STEM-Talk

Back in early days of the COVID-19 pandemic, Dr. John Ioannidis wrote an article in March of 2020 questioning government statistics about the fatality rate associated with COVID-19. The backlash was swift and brutal and John’s reputation as one of the most influential scientists in the world took a beating. Today, John makes his second appearance on STEM-Talk to discuss his extensive research into the COVID-19 pandemic as well as the public shaming he received in 2020 for questioning the World Health Organization’s prediction of a 3.4 percent fatality rate associated with COVID-19. John also talks about his most recent peer-reviewed paper that looked at the age-stratified infection fatality rate of COVID-19 in the non-elderly population.  The study found that the pre-vaccination fatality rate for those infected may have been as low as 0.03 percent for people under 60 years old, and 0.07 percent for people under 70, far below the World Health Organization’s prediction of a 3.4 percent fatality rate. In today’s episode, John walks us through this paper, which was published in January, as well as what he describes as the U.S. government’s bungled response to COVID-19. He also discusses the importance of collecting reliable data in the future to guide disease modelers and governments before they make decisions of monumental significance like lockdowns. He goes on to share how he underestimated the power that politics and the media, or powers outside of science, can have on science. Over the past two decades, John’s research has earned him a global reputation as a consummate physician and researcher, which contributed to The Atlantic describing John in 2010 as one of the most influential scientists alive. He is a professor of Medicine, Epidemiology and Population Health as well as a statistician and professor of biomedical data science at Stanford University. Back in 2018 when we interviewed John on episode 77 of STEM-Talk, we talked to him about his 2005 paper questioning the reliability of most medical research. The paper, titled, “Why Most Published Research Findings Are False,” found that much of the medical science reported in peer-reviewed journals is flawed and cannot be replicated. The paper is the most citied article in the history of the journal PLoS Medicine and has been viewed more than 3 million times. Show notes: [00:03:16] Dawn opens the interview welcoming John back to STEM-Talk. his last appearance being in 2018. Dawn explains that when John last appeared on STEM-Talk in 2018, he was described by Atlantic Magazine as “one of the most influential scientists alive.” But in the intervening years, John became public enemy number one in 2020 after a paper he published questioning government statistics about COVID 19’s fatality rate. Dawn asks John if it’s fair to say that he has been on a rather rocky ride for the past few years. [00:03:54] Dawn explains that John was trained at Harvard and Tufts universities in internal medicine and infectious disease, and asks John what led him to study infectious disease. [00:04:54] Ken asks John about his initial thoughts in 2019 when he first heard the reports coming out of China about COVID-19. [00:05:52] Ken explains that in March of 2020, John fell into some hot water for writing a piece questioning the 3.4 percent fatality rate associated with COVID-19. John found this number to be inflated and wrote that while COVID-19 was indeed a threat, it did not behave like the Spanish Flu or a pandemic that would lead to a 3.4 percent fatality rate. Ken asks John how he came to this conclusion. [00:08:37] The article that John wrote in 2020 was titled “A fiasco in the making? As the coronavirus pandemic takes hold, we are making decisions without reliable data.” John argued in his article that the data collected in the first three months of the pandemic was “utterly unreliable.” He went on to write that no one had a good way of knowing how many people were infected and therefore how the pandemic would evolve over time. Dawn asks John what could have been done so that governments and health agencies could have more accurately estimated incidents of new infections, particularly in the early months of the pandemic. [00:10:19] Dawn mentions that John initially supported the lockdown, but only as a temporary measure, and that he was of the mind that after February of 2020, we had missed the window to nip the pandemic in the bud. Dawn goes on to say that John believed that if we had acted earlier and more aggressively with testing, tracing, and isolating, like in South Korea, that we could have significantly slowed the spread of the virus. Dawn asks if John still feels this way now. [00:12:53] Dawn mentions that John wrote that the bulk of the mortalities related to COVID-19 occurred in people with limited life expectancy rather than young people. Dawn goes on to say that John was criticized for this, accused of minimizing the lives of the elderly and was even referred to as a “heartless granny killer.” Dawn asks John to expand on his point that age predicts mortality better than comorbidities. [00:15:16] Ken follows up regarding the disproportionate infections in nursing homes, mentioning that, among other stories, New York City showed very negative outcomes in terms of nursing-home populations. [00:16:13] Dawn asks if John investigated the nosocomial spread of COVID-19. [00:17:53] Ken mentions that one of the things we heard early on in the pandemic, was talk of flattening the curve so that we wouldn’t overwhelm hospitals. Ken asks John for his thoughts about this. [00:20:04] Dawn asks John what he thought of the Great Barrington Declaration, a paper that questioned school closings, lockdowns, travel restrictions and other governmental responses to the COVID-19 pandemic. Dawn goes on to mention that one of the authors of that paper, Dr. Martin Kulldorff, was our guest on episode 132 of STEM-Talk. Dawn goes on to say that Martin and his co-authors recommended protecting senior citizens and others who were most at risk from COVID, while allowing young people and others who face minimal risk to lead their normal lives. Dawn asks John about the recommendations found in the Great Barrington Declaration. [00:23:26] Ken mentions that outrage propagated by social media and news sources became such a negative force that it shut down civil discourse in public and academic circles. Ken goes on to say that this led to harsh control over conversations regarding important topics. There were swift attacks against anyone who dissented with official narratives, no matter how well founded someone’s opinions were. Ken asks John about his experience now that he has being on the receiving end of these brutal attacks. [00:27:00] Ken follows up and agreees that the self-censorship among scientists with regards to COVID-19 has been severe and problematic. [00:28:33] Dawn brings up John’s recent paper published in January of this year in Environmental Research. Dawn explains that this paper points out that the largest burden of COVID-19 is carried by the elderly, but that 94 percent of the global population is younger than 70 years old, and 86 percent is younger than 60. Dawn goes on to explain that John set out to accurately estimate the infection fatality rate of COVID-19 among non-elderly people in the absence of vaccination or prior infection. Dawn asks John how he and his co-authors came together to work on this study. [00:31:45] Dawn mentions that John’s aforementioned study reported infection survival rates around the world. John found that wealthy nations had infection survival rates of 99.962 percent for those under 60, and 99.902 percent for those under 70. In poorer nations, however, the survival rates were even better: 99.992 percent and 99.988 percent respectively. Dawn goes on to mention that John and his co-authors speculate that lower obesity rates in poorer countries may have improved their survival rates, and asks John how the U.S. would have fared if the obesity rate was at levels more common in the 1970s or ‘80s. [00:35:08] Ken mentions that unsurprisingly the countries hit the hardest by COVID-19, like Italy and China, had two of the most elderly populations in the world. [00:38:09] Dawn mentions that John’s paper noted that 44 percent of the population had already been infected with COVID-19 before Omicron arrived in the fall of 2021. Because of this, John points out in the paper that an infection rate of 50 percent would have only caused modestly higher fatality rates than seasonal flu fatalities for those under 70. Dawn asks John to elaborate on this. [00:40:52] Dawn mentions that around the time John published his paper in STAT in March of 2020, the Imperial College of London predicted Covid-19 would kill 40 million people. [00:41:56] Ken mentions that miscalculations like the one by the Imperial College of London were unfortunate because they prompted lockdowns and other heavy-handed responses from governments. Ken goes on to say that John wrote in 2020 that we need data to inform us about the rationale of lockdowns, mask mandates and social distancing measures. At a minimum, Ken said, we needed unbiased prevalence and incidence data for the evolving infectious load to guide decision-making. Ken asks John for his thoughts about why this never happened. [00:46:34] Ken asks John what were some of the unintended consequences that resulted from lockdowns, school closures, and travel bans. [00:49:47] Dawn mentions that John has published dozens of peer-reviewed COVID-19 related papers. John has mentioned before that any scientific papers will have some weaknesses. Dawn asks John what, in hindsight, he sees as weaknesses in his papers. [00:50:41] Ken asks about John’s investigation into the recent study commissioned by the British nonprofit Cochrane that found no clear reduction in respiratory viral infection as a result of mask mandates. Ken mentions that the paper noted that the use of medical/surgical masks, including N-95 masks, were not effective in reducing the spread of acute respiratory viruses. [00:55:02] Ken mentions a Zoom call he was on with a government official who was alone in his house wearing a mask during the Zoom call. Ken discusses the gentleman’s response after he was asked about wearing the mask even though he at home by himself. [00:56:48] With respect to randomized controlled trials regarding the effectiveness of masks, Ken mentions that the media’s portrayal of such studies shows that the media does not understand statistics, and specifically the difference between relative and absolute risk. [00:57:51] Ken launches into a discussion about the education of journalists in modern times, and how education in journalism should include a sophisticated understanding of statistics. [01:00:24] Ken asks John what his thoughts are about the possibility of future pandemics and how this kind of situation might be handled differently. [01:02:50] Ken mentions the issues created by funding agencies during times of pandemic and other world shaping events. [01:03:41] Ken explains that trust, or lack thereof, in institutions and the media has turned out to be a key factor in people’s reaction to non-pharmaceutical interventions such as lockdowns and mask mandates and vaccine mandates. Ken goes on to say that surveys of trust are showing a substantial decline and offers that there may be strong negative consequences from this lack of trust in the future. Ken goes on to say that this trust could, of course, be reestablished through transparency and accountability and asks John if he sees this happening anytime soon. [01:06:28] Ken closes the interview asking John if there are any other COVID-19 studies he is working on or hopes to pursue. Links: John Ioannidis bio Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Dawn Kernagis bio

