called the
GENA Act. The Genetic Information Non Discrimination Act. That means
that your healthcare provider or your health care insurance entity
does not have any right to your genetic information. You
have to share it with them and what your risk
are from that, and so we don't supply any of
that to any type of health care institution or anyone
(10:37):
doing anything like that. We've also hired an amazing chief
data officer who's done this for many many years at
m D. Anderson and at Baylor College of Medicine. This
is what he's built his career on and so we
were really lucky to get him here to Alabama to
help us build this data set. So we've built in
a lot of security from a lot of different ways.
(11:00):
So the information that a patient fills out on what
we call their patient portal, which would be their identifying information,
their name, their address on their phone number that lives
in one system, right, they.
Speaker 2 (11:11):
Take their surveys there.
Speaker 3 (11:12):
So we do social determinants of health because we understand
that Robert what Johnson says eighty percent of your health
outcomes actually come from your social determinants of health, not
from your clinical care. So we want to make sure
that healthcare providers know that about their patients. So all
of those things live in this data set that is
your patient portal. Your genetic information again is deidentified from
(11:34):
that and housing a completely different set. And so we've
made this structural segregation for a lot of different ways.
We don't want somebody to be able to have access
to one system and know everything about you.
Speaker 2 (11:46):
So even if someone somehow.
Speaker 3 (11:48):
Got access to this super lockdown system, they would then
have to be able to have access to both systems
and then figure out what the crosswalk is to put
you together with this other data set to figure out
that it's you. And that's something that we've learned from
missteps that of other programs, not here in Alabama, but
they're like.
Speaker 1 (12:06):
You've heard about twenty three and meters how they're about
ready to go belly up, and so there's a concern
that well wears all that data going to go that
they've amassed. So that's why I guess, you know, you
guys have been more careful with it, which makes a
lot of sense because you're you're smart, there's Southern research,
you know what you're doing.
Speaker 3 (12:20):
Yeah, we're doing our best to make sure that people
feel confident that what we're doing keeps them safe. And
that's a great thing about us being in Alabama based nonprofit.
It's not like you're having a drive to New York
or call somebody in California. We're right here. So if
you have questions, we're homegrown. We're home home based, and
so we're built here for Alabama, serving Alabama, and so
(12:41):
you can show up on our front doorstep if you'd
like and ask about your data. There's a way to actually,
you know, pull your data out if you would like to.
You know, you've consented, you've participated, and now you said, hey,
I really don't think I'm comfortable with this anymore, or
I don't want to be a part of this anymore.
There's always a way to say, Okay, I no longer consent.
And that's part of what you know. People don't we
(13:01):
hear a lot about what's gone on in research in
our states, specifically in Alabama, because we do have a
lot of mistrust.
Speaker 2 (13:07):
We've made a lot of missteps.
Speaker 3 (13:08):
In our history, but we are we are also much
like civil rights.
Speaker 2 (13:13):
I don't think people will realize that the.
Speaker 3 (13:15):
Pioneering of consenting and ethical medical treatment was born right
here in Alabama.
Speaker 1 (13:20):
Well after that civilist thing. I'm sure that's what you're
referring to. Yeah, Ever since that, I'm sure there's a
lot of people who are very concerned about that in Alabama,
and so we led.
Speaker 2 (13:29):
The charge for that.
Speaker 3 (13:30):
We have the Center of Bioethics that now lives at
Tuskegee who make sure worldwide that we're doing ethical research.
So we have learning from our past and we're getting better.
We're being better, we're being ethical. And that's the great
thing about having Tuskegee and the UABS that's you know,
fourth and nih is funding and doing all the great
work that they do. That we're all committed to doing
(13:52):
things and doing them the right way and making sure
that Alabama stays at the top of that research. So
we're informing not just Alabama, but nationwide and worldwide. We
really are pioneering treatments that help people worldwide.
Speaker 1 (14:04):
So, doctor Brian, you've given us a lot of good
reasons why you should participate in this project. So how
do people participate?
