February 14, 2024
During the meeting, various topics related to health, particularly osteoporosis, diabetes, and nutrition, were discussed.
1. * CGM Discussion:**
- Dr. Doug discussed Continuous Glucose Monitors (CGMs) and their use in practice for understanding carbohydrate tolerance. An affiliate company, NutraSense, was mentioned for their app and dietitian team.
- Ashley, an RD and coach who previously worked for NutraSense, will join a future meeting to discuss CGMs in detail.
2. **Liftmore Study:**
- Liftmore trial, which studied the effects of high-intensity resistance training and impact on bone mineral density.
- The trial included exercises like back squats, overhead presses, and deadlifts, emphasizing the importance of proper form to avoid injury.
- The study also involved impact training, described as an assisted pull-up followed by a controlled drop to the ground.
- impact training or alternatives like vibration plates or osteogenic loading to complement resistance training for bone health.
- The concept of high intensity was clarified as lifting weights at 80-85% of one rep max for 8-10 reps.
3. **Participant Questions and Experiences:**
- Experience with resistance and impact training, leading to significant bone density increases. He asked for a variety of exercises and impacts for long-term maintenance.
- The importance of progressive overload and the need for caution with impact training. He mentioned a program developed with Dr. Trubi that includes a few well-studied impact exercises.
- Evaluating trainers for osteoporosis exercises and the safety of OsteoStrong sessions. Dr. Doug advised that there is no specific certification for osteoporosis training and to ensure the trainer has experience with the population.
- Positive experiences with OsteoStrong and the use of vibration plates.
- The impact component of exercises given her vertebral fractures. Dr. Doug emphasized the need for some form of impact or loading while being cautious.
- challenges with severe osteoporosis and finding safe impact exercises to strengthen spine.
- concerns about lifting heavy weights due to a history of SI joint problems and discussed alternative exercises like single steps on stairs.
4. **Nutrition and Diet:**
- saturated fat and insulin resistance. Dr. Doug expressed skepticism about the claim that red meat causes diabetes, citing the carnivore community's experience with reversing diabetes despite high saturated fat intake.
- Dr. Doug advised that those with insulin resistance or diabetes should focus on a carbohydrate-restricted diet and not worry about discussing diet with doctors who may not be well-versed in nutrition.
5. **Full Script Access:**
- Participants should have access to the Full Script dispensary for supplements. He suggested creating a list of recommendations for the group and encouraged participants to let the team know if they need specific items added.
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Dr Doug: Well, good afternoon on the East Coast, everybody.
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Thomas Schellberg: How's everybody doing?
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Nancy Mandowa: Afternoon
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Dr Doug: afternoon?
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Dr Doug: Alright! Everybody got here early.
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Dr Doug: Alright! Let me just change my name. Sorry we're in a jacket a little bit ago, and I am still freezing.
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Helen: You said you took a plunge, a cold plunge.
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Helen: a cold plunge. I've heard of those.
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Dr Doug: They are fun. I want to mute everybody.
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Dr Doug: Figure out where that noise is coming from.
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Dr Doug: I don't think it's you, Nancy. Okay.
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alright. So I'm gonna get our list pulled up here. I was chatting with
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Dr Doug: Julie, who is actually on the call.
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Dr Doug: But I was chatting with Julie earlier about the volume of questions. And, we're going to try to
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Dr Doug: We're trying to answer all the questions. But basically, what we're gonna try to do is sort of condense them into topics. And address some broad topics as our question list is a little out of control.
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Dr Doug: Couple of things.
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Dr Doug: Let's see a couple of things right out of the gate.
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Dr Doug: I wanted to mention. Oh, we have
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Everybody's familiar with a Cgm. Or a continuous glucose monitor. We talked about it a little bit before, hey, Alan?
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Al K: Yeah, I know what it is.
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Dr Doug: So we've had some requests of people asking to talk about Cgm's
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Dr Doug: and
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Dr Doug: we use them in our practice. Excuse me
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Dr Doug: for people that want to learn more about their carbohydrate tolerance. They're great devices. We have an affiliate with. The company nutrasense. They're one of the first direct-to-consumer. Companies. They've got a great
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app and a dietitian team that helps people to understand the data.
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Dr Doug: But rather than me, talk about that. And I'm actually gonna have one of our Rds and coaches. Ashley, talk about that! She used to work for nutrasense, so she helped them to develop their protocols.
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Dr Doug: So she's gonna join us in a couple weeks, I think when I'm out of town.
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Dr Doug: and she'll actually run through Cgm, all the the details about it. And then you guys can ask her directly some information and questions about Cgm. so we're going to do that. In the meantime, if you want to check out that affiliate. It's it's on the the Hsn site
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Dr Doug: under affiliates.
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Dr Doug: And we get a we offer a discount to people that wanna use do that from Hsn. So that is there. If you're in the
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Dr Doug: if you're in the desire to learn more about glucose.
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Dr Doug: The other thing that we had talked about doing was to review the Lyftmore study. Was that still something that people want to do?
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Dr Doug: Yes, lots of people. Okay. So
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Dr Doug: I should be able let me pull up the publication, but I'll just start talking about it while I'm doing that. So the Liftmore trial
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Dr Doug: was. It's actually a series of publications. But it's based off of one main study and what they did was essentially look at high-intensity, resistance, training
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Dr Doug: and impact. And that's the part that people forget a lot
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Dr Doug: is a number of a number of publications that came out of this. Let's hear
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Dr Doug: lyft, mar. Yes, that is what I meant.
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Dr Doug: there we go!
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Dr Doug: There we go. So this is actually this is a follow up alright.
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Dr Doug: Well, I won't waste your time to look.
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Dr Doug: because there are a bunch of follow ups in here. But the original trial
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Dr Doug: looked at like, I said, high intensity training. They had 3 specific exercises. And then they did impact training as well. So the 3 exercises, as I remember it, are back squat. So that's a bar across your back an actual like.
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Dr Doug: you know
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Dr Doug: Bar Bar Barbell across your back, back, squat overhead, press probably with the same bar, and then dead left. So you know, 3 exercises that require good form in order not to get injured. And that's a really important part to remember. I see a lot of people
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Dr Doug: in our in our Youtube comments.
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Dr Doug: Thomas.
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Dr Doug: I see a lot of people on a Youtube comment saying that they follow the recommendations from the lift. More trial. And let's be clear. They're not. They're not recommendations. And you definitely have to do that with good form. So making sure that somebody's watching you do that, and that the form is good. I do those exercises, and I still send my videos to my trainer, because something like a deadlift is so hard to do. Well.