Today we have Dr. Barbara Thorne, a termite biologist and an expert on the invasive conehead species, a Central and South American termite that has invaded South Florida. Barbara is a research professor and professor emerita in the Department of Entomology at the University of Maryland. Since 2012 she has served as the Florida Department of Agriculture and Consumer Services science advisor on the state’s Conehead Termite Program. She also chairs the National Scientific Advisory Committee for the Conehead Termite Program. Barbara’s research focuses on the biology of termites, which are highly social insects that form complex colony structures. She earned her Ph.D. in Organismic and Evolutionary Biology in 1983 from Harvard University where she studied with the late Dr. E. O. Wilson, a renowned biologist and naturalist. Show notes [00:03:14] Dawn points out that Barbara is from Southern California and asks Barbara if she were a Valley Girl since she grew up in the San Fernando Valley. [00:03:42] Dawn mentions that it was wanderlust that sent Barbara from the West Coast to the East Coast for college and asks why she decided on Brown University. [00:04:14] After Barbara explains that she was originally not interested in science, Ken asks what changed her mind. [00:06:34] Dawn mentions that some kids grow up fascinated with bugs, but not Barbara, so Dawn asks what eventually triggered Barbara’s academic interest in insects. [00:07:58] Ken asks Barbara to elaborate on how Bug Camp and E.O. Wilson’s book “The Insect Societies”  motivated her to go to Harvard. [00:10:22] Dawn explains, for those who aren’t familiar, that E.O. Wilson was an American biologist who was recognized as the world’s leading authority on ants among other topics. He spent 40 years on the Harvard faculty and authored more than 30 books, including two that won Pulitzer Prizes. Dawn asks how Wilson became Barbara’s Ph.D. faculty advisor. [00:14:15] Ken asks why Barbara often refers to the time she was at Harvard as the golden age for research into social insects. [00:18:31] Dawn asks about Barbara’s initial goal for her Ph.D. dissertation, which was to investigate the evolutionary driver that created the sociality in termites, who are a completely different branch of insects from the classic social insects (ants, bees, and wasps). Dawn goes on to ask what Wilson thought of this idea when Barbara proposed it. [00:21:22] Barbara spent 15 years in E.O. Wilson’s lab and Ken wonders if she has a favorite story about Wilson. [00:28:29] Dawn explains that for Barbara’s postdoc research, she continued to expand on the work of her dissertation, and then began working in the field of applied termite biology and targeted applications for control. This was when chlordane, a powerful pesticide against termites, was pulled from the market. Dawn asks Barbara to talk about the significance of pulling chlordane from the market and how this created an opportunity for her. [00:31:30] Ken asks Barbara what led her to join the faculty at the University of Maryland in the early 1990s. [00:33:59] Dawn mentions that during Barbara’s time at Maryland, she investigated her hypothesis of accelerated inheritance as a driver for the evolution of eusociality in termites, following up this research in a 2003 paper in PNAS. Dawn goes on to explain that the paper provided experimental evidence for the powerful selective forces driving the evolution of eusociality in termites, a question that perplexed Charles Darwin. Dawn asks Barbara to talk about why Darwin was confused by the existence of social insects and how Barbara approached this question in termites. [00:49:16] Dawn mentions that Barbara expanded on the previously mentioned research with a study in 2009, using genetic markers to demonstrate that in merged colonies, offspring from both original, unrelated families can become new reproductives and even interbreed. Dawn asks Barbara to explain why this observation is important. [00:50:33] Ken explains that Barbara helped put together a TED-Ed video lesson last year that depicted a conehead termite queen as she begins her reign as one of the longest living insects in the animal kingdom. Ken goes on to mention that this video was a collaboration with Thomas Johnson Volda, and Ken asks how the idea for the video came to be. [00:53:20] Dawn explains that since September of 2012, Barbara has served as the science advisor for the Florida Department of Agriculture and Consumer Services, and is helping the state target the invasive conehead termite. Dawn goes on to mention that this species was the focus of Barbara’s Ph.D. dissertation research in Central America. Dawn asks how Barbara was approached to aid in handling this species invasion into Florida. [00:55:11] Dawn mentions that conehead termites have expansive tastes, which makes them a serious problem in Florida, and asks Barbara to give a sense of the damage that the conehead termites are causing. [01:01:34] Ken mentions the similarities between the current situation with conehead termites and the Formosan termite invasion into North America. [01:05:38] Ken explains that in Pensacola, the home of IHMC, the historical district has many homes built in the 1800s and early 1900s that are made from very strong, dense, old-school wood, the kind of wood that is harder for termites to get into. Ken goes on to ask if it is true that Barbara has described the cheap, fast-growing wood used in today’s structures as a kind of candy for termites. [01:09:14] Ken mentions that we recently had Barbara’s husband Dr. Ed Weiler on STEM-Talk, episode 148. Ken goes on to mention that Ed and Barbara listened to the interview together and Ken asks what she thought of Ed’s episode. [01:13:11] Dawn closes the interview asking Barbara what she and Ed get up to now that they’re both retired. Links: Barbara Thorne bio Reign of the Termite Queen video Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Dawn Kernagis bio  

Dr. Jeff Volek has been investigating how humans adapt to ketogenic—and carbohydrate-restricted diets for the past 30 years.  Today, Jeff returns to STEM-Talk to discuss a growing accumulation of studies supporting a ketogenic diet as a way to improve metabolic health, as well as research confirming the relative safety of dietary fat. Jeff is a professor in the Department of Human Sciences at Ohio State University. He is known for his research on the clinical application of ketogenic diets in the management of insulin resistance and type-2 diabetes. His research particularly aims to understand individual variability, including how well-formulated ketogenic diets alter fatty acid composition, lipoprotein metabolism, gut microbiome and overall metabolic health. Jeff has performed several prospective diet studies that demonstrate that well-formulated ketogenic diets result in substantial improvements in (if not complete reversal of) metabolic syndrome and type-2 diabetes. In today’s episode, we talk to Jeff about: — How a well-formulated ketogenic diet results not only in weight loss, but also leads to substantial improvements in insulin resistance as well as improvements in a number of cardio-metabolic biomarkers associated with metabolic syndrome. — The remarkable progress that has been made in the science of low-carbohydrate nutrition in the past 30 years. — How Jeff’s research has expanded to look at a well-formulated ketogenic diet’s potential in the treatment of mental health, heart disease and cancer. — An initiative Jeff is conducting to address how the poor metabolic health of the nation is impacting our military troops and therefore poses a significant threat to the future of the military and our nation’s defense. — We also ask Jeff about his thoughts on the recent popularity of fasting and time-restricted eating.  We then ask what his own daily dietary intake looks like. Show notes [00:02:48] Ken opens the interview welcoming Jeff back to STEM-Talk. Ken mentions that Jeff, who appeared on episode 43,  has perhaps published more research on the ketogenic diet and its effects on humans than anyone. While most STEM-Talk listeners are familiar with Jeff’s research, Ken points out that many people might not know that Jeff was once an accomplished powerlifter, achieving impressive numbers for his body weight. Ken asks Jeff what his best lifts were, and if his background in powerlifting inspired him to study exercise physiology. [00:05:25] Dawn mentions there is a paradigm shift in terms of low-carb diets and the public perception regarding the relative safety of dietary fat.  