Speaker 3 (14:11):
So you can go to Catalysts by Southern Research dot
org or googling to get more information. We've got a
website there. What we're doing right now is really trying
to get the information out to healthcare providers so that
they know what their patients are eligible for.
Speaker 2 (14:28):
Again completely free.
Speaker 3 (14:29):
We don't take any insurance information from beginning to end,
from your testing all the way through to your genetic
counseling appointment. All that information goes back to the patient
and their healthcare provider, and there's no charge for that.
So we're really lucky in the state that our state
understood the impact from this, not just from a medical standpoint,
(14:49):
but there's also an economic impact. We saw that during
COVID when small businesses had to shut down because of
the health of their staff, and so how do we
redirect that to chronic disease? As our population gets older
and older Americans are working, how can we help them
be healthier so that they can go out and fuel
(15:10):
our economy. They can keep their jobs, they can keep
putting dinner on their table because they're healthier. Health really
is wealth, So how do we help Alabamians really have
a window into their health and help their health care providers?
Speaker 1 (15:23):
When you actually talk about the participation process, because we
have listeners not only in Birmingham but also in Mobile,
so it's about a three and a half hour drive
from Mobile, So do you need to go to Birmingham
or can you do these? Can you actually participate from
you know, three hours away?
Speaker 3 (15:38):
Yeah, right there with your health care provider in your
clinic where you've already established trust. That's the whole thing
is that it's put in the hands of your health
care provider who can make it actionable in your care.
We know from lots of different studies that people are
more likely to do something if their primary care provider
recommends it, and so we want to make sure that
(16:00):
the person that they trust with their day to day
care has this information, has reviewed it, has talked to
the specialist, and can now say hey, I think this
is what's right for you, or this is a variant
that we've found, this is a problem with this medication,
and they help you make that actionable in your care.
So it puts it in your health care provider's hands
to help you make an informed decision about what's best
for your care.
Speaker 1 (16:20):
So they take samples like blood and the usual samples
they would take.
Speaker 3 (16:24):
Correct So we're taking two small purple top tubes, just
like you would if you were getting a CBC or
a LIMPID panel during a regular clinic visit. So when
you're going for your regular clinic visit, you tell us
that you're going, we'll send a kit and we just
make sure that the providers have what they need and
then we do that sequencing and get it back to
get it back to healthcare providers through their provider portal.
Speaker 1 (16:46):
So in other words, not even an extra stick, just
you know, whyle, they've already got the needle in. You
just draw an extra tube. Correct, That's always very important.
I have minimum sticks is always the best thing. Well,
let's talk about where what's on the horizon. What's next
for cat List Once all this data is a mass
what we already know what's going to benefit me and
my family, But what about the Alabama and the world
(17:08):
at large? What does Catalyst see the future.
Speaker 3 (17:11):
As So Number one, as you talked about with AI,
we want to make sure that Alabama is part of
that data set. AI only spits out what's in there
right now, we aren't represented. So we want to make
sure that Alabama is represented there because lots of companies
are using that to design drug targets, to design the
drugs and the treatments for the future. And so we
(17:32):
want to make sure that we're involved in that, that
we're not secondary or on the back end of that.
So often that happens when you're outside of the University
of Alabama at Birmingham or USA and Mobile. If you
live in you know, rural and Dealusia or Florence, are
you getting access to those clinical trials? Usually not, And
(17:52):
so we want to a make sure you're part of
a data set. So we're bringing it to you, but
we're also going to let patients know when they're eligible
for clinical trials, because clinical trials is treatment is.
Speaker 2 (18:02):
A real thing.
Speaker 3 (18:03):
It is a life saving thing for many many people.
So based on the data that you provide, what clinical
trials are you eligible for?
Speaker 2 (18:11):
And again, we want.
Speaker 3 (18:12):
You to go back to your primary care provider and
say is this right for me? We don't want to
tell you what we think is right for you or
even what your data says is right for you, because
there's a human component to that. You should be able
to make your health care decisions with your health care provider.
