Live Long and Well with Dr. Bobby

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In this episode, Dr. Bobby tackles the often perplexing world of health headlines. From bold claims about intermittent fasting to the benefits of wearing socks to bed, he breaks down how to evaluate these headlines critically. With nine key questions to ask about a headline, insights into the hierarchy of evidence, and two practical examples, Dr. Bobby provides listeners with tools to discern fact from fiction in health journalism.

And, your Health Type influences how you might use information.  Take the Health Quiz

Join the Mastermind Workshop Waitlist here:  the Live Long and Well Jumpstart

Key Topics Covered:

1. Understanding Health Headlines:
   • Should you believe a health headline?  How do you decide whether it is likely to be true, or not adequately based upon evidence?
   • Common examples of sensational headlines and their flaws.
2. Nine Essential Questions to Evaluate Headlines:
   • Is the article published in a reputable outlet by a science writer?
   • Was the headline based on actual scientific studies or just an expert's opinion?
   • Is the study published in a peer-reviewed journal, or was it just presented at a meeting?
   • What journal was it published in, and what is its impact factor?
   • Who conducted the study, and where?
   • How large was the study population?
   • What type of study was it? (Randomized controlled trial vs. observational vs. model-based.)
   • Was there an editorial discussing the study’s limitations?
   • Does the headline sound "too good to be true"?
3. Hierarchy of Evidence:
   • From most likely credible to least likelycredible:
     1. Meta-analyses.
     2. Randomized controlled trials (RCTs).
     3. Observational studies.
     4. Case series.
     5. Expert guidelines.
     6. Individual expert opinions.
   • Explanation of each and when to trust them.
4. Examples of Health Studies:
   • Intermittent Fasting and Heart Risk: Why the headline about a 91% increased risk of death was flawed.
   • Meal Replacement Shakes: Insights from a Chinese randomized trial and its limitations.
5. The Problem of Data Manipulation (P-Hacking):
   • How over-analysis of databases can lead to misleading conclusions.
   • The importance of recognizing correlation vs. causation in studies.

Takeaways for Listeners:

• Use the 9 Questions Framework to critically evaluate health headlines and articles.
• Understand that the type of study (e.g., RCT vs. observational) significantly impacts its credibility.
• Remember that sensational headlines often oversimplify or distort study findings.
• Stay skeptical of small studies or ones with vague methodologies.

Engage with Dr. Bobby:

• Have a confusing health headline you’d like Dr. Bobby to analyze? Send it in!
• Take the health type quiz at DrBobbyLiveLongAndWell.com to better understand how your approach to wellness influences your perception of health information.
• Don’t forget to leave a review on Apple Podcasts, Spotify, or wherever you listen!

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In this episode, I dive into a new way to think about wellness—your unique Health Type. Unlike traditional advice that tells us what to do to stay healthy, I explore how we approach our health, which is just as crucial for long-term well-being. By understanding your personal Health Type, you can make lifestyle choices that align with who you are, making it easier to stick to routines and prioritize what truly benefits you.

Take the Health Type Quiz here:

Join the Mastermind Workshop Waitlist here:  the Live Long and Well Jumpstart

Key Points:

• The Concept of Health Types: Just as each person has unique health goals, we also have unique ways of approaching health. Understanding your Health Type helps tailor your wellness plan to suit your personality, motivations, and lifestyle.
• Why Health Type Matters: Whether you’re driven by evidence, need simplicity, or seek balance between life and wellness, knowing your type allows you to set realistic and sustainable health goals. It's not one-size-fits-all; it’s about finding what works for you.
• Introducing the Five Health Types:
  1. Holistic Health Hacker - Comprehensive, curious, and often data-driven, these individuals optimize every area of health.
  2. Single-Minded Achiever - Focused on specific areas (e.g., fitness or nutrition) but may overlook other health aspects.
  3. Purposeful Path Planner - Knowledge-seekers who can feel overwhelmed by too many health options and may struggle with decision paralysis.
  4. Contentment Creator - Health needs to fit around their lifestyle, valuing balance and ease.
  5. Hopeful Health Seeker - Persistent, often dealing with chronic issues or setbacks, and needing encouragement and support.
• Health Types Are Fluid: Your Health Type isn’t static; it can change with life events, new health challenges, or aging. Recognizing this flexibility can help you adapt when your approach to health needs to shift.
• Take the Quiz: To identify your Health Type, try the quiz at DrBobbyLiveLongAndWell.com. This quick quiz provides personalized insights and recommendations based on your unique approach to health.