Americans have long been led to believe that saturated fats lead to obesity and heart disease. Dawn goes on to explain that in the last 20 years, there has been a steady accumulation of studies supporting carbohydrate restriction as well as the relative safety of dietary fat. Jeff addressed this in a paper in Science titled “Dietary Fat: From Foe to Friend?”, and also a paper in the Journal of the American College of Cardiology titled “Saturated Fats and Health: A Reassessment and Proposal for Food Based Recommendations” Dawn asks Jeff to talk about this research and what listeners should take from it. [00:08:37] Ken mentions that Jeff at one point in his life demonized fat, and was a strong advocate for low-fat diets. Ken asks what changed his mind on this issue. [00:10:04] Dawn mentions that when Jeff was interviewed back in 2017, he was in the early stages of launching Virta, a company that was founded in 2014 to address the type-2 diabetes epidemic that we’re seeing in the United States and across the world. Dawn asks Jeff to explain what type-2 diabetes is and how it’s different than type-1. [00:13:36] Ken explains that diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower-limb amputation. In light of this, Ken asks Jeff if we know how many deaths can be annually attributed to diabetes. [00:14:54] Dawn explains that Virta’s website describes the company’s program as “blood sugar control without the drugs.” Virta works with diabetics to not only lower their blood sugar, but help them lose weight, eliminate their need for insulin and other medications, and restore their metabolic health. Dawn asks Jeff to give an overview of Virta and the progress being made in its endeavors. [00:17:57] Dawn mentions that Virta has had a number of recent papers and trials that have demonstrated some amazing results. With a paper in Nutrients last year that reported on the results of a two-year pilot study that highlighted the effectiveness and sustainability of Virta’s intervention in reversing a variety of metabolic conditions. Dawn goes on to explain that Virta was able to help 97 percent of its prediabetic patients in the two-year study to avoid type-2 diabetes. She asks Jeff, as the chief science officer of Virta, for his thoughts about the successful outcomes being seen by Virta’s trials and studies. [00:19:48] Ken shifts to talk about Jeff’s work at Ohio State. Jeff joined the university in 2014, and in the past decade has established the Volek Low-Carbohydrate Laboratory, which specializes in dietary carbohydrate restriction and nutritional ketosis. Ken asks Jeff to give an overview of the lab and the research that goes on there. [00:22:56] Dawn mentions that Jeff’s lab also has a team of registered dietitians who work with clients on a variety of approaches to low-carb and ketogenic diets. Dawn asks Jeff to talk about the services the lab provides. [00:24:59] Ken explains that a lot of people have the belief that a ketogenic diet is only about losing weight. Jeff, however, stresses that a well-formulated ketogenic diet results in not only weight loss, but also substantial improvements in insulin resistance and improvements on a number of cardio-metabolic biomarkers associated with metabolic syndrome. Ken asks Jeff to talk about the wide range of benefits people experience as a result of a ketogenic diet. [00:28:15] Dawn asks Jeff to talk about the symposium he and Ken as well as some other folks put together at Ohio State that addressed the remarkable progress that has been made in the science of low-carbohydrate nutrition. Jeff goes on to describe some the key takeaways from the symposium. [00:31:20] Dawn asks Jeff to talk about his lab’s research into cancer and how research has shown that the majority of tumors use glucose as their primary fuel source. [00:34:01] As a follow-up, Ken mentions the STEM-Talk interview with Colin Champ that centered on ketogenic cancer research. [00:34:17] Ken asks Jeff about a couple of pilot ketogenic diet cancer studies that are currently underway in his lab, as well as a pilot study that is specifically looking at advanced-stage breast cancer. [00:37:15] Dawn mentions that while weight loss is a common outcome of consuming a ketogenic diet, a question that has been rather controversial in the research community is whether there are metabolic improvements as a result of carbohydrate restriction that are independent of weight loss. Dawn explains that Jeff published a study last year in the Journal of Clinical Investigation Insight that found more than half of your obese study participants who were suffering from metabolic syndrome no longer met the criteria for metabolic syndrome at the end of a four-week low-carb diet, even though the participants didn’t lose any weight. The results demonstrate that irrespective of weight loss, a low-carb diet improves a host of metabolic problems. Dawn asks Jeff to talk about this study and the significance of its findings. [00:41:27] Ken mentions that Jeff’s lab is currently doing work with the military, going on to mention that Jeff’s lab received funding a few years ago to look into whether a ketogenic diet could help the military deal with its ongoing challenge of obesity among the troops.  The subsequent study showed that participants lost an average of 17 pounds after 12 weeks on the ketogenic diet, and as a group, the participants lost more than five percent of their body fat, and almost 44 percent of their visceral fat, and had a 48 percent improvement in their insulin sensitivity. Ken asks Jeff to go into further depth about this study and its findings. [00:46:07] Ken asks about Jeff’s project, currently underway, called “Strategies to Augment Ketosis,” or STAK. It’s a comprehensive initiative that is going to address the physical and financial toll attributed to the pervasive poor metabolic health of the nation and how this impacts our military troops, especially veterans, and therefore poses a significant threat to the future of the military and our national defense. Ken explains that there are multiple layers of research involved in STAK, many of which utilize ketone esters, and asks Jeff to explain what ketone esters are for those listeners who have not listened to episode 54 of STEM-Talk with Brianna Stubbs. [00:48:41] Dawn explains that one of the major topics being examined in STAK is sleep deprivation, which is a major problem in military populations, with only one in three U.S. Army Active-Duty Soldiers estimated to get their target of seven hours of sleep on duty days. Given that insufficient sleep leads to a drop in performance and an increase in errors, it is an important problem to solve. There is evidence that ketone ester supplements may lessen the adverse effects of sleep deprivation, and thus STAK will further explore this possibility. Jeff talks about the clinical trial he is putting together, which will look at whether ingesting a ketone ester supplement twice daily can improve cognitive and physical performance during short-term sleep restriction. [00:51:45] Ken follows up, asking Jeff what the rationale is for his hypothesis that ketosis will mitigate the negative effects of sleep deprivation. [00:53:48] Dawn explains that another element of STAK is exploring the effects of ketone esters and the sustained long-term effects of a ketogenic diet on type-2 diabetes and heart failure. Dawn asks Jeff to talk about this study, and why he thinks ketones would be beneficial for the heart. [01:00:28] Dawn asks about the STAK study looking at the possibility of delaying or preventing the progression of diabetic nephropathy. [01:02:24] Ken shifts to talk about work Jeff’s lab is doing on metabolic psychiatry. Ken goes on to explain that we have known for a long time that food choices can alter a person’s neurochemistry, but we are just now beginning to research the impact that macronutrients can have on our mental and emotional well-being. Jeff discusses this work and explains what metabolic psychiatry entails. [01:05:58] Dawn mentions that a common struggle for physicians who are strong proponents of a ketogenic diet is getting their patients to stick to it. Dawn goes on to mention our recent interview with Vyvyane Loh who talked about how some of her patients struggle with the diet and so she often ends up recommending a less stringent low-carb diet instead. Dawn asks Jeff his thoughts on this, as well as the critique of the ketogenic diet that it is not sustainable. [01:12:03] Dawn talks about the so-called keto flu being a hurdle that many people feel they can’t overcome, and asks Jeff what his thoughts and advice are about this. [01:16:08] Ken mentions the current popularity of fasting and time-restricted eating. Going on to say that while fasting is an effective way to get into ketosis, Jeff has reservations about fasting, particularly those that last beyond 24 hours. [01:20:36] Dawn mentions the surge in new products on grocery shelves advertised as keto breads, keto donuts, keto bagels, etc. Dawn asks Jeff what his thoughts about the flood of keto-branded products we’re seeing. [01:25:56] Dawn describes Jeff as a walking testimonial for ketogenic and low-carb diets. Jeff has followed a low-carb diet for more than 20 years, all the while maintaining a healthy body weight and lipid profile. Dawn asks Jeff to share with listeners what his daily dietary intake looks like and how the diet benefits him. [01:29:07] Dawn closes the interview by asking Jeff where he sees the field of ketogenic research going in the next decade, and if the dietary recommendations might change in that time. Dawn goes on to mention that Jeff published a recent article with several prominent co-authors titled          