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Dr Doug: it is like a millimeter shift to have the right angle so that you're not putting excess stress on your back, etc. So they really have to be done well, and then the the other component of that
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Dr Doug: was the impact and the impact side of it
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Dr Doug: is they describe it in the study as an assisted pull-up, basically onto a pull up bar and then letting go in hitting the ground.
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Dr Doug: And so they describe a little bit about like keeping your knees relatively not totally straight, but semi extended, I think, is the term they used with the idea that you're gonna try to put as much shock through your bones as possible. And also something that should be done under observation and guidance. So
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Dr Doug: I like the study because it showed that you can increase bone mineral density with high intensity.
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Dr Doug: exercise and with impact. But I think the impact part has to be remembered in there, too. And so that's why we now have in our program. We say, look, you should be doing some kind of impact training
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Dr Doug: or using a vibration plate or doing osteogenic loading through osteostrong or biodensity. I think, adding that stimulus is gonna help, the resistance training to do a lot more work. If that makes sense.
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Dr Doug: One other thing. I'll Matt before I take a question on it when they say high intensity. The reason why they're using that term
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Dr Doug: is they're talking about the amount of weight versus, or compared rather to the their maximum output. So if you, they describe it as I think they use 80 to 85% of one rep. Max is what they did. So what that means is a one rep. Max, is the amount of weight that you can lift
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Dr Doug: one time.
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Dr Doug: and they would help people to determine that. And then they would increase their the amount of weight that they're lifting up to 80 to 85% of one rep, Max, and then their goal was to do. I believe it was 8 8 to 10 reps of that weight. That's pretty heavy, if you consider you know what somebody's one rep. Max is
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Dr Doug: and then training with that consistently. So this is why, when I say I recommend people to lift weights. I'm not talking about a 5 pound dumbbell. I'm talking about lifting heavy weights, but doing so in a way that you don't get injured is really important.
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So that's that's the Liftmore trial. Any questions on that?
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David Callen: Yes, I'm
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David Callen: so go ahead. I you know, before I found Liftmore, I ended up following a physical therapist, and she had given me high resistance and also suggested impact. So I was left to myself. But what does that mean? So I ended up doing the heavy ropes and jumping into, you know, a squad jump.
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My numbers ended up being and I mean there's a whole series. Wood chops reverse wood chops.
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David Callen: Those types of things with a 20% string
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David Callen: bone density increase on my spine and in about 6 to 10% on the hips. Then I got into Liftmore.
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David Callen: So I'm looking at this long term going
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David Callen: well, what happens when I max out at my body weight doing back squats and dead lists, and I still need to increase. And that leads me more to the impact portion of the things where you're not carrying any weight, but maybe 2 hand, you know, 10 pounds worth of weight or rucking, or something. So
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David Callen: per impact. So my question is, is there a list that you that's been developed. So we have some variety of exercises and impacts to be able to continue on long term through the 3 to 5, 1020, however long we live.
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Dr Doug: Yeah, so great great question, David and I. You also. I'll address your 4.2 times body weight. Comment in the chat. And then, Diane, I'll actually address. I'll address your comment in there, too, about the chat as well. So we'll talk about. We'll talk about etiquette there, we really don't have any formal etiquette. But thank you for raising your hand.
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Dr Doug: Okay, so so, David, great great questions. And first let me say, too, I'm gonna go back to your statement. I'm saying, did you say you increased your spine? Bmd, 20 in a year? Yeah, I went from a 3 point to a 2.4.
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David Callen: That's true. That's tremendous.
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Dr Doug: by the way, so congratulations, thank you. And and so then the follow up to that is to say that you felt like you needed to do more, that my question is
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Dr Doug: that trajectory is really good. Why do you feel like you need to do more.
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David Callen: Well, see, I didn't know it was really good. I had one doctor say, well, that's not very good. Well, on another doctor say you only had a 50% chance of increase. So I was getting, you know, II was getting warm. Fuzzy's from the physical therapist, but I didn't know what the expectations were.
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David Callen: I? You always avoided back squats and dead lists, my workout just because but then, when they said, Those are the ones. Okay, I'm going to do all that's fine. So
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Dr Doug: well. And I and I like, I like those exercises for the specific intent of loading the spine. And we've seen that in our patients where
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Dr Doug: people who've done a lot of like leg work or loading the lower body will see improvement in femoral neck, bone, mineral density, but then not see improvement in spine, and I really think you do have to load the spine in one way. So overhead press will definitely load the spine through the scapula right back squats, gonna load the spine, awk awkwardly through the spine. But deadlift is really loading the spine. I mean the amount of the amount of push.
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Dr Doug: If you were to draw the force. Vectors going through this bind on a dead lift is really really high, which is why it's scary.
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Dr Doug: But I think so many people back away from these exercises because they look scary. But again, if done right with the right weight you can build up over time.
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David Callen: and I found that it took a while to get through the scariness, and then I began to find that I would go to my Max up to 10, but then, as I increased weight, I would back off, and I found that that gave me a little more strength when? When I added the additional weight.
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David Callen: yeah, so that leads to a great, a great follow up, which is, how do you?
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Dr Doug: How do you continue to progressively overload over time?
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David Callen: By the seat of my pants. I've got a physic. I don't know what you call it's great big, long name, a physicologist coach, and talk about that. And so what I've developed is it's usually I'll stay about 2 to 3 weeks on. Say, I'm
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David Callen: squatting and deadlifting 1, 45, for example.
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David Callen: until I feel I can do it 10 times with with confidence, and then I will either increase 5 pounds or 10 pounds.
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Dr Doug: Yeah, in the. And eventually you'll reach a plateau
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Dr Doug: which is okay. And this is where adding in other things like different types of impact training. Can be really helpful. But honestly, if you're on that trajectory, I wouldn't be in a rush to change that much. You know what I mean, there there are. There are only so many ways to do impact without potentially hurting yourself. We actually just created a program with with Dr. Trubi, our exercise physiologist, but it only has, like 4 things in it.
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Dr Doug: Because when you look at the research, there aren't that many things that are well studied. There's the Lyftmore trial. There's a couple of studies that look at different ways of jumping off of a plyometric box.
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Dr Doug: but that's gotta be done again under pretty close observation to make sure that you're doing it right. And you're not gonna injure your knees or other joints. So I think we have to be cautious there. But then that's also why there is the Osteogenic loading side and vibration plates can do the same thing without risk, you know. Okay? Cause. I started doing jumping squats. And then after a while, I've done, you know, up to 100 and stuff. Then. So I added, 10 pounds worth of weight.
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Dr Doug: Yeah, I just it. That scares me with joints to do loaded impact.
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David Callen: Because, like, if I did that, my knees would scream at me, you know.
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David Callen: Yeah, so I would. I would keep the impact separate from resistance training. And that's a little bit different than say, walking with a rock sack or walking with a weighted vest. Because that's not really impact. That's more.