Key Takeaways:

• Discovering your Health Type can make wellness more attainable and enjoyable, helping you make informed choices that fit your life.
• Embrace flexibility in your wellness journey—health needs can evolve, and understanding this can help you support yourself and others.
• Start by taking the quiz to gain clarity on your Health Type and apply its insights to live long and well.

For more personalized guidance, resources, and episode recommendations based on your Health Type, make sure to visit the website and let me know your thoughts. Let’s take this journey together toward a healthier, more fulfilling life.

Join the Mastermind Workshop Waitlist here:  the Live Long and Well Jumpstart

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Managing your health is a team effort, and partnering with a good doctor is essential.  We’ll explore what defines a productive visit and a meaningful doctor-patient relationship.  Today, it is typical to wait weeks to see your primary care doctor and months to get a specialist visit.

1. Why You Visit Your Doctor: Different Types of Visits

• New Symptoms: When you’re feeling unwell and need answers.
• Ongoing Care: Managing chronic conditions like high blood pressure.
• Annual Check-ups: Routine screenings and vaccinations.
• Referrals: Accessing specialized care when necessary.
• Building a Relationship: Establishing trust with your doctor, which is crucial for long-term care.

2. What Makes a “Good” Doctor?

• Qualities to consider: clinical expertise, communication skills (ability to explain, to listen, to focus on you), empathy, and whether they take a holistic view.
• The role of the doctor as a “quarterback” who coordinates all aspects of your care.

3. Considering the Doctor’s Office and System

• Factors like insurance networks, appointment scheduling, and the ability to connect with your doctor’s office between visits.
• Importance of a patient portal for streamlined communication and easy access to test results.

4. How to Find a New Doctor if Needed

• asking for recommendations from other doctors or trusted medical professionals.
• Utilizing reviews, training history, and online directories to narrow your search.

5. Preparing for a Doctor’s Visit

• How to make the most of your visit by sending questions in advance and understanding the doctor’s time constraints.
• Practical tips on handling additional questions and arranging follow-up visits to maximize care without overwhelming the appointment time.
• Consider telehealth  visits for ongoing care or to have time to ask additional questions

7. Should You Consider a Concierge Doctor?

• Explanation of concierge practices and the benefits they offer, such as longer appointment times, same-day availability, and personalized care.
• Pros and cons of concierge medicine, especially for patients seeking more accessible and comprehensive care.

Key Takeaways

• Enhancing Your Doctor Visits: By preparing ahead and understanding your doctor’s time constraints, you can improve the quality of your visits and be able to answer the question that you are happy with your doctor.

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Are seed oils the dietary villain social media makes them out to be, or is this just another food fear fad? Join me, Dr. Bobby Dubois, as I unravel the truths and myths surrounding seed oils like canola and safflower. 

There are NO randomized clinical trials comparing people who eat a diet with seed oils vs a diet consisting of non-seed oils like avocado, coconut, or olive.  Since we lack the key studies that we desire, I explore the topic based upon the following questions:

1. Are corn, peanuts, and the vegetables that produce these seed oils bad for you? (no evidence to support this concern)
2. Is the problem getting the oils out of these good vegetables (the extraction and denaturing process)?  Likely not.
3. Is it the contents of the seed oils themselves harmful (e.g., the omega 6 polyunsaturated fats)?  Our bodies need omega 6s and the studies that switch folks from saturated fats to seed oils show no risk of heart disease (and maybe the opposite). No evidence they they raise markers of body inflammation, and don't increase the risk of diabetes.
4. Is the harm related to the heating of the seed oils? Heating seed oils can produce potentially harmful compounds, but so does grilling a steak or salmon.
5. How much seed oil do we consume as we cook food?  Not a lot. 70% of the fat we eat comes from meat (fish, beef, chicken) and not added oils.
6. Are we blaming the wrong food?  Likely this is the key issue as cheap seed oils led to the production of yummy, highly processed, calorie dense foods.  And the problem lies there....
7. Avocado or olive oil costs 5 times what canola/corn oil costs.  Is it worth the cost to switch from seed oils to these non-seed oils? A

Take-home messages:

• i don't fear seed oils
• where they can be a concern is reusing oils over and over in a deep fat fryer where potentially worrisome compounds can accumulate
• If you have symptoms that bother you, perhaps do an N-of-1 trial of removing them from your diet.