Our guest today is Dr. Ed Weiler, a retired NASA scientist who spent 20 years as the chief scientist for the Hubble Space Telescope, the forerunner of the James Webb. During his 33-year NASA career, Ed wore many hats, including Associate Administrator of the Science Mission Directorate; Center Director of NASA’s Goddard Space Flight Center, Associate Administrator for NASA’s Space Science Enterprise, chief of the Ultraviolet/Visible and Gravitational Astrophysics Division and director of the Astronomical Search for Origins Program. In today’s episode, we talk to Ed about: — NASA’s accomplishments in the past year, including the Perseverance mission, the success of the James Webb telescope, and the launch of Artemis-1. — Ed’s experience as the Chief Scientist for the Hubble Space Telescope during its early development. — Ed’s time as the director of NASA’s Astronomical Search for Origins program. — Ed’s role in the development of the New Horizons space craft and its mission to fly by and study Pluto and it’s moons. — Ed’s belief that in the next 20 to 50 years, we will be able to the prove the existence of other life in the universe. Show notes [00:02:59] Dawn opens the interview mentioning that she and Ed share a common experience of going through the selection process to become a NASA astronaut. [00:03:55] Dawn mentions that instead of becoming an astronaut, Ed joined NASA in 1978 as a scientist, serving in a variety of science leadership roles throughout his career, eventually retiring in 2011 after 33 years of service. Dawn asks Ed to talk about his various accomplishments at NASA. [00:05:57] Dawn asks Ed about his feelings toward the various accomplishments of NASA in recent years since his retirement, such as the Perseverance mission, the success of the James Webb telescope, and the launch of Artemis-1. [00:08:42] Ken asks Ed to discuss the recent images from the James Webb telescope, images that have captured the public’s imagination. [00:12:10] Dawn asks if it’s true that Ed decided to become an astronomer and go to work for NASA when he was only 13 years old. [00:15:36] Dawn mentions that we have had several guests on STEM-Talk that cite the Apollo missions as their inspiration for pursuing a career in science. Dawn points out that Ed was already in grad school when Neil Armstrong first stepped on the moon. Dawn asks Ed about watching the moon landing on the campus of Northwestern University. [00:16:48] Ken asks about Ed’s experience as the Chief Scientist for the Hubble Space Telescope during its early development. [00:25:01] Dawn points out that after graduating from Northwestern University, Ed joined the research staff at Princeton while also working at the Goddard Space Flight Center. In 1978, Ed became a staff scientist at NASA headquarters and Dawn asks how that position came about. [00:29:45] Dawn mentions that Ed was also the director of NASA’s Astronomical Search for Origins program and asks Ed to talk about that experience. [00:33:03] Ken mentions that in 1998, Ed became the Associate Administrator for Space Science for the first time. Ken goes on to mention when Ed was first approached about the position, he said “not in a million years.” Ken asks what eventually changed Ed’s mind. [00:37:10] Dawn asks Ed about his first stint as NASA’s Associate Administrator, where he oversaw several successful missions and set in motion an ambitious Mars exploration mission. [00:43:43] Dawn asks Ed to talk about the role he played in the development of the New Horizons craft and its mission to fly by and study Pluto and its moons. [00:45:46] Ken mentions that when Ed’s first tenure as Associate Administrator for the Science Mission Directorate ended in 2004, he took over the leadership of the Goddard Space Flight Center, which is one of the premier institutions for space and earth science missions. Ken asks Ed to talk about the work he did at the center. [00:50:06] Dawn mentions that Mike Griffin, our guest on STEM-Talk episodes 23 and 134, was the NASA Administrator in 2008, and asked Ed to return as Associate Administrator. Dawn asks why Ed was brought back again and what he was asked to accomplish. [00:56:47] Ken asks Ed about one of his priorities at NASA, which was RTGs (Radio-Isotope Thermo-Electric Generators).  Ken asks Ed why this was a priority, and what that experience was like. [01:00:21] Dawn mentions that Ed was an early proponent of STEM education, and during his time as Associate Administrator at NASA, he required all project proposals to set aside one to three percent of their budget for STEM education. Dawn goes on to ask Ed about a letter he received from a Mexico City student in the early days of Hubble that made an impression on him. [01:06:38] Dawn mentions that Ed has been quoted as saying that in the next 20 to 50 years, we will be able to prove the existence of other life in the universe. She asks Ed why he’s so confident about that. [01:14:13] Ken follows up on the previous question and asks Ed what his thoughts are on the Pentagon’s recent report on Unidentified Aerial Phenomena (UAP), which Ken and Dawn discussed in episode 127 of STEM-Talk. While the study does not imply that these UAPs are extraterrestrial crafts, the report does indicate that they are likely physical objects of some kind.  Ken asks Ed what he thinks these objects are? [01:20:32] Dawn wraps up the interview by mentioning that Ed has been known throughout his career for building effective teams and, toward that end, he would often take his staff water skiing. Ed Weiler Wikipedia page Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Dawn Kernagis bio    

Today’s interview is with IHMC’s Dr. Gwen Bryan, a research scientist who investigates wearable robotic devices aimed at augmenting human performance in clinical, occupational, and military applications. She is particularly focused on maximizing the benefits of powered exoskeletons. At IHMC, Gwen leads the exoskeleton team, which is developing a novel augmentative device that continues IHMC’s research on mobility devices for people with spinal cord injury. The team also is researching a powered exoskeleton to aid government employees whose work involves nuclear site remediation. Gwen and her team’s effort, which utilizes a human-centered research approach, is uniquely situated to expand exoskeleton research and technology because of the expertise and collaboration that’s available among IHMC’s robotics and human-performance research groups. Gwen joined IHMC after completing her Ph.D. in the Stanford Biomechatronics Lab. Outside of work, Gwen enjoys soccer, weightlifting, painting and snowboarding. She also is a dog mom to two very adorable shelter dogs, Bandit and Oreo. Show notes: [00:02:32] Dawn asks Gwen what it was like growing up in Albuquerque, New Mexico. [00:03:02] Dawn mentions that it seems science was a part of Gwen’s life early on. Dawn goes on to mention that Gwen’s father was an engineer, and her mother was a nurse and asks how her parents having these backgrounds influenced her. [00:03:35] In addition to a science background, Gwen’s mother is also a clarinetist who instilled a love for the arts in Gwen.  Dawn asks Gwen about her painting and how art benefits other aspects of her life. [00:04:17] Ken asks Gwen what she was like as a kid. [00:04:59] Ken asks Gwen to talk about a rafting trip she took with her cousin through the Grand Canyon. [00:06:27] Dawn asks Gwen how chocolate chip cookies factored into her third-grade science fair project. [00:08:04] Dawn mentions that fitness became a part of Gwen’s life following an injury she had as a senior in high school. Exercise, particularly weightlifting, helped alleviate her back pain. Dawn asks Gwen what her fitness journey taught her about her body, and ultimately, how that experience gave her insights into the work she does today. [00:09:16] Ken asks Gwen how she chose to go to the University of Texas in Austin. [00:10:38] Dawn mentions that Gwen transferred to the University of New Mexico for her undergraduate work. Dawn asks Gwen what motivated her to apply her interest in mechanical engineering into robotics. [00:11:28] Ken asks Gwen what was involved in her transfer from the University of Texas to New Mexico. [00:12:34] Ken asks Gwen what led her to the Stanford Biomechatronics Lab. [00:13:38] Ken asks Gwen to talk about her internship with the Sandia National Research Labs. [00:14:40] Dawn shifts to talk about Gwen’s current research focus on wearable robotics, particularly exoskeletons, mentioning that when the public hears this term most people generally think either insect exoskeletons or Ironman. Dawn asks Gwen to describe the exoskeletons she works on. [00:15:25] Dawn mentions that the potential uses of exoskeletons to help people with limited or no lower-limb mobility seems, in some respects, clear, but the application has been limited, and asks why that is. [00:16:40] Dawn asks what some other applications of exoskeletons are that are important to know about. [00:18:35] Ken mentions that during Gwen’s doctoral work at Stanford, she developed the first cable-driven exoskeleton to assist all the three leg joints — hips, knees, and ankles — and asks Gwen to talk about how that design was developed and what made it special in the exoskeleton field. [00:20:10] Ken explains that Gwen’s work also developed novel control systems for exoskeletons by using feedback from real-time physiological measurements of the user – coined human-in-the-loop optimization (HILO). Ken asks Gwen to talk about this strategy, and why it is an important innovation. [00:21:56] Ken asks Gwen to talk about what she learned about the impact of exoskeleton assistance on walking economy when assisting the hips, knees, or ankles individually versus simultaneously. [00:22:58] Dawn asks if the multi-joint strategy depends on the walking task, mentioning that it seems as though demands change for different joints when walking faster; or up and downhill; or carrying load. [00:23:49] Dawn explains that the laboratory emulator approach seems to have led to many fundamental findings. Dawn goes on to ask, however, about the limitations of assisting people in the real world in an approach that has users stuck on a treadmill and in the lab. [00:25:02] Dawn asks if exoskeletons are a ‘one-size fits all’ technology, or if they need to be customized to each individual. [00:26:08] Ken mentions that Gwen is involved in a couple of exoskeleton projects at IHMC, and asks first about the Eva project. [00:28:16] Dawn asks what other applications Eva, or exoskeletons in the same vein, might have in rehabilitative or therapeutic settings. [00:29:01] Dawn asks about IHMC’s Quix, another exoskeleton that Gwen is working on, which has been primarily used to help people with lower-body paralysis gain movement. Dawn goes on to mention that the team has been looking into rehabilitative applications that Quix could serve in as well, and asks Gwen to discuss new developments with this project. [00:31:27] Ken asks Gwen to share some final thoughts on exoskeleton and what she sees as the grand challenges facing exoskeleton development. [00:33:18] Dawn asks about Gwen’s passion for cultivating interest in STEM among girls and young women and why that is so important to her. [00:34:59] Gwen talks about some of the mentors in the field that helped her along the way. [00:36:11] Dawn asks Gwen about her two rescue dogs, Bandit and Oreo, to close the interview. Links: Gwen Bryan bio Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Dawn Kernagis bio