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Dr Doug: it's more strength training. It's more resistance. It's more, you know, including your spine under, I did separate activities. So yeah, great question. And then the the last thing you mentioned there, too, is that that 4.2 times body weight. So that comes from Jake wishes research. And that's why I think that you really can't
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Dr Doug: rely on resistance training alone to build bone.
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Dr Doug: It's indirectly going to impact the bones through building muscle. But you're right. The the literature shows 4.2 times body weight is required to get a stimulus of bone.
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Dr Doug: Nobody's going to lift that much. Not even the most powerful lifter in the world can do 4.2 times their body weight in any exercise.
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So it's not. That's unrealistic. But that's why we need impact
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Dr Doug: alright, and just on the same topic. And then, Diane, I'll I'll get to you. So Lauren was asking, what about other types of deadlift? So, yeah, there are. There are a lot of ways to do.
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Dr Doug: There are a lot of ways to do. Dead lifts. Rdls are more like a hinge type of deadlift. Romanian deadlift, single leg. My coach has me doing all kinds she loves. Gosh! She loves posterior chain work.
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Dr Doug: I've never done so many. Rdls and dead lips in my life.
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Dr Doug: But there's a lot of ways to do it in different ways. You're gonna stress your back in different ways. Yeah. So that's again, it's a trainer thing.
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Dr Doug: who's worse family? Who's family?
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Dr Doug: That's fine. We got a lot of people today. We got 2 screens.
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Dr Doug: Well, whoever family is, I'll get to that in a second about power plate. All right, Diane. Yes, please
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Dr Doug: unmute yourself and ask your question.
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Dr Doug: Sorry we have 2, Diane. So yeah, Diane Barkley.
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Dr Doug: Where'd you go? Oh, there you are.
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Thomas Schellberg: hey, Dan, I can't hear you very well.
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Dr Doug: Can anybody else hear, Diane? I can't hear I can't.
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Dr Doug: We can't hear you, Diane. Maybe try one more time, and if you can't.
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Dr Doug: No.
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Diane’s iPad: it's garbled.
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Dr Doug: Yeah, it's really garbled. So, Dan, I would either. You can log off and log back on and see if it's a zoom thing or you might just have to type it in the chat. Sorry about that.
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Dr Doug: Yeah, yeah, there you are. Hi.
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Dianne Barclay VT: I'm just really trying to gather information. I did start with the trainer yesterday and told her my goal was to be doing the movies and the lymphomore study.
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Dianne Barclay VT: But I turn that nest. I'm not necessarily getting the.
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She's not necessarily the right person, and I don't really know how to evaluate
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Dianne Barclay VT: a trainer, even though I've done weight training. And I've done for bodies for years and years and years. So she gets this excitement
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or as it did.
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Thomas Schellberg: okay.
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Dianne Barclay VT: Gary, so
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I'm just trying to figure out what
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Dianne Barclay VT: you know. II think, from my recollection, reading the study because I've read so much in the last 2 weeks
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Dianne Barclay VT: is that they actually work to them up to it over the course of 4 to 8 weeks before they were doing.
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Dianne Barclay VT: Okay. So I'm just.
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Dianne Barclay VT: I'm trying to get a little more guidance, and also you mentioned both Ostia Strong. We set myself up for a a session next week, and now I'm really nervous about that, because I'm afraid about the joint issue. And
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Dianne Barclay VT: yeah, I maybe I'm going too much too fast. So
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Dr Doug: that's fair. Yeah. So you're right in the in the Liftmore trial. They did work them up over. I don't know how long it was, but it was over a period of several weeks, so you're absolutely right
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Dr Doug: as far as knowing what your trainer knows, boy, there's really no way to know. There's no like real certification specific for osteoporosis. I would just ask them if they have worked with this population. And and then it's almost a little bit of a double edge sword, because if they are used to working with people that are that are not willing to lift heavy because they have osteoporosis, and it could actually work against you, cause they may not be willing to actually load you appropriately.
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Dr Doug: So it it's really tough. And we hear this all the time, and there is no real certification that I'm aware of that would reassure me that someone is well trained.
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Dr Doug: Unfortunately.
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Dr Doug: as far as Osteo strong and joint issues.
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Dr Doug: Remember, the thing about osteo strong is that or biodensity I always try to use, both because both are the both are very similar, but osteo, strong and biodensity are both machines that will push
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Dr Doug: only as hard as you can push.
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Dr Doug: so it's not going to push in. Anyway, that should be uncomfortable for you, and if you have any pain in your joints as you're doing it. You just stop pushing, and the the force will go away. So
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Dr Doug: it's all generated. Excuse me, it's all generated by you.
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Dr Doug: That make sense.
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Dianne Barclay VT: Thank you. Okay, yeah. We check it out. If you have close access to one then I would definitely check it out.
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Dr Doug: Yeah, yeah, once a week. It's not too far. Hi, Don.
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Dawn Aragón, PhD: So I've been to. I did my free session at Osteo Strong. And it was really awesome. I'm gonna start it after I get my rem. So it's it's an investment. I think I put on slack how much it costs and the breakdown if you want to go get that. But I was. It was. It was a odd experience, because when I was done I didn't really feel like I did anything
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Dawn Aragón, PhD: and I maxed out every machine. So it was like I did the Vi plate for a warm up. Then I did, and then the Vi plate after I mean, honestly like I love the vibe plate more than anything during the whole like hour session that I was there.
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Dawn Aragón, PhD: But yeah, I'm gonna give it a go. I mean, if if what they say about I you know, I just gotta try it. And what it's a. It's an investment for a whole year. It's about 2 grand.
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Dawn Aragón, PhD: but once a week, so it turns out to be like $38 or something. $35 a session with, you know.
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Dawn Aragón, PhD: if it's works, it works, you know.
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Dr Doug: and it's so. What I like about it is it provides that stimulus to grow bone without the risk of impact. So it's it's nice that way, or let's talk about Diane from Diane's ipad.
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Diane’s iPad: Hello, I've been doing that look more resistance exercise is quite a while under the initial guidance of a trainer, and I've been up going to a gym since before was 20 lifting weights so familiar and comfortable. My challenge is the impact because
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Diane’s iPad: I apparently have 6 vertebral fractures depending on whom I'm actually talking to. So when I talk to a radiologist and a physiatrist, and so so that's that's my challenge isn't like. And I'm hearing what you're saying. And I'm hearing. There's a discussion with David. How well he's
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Diane’s iPad: progressed, and that impact is is is clearly in there for that and I just feel right now I'm not doing any impact aside from heel drops
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Diane’s iPad: for that reason, and I do this squats with the bar in front of me and that chest and but II you know the others are doing fine, and I understand that I'm okay to do that. And the bioterrorist and radiologists have said, I am fine. Who I? What's your like with regard to the impact? I have no access to Osteo strong. I live in Canada.