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Heart disease is the number one cause of death in the US; we understand the risk factors for it, and there are 7 key steps you can take to reduce that risk. Here is a risk calculator that will give you your 10 year risk (and test how that might fall as key problems are addressed).
1. Treat the treatable causes like hypertension, high cholesterol, smoking, diabetes, and obesity.
2. Get exercise:  the most powerful way to reduce your cardiac risk based upon key studies. And more exercise leads to additional benefits.
3. Optimize your sleep.  Studies show benefit from getting 7-8 hours/night, and having sleep regularity (similar sleep times each night).
4. Think about your nutrition. weight control impacts risk of diabetes and risk of heart disease.  The story on type of fats is complex with no differences shown in studies of low vs. high fat diets. 
5. Add some mind-body work to your life.  Although there are no long term studies demonstrating that yoga/breath work/meditation lowers mortality, short term studies show that yoga reduces blood pressure (an important cardiac risk factor)
6. Consider taking a sauna:  studies are pretty clear that taking a sauna (perhaps 3x/week for 20' each time) is associated with lower cardiac risk of sudden death.
7. Build and maintain strong social relationships. Large differences in mortality between those with and without strong social relationships.

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It used to be when you got sick, you were advised to "take it easy".  But, does the evidence support this approach?  And, it isn't just an academic question since, on average, we get 2-4 colds/year and many of us will have an episode of low back pain.  And, how about COVID?  Rest or stay active?

1. Low back pain: a key randomized clinical trial showed that prolonged bed rest did not do better than usual activities.  Now we advise patients to continue activities.

2. Moderate exercise does not lessen (or worsen) cold symptoms.  But, exercise may reduce the number of colds you get.

3. Sauna use doesn't make the cold go away faster but may reduce the number of infections that you experience.

4. COVID-it appears that exercise may reduce the likelihood of fatigue, anxiety, brain fog if you do get long COVID.

5. Multiple Sclerosis-previously it was feared that exercise might worsen the disease.  Recent guidance is to be physically active.

Reach out to Dr. Bobby:  www.DrBobbyLiveLongandWell.com

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In this episode, we explore wearables and self-monitoring tools like step counters, sleep trackers, and continuous glucose monitors (CGMs). We'll dive into the science behind these devices and share how they can help you gain insights into your health, track progress, and personalize your wellness journey. We discuss the value of self-monitoring, backed by scientific studies, and how these tools can help motivate behavior change.

Key Topics:

1. Step counters (smart watches, FitBit)
   Studies have shown that this feedback helps increase amount walked, but only if you continue to use them.  
2. Home Blood Pressure Monitoring
   Using a home blood pressure monitor, I learned that my blood pressure is higher in the morning, helping me adjust my medication timing. A review of 52 studies found that home monitoring improves blood pressure management. However, it may only be effective if used consistently.
3. Sleep Trackers and Better Sleep
   Sleep trackers like the Oura Ring can help you monitor and improve sleep habits. Studies have shown that using devices like Fitbits, paired with sleep education, can improve sleep quality. Personally, I’ve found that tracking sleep has revealed important insights into how alcohol and consistent sleep schedules affect my sleep length/quality.
4. Continuous Glucose Monitors (CGMs)
   CGMs are not just for diabetics—many people use them to personalize diet and exercise. Studies show that CGMs improve glucose control when meal plans are personalized based on individual glucose responses. For example, I learned that pizza doesn’t spike my blood sugar much, but popcorn does.

N-of-1 Trials and Personalized Health
Wearables enable N-of-1 trials—personal experiments to find what works best for you. Whether it's testing the effects of sleep habits, exercise, or dietary changes, self-monitoring helps tailor interventions to your body’s needs, offering a personalized approach to health.