Our guest today is Dr. Dan Pardi, the CEO of humanOS.me, a digital health training application. Dan is well-known for his research into sleep and has collaborated with many high-performing organizations, from Silicon Valley venture capitalists to companies like Adobe, Salesforce, Workday, Pandora, Intuitive Surgical, and more. He also works with several branches of the U.S. Military to help elite warfighters maintain vigilant performance in both combat and non-combat conditions. Dan’s podcast, humanOS Radio, is the official podcast of the Sleep Research Society, the Canadian Sleep Society, and a content partner of the Buck Institute on Aging. Dan collaborated with more than 100 science professors around the globe to create his digital humanOS application. Dan has a Ph.D. in cognitive neuroscience from Leiden University in the Netherlands and Stanford University in the United States. He has a master’s degree in exercise physiology from Florida State University and currently lives in Austin, Texas, with his wife, two young boys, and their dog, Wally. Joining STEM-Talk host Dr. Ken Ford for today’s conversation with Dan is Dr. Marcas Bamman, a senior research scientist here at IHMC. Marcas was a STEM-Talk guest on episode 116. In today’s interview with Dan, we cover his early career in bioinformatics and how a trip to Moscow led to his doctoral research of sleep and treatments for narcolepsy. He also talks about the Loop Model to Adopt and Sustain Health Behaviors, a program he developed during his Ph.D. studies. The Loop Model became the core of his company, humanOS. Finally, Dan talks about the concepts of “actual health,” health-performance experts and a shift in what aging means, which he believes is important to improving the quality of life for all of us. Show notes: [00:03:19] Marcas starts the interview by asking Dan to talk about his years growing up in Northern California’s Marin County. [00:04:06] Ken asks Dan about building radio-controlled cars with his father. [00:05:11] Marcas explains that Dan’s father was a successful businessman who, after a successful career as a salesman for Remco selling kitchenware, started his own company in California that grew to 200 employees. Dan has been quoted as saying that one of the lessons he learned from his father was the value of relationships. Marcas asks how that lesson has affected Dan’s life. [00:06:29] Dan talks about his passion for basketball and how his time at the Cap Lavin camp influenced his early life. [00:08:15] Marcas mentions that Dan’s “science life” seems to have begun with a seventh-grade science-fair project that ended up landing him a job with Nike. Marcas asks Dan to talk about that story. [00:09:26] Ken mentions that Dan went to the University of San Francisco for his bachelor’s degree and then went to Florida State for his Masters in Exercise Physiology. Ken asks what led Dan to FSU. [00:10:26] Ken asks why Dan decided to pursue a career in cancer research, going to work at the Preventive Medicine Research Institute in Northern California after graduating. [00:12:04] Marcas commends Dan for being ahead of his time by leveraging the new technological development of the internet portal to empower life scientists while he was working with the Bioinformatics Biotech DoubleTwist, and asks what that experience was like. [00:13:41] Ken asks Dan how a trip to Moscow led Dan to pursue a Ph.D. at Leiden University and Stanford, after already working in the industry for 10 years. [00:15:17] Marcas explains that Dan’s Ph.D. research at the Zeitzer Circadian Biology Lab at Stanford University focused on gamma-hydroxybutyrate (GHB), sleep and ingestive behavior. Marcas asks what was most interesting about this research for Dan. [00:16:24] Marcas asks about a randomized controlled trial that Dan conducted to look into ecologically relevant amounts of sleep loss. This trial enrolled 50 participants and manipulated their next-day alertness by randomly assigning different levels of sleep. Dan talks about the findings of this study. [00:21:50] Marcas explains that while Dan was working on his Ph.D., he developed a behavior model called the Loop Model to Adopt and Sustain Health Behaviors. Marcas goes on to explain that Dan has presented this model at several healthcare conferences, such as Stanford Medicine X and Health 2.0, and asks Dan to explain what this model is and how it works. [00:24:53] Marcas mentions that Dan’s company, humanOS.me, is described as a digital health training application and asks what this means. [00:26:23] Ken mentions that simply giving people more information doesn’t drive changes in health-related behaviors, and asks how humanOS.me approaches things differently to address this problem. [00:29:03] Ken asks if Dan sees any downsides in tracking health markers. Ken mentions that STEM-Talk listeners often ask about the quality of data collected, but Ken goes on to say that there are also problems of becoming hyper-focused on things like sleep and food to the point where these things are no longer pleasurable experiences at all. [00:35:02] Ken asks about the concept of health, mentioning that in 1948 the World Health Organization defined “health” as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Ken mentions that this definition has been criticized for being too demanding and asks Dan what his thoughts are on this definition. [00:37:51] Marcas mentions that a biogerontologist named Suresh Rattan at Aarhus University in Denmark, defines health as the maintenance of homodynamic space, and asks Dan to explain for listeners what this means. [00:42:44] Marcas asks Dan what he means by “Actual Health,” the concept that is the core of the upcoming book that Dan is co-authoring with STEM-Talk guest Josh Turknett. [00:44:56] Marcas mentions that Dan has been working on developing the concept of a health performance expert, and to set the stage for this discussion, Marcas asks what Dan’s views are on the gaps in our current healthcare system and how these might be addressed. [00:50:17] Ken mentions that he likes that Dan’s idea of a health performance expert is something that should develop independently, even in coordination with, the current sick-care system. Dan elaborates on this idea. [00:57:47] Marcas explains that in Dan’s TED talk on optimizing light for health, he opened by talking about the impact of microgravity on health. Marcas asks Dan to talk about why he chose to open with that topic. [0:59:47] Ken shifts to talk about the difference between age and aging, making the point that we often think of aging as a continual decline from our peak but goes on to say that age and aging are more nuanced than that infers. [01:07:20] Marcas mentions that from an evolutionary biology perspective, age and experience are valuable to the success of one’s progeny and the tribe one’s offspring inhabit, as the grandparent hypothesis posits. Marcas asks if Dan agrees that this emphasizes the importance of working at preserving our cognitive functioning as we age. [01:10:27] Marcas asks Dan to talk about his personal practices to maintain or improve overall health, and what the key ingredients of optimized health are. [01:16:36] Marcas asks Dan what he hopes will be the key takeaway for people to remember from this episode. Links: humanOS Dan Pardi bio and IHMC lecture Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page         Should this not be a link to Marcas?

It’s time for another Ask Me Anything episode where STEM-Talk cohost Dawn Kernagis asks Ken questions submitted by listeners. In this episode, Ken and Dawn weigh in on: —  Whether AI is becoming sentient. — How women in midlife might protect their bodies from the negative effects of a slowing metabolism. — A Stanford study that compared a low-carbohydrate diet with a Mediterranean diet. — Whether fasting helps optimize cognitive performance. — The future of hypersonic technology. — And a lot more. If you have a question after listening to today’s episode or any episode of STEM-Talk, email your question to STEM-Talk Producer Randy Hammer at rhammer@ihmc.org. Show notes [00:02:45] Dawn begins the AMA with a question for Ken that was inspired by the Mark Mattson interview, episode 133. Mark talked about skipping breakfast and in his recent book,  “The Intermittent Fasting Revolution,” Mark points out that bodybuilders often skip breakfast and do their weight training in a fasted state, which has the effect of optimizing both muscle building and cognitive performance. The listener mentions that they feel more cognitively sharp in a fasted state but as soon as they break their fast, they don’t feel as sharp. The listener asks Ken if this is normal. [00:04:35] A listener asks Ken about a recent news story in which a Russian robot broke a boy’s finger during a chess match. The listener goes on to state that several of their friends have jumped to the conclusion that this is proof robots are becoming sentient beings and asks Ken for his take is on this given Ken’s AI background. [00:06:02] A listener asks another AI question, this one regarding the Washington Post’s reporting on a Google engineer who was fired over claims he made while at the company that an AI chatbot he had been testing had become sentient. The engineer claimed in an interview with The Guardian that the chatbot, LaMDA, was afraid of being turned off, had read “Les Miserables” and that it had emotions. Google maintains that LaMDA is merely responding to prompts designed for it. The listener asks Ken what would be an appropriate test for gauging AI sentience and what other thoughts Ken has about this story. [00:08:32] A listener mentions that they have been following the ketogenic diet for 18 months and have lost 40 pounds. Recently they checked their liver enzymes GGT, AST, TSH and found they were elevated above “normal” and their Alpha fetoprotein marker was measured at 10.3. The listener asks Ken what he has learned about the ketogenic diet’s impact on the liver. [00:09:48] A listener asks about a recent paper regarding a Stanford study that compared low-carbohydrate diets with a Mediterranean diet. The listener mentions that in the Stanford study the diets had three similarities – no non-starchy vegetables, no added sugars and no refined grains. The key difference in the diets was that the low-carb diet avoided legumes, fruits, and whole grains while the Mediterranean diet included them. The study measured glucose control and cardiometabolic risk in people with prediabetes and type 2 diabetes. The study found that comparative outcomes did not support a sufficient benefit to justify people avoiding legumes, whole fruits, and whole grains to achieve the metabolic state of ketosis. The listener asks Ken for his thoughts on the study and in his answer, Ken mentions an interview Dr. Ben Scher did with one of the study’s authors, Dr. Lucia Aronica. [00:14:57] A listener mentions in their question that they found the Mike Griffin and Mark Lewis interviews both fascinating and worrying. The listener’s key concern is that China and Russia are ahead of the U.S. in terms of hypersonic capabilities. The listener goes on to mention that they recently saw “Top Gun Maverick” and asks if it is reasonable that someday we will see jets with human pilots that are capable of flying 10-to-20 times the speed of sound, as depicted in the film; or will these sorts of aircrafts need to be operated by AI or humanoids. [00:18:17] A listener sends a question that reads, “They say that 50 is the new 30, but after listening to STEM-Talk, I now know that I can expect my metabolism to fall off the “50-cliff” once I meet the chronological milestone of turning 50 years old.”  