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Diane’s iPad: so I that these things are challenged. I'm gonna go out of province to get a Np test and and hopefully around rems in the in the near future. But just from that impact
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Diane’s iPad: component, like, if if you can't really do it. And I and I've seen the video where they're they're kind of grabbing onto that bar and then going down. And I was doing that initially, and then thought, Oh, I better! And then I found out about the 600 fractures, and thought, Oh, God! Did I do that? Then
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Diane’s iPad: there's no understanding as to when they could have happened. And the radiologist said, he's kind of thinking. Maybe it's just the way my spine is. I can't ignore it, though, because I've never had any pain. I've lower lump. I have lower back pain. But in the thoracic. I've not had pain. So why, just totally stay away from anything. Impact?
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Susan J: no.
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Dr Doug: but it's but it's it's tough. So III get it? And the sort of what's scary about the vertebral fractures that you didn't know happened. Is that like you don't know like that? I just do it today, like I don't know. But that's that fear and anxiety that goes along with having osteoporosis, which is really frustrating. But remember to you have to load, to build bone.
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Dr Doug: so if you, if you hide from it, you stay away from it. Then you you will continue to lose bone marrow density. So
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Dr Doug: you shouldn't continue to just stay away from it and just do resistor training that you can do. I think you have to add either one of those 3 things, either osteogenic loading which you don't have access to vibration, which is a significant investment or impact which you can do for free, but you have to be. Do very carefully. Right?
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Dr Doug: So then different exercises, heel drops, heel drops are super popular, because again, they're free, very unlikely to hurt yourself doing a heel drop, and it's a good starting point, just not well studied, and it's probably not delivering enough stimulus, but it's more than nothing
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Dr Doug: right, so heel drops would be great if you have access to them. Do them a couple of times a day, and there's no reason not to right and then the next step from there, I think what Nick put next in our protocol is jumping off of little ply metric boxes so you could do that. It doesn't have to be a fancy plyometric box.
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Dr Doug: but you could do that literally just off of the bottom. Step at at at your house right? So like step is 8 inches, and so literally just both feet off of the step. Letting your heels hit the ground would be the next step up.
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Dr Doug: If you slowly increase over time, you'll continue to increase bone density and strength. If you do it slow enough you shouldn't fracture. I obviously can't guarantee that.
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Dr Doug: But you have to do something otherwise. It's a downward spiral.
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Dr Doug: it always is. That's the nature of life, right? So we gotta fight. That.
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Dr Doug: Does that make sense? Yes, thank you so much. II appreciate it.
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Dr Doug: Couple of things in chat. Who is that? Oh, Susan! Hi, Susan!
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Susan J: Hi, Doctor Doug, I just wanna add, for the woman interested in Osteo Strong. I'm located in Florida, and I spoke with a insurance guy last week who is trying to convince me to switch from straight Medicare to United American because United United because, he said, Osteo Strong is recognized through united healthcare, and they have significant discounts.
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Dr Doug: Yeah. So that's what David put in the chat actually, is that united for someone's Austria? No, it's fine. I appreciate you sharing that. So, and I last time I talked to
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Dr Doug: Kyle
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Dr Doug: z last name the CEO. They were working on that relationship with different insurance companies. Cause it, it should be covered by insurance. I mean, it is a it's recognized, I think the challenge that they're gonna have is that there? There aren't enough big studies. But if United's paying for it, that's a that's a great precedent. So that'd be amazing.
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Nancy Mandowa: The other thing is.
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David Callen: your physical therapist sometimes will have a vibration plate.
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Dr Doug: Oh, they were.
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Dr Doug: So who's talking? Alright, David, yeah, right? So you put that in there. And that's that's that's true. Physical therapists. Chiropractors often have them as well. In fact, chiropractors also, it's harder to find, but the biodensity of machines, which is the still actually the company that makes the Osteogenic loading machines for osteo strong kind of an interesting history there. But the biodensity machines
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Dr Doug: also made by the same company that makes power plate. The biodensity machines are usually gonna be found in chiropractic offices. And so that's another place that you could look. It's harder to find, because you would have to know of the place to look it up. I don't think that biodensity
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Dr Doug: has a like a find, a find, a machine
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Dr Doug: website that I'm aware of they should
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Dr Doug: alright. And then Don put in there a question about the drop. I don't remember, Don, in the study, how high they said that drop was 24 inches is not insignificant, so I don't know if it's 24 inches or not
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Dr Doug: to be clear. And then Julia popped in a question about activities like kickboxing and Zumba.
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Dr Doug: I think it's gonna be 2 variable, Julia, as far as you know, are they? Are they good? If you're doing a lot of jumping on one leg, and you're hitting things is that impact it is. But I don't know how good it's gonna be, because everybody's gonna be doing it differently. And all classes are gonna be different. So I think they're fine. I would just put them in the category of like extra stuff but have a solid program outside of that.
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Dr Doug: And then someone whose username is user user user
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Dr Doug: was asking about using wider weights on dead lift due to back problems. And it's total that's great.
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Dr Doug: You're loading it every little bit that you loaded is good. And so, even if you're starting with, say, just a bar. If you have a 45 pound bar, and you're doing a 45 pound bar totally fine. If you're doing it with Dumbbell, I don't wanna talk down about, you know, 5 pound dumbbells, but a deadlift you can do. I forget what the name of
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Dr Doug: Dumbbell deadlock. Sorry. But if you do them with with dumbbells. You can actually shift your weight back a little bit by sliding the weights around your legs. And you can change the the load that way, and you can do it with very lightweight and then work your way up to. So I've also I've been playing with those.
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Dr Doug: there you go. Okay? So any other questions. Before I turn to our list, our overwhelming list
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Al K: for squats, I use a hack, squat machine.
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Al K: Is that enough load
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Al K: to? Yeah, totally so. But the so your hack, squat machine is your back is supported. Is that right? Yeah. My back supported, and it slides on 45.
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Dr Doug: Yeah. So it's that's definitely gonna load your your your femoral neck, your hip. But it's not gonna load your spine. And that's why I think that there's benefit to doing a traditional back squat or like Diane, like you were saying, actually doing a front squat's interesting, too. I think front squad's really hard to do except to have this really awkward sort of elbow arm position. But back, squat's gonna load your spine and your hips.
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Al K: So I think it's a hacks. What's great on the machine. You can really load your pips safely that way. But you're not going to load your spine. I just look to protect my back.