So we give you the information and then say, hey,
sit down with your healthcare provider and talk about whether
or not participation in this is what's right for.
Speaker 1 (18:33):
You also as somebody who has participated in some of
those things. Usually there's a little bit of compensation, not always,
but usually so to defray the cost of travel or
whatever else. So you know, it's not just you know,
your time, you're giving up for nothing, you're helping others,
you're helping yourself, and you might actually get a few
bucks on the side.
Speaker 2 (18:49):
Correct.
Speaker 3 (18:49):
And our hope is as we build this information and
we show that Alabamians participate in research that we want
to know more about our health care, that we want
to be at the forefront. That farmer companies now come
in and they do research with Alabama as opposed to
what's happened in the past doing research on Alabama.
Speaker 2 (19:07):
We want to say, hey, come here, be our partners.
Speaker 3 (19:09):
Invest in Florence, invest in Coleman, invest in Aniston, invest
in Andalusia, wherever you may be, Dothan, there's great research
being done in small, community based areas.
Speaker 2 (19:20):
How do we build that up.
Speaker 3 (19:21):
We've got the Health Sciences Academy come into Demopolis, Alabama.
Speaker 2 (19:25):
How do we put that there.
Speaker 3 (19:26):
We'll have students who are working on this from high
school up. There'll be a nursing school there. So how
do we build a long clinical trials there to provide
access now for patients in Demopolis in Tuscaloosa.
Speaker 2 (19:37):
That's the infrastructure we want to build.
Speaker 1 (19:39):
So one more time people, We've given them all the
reasons to participate. Where do they need to go and
what do they need to have ready to supply when
they fill out the online forms.
Speaker 3 (19:49):
So, if you want to get more information about catalyus
again catallus by Southernresearch dot org.
Speaker 2 (19:54):
If you want to learn more, all the information is there.
There's learn more button.
Speaker 3 (19:58):
If you're a healthcare provider, you can sign up to
offer the clinical tests to your patient. We want to
make sure that anybody who wants access has access.
Speaker 2 (20:06):
And that's how you can get more information.
Speaker 1 (20:08):
And once the research is kind of amassed and completed,
I assume that Southern Research, you guys are probably going
to put some stuff on your website. People want to
find out how we're doing because I'd like to see
the report. You know, do we have more of this
and less of that? I think it'd be great for
you know, just just general knowledge.
Speaker 4 (20:23):
Yes.
Speaker 3 (20:24):
So I spent fourteen years in public health at Jefferson
County Department of Public Health and I know how important
it is to inform what we do in public health
in our state, and so our goal really is to
be able to work with you know, adph.
Speaker 2 (20:37):
These local public health.
Speaker 3 (20:38):
Departments are federally qualified health centers to say, hey, these
are the things fluence looks different from SELMA, right, these
are the things that maybe we should be focusing more
on influence. We want to make sure that not just
people have benefit from their data.
Speaker 2 (20:52):
How do their.
Speaker 3 (20:52):
Communities build programs around what's going on? If we've got
more brackup patients in one area, how do we get
the Susan g Coman's of the world to say, come here,
let's invest Let's do a study here, let's invest some
money here to help these patients.
Speaker 1 (21:08):
Invest in Alabama. I love a chief Medical Officer Southern Research,
doctor Khali Brown. Thank you so much for joining me
this week on Viewpoint Alabama.
Speaker 2 (21:14):
Thank you for having me.
Speaker 1 (21:15):
This is National Arthritis Awareness Month and also National Osteoporosis
Prevention Month. Anyone over the age of fifty has an
increased risk of arthritis in osteoporosis, but everyone should be
concerned about preventing it. Hello, I'm John mountsin This is
Viewpoint Alabama on the Alabama Radio Network. Joining me right
now is Joshlyn Witstein. She is a board certified orthopedic
(21:36):
surgeon and the Associate Professor of Orthopedic Surgery at Duke
University School of Medicine. She's also the co author of
the Complete Bone and Joint Health Plan. Jocelyn, Welcome to
Viewpoint Alabama.