The listener says it’s her understanding that hormonal changes related to midlife, especially for women, are key drivers of metabolic changes that lead to everything from brain fog to weight gain. The listener would like to know what she and other women can do to ward off the negative effects of aging and a slowing metabolism. [00:19:53] A listener mentions that in the Satchin Panda interview, Dr. Panda says that black coffee in the morning probably won’t break an overnight fast, but that coffee with cream will. The listener goes on to say that they listened to a Dave Asprey podcast in which he said drinking “Bulletproof Coffee” with two tablespoons of butter and two tablespoons of brain octane fuel was okay in the morning because it will elevate a person’s blood ketones to 0.7 millimoles per liter within 30 minutes. The listener asks Ken for his thoughts on this advice. [00:22:33] Dawn closes the AMA with a listener question asking if Dr. Ford has any particular pet peeves that he is willing to share. Links: Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Dawn Kernagis bio

Our guest today is Dr. Jason Fung, a Toronto-based nephrologist, and the best-selling author of “The Obesity Code,” “The Diabetes Code,” and “The Cancer Code.” Jason is best known for his success in combining a low-carb diet with intermittent fasting to help thousands of overweight patients reverse their type 2 diabetes, lose weight, and improve their metabolic health. Jason is the author of the blog “The Fasting Method” and the co-founder of the Intensive Dietary Management program, an initiative that provides low-carb dietary guidance and counseling on various fasting regimes. Jason is also the co-author with Jimmy Moore of “The Complete Guide to Fasting,” which looks at the history and culture of fasting and how it helps people improve their metabolic health. In today’s episode, Ken is joined by Visiting IHMC research scientist Dr. Tommy Wood and together, they and Jason discuss: How in the beginning of his practice, Jason prescribed insulin for type 2 diabetes patients. How a series of landmark studies starting in 2008 changed Jason’s mind about using glucose-lowering medication for type 2 diabetes. Jason’s realization that type 2 diabetes is largely a dietary disease and therefore requires a dietary solution rather than a pharmaceutical one. The origins of Jason’s Dietary Management program, which counsels overweight and obese patients to follow a low-carbohydrate, high-fat diet to reduce insulin. A critique of the “eat less, move more” strategy acclaimed by many obesity experts. Mark Mattson’s research into the powerful impact of intermittent fasting on metabolic health and a recent paper that questioned the effectiveness of time-restricted eating when compared to daily calorie restriction. Recent research and evidence that fasting during chemotherapy may reduce the side effects of the treatment. Show notes: [00:02:25] Tommy opens the interview mentioning that Jason was born and raised in Toronto and asks what drew Jason to science as a kid. [00:03:43] Tommy mentions the irony that Jason has written several best-selling books, yet Jason was not fond of English or writing when he was in school. [00:04:53] Ken mentions that after graduating from high school, Jason stayed close to home and attended the University of Toronto, entering into medical school just after turning 19 to study internal medicine, eventually specializing in nephrology. Ken asks Jason what intrigued him about becoming a kidney specialist. [00:06:36] Tommy asks Jason what led him to go to UCLA after medical school for his specialty training in kidney disease at Cedars-Sinai Medical Center. [00:07:37] Tommy mentions that Jason has been practicing clinical nephrology in Toronto since 2001, and that in those early years of his practice, Jason saw patients with type 2 diabetes and prescribed medications to keep their blood glucose low. When that didn’t work, he would prescribe insulin, which is the standard medical practice. Tommy asks what Jason observed during these early years of his practice. [00:09:28] Ken mentions that in 2008, two landmark studies were published, the ACCORD study and the ADVANCE study (a summary of ADVANCE). These studies were followed by two more studies, the ORIGIN and VADT studies, all four of which demonstrated that using blood glucose-lowering medication for type 2 diabetes didn’t necessarily have the expected benefits. Ken asks Jason to talk about how these studies were eye-opening for him and confirmed his own experience in treating patients. [00:16:27] Tommy explains that in 1972 Robert Atkins published the “Dr. Atkins’ Diet Revolution,” which shared his findings on the effectiveness of low-carb, high-fat dieting. Tommy goes on to mention that in the late 1990s, a string of Atkins-styled diet books surged in popularity, with most physicians being opposed due to the conventional wisdom that these high-fat diets would cause heart disease. As a result, several trials were launched in the early 2000s to prove this point. Tommy asks Jason to talk about how these trials revealed that the real story is more nuanced than people might think. [00:20:42] Ken mentions that even though Jason and countless other doctors were appalled at the notion that high-fat diets were being promoted as safe and effective, Jason and other physicians had virtually no nutritional training during their years in medical school. Ken asks if, in hindsight, Jason believes this is something that needs to change. [00:24:49] Tommy explains that Jason’s realization that type 2 diabetes was largely a dietary disease and therefore required a dietary solution rather than a pharmaceutical one led him, along with Megan Ramos, a medical researcher, to establish the intensive Dietary Management program in Scarborough, Ontario, in 2011. The object of this program is to counsel overweight and obese patients to follow a low-carbohydrate, high-fat diet to reduce insulin. Tommy asks about the results of this initiative. [00:28:56] Tommy points out that when when Jason started seeing positive results with his patients losing weight and getting off their medications with a high fat diet, Jason started giving lectures around Toronto. He  eventually posted a six-part lecture on the etiology of obesity on YouTube and starting a blog, “Intensive Dietary Management,” which evolved into “The Fasting Method.” This all received good feedback and opened the door for Jason to write a book, “The Obesity Code.” [00:30:43] Ken explains that Jason’s book begins with a critique of the “eat less, move more” strategy acclaimed by many obesity experts.  Jason points out in the book that while this sounds like a reasonable approach to weight loss, the approach has generally been ineffecitve. Ken asks Jason to elaborate on this. [00:37:08] Tommy explains that there is substantial experimental evidence that the “eat less, move more” approach is not particularly effective advice for individuals in an environment that promotes being sedentary while surrounded by hyperpalatable, calorie-dense, low-protein food. Tommy goes on to say that this does not imply that an integrated calorie balance model is incorrect, only ineffective. Tommy asks Jason for his thoughts. [00:46:58] Ken mentions that in Mark Mattson’s appearance on STEM-Talk, he talked about his recently published book, “The Intermittent Fasting Revolution: The Science of Optimizing Health and Enhancing Performance.” Ken goes on to say that in this interview Mark talked about a paper he had in the New England Journal of Medicine that highlighted how studies in animals and humans have shown that eating in a six-hour window and fasting for 18 hours has been shown to have positive effects on lifespan and a wide range of chronic disorders including obesity, diabetes, cardiovascular disease, cancers, and neurodegenerative brain diseases. However, a recent paper that appeared in the same journal reported that a year-long study among patients with obesity found that a regimen of time-restricted eating was not anymore beneficial – with regard to reduction in body weight, body fat, or metabolic risk factors – than daily calorie restriction. Ken asks Jason for his opinion on this recent study. [00:55:54] Ken mentions that Jason’s answer has circled back to efficaciousness versus effectiveness, and asks if Jason would agree that fasting is a more effective method than calorie restriction to lose weight because it is easier to follow. [00:57:52] Tommy asks if Jason agrees that calorie restriction is efficacious but not effective because it is hard for people to follow. [00:58:45] Tommy asks Jason about his third book in what has been referred to as the wellness series, “The Cancer Code.” [01:02:35] Ken explains that there is obviously a genetic aspect to cancer, but our environment also plays a huge role in the development of cancer. Jason points out in his book that a Japanese woman who moves from Japan to San Francisco often doubles and or triples her risk of cancer. Ken asks what makes the environment of the U.S. such a risk factor, and what makes the environment in Japan protective. [01:05:47] Ken mentions that there is also evidence that fasting during chemotherapy may reduce the side effects of the treatment. Ken asks Jason to talk about this and how fasting might also increase the efficacy of chemotherapy. [01:07:50] Tommy mentions that he understands that Jason weighs the same as he did in high school, and asks what his diet and fasting protocol look like. [01:11:15] To wrap up the interview, Ken  asks Jason for his take on rapamycin and concerns about the risk-reward ratio of using rapamycin as a prescription medication. Links: Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Tommy Wood IHMC bio Tommy Wood University of Washington bio Jason Fung  bio  