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Dr Doug: Yeah, well, that's fair. But you gotta load your back, too. And then Thomas was asking any options. If you can't use dumbbells, you to thumb pain, and that's really really common, Thomas, so that especially this joint here at the bottom of your thumb, that's called the basil or joint or basal joint arthritis. It makes it really hard to to grip.
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Dr Doug: And, Diane, yeah, this one, actually, if you can do this yourself, Diane, if you actually take this bone and and grind it like that. If that really hurts, then you have arthritis in that joint.
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Dr Doug: Yeah, so it can make it hard to to grip things. And so, yeah, so Don, put in there, what about like using a band or using a you could even use like a wrist strap can be helpful to. So if you look at like weight lifters that have the straps that they, you know they wrap around the bar. Oh, I just activated my camera. If they have straps or they wrap around the bar, then they can hold heavier weights that way. You could try that. II can do that. So I'm pretty much not using my thumb on some heavier weights when I use the straps
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Dr Doug: can be a little awkward to get used to, but wrist wraps can do that, too. So yeah, there's lots of ways around it. You don't need those darn thumbs
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Helen: just us in the month. Let's see, I think, Helen, yeah, you were up before Diane. So what you got, Helen fracture, which was months ago is doing pretty well.
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Helen: And I've been using bands at my Pts recommendations. So
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Helen: I have a whole bunch of things which what really helped us trying to get the core muscles around the spine strengthened.
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Helen: That's when I really made a a we'll call it a leap in my condition.
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Helen: I do use some weights but very safely, very carefully.
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Helen: And I'm trying to find exercises where I can do impact in a very safe way
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Helen: and load my spine, because that's
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Helen: both. By hips and spine are osteoporosis advanced, and I need to straighten my my spine is, but especially
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Helen: I know it's weak. I can feel it. My muscles are stronger than my spine. so I could lift a lot more, but my spine pays the price. It gets sore.
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Helen: So I stopped by back off on the strength of the of the bands, and Just and and II work out a couple of times a day just
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Helen: short short workout, so I can get as much in as I can.
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Dr Doug: Helen. How, when you say severe osteoporosis, how severe! Do you know what your T. Scores are.
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Helen: Well, we'll say that minus 3.5
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Helen: in in all areas 3.1, maybe, and 1 one hit and 3.4 or 5 and another. But this fine is 3.5 minus 3
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Dr Doug: right? And have you been able to get a rems? Is that an option for you?
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Helen: Well gotten. Dexa and I had a bunch of rems and the rims
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Helen: unbelievably we're negative 2.5 all over.
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Dr Doug: Difference, right? And was your what was your phone or your what do they call it?
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Dr Doug: The fragility score is the word. Oh, yeah, II don't know. Off the top of my head. I have the records, of course, but
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Dr Doug: so the reason why I ask is that we we it's so easy to get into that mindset of. Oh, my gosh! My spine is fragile! If I do this, you know my spine is sore. Right. You those are the words you said. My spine is my spine. It's sore. Remember, though, that bones don't have nerve endings, except for in the periodium, which is the soft tissue lining around the bones. So your spine is not gonna get sore.
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Dr Doug: The joints could potentially get sore. Arthritis can hurt. But probably what sores them is actually the muscles. So there are so many tiny. When you do anatomy of the spine, these tiny little muscles that connect to vertebrae vertebrae to vertebra
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Dr Doug: so you can get a lot of different ways of getting sore, but unless you like I would, I mean, I would verify. Make sure you're not actually getting a little compression fractures. But as long as you're not continue to load it, and then just treat that like muscle soreness, you know. So those are all the modalities, like like a cold plunge.
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Dr Doug: for example, but, like rest, ice coal plunge, if you have access to it. And then stretching is really great for the spine, too, as long as you're doing it the right way. But if you're if you're Dexa, I'm sorry if your Rems T. Scores were at negative 2 5, especially if you have a good fragility scores, then you don't have severe
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Dr Doug: osteoprosis. Right like you have. You have borderline osteoporosis. Well, it surprised the person that did the rims? Because, you say, I,
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Helen: yeah. The fact that you have this fracture.
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Helen: I I'm really surprised that you have, because it said I think it was a minus 2.4. So it's between osteoporosis and osteopenia. So yeah, I'll look up that fragility score. Look up at the fragility score. And really what you're looking is to see. They'll have a chart on there, and just look to see if it's in the green or in the yellow. I've never seen one in the red.
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Dr Doug: You know. UN. Unfortunately, we never really know. But I've I've learned to trust the Rems over the dexa because there's so much variation in Dexo.
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Helen: Okay, well, thank you.
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Dr Doug: Yeah. Diane.
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Dianne Barclay VT: okay, quick question on the vibration plates. I watched your video interviews with.
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Dianne Barclay VT: I forgot his name, the inventor of meridine, and then power play thing, and then your
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Dianne Barclay VT: conclusions, or whatever
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Dr Doug: I travel a lot. And the thing that was attractive about meridian is, I thought I could probably fit it in my suitcase.
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Dianne Barclay VT: So is is it? Is that still valuable, or am I kidding myself?
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Dr Doug: Is this being recorded?
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Dr Doug: so I know I can. I can honestly. My opinion of it is what I said in the third video is, is is my true opinion, which is, I can't make sense of the the 2023 meta-analysis that concluded that the type of vibration in meridine was the only thing that can be recommended.
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Dr Doug: It just doesn't make sense to me that they would come to that conclusion when the only study that they included of that type
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Dr Doug: was Ruben's own work.
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Dr Doug: And so you know that unfortunately, that means that I'm I'm sort of calling into question his study. But I think you always have to call into question a study where someone has that kind of financial bias.
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Dr Doug: I'm in the middle of the same process reviewing the algae studies, you know, and and the challenges associated with those studies. And they're real. But that's a whole different conversation. So I would say, unfortunately, you know, is that device going to do you any good.
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Dr Doug: I don't know. I just it's not gonna hurt you. And I think that's the big takeaway right? The meridian is safer. Probably without a doubt. But the question is, is, does it do enough? And I think if you're you know, if you're looking for for, for tibial bone changes
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Dr Doug: or ankle benefits, then sure. But is it going to make its way to your hip and your spine? I don't. I just I can't say with confidence that it is concerned about.
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Dr Doug: you know. And so then I asked him, you probably saw me ask Reuben. I was like, well, can you sit on it like, what if you sit on it? And it's going right through the issue to yourosities of your spine like, would that do it? But it's never been studied, so I can't. I can't say that that's smart.
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Dr Doug: Yeah.