Speaker 4 (21:46):
Thank you for having me, Jocelyn.
Speaker 1 (21:48):
I always say an ounce of prevention is worth a
pound of cure, but easier said than done. First question,
how do we prevent these things?
Speaker 5 (21:56):
Yes, we would all love to escape these problems, wouldn't
we First maybe to think of the scale of the problem,
which is that twenty percent of adults will experience arthritis,
and one in three women will experience osteoporosis related fractures.
One in five men will as well, so it's extremely common,
(22:17):
and of course it's an age related process. And well,
we really can't entirely prevent arthritis. There are so many
things we can do to make this less symptomatic and
maybe progress lower. And then when we think about osteoporosis
that is actually quite preventable through dietary choices and specific
(22:41):
exercises and for women actually use of hormone therapy.
Speaker 1 (22:45):
We'll talk about arthritis. I always consider that there is
two major areas. There's osteoarthritis and rheumatoid arthritis. Can you
explain the fundamental difference between those two.
Speaker 5 (22:56):
Yes, there's actually more than two types, but I like
to use those two types as an explanation for you know,
variations and types of arthritis because they're kind of at
the opposite.
Speaker 4 (23:07):
End of the spectrum.
Speaker 5 (23:08):
But when we think about osteoarthritis, this is your classic
wear and tear, you know, age related arthritis that is
from just overload of the joint like a you know,
just mechanical like you're just using these joints over the
course of your lifetime. And at the opposite end of
the expect of the spectrum is rheumatoid arthritis, which is
an inflammatory condition. This is an autoimmune condition where inflammation
(23:33):
and your joints is literally destroying the surface or what
we call the cartilage of the of the joint. There
are other types actually in between. I would say there's
something called post traumatic earthritis. Like if you have an
injury like tear your acl you get some inflammation in
your need, you're more likely to develop arthritis. And there's
also menopause arthritis, which is arthritis related to the inflammation
(23:55):
that occurs in women as their estrogen levels drop.
Speaker 1 (23:58):
So it sounds like inflammation is an issue. And then
also just as you mentioned, wear and tear, because that
cartilage that makes it to where our bones can slide
at best each other easily eventually wears down and there's
not much you can do, I guess to I mean,
things wear out through time, but there's ways that we
can prevent them from I guess wearing as quickly from
(24:20):
And I've heard all sorts of like things that might
go in the category of old wives tales like oh,
you shouldn't you shouldn't run on concrete, or you should
get better shoes or that kind of thing. And then
I've also heard where you should take this medicine or
that medicine. What are some of the I guess, the
clinically proven things we can do from a lifestyle standpoint,
and then we can talk about a pharmacologic standpoint.
Speaker 5 (24:39):
There are a lot of myths about arthritis.
Speaker 4 (24:41):
This is true.
Speaker 5 (24:42):
Even the wear and tereror type of arthritis does have
some component of inflammation. So you know, lowering your inflammation
in your body. Eating a diet that is anti inflammatory
can help. Maintaining a healthy body weight can help. Obest
people are more likely to have arthrit and not even
just in their weight brain joids, just in general and
(25:04):
all joints in their body. So losing weight can help
and also help slow the progression of earthritis. If you
have some mild arthritis, choosing activities that are not as
high impact or load on your joint, like running and jumping,
can help minimize the symptoms of arthritis. As you mentioned,
(25:24):
running is often blamed for you know, we blame running
on you know, causingthis, but it actually doesn't cause earthritis.
Runners are not more likely to have arthritis. They are
less likely to have arthritis. However, if you already have arthritis,
running may exacerbate it. And then there are supplements that
(25:44):
help support our joint health.
Speaker 1 (25:46):
So it sounds like inflammation is an issue from a
systemic standpoint, and also there's just general wear and tear.