Today’s episode features the author of “Why We Get Sick,” Dr. Ben Bikman, a biomedical scientist at Brigham Young University. Ben is known for his research into the contrasting roles of insulin and ketones as key drivers of metabolic function. In “Why We Get Sick,” Ben takes a deep dive into insulin resistance and metabolic health. The book particularly focuses on the role that insulin resistance plays in many of today’s most common diseases: heart disease, diabetes, cancer, and Alzheimer’s. Ben and his colleagues at the Bikman Lab investigate the molecular mechanisms behind the increased risks of disease that accompany obesity and excess visceral fat. Much of the research at the Bikman Lab particularly focuses on the etiology of insulin resistance and how it disrupts mitochondrial function. In today’s interview, STEM-Talk cohosts Drs. Ken Ford and Dawn Kernagis talk to Ben about: How insulin resistance is tied to multiple chronic diseases. The relevance of ketones in mitochondrial function. How so many of our modern chronic diseases are self-inflicted and driven by insulin resistance. How many of the hallmarks of aging are a consequence of insulin resistance. The theory that the longest-lived people are likely the most insulin sensitive. The benefits that occur with carbohydrate reduction as a result of increasing insulin sensitivity. Ben’s thoughts about the degree of intermittent fasting needed to induce autophagy in humans. Show notes: [00:02:32] Dawn begins the interview asking Ben about his early life growing up in a small farm town in southern Alberta, Canada, as one of 13 children. [00:02:48] Dawn asks Ben what he was like as a kid and what made him stand out from his 12 brothers and sisters. [00:06:01] Dawn asks about Ben’s mother’s influence and how she wanted her sons to be Renaissance men. [00:08:29] Ken asks about Ben’s experience as a Church of Jesus Christ of Latter-Day Saints Missionary in Samara, Russia. [00:15:18] Dawn mentions that while Ben went into his undergrad majoring in exercise science, he wasn’t that interested in science at the time. It wasn’t until he began working on his master’s degree at BYU with Dr. Will Winder that he developed a true interest in science. [00:19:49] Dawn asks Ben how he ended up at East Carolina University for his Ph.D. in bioenergetics. [00:21:42] Ken mentions that Ben, after completing his Ph.D. moved to Singapore for his postdoc work at the Duke National University of Singapore. Ken asks how that came about. [00:25:49] Dawn mentions that Ben is well-known for his work on insulin resistance, stemming from his time at East Carolina when he realized that insulin resistance is tied to many different chronic diseases. Dawn asks what was Ben’s ah-ha moment that led him to focus his research on insulin resistance. [00:27:49] Dawn mentions that much of Ben’s work is focused on the role of elevated insulin in regulating obesity and diabetes, as well as the relevance of ketones in mitochondrial function. Dawn asks if it is correct that Ben has been on a sort of mission as a professor to teach a new generation of doctors and nurses how insulin resistance works, and why it is so relevant in terms of chronic disease. [00:29:56] Ken mentions that Ben began to take his message about insulin resistance beyond the classroom, appearing on podcasts and making YouTube videos, and also giving a speech to the student body at BYU, titled “The Plagues of Prosperity” making the case that the human race is currently eating itself into metabolic disarray. [00:32:31] Ben’s book “Why We Get Sick” points out that historicall, people got sic because of infectious diseases. In modern times, due to sanitation, vaccines, and antivirals, that is less of an issue. Today more people are afflicted by chronic illnesses, many of which are related to metabolism. Dawn explains that the overarching message of the book is that these diseases are, in part, self-inflicted, and partially driven by insulin resistance and hyperinsulinemia. Dawn goes on to say that while it is fairly well-known that insulin resistance plays a role in cancer, heart disease, and diabetes, many people may not know that it also contributes to neurological disorders, reproductive health, kidney disease, gastrointestinal disorders, and even reduced muscle mass, bone loss, and even hearing loss. [00:34:42] Ken explains that Ben has often pointed out that many of the hallmarks of aging are partially a consequence of insulin resistance. Ben has also pointed out in his book the theory that the longest-lived people are likely the most insulin sensitive. Ken asks Ben to elaborate on this. [00:41:36] Ken mentions that in Ben’s book, he explains that there are three primary causes of insulin resistance, the most obvious one being chronically elevated insulin levels. In addition to this, however, the second category is stress hormones including cortisol and epinephrine. The third cause is inflammation. Ken asks Ben to elaborate on these three causes. [00:45:15] Dawn asks Ben to talk about why our healthcare system has a glucose-centric view of metabolic health. [00:50:26] Ken points out that there’s a lack of consensus on what optimal levels of insulin should be. He also points out that most Americans do not have optimal levels of insulin since most are metabolically unhealthy. Ken asks Ben for his thoughts on what a person’s optimal level of insulin should be. [00:53:34] Ken brings up the problem with the reliance on “normal” readings since unhealthy people skew the average and therefore what is considered normal. Ken asks Ben to talk about how this leads to people who are ketogenic being flagged by their physicians because their insulin levels are low according to their charts. [00:59:25] Dawn asks Ben why he believes building and using muscle is a key component in the fight against insulin resistance. [01:01:03] Dawn mentions that Ben advises people to control carbohydrates, prioritize protein, and “fill with fat.” Dawn asks about the numerous benefits seen with carbohydrate reduction via increasing insulin sensitivity and lowering hyperinsulinemia. [01:03:55] Ken asks Ben to give a quick primer on the process of autophagy, with respect to intermittent fasting. [01:07:54] Ken mentions that a lot of the research about autophagy and fasting uses rodent models.  Autophagy is activated much more quickly and to a much greater extent in rodents than in humans. In light of that, Ken asks Ben if we know to what degree intermittent fasting induces autophagy in humans and how long a fast would have to be to incur that effect. [01:11:01] Ken asks Ben to explain how the standard American diet drives fat storage in the body and slows a person’s metabolic rate. [01:16:53] Dawn brings up that recent studies have shown that ketones are not only viable fuel sources for all cells with mitochondria but are also legitimate signaling molecules that elicit advantageous changes in inflammation, cognition, oxidative stress, and more. Additionally, ketones may be relevant metabolic fuel in the context of physical activity and athletic performance. Dawn mentions that further exploration of this can be found in episode 94 of STEM-Talk with John Newman on the topic of beta-hydroxybutyrate, or BHB, and episode 54 with Briana Stubbs on the topic of ketones and athletic performance. Dawn goes on to mention that in a paper published by Ben in 2018, in a special issue of the International Journal of Molecular Science, Ben wrote about the effects of ketones on metabolic function. He reported on the results of a study that sought to shed light on the specific effects of the ketone body BHB on muscle cell mitochondrial physiology. Dawn asks Ben to walk listeners through the results of this study and its implications. [01:20:54] Ken mentions that looking at the role of ketones on the maintenance of muscle, it appears that ketones have less of an anabolic role and more of an anti-catabolic role, which produces a strong protective effect against sarcopenia. Ben talks about this. [01:23:02] Ken mentions that we could make a serious dent in our obesity and type-2 diabetes epidemics if people would think more seriously about insulin and if more physicians tested for it. Ken asks Ben what research, in this regard, are he and his colleagues excited for on the near-term horizon. [01:27:03] Dawn shifts topics to ask Ben what his exercise routine looks like. [01:30:29] Dawn closes the interview by asking Ben if he still plays any instruments. Links: Ben Bikman bio Ben Bikman Lab Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Dawn Kernagis bio  