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Dr Doug: it seems like that would work. Let me just take a quick peek in here. So a couple of questions. So Nancy had a question about Si joint problems
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Dr Doug: an hl, a so what she's asking and I'm happy to just talk about this, Nancy, unless you wanna get more information there. But when you have Si joint, which is where the the sacrum, which is the bottom of the spine and the ilium, which is in the the pelvis
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Dr Doug: where those 2 come together. That's a really weird joint. The anatomy of it has all these different contours
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Dr Doug: understand how that joint was made over time. But when you have Si joint pain that could be really, really debilitating, it's supposed to move in there. When you have this thing called HLA, it's basically an inflammatory arthropathy, meaning that the joints get inflamed and they kind of stop moving. They sort of get stuck. That's a challenge. And so you're gonna have to try to find ways to load the best you can. But you might just have to accept. There are likely some limitations, cause you. If you load your Si joints, it's probably gonna hurt.
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Nancy Mandowa: Well, can. I? Can I just add all the all the and I'm sorry I'm I'm not really clear on the etiquette of this slack. I haven't attended all the sessions. So are we using the raise hand feature of of zoom, we we haven't in the past, but I'm happy to, for you guys to use it. One page. Actually, I think we do have to use it, because I can't tell
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Dr Doug: who's on the second page. So let's let's say that as of. Now, if you have a question, raise your hand.
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Nancy Mandowa: I don't even know how to raise my hand to those. So that's why I haven't used it. It's down under the reactions. You just use the raise hand under reactions. And that just means like to putting your hand up in class. Ii just wanna ask about the Si joint thing I mean, all the all the talk about lifting weights is kind of like depressing to me, because it seems like.
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Nancy Mandowa: I'm in basically remission after severe problems with Si joins. And for 10 years I haven't had any problem. Until recently I did injure my Si joint by lifting something. II didn't lift it properly, but the thought of lifting heavy weights is not appealing to me because of that. So it seems like the only options I have are
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Nancy Mandowa: as you're strong, or or other things to strengthen my muscles. I'm yeah. I can lift weights with my arms and things like that. And and I've also been doing this step thing. I think I mentioned it in one of your video comments that I've been doing this single steps on stairs where you just use one leg and one leg and one leg, and it really stresses the leg. It's not necessarily really impact. In a sense, it's just like continued stress on the leg.
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Nancy Mandowa: And I did have an increase in my phone density. Whether that was completely coincidental or not I don't know.
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Dr Doug: Well, I think it's all part of it, and that's where people get. I see a lot of. There's some interesting back and forth, especially on Youtube.
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Dr Doug: Very spirited conversation there. But people will really dial in on the one thing that they think is making a change, and they really get behind that. But really it's it's all the things. And right and hopefully all the things are helping you in the same in in the same direction, and it's not forward and backward. But that was likely helping with muscle. And if you can do that and not stretch your Si joint. That's fine
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Dr Doug: for people that have those kinds of challenges to have a lot of people that have, you know, degenerative discs, and you know they have. You know, other lumbar spine issues and can't load
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Dr Doug: we just have to work around it, you know, and figure out, what can you do? What position can you do? And so like? So say, for example, like a deadlift like, oh, if I can't do a traditional deadlift! What if I do like a staggered stance? You know? Rdl, it's gonna load the spine. Similarly, it's gonna take less.
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Dr Doug: Put less stress on the the Si joint. So that's where just working with somebody who can be creative and help you to do that is really helpful. But you just. We have. We all have limitations in different things.
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Nancy Mandowa: Thanks.
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Dr Doug: So let's see here. So candy was asking about different vibration plates. So I've I set myself up for this
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Dr Doug: by making these videos. So I have, I think, been told about probably every vibration plate that's on the market across the world. And so what I'll say about this is the you have to look from the manufacturer. The the 2 main things you're looking for is the frequency, which is how fast the machine moves.
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Dr Doug: I guess there's 3 things, the frequency, the displacement, which is how far it moves. And then also what type of motion it has. So I'll do the last one first. So from a type of motion perspective, you have 2 different types. There's teeter totter. So it's basically a single plate with a fulcrum in the middle, and it does this versus vertical movement where the whole plate is going up and down. So both meridian and power plate and by plate, which is what they have at at Osteostrong.
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Dr Doug: They all go up and down vertical displacement. So it doesn't matter where you stand on the device. You're gonna see the same displacement.
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Dr Doug: That's the biggest difference between that type of displacement versus the teeter totter, where, if you're standing right in the middle, very close to the fulcrum. It'll be a tiny amount of displacement if you stand on the edges, though it's like you're you're rocking back and forth like crazy.
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Dr Doug: So that's why I don't like those devices. Most of the less expensive devices are the teeter-totter form, because they're cheaper to bank.
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Dr Doug: And so you have to figure out what those things are. If it's a teeter tire device, I don't recommend it because there's no way to know what that displacement is, and I think that vibration can be damaging if it's too much.
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Dr Doug: So most of the devices that are out there that are are well designed are between that 2 to 3 of displacement, and they should be between 30 and 35 hertz of frequency.
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Dr Doug: So 30 to 35 times per second, they're moving up and down 2 to 3 of displacement, and that puts you in that like 3 to 4G's of force.
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Dr Doug: and depending on which studies you read.
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Dr Doug: and it can be over the map. But that's generally what we're looking for. Power plate fits that. That's why we support power plate because they make great devices, and I know the company. So I've talked to the CEO and the Cmo. And I think they make a really good quality device, Viplay, which is, which is what they have at Osteo. Strong is probably as good. I just don't know the company, but outside of those devices there really isn't a company that I would get behind, because I just don't know enough about them.
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Dr Doug: And there's a lot of them.
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Dr Doug: Alan, you're asking about weighted lunges.
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Dr Doug: Yeah, so waited lunges. If you don't have, I can't do them because I have a big toe joint arthritis from years of doing stupid stuff. I can't. I can't get in that position very well, but yes, if you can do it, or what I prefer to do, what I can do
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Dr Doug: is using back foot being supported on like a step or up on a bench. If you can get up that high and doing a split lunge or squat that way, cause that's gonna get both front of your leg and back your leg and glutes all the same time. And if you do, those weighted with thumb bells. It's legit. You can go as heavy as you possibly can that way
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Al K: I do lunges and the bridges waited along with the hack squad.
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Dr Doug: Yeah. So yeah, so you're gonna load. And any anytime you're carrying.
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Dr Doug: actually having this conversation.
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Dr Doug: I know so many guys that are getting into. Excuse me, weightlifting later in life like 40 s. 50 s. 60 s.
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Dr Doug: And one of the things that's consistent.
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Dr Doug: that this group, this doesn't happen for women thankfully. But the men where where they're starting to lift with a lot of heavy dumbbells is they get like, get these big traps, and it's they're, you know. They're all proud of their like traps. But what's funny is, none of them are lifting traps. It's just from supporting, like holding your scapula back and holding dumbbells.