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Have you ever wondered why weight loss seems so elusive despite following strict diets and exercise routines? Obesity rates have skyrocketed, and we are eating more, likely due to 3 key factors:

• portion sizes are larger than ever before, often doubling what we ate 30 years ago
• the foods on our plate are more calorie dense than ever
• Foods we buy often have the perfect combination so that we crave them:  fats, carbohydrates/sugar, and salt (chips, pizza, ice cream)

My key thoughts on losing weight include:

• All diets can work, and ultimately no approach wins out over all of the others (e.g., keto, intermittent fasting, vegan, Mediterranean).  Ultimately, weight loss is about the number of calories consumed vs. burned.
• The new GLP-1 obesity drugs have taught us that eating too much is not just about will power--folks who struggled all their lives to lose weight, instantly feel more full and less hungry once starting them.  These drugs also help folks lose about 15% of their body weight

Evidence based strategies that might help you to lose weight

1. Be more aware of portion size and how many calorie dense and "craving" foods you eat (fat/carbs/salt).  For me, portion size has been the key.
2. Choose a diet that works for you.  And switch them up.
3. Give your brain time to adjust (20-30') before eating more.  That satiety lag is real and if you start with small portions and wait, you may feel full and satisfied.
4. Protein (and fat to a lesser extent) helps reduce our hunger.

Perhaps try an N of 1 study on yourself with some of the strategies above.

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Our bodies are 60% water and water  is really important.  But, It is not clear the origin of drinking  8 glasses of water per day. There were no studies that scientifically show that this number is the correct amount.  I vote that it is an "urban myth."  Good report summarizes important information about how our body uses water

But, water is crucial for us, just not that mythical amount.  Our body uses water in the following ways:

• urine to excrete byproducts of what we eat (perhaps 2-3 glasses of water per day needed)
• respiratory loss (perhaps 1 cup/day)
• "insensible loss"-sweating to maintain body temperature (wide range depending upon temperature--2 glasses of water/day up to 1 gallon or more)
• stool perhaps 1/2 cup of water per day

My take on the scientific evidence:

1.        The body is amazing at controlling our water balance.  Trust it!  There is no evidence based reason to focus on getting 8 glasses of water each day.  And, we get substantial fluids from our food/morning coffee/milk or sodas at meals...

2.        If you are thirsty, drink.  If your urine has gotten much darker, then perhaps drink.  Otherwise trust your body
3. these observations don't apply if you have kidney disease or are elderly.  Ask your doctor.

Tasty water "tidbits":  drinking extra water each day...

•  does not seem to make our skin look young and full (might hydrate it a little but not clear if it looks better)
• does not seem to affect our joints/cartilage (no evidence found here...)
• does not reduce dry eyes
• probably doesn't help us eat less 
• DOES reduce the risk of recurrent urinary tract infections

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• Approximately 40% of the risk for cognitive decline is preventable through lifestyle changes and proactive measures.
• Nearly 7 million Americans are affected by Alzheimer's, with numbers expected to double in the coming decades. It's the sixth leading cause of death, costing the US around $800 billion annually.
• Not Inevitable: Cognitive decline is not an inevitable part of aging, as demonstrated by figures like Barbara Walters and Henry Kissinger, who remained mentally sharp well into their later years.

Part 2: Strategies That Work

1. Exercise: Regular physical activity is associated with a 28% reduction in the likelihood of Alzheimer's. Dancing, in particular, has shown benefits due to its combination of physical and mental engagement.
2. Sleep: Adequate sleep (around seven hours per night) is crucial, with poor sleep increasing the risk of Alzheimer's by 68%.
3. Smoking: Smoking cessation is critical, as smoking is linked to 5% of dementia cases.
4. Blood Pressure Control: Managing hypertension can greatly reduce the risk of cognitive decline
5. Obesity and Diabetes: Both conditions are associated with an increased risk of dementia.
6. Sauna Use: Regular sauna use correlates with a reduced risk of dementia, with benefits increasing with frequency of use and time/session.
7. Hearing Loss: Treating hearing loss may lower the risk of cognitive decline by maintaining cognitive stimulation.
8. Alcohol Consumption: Reducing alcohol intake can decrease the risk of cognitive impairment.
9. Social Engagement: Maintaining strong social connections is associated with a reduced risk of dementia.

Part 3: Strategies That Don't Work

• Omega-3 Supplements: No substantial evidence supports their role in preventing cognitive decline.
• Brain-Focused Diets: Diets like the MIND diet have not shown significant benefits in reducing cognitive decline in clinical trials.

Part 4: Unclear or Emerging Strategies

• Probiotics, Viagra, and Multivitamins may have benefits.
• Brain Training Games: While they may improve specific skills, there is limited evidence that they prevent general cognitive decline. Newer approaches have some promising results