Our interview today is with Dr. Vyvyane Loh, a board-certified physician in obesity and internal medicine. She is the founder and leader of Transform Alliance for Health, a Boston preventive-care practice that  specializes in weight management and the treatment of chronic metabolic diseases such as diabetes, hypertension and dyslipidemia. She and her staff are known for helping people lose 50 pounds or more and getting their type-2 diabetic patients off their many medications. Vyvyane has spent her medical career developing expertise in immunology, metabolic syndrome, fat metabolism, clinical nutrition, and preventive medicine. In today’s interview, we discuss how abdominal, or visceral, fat is linked to a wide range of metabolic disorders. Vyvyane goes on to explain how there’s a clearcut association between obesity and decreased brain volume that rarely gets discussed. When her overweight patients complain about their behavior around food and how they consistently give in to snacks that patients know are bad for them, Vyvyane explains how the challenges they are facing is often a result of the brain struggling with decreased blood flow and the shrinkage of neurons. Vyvyane also shares how a patient asked Vyvyane if she knew anything about the Atkins diet, and although she didn’t, Vyvyane ended up doing the diet along with her patient. This led Vyvyane to start seriously researching whether a ketogenic diet could help people not only lose weight, but also reverse chronic disease. Toward the end of today’s interview, we explore Vyvyane’s interest in macrophages, which are specialized cells involved in the detection and destruction of bacteria and other harmful organisms. We also have a nice discussion about how Vyvyane took some time off from practicing medicine to enroll in the writing program at Warren Wilson College in North Carolina in 1999. She spent the next two years writing a novel, “Breaking the Tongue.”  Set in Singapore during World War II, her book was nominated for the prestigious International IMPAC Award in fiction and was selected by the New York Public Library as one of its top 25 books of 2004. If you are interested in finding out more about Vyvyane, check out her website, vyvyanelohmd.com. Also, Vyvyane launched a podcast this week, which you also can find on her website. Episode one looks at “Metabolism: What It Is, And How It Affects Your Health.” If you enjoy today’s interview with Vyvyane and the many other interviews we’ve had on STEM-Talk discussing the treatment and prevention of chronic metabolic diseases, you may want to check out the upcoming virtual conference on Targeting Metabesity. Our cohost Dr. Ken Ford will be one of nearly 70 speakers, including many former guests on STEM-Talk, talking about the growing evidence that the major chronic diseases of the day share common metabolic roots and as a result may also share common solutions. To find out more about the conference, follow this link to the Targeting Metabestiy home page where you find a program guide and list of speakers. If you would like a free ticket to the conference, click on this link where you will find instructions on how to receive a code for complimentary admission that is being offered to STEM-Talk listeners. Ken will be moderating a session on emerging research related to endogenous and exogenous ketosis in health and disease as well as the role of ketones in mild traumatic brain injury and the prevention and treatment of cancer. If you have enjoyed the interviews we’ve had on STEM-Talk with Drs Steven Austad, Colin Champ, James Kirkland, John Newman, Brianna Stubbs, Jeff Volek and Morley Stone, who are all speaking at the conference as well, you should find the talks by the over 70 speakers quite interesting and beneficial. So, click here to request a free registration and we will make sure to send a you a code for a complimentary ticket. Show notes [00:04:45] Dawn mentions that, based on the interviews she’s listened to with Vyvyane, that writing and dance have been passions of hers since she was a child. Dawn then asks Vyvyane at what point did she become interested in science. [00:05:25] Dawn asks Vyvyane how she ended up in the states attending Boston University. [00:06:25] Ken asks why Vyvyane decided to double major in biology and classics. [00:08:14] Ken mentions that Vyvyane’s classics advisor has a connection to the town of Seaside, near where IHMC is located. [00:09:01] Dawn shifts topics to talk about Vyvyane’s research, and asks about TOFI, which stands for “Thin Outside, Fat Inside.” It refers to people who outwardly appear thin, but have a disproportionate amount of adipose tissue in their abdomen, as well as “normal weight obesity.” [00:10:58] Ken mentions that the TOFI phenomenon helps to highlight the relative lack of utility of BMI, which is just a function of the relationship between a person’s height and weight, meaning that people with TOFI will look fine in terms of BMI, and someone who is lean and muscular may be categorized as obese by BMI, particularly if they are not very tall. Ken asks Vyvyane to elaborate on this. [00:12:26] Dawn explains that abdominal, or visceral, fat is of particular concern because it’s a key player in a variety of health problems, more so than subcutaneous fat. She goes on to explain that visceral fat is found deep within the abdominal cavity, where it pads the spaces between our organs. Dawn asks Vyvyane to talk about how visceral fat is linked to a wide range of metabolic disorders. [00:14:37] Ken explains that obesity often causes endothelial dysfunction, which results in the vasculature being inflamed and damaged, resulting often in decreased blood flow to the brain. Ken asks Vyvyane to talk about her frustration with the fact that this clearcut association between obesity and decreased brain volume rarely gets discussed. [00:17:22] Dawn mentions that it is estimated that just 12 percent of Americans are categorized as metabolically healthy. She goes on to mention that researchers at the University of North Carolina published a study that found that just one in eight American adults have optimal metabolic health. [00:18:22] Ken asks Vyvyane what she has learned about metabolic disease in her practice that she didn’t learn in medical school or her residency. [00:19:10] Dawn asks about the prevalence of using food to relieve stress in the wake of the COVID-19 pandemic, and what effects of this trend Vyvyane has seen in her practice. [00:20:13] Ken asks about Vyvyane’s practice, which she started in 2015 because she had been working in the medical system and came to the realization that she couldn’t develop a new way of providing preventive care from within the system. [00:21:53] Dawn mentions that Vyvyane’s practice is called the Transform Alliance for Health, and the website is quoted as saying: “Chronic stress and emotional issues commonly lead to using food to self-medicate or self-soothe. The visible result, the patient’s weight, becomes the focal issue for their healthcare providers. For us, however, it is merely the physical manifestation of the patient’s internal struggle with his/her real problem. From this starting point, we work with our patients to uncover their deeper and often more complex reasons for overeating and to take charge of their lives.” Vyvyane elaborates on this approach to her practice. [00:23:29] Dawn mentions that she listened to an interview with Vyvyane where she talked about how a ketogenic diet can often reduce inflammation and reverse metabolic disease, but that it can be hard to get people to stick to a ketogenic diet. Dawn asks if this is why Vyvyane emphasizes going on a low carb diet for her patients rather than a strict ketogenic diet. [00:25:07] Ken asks about the struggles of having to convince patients to give up carbs. [00:27:17] Dawn explains that non-alcoholic fatty liver disease is today one of the most common maladies in the United States, with a remarkable 30 to 40 percent of adults in this country having it. Dawn asks Vyvyane to discuss NAFLD and what she sees as its causes and the most efficacious treatments. [00:29:07] Dawn asks about the markers Vyvyane uses in evaluating a patient’s metabolic health, including insulin resistance scores and advanced lipid panels. [00:31:45] Ken asks about the curriculums Vyvyane offers for her patients, which explain to them the importance of sleep and mobility and strength training as a way of pressing the body’s “the reset button.” [00:34:00] Dawn mentions that we recently had Greg Potter and Jeff Iliff on the podcast to talk about the importance of sleep and particularly how a lack of sleep can lead to many negative health outcomes. Dawn goes on to mention that something Vyvyane has emphasized in the past is the role of nocturnal blood pressure dipping during sleep. Dawn asks Vyvyane to explain what she means by that, and how a lack of it increases a person’s risk for silent strokes and kidney dysfunction. [00:35:45] Ken asks Vyvyane to talk about her recommendations for protein intake as it relates to body composition and sarcopenia. [00:39:18] Ken asks Vyvyane to talk about some of the immune cells that are involved in regulating metabolic health. [00:41:34] Dawn mentions Vyvyane’s recent lecture at IHMC, titled “On the Magical Mystery Macrophage Tour, where she refers to macrophages as mysterious, specialized cells of innate immunity that play significant roles in some of our most common medical conditions ranging from cardiovascular disease to gastrointestinal disorders to obesity to osteoarthritis. Vyvyane elaborates on what these cells are and their various functions. [00:43:02] Ken asks how and when Vyvyane first became interested in macrophages. [00:43:41] Ken mentions that macrophages also stand out because they possess the unique ability to become polarized in response to different environmental stimuli and asks Vyvyane to explain how this works. [00:46:22] Dawn explains that macrophages can detect products of bacteria and other microorganisms using a system of recognition receptors such as toll-like receptors or TLRs. Vyvyane explains the role and significance of these receptors. [00:48:13] Dawn mentions that tissue-resident macrophages, or TRMs, are heterogeneous populations originating either from monocytes or embryonic progenitors and distribute in lymphoid and non-lymphoid tissues. Dawn asks Vyvyane to talk about the diverse roles that TRMs play in many physiological processes, including metabolic function. [00:50:46] Ken mentions that current medical practice still looks at obesity through the lens of caloric balance. Ken asks what new discoveries in obesity research challenge that dogma. [00:54:39] Dawn asks about the aspects of Vyvyane’s life outside of her medical practice such as writing, dance, and choreography. [00:55:47] Ken mentions that Vyvyane’s novel, “Breaking the Tongue,” was selected as one of the Top 25 Books of 2004 by the New York Public Library and in 2006 was nominated for an International IMPAC Award, which is the world’s richest prize for a single work of fiction published in English. Ken explains that the novel chronicles the fall of Singapore to the Japanese in World War II, and asks Vyvyane to talk about the book and how it deals with issues of race and class. [00:58:08] Ken mentions that Vyvyane has another novel she is working on, but that it, and her fiction writing as a whole, is on hold because she is working on a nonfiction book. Ken asks Vyvyane to talk about this new book. [00:59:47] Dawn closes the interview asking about Vyvyane’s morning routine, which incorporates an hour of meditation. Dawn also asks what else Vyvyane does on a regular basis. Links: Vyvyane Loh bio Vyvyane Loh podcast Learn more about IHMC STEM-Talk homepage Ken Ford bio Ken Ford Wikipedia page Dawn Kernagis bio