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Dr Doug: That just shows you how much load you're putting through your spine. Because all of that, you know, if I'm holding 40, 45 pound dumbbells.
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Al K: It's 90 pounds through your spine with every exercise that you do. So anytime you're doing an exercise where you're holding something with your arms, even if they're down by your side, you're still loading your spine. So all those things are gonna have benefit. One last question on the the presses. It's not tall enough. II sit, you know, on my bench
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Al K: and I do. My back is supported a little bit. It's just lean back, you know, about that bar when I do my presses with dumbbells.
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Al K: cause I can't stand up and do.
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Dr Doug: Yeah, that's fun. Interesting. What if you could you kneel if I had like a pad on the ground. Yeah.
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Dr Doug: cause II think ideally, you would want cause you don't care about what happens below the knee so ideally. If you can load through your hips in your spine in that position, if you could kneel, I think that'd be better alternatively. If you're sitting on a bench. You're still loading your spine. But then you're not getting anything out of your hips because you've reduced you've taken the hip. Join out of that equation
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Dr Doug: that make sense.
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Dr Doug: Let's see here.
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Dr Doug: So Lorna was asking about the cheapest power plate. Yeah, their personal power plates, the little black one. Yeah, so it is same thing. 2 to 3 of displacement. 30 hertz. I think it only has one setting. That's the biggest difference between that one and the move. The move is the one that I have. It has like 6 settings. I only use the one, so the only difference between them, then, is that this? The move will go for 9 min straight. The personal cuts off at 60 s.
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Dr Doug: So the 60 s timer, which is what you're supposed to do, anyway, which is why they do that. So on it for 60 s it turns off. You take 60 s off, and then you stand back on it for 60 s. Do that 5 times. That's your 10 min on the vibration plate.
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Dr Doug: And then Don dropped in here the from Jake. Wish medical. Yeah. And I like that, too, Don. II think so. I emailed him about getting us a band that was lighter than the white band, and he didn't write me back. I think I may have may have
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Dr Doug: overloaded my capacity to ask him questions, but so what? We've been getting a little bit feedback on is that that white band is just too
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Dr Doug: too heavy. It would be the right term for some people in this population. So there were some alternatives, though, Dawn and you had some recommendations for bands that you found that were lighter, that worked.
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Dawn Aragón, PhD: Yeah, I have to buy a whole
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Dawn Aragón, PhD: set of bands for myself, because the ones that came with the X bar I couldn't. I couldn't budge, and they were just head way, too much force. So once I got new bands it it took me a while just to get the form and watch the videos. And there was a learning curve for it. But in the end the logic behind loading it when you're at the strongest
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Dawn Aragón, PhD: versus when you're at your most vulnerable join is brilliant. I mean variable resistance. Training has been out there forever, but especially whoever mentioned the thumb issue, it would resolve honestly. And for some people who are have injuries, or are fearful of their spine. It's also a good way to control the load and get a lot more force with with less possible risk of injury.
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Dawn Aragón, PhD: I mean, II love the thing. It's at home. It's a little. The price point is a little high for mine, but
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Dawn Aragón, PhD: if you can swallow that price point and and buy new bands I can. Anyone wants to direct. Message me, I can tell you. Serious deal. I'll put it in the chat. Serious deal is where I got my bands, and I really my husband and I do it. We used to do it 4 times a week. Now we just do it twice a week. I'll push in a whole day, and I do other stuff, even though, is the only thing you ever have to do in life.
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Dawn Aragón, PhD: I don't quite agree with that, but it is awesome. It's an awesome addition to get that that resistance without using dumbbells or barbells. Variable resistance with the X bar, I think, is a pretty brilliant home option.
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Dr Doug: Yeah. And I so I use it. I have one. I don't use it at home, because I have such a nice gem setup but I do use it when I travel, and so I that will. It fits in my suitcase. I don't take. You can't take it on a plane. So that's limiting. I, Jake, wish apparently got in trouble with that with the faa. But you can. You can definitely travel with it in other ways. And I anytime I drive somewhere. I always take it with
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Dr Doug: But yeah, if you could Don, maybe in the in slack, too. I think they're already in there. But maybe even like PIN that somehow.
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Dr Doug: Very cool. yeah. And, Helen, if you know what those companies are, the bands that they recommended, that would be great, too.
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Dr Doug: Yeah, Diane, you can put it in checked luggage. You can't take it on the plane, because it's it's a weapon
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Dr Doug: fair enough, fair enough. Okay, let's why, we like didn't even get to the question list. So this is why we need to do this a different way
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Dr Doug: somewhere. Okay, oh, full script. So everybody should have access to our dispensary and full script. Right?
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Dr Doug: So. I learned this. I think they changed this. It used to be that as long as you had access to full script, then you could look through their entire list. That obviously isn't true anymore. So I think I have to put it in a recommendation specifically for the group. I could do it individually, but that's not scalable. So if there's something that you want to see in full script, just let the team know. And we can create like a, we can create a separate list. And we can just add stuff in there.
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Dr Doug: What I did, though, is, I put all of the things I basically just created like
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Dr Doug: a a vague
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Dr Doug: bone health list that has a a complete list of things. If you were to just do. Wanna do a complete program of supplements. That's what it is. Obviously, it's not customized. But all the things that you want are potentially available through full script. So those are all in there again. If there's something else, maybe we should create Don, if we can create a a channel and slack on that maybe even call like a full script recommendations.
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Dr Doug: And then I can have somebody in the team go in there as me, and basically just create a list for that. So we can get whatever we want. Cause you guys get a discount, does it? Ship? Internationally? Helen's asking. And I think the answer is, maybe, but it might depend on the product. So that's
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Dr Doug: I would say, Helen, actually just log in and see see what happens when you try to do that.
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Dr Doug: So that's full script.
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Dr Doug: and I don't know if if any, if everybody's probably not aware. So Don is very active in Hsn. And our
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Dr Doug: slack channel so dawn and and are working together so we can have somebody in there who can act as a champion for everybody who's Nhs. N, so you'll see her all over the place. So that's very intentional that she is helping people to organize, and she is tasking the other. Oh, team members with things that potentially could go to somebody else and make sure that they're seeing those cause as we get more and more people in there. It's harder to keep track, as you know.
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So we really appreciate Don for that. Thank you, Don
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alright.
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Dr Doug: What else
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Dr Doug: we have like 6 min.
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Dr Doug: great question, David, when it's appropriate now, is appropriate.
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Dr Doug: Let's talk about that now.