Things wear out over time, and then you have to
think about like these old wives tales you always hear,
like you shouldn't run on concrete, you'll develop authritis, or
you shouldn't pop your knuckles or all of these things
that you hear. What are some proven treatments at clinically
(26:07):
proven treatments for prevention and treatment Author Authritis. We'll talk
about both lifestyle and then we'll talk about pharmacologic treatments.
Speaker 5 (26:16):
Well, I think certainly a good diet that includes you know, calcium,
vitamin D, micronutrients that you need for bone health, like
magnesium and you know, vitamin K, vitamin C, things like
that all important for bone health. But activity that includes
strength training and some impact is extremely important for establishing
that you know, base of your peak bone density, which
(26:38):
peaks at age thirty. And then after the age of thirty,
we do start to gradually lose bone density about one
percent per year and then, unfortunately for women, when they
reach menopause with estrogen withdrawal, that becomes.
Speaker 4 (26:51):
A two percent per year loss.
Speaker 5 (26:52):
And then the thing that we really, I think don't
give enough credit to is hormone therapy. So when women
go through menopause doesn't have estrogen withdrawal, they can be
treated with hormone therapy that includes estrogen and this significantly
reduces risk of osteoporosis and reduces risk of hip fractures
by thirty percent.
Speaker 4 (27:11):
So there is so much that we can do.
Speaker 5 (27:14):
It's not like once you have it, you know it's
doomsday and there's nothing you can do.
Speaker 4 (27:17):
But it's best to be proactive and doctor Wistein.
Speaker 1 (27:20):
One of the things that I've heard throughout my lifetime
for my mother, my grandmother, is you shouldn't slouch, you
should have better posture. It's better for you so you
won't develop you know, poor posture and arthritis and all
these other things. Is there any truth to that?
Speaker 5 (27:34):
Well, I think good posture is extremely important. It's basically
exercise all day for your core muscula sure, and it
does help your back for sure as well. Not to
be in the slouched posture unfortunately, and today's landscape, everyone's
on their tablet or iPad or phone or whatever, and
I think there's even worsening posture and slouching even in teenagers.
(27:58):
But you know, I think being more active, being more
engaged in strength training and using.
Speaker 4 (28:02):
Your core, thinking about your poster those are all good things.
Speaker 1 (28:05):
It's true we do seem to spend a lot of
time looking down, and I know that's going to cause
some problems at least in your cervical spine, if not
in your spine as a whole. Plus, just by being
on your devices, you're not as active as we used.
Speaker 4 (28:16):
To be, right, Yeah, that's true, Jocelyn.
Speaker 1 (28:19):
In your book The Complete Bone and Joint Health Plan,
are there some simple steps that you lay out that
people should take every single day. I'm not discouraging them
from going out and buying the book, but right now
some simple steps they can take every day to help
them prevent developing these problems later in life.
Speaker 5 (28:36):
Absolutely. In The Complete Bone and Joint Health Plan, we
try to make this really easy for people. Basically your
own you know what. The actions that you can take
are in the form of educating yourself about what causes
arthritis and osteoporosis so that you can know how to
attack this problem. There are dietary choices you can make,
and we outline how to follow a diet that meets
(28:59):
both anti and slamsy needs and bone health needs. We
provide recipes that allow people to combine ingredients that nourish
both their bones and their joints, and we provide the
exercises that you can incorporate several days a week to
be proactive about maintaining your muscle mass, maintaining your bone density.
And then lastly, I think the most helpful section may
(29:20):
be the frequently asked question section, where my co author,
Sitney nur Skorsky, who's a registered dietitian and fitness instructor,
and myself include all of the things that her clients
and my patients ask me every day.
Speaker 1 (29:33):
Doctor Jocelyn Witstein, thank you so much for joining us
this week off Viewpoint Alabama.
Speaker 5 (29:37):
Thanks for having me.
Speaker 1 (29:38):
You've been listening to Viewpoint Alabama, a public affairs program
from the Alabama Radio Network. The opinions expressed on Viewpoint
Alabama are not necessarily those of the staff, management, or
advertisers of this station.
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