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Dr Doug: There we go. Okay. So David has a question. He sent it just to me. So no one else can see it. But it's okay. basically. No, no, no, no, it's fine. This is, these are tough topics. So this is a topic about saturated fat and insulin resistance. So
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Dr Doug: this is actually a really controversial one. I did a video on that Harvard study, showing that red meat causes diabetes. Anybody see that study or headlines? Probably more likely.
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Dr Doug: So I did a whole video on that, because for me the the entire concept that a
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Dr Doug: food product that has no carbohydrate can cause diabetes is just stupid.
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Dr Doug: however, in the study. Smart people from Harvard, who wrote the study. They propose different mechanisms which potentially red meat could cause insulin resistance, and therefore diabetes and II think that they are just for the most part they're interesting mechanisms. So specifically, one of the things they said is, does saturated fat, which is, gonna be higher in animal sources of protein
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Dr Doug: does saturated fat increase insulin resistance, and so the mechanism they propose. I don't remember the actual details of it. It sounds interesting. but clinically, what we see is that it's not true, because
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Dr Doug: if that were true. the carnivore community would have been slow resistance in diabetes.
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Dr Doug: right like they're literally main lining red meat all day long, 200 300 400 grams of protein a day, hundreds of grams of saturated fat.
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Dr Doug: and yet diabetes is reversed almost universally in that population.
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Dr Doug: So II can't believe that that would be a primary factor. There, go ahead, David.
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David Callen: so does that. But that's does that.
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David Callen: I mean, I ran into this and tell you why you walk in. The doctor says, don't talk to me about Keto diet. It's it's a really bad word that says, Okay, okay. Mediterranean died. I'll do it. But
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David Callen: I've had a long history of this and there. And so when I first got the whole oh, you better look at do a diabetic diet! And when I went to the glycemic index I noticed everything has saturated fats in. It was
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David Callen: good for me.
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David Callen: And so I went that route, and then I get this curve thrown at me. Well, that's they create insulin resistance, and I go. Ho! Now, what do I do? So what I'm hearing you say is Nada. It doesn't.
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Dr Doug: It doesn't make sense clinically. So there is there. There might be a subgroup of the population that has an inflammatory response which may have an impact on insulin resistance.
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Dr Doug: That's why I think that you have to choose. So where I see people really run into issues even on carnivore is, they say, well, I'm not going to worry about my cholesterol. I'm going to eat as much dietary fat as I want, but I'm also going to eat
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Dr Doug: bread every now and then in some sweets and some a bunch of apples and pineapple.
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Dr Doug: You can't do both, or you got to pick a side. So I think if you're gonna do that, you're gonna go that route. And what you should tell your doctor is. You're eating a a mildly carbohydrate, restricted Mediterranean diet.
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Dr Doug: IE. Keto and and just do what you need to do. Cause doctors are not trained in nutrition. They're they just are parrots. The repeating what they've been told for the most part, not all doctors, but most doctors.
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Dr Doug: So don't even talk to your doctor about diet. Actually, it would be probably a better choice.
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Dr Doug: cause they don't know. They don't have time
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David Callen: right so. But see, when I first got into this whole osteoprosis thing, I read well, you. There's a lot of fruit tomatoes, oranges, you know, all of this. And I, Barry said, Okay, I'll go for it. I mean, I like food doesn't matter what it is. I'll eat it and
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David Callen: So
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hmm!
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Dr Doug: So just what you're saying is, avoid the carbs. Make sure if you have a car that's high fiber. And this is. And this is for somebody who has insulin resistance and diabetes or prediabetes right? And and I see this all the time. People that get diagnosed with osteoporosis. They go online. They go to a Facebook group. They start eating more plants, which is not necessarily a bad thing.
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Dr Doug: But if you start loading up on too many carbohydrates, especially if you start reducing dietary fat and protein, because you're leaning more plant-based. Your diabetes is going to go haywire
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David Callen: because it's so. I can drink my whole milk
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Dr Doug: as long as you can tolerate dairy. I love dairy. Come on. I grew up in the county, has 10 million cows.
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Dr Doug: There you go. That's a lot of cows. Yeah, so I'm a I'm a big advocate of dairy. As long as it's non inflammatory you can tolerate the lactose. But yeah, it's a great source of saturated fat of dietary, fat of calcium, of lactoferrin, and the other
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Dr Doug: thing that's in basic or the milk basic protein and Mvp, so whole supplement based on that.
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Dr Doug: And red meat's fine. I mean, I grew up on a cattle ranch. So yeah, red meat is fine. But there is again that sub group that doesn't do well with with saturated fat. So there is a group, some genetic issues around the oh, like the snp of apoe. Have you heard of Apoe is not? That is.
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Dr Doug: yeah. Alan knows what that is. That's because Alan's a patient. So from a genetics perspective Apoe and some other Snps.
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Dr Doug: What are genetic variations?
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Dr Doug: will make you more likely to have an inflammatory response to saturated fat. And so that's where you could still consume whole fat milk. But you have to be careful from a saturated fat perspective. It's easily testable. And knowing which one of those alleles you have is actually really important, because then you would need to restrict saturated fat. You can still eat a car restricted diet and get your protein from animal sources. You just have to be cognizant of saturated fat intake.
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Al K: You need the bugs.
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Dr Doug: Don't eat bugs.
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Al K: not me, Allen. I'm not a cooking guy.
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Dr Doug: but think about that at scale, though, and this is thing these things like drive me bonkers is like, what would it be like to replace all animal protein with crickets?
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Al K: Where will we grow all those crickets.
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Dr Doug: How does that work?
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Dr Doug: And I don't wanna eat crickets. So, anyway. Alright, I have a patient right at one. Nancy, said Dr. Robert Blustig is a great source of information on insulin resistance. He's got a bunch of Youtube videos. Yeah, they're really good. I pretty much agree with everything he says.
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Dr Doug: okay, guys, this was fantastic. I think one of the things I'm gonna have, Julie. She's still on here. I'm gonna have Julie do is I don't wanna stop allowing you guys to ask questions. But clearly, we're not gonna be able to get through this question list. So
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Dr Doug: I think what I'm gonna have, Julie do is sort of combine can just condense them into topics, you know. So we'll have like a supplement day. We'll talk about different supplements like, I'm looking at the supplement list right now, and it's you know, Omega 6 is, and Full Vick and Hume and
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Dr Doug: some gut stuff. I looked up David, about B 6 induced neuropathy.
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Dr Doug: So many things to talk about. Kathy's got great questions about
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Dr Doug: these things. Anyway, we need to get into these things. They just need to be sort of like balked into a
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Dr Doug: different topics. And then we can just hit a topic if that makes sense. So alright I gotta run. Thanks. Everybody so good seeing you and this Wednesday at noon is is gonna stick. Cause if I'm out I'm gonna have team members substitute like Ashley for for cgm, so this is gonna be consistent. Okay.
