Influenced to Death

Dr. Jordan Robertson, founder of The Confident Clinician Club and educator in integrative medicine, joins to unpack how the internet influences health decisions. They explore the challenges of discerning reliable medical information in a sea of wellness trends. The conversation highlights outrageous health claims and the need for critical thinking. Robertson emphasizes the evolution of Google’s algorithms towards accuracy and discusses the importance of effective communication between patients and providers in navigating health information.

In this episode, Hannah and Victoria are joined by fellow balanced babe Jenny McGruther of Nourished Kitchen fame for the beginning of a deep dive (yep, expect part 2) into the Weston A. Price Foundation.Interview with Sally and Kelly the Kitchen Kop (Kelly Moeggenborg) on how the WAPF was bornThe Nina Planck book review: Real Food for Mother and BabyDr. Kaayla Daniel’s original publication on fermented cod liver oil This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit influencedtodeath.substack.com/subscribe

In this episode, Hannah & Victoria speak with Dr. Mark Messina, an international expert and soy researcher. We read his research. We emailed him with high hopes. He responded! Dr. Mark brings the juice on soy, “myth-busting,” and even sheds some light on GLP-1 agonists. DO NOT SLEEP on this episode! Dr. Mark isn’t some dull researcher…he’s passionate, engaging, and one of the most knowledgeable guys on the planet when it comes to soy. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit influencedtodeath.substack.com/subscribe

In this episode, Hannah and Victoria have the pleasure of speaking with Dr. Sarah Ballantyne about her stance switch from anti- to pro-seed oils.Hi everyone, Vic here. Hannah and I asked Dr. Sarah to come on the podcast to speak with her about some of the science backing why she switched her viewpoint, but mainly about the dynamics of telling her millions of followers she was wrong. This episode is my favorite we’ve recorded so far. Why?If you’ve spent any time in the wellness world, you may have noticed that big names don’t shift their stance very often, and they especially don’t do it loudly. But in this case, Dr. Sarah not only changed her mind, she did it very publically. And very loudly. We’ve seen some nasty social media comments pointed in her direction…everything from she’s hit her head to she’s being bought by “big oil.” While I was transparent in our interview that I wasn’t so sure I was committed to incorporating vegetable oils into my diet, I fully believe she’s come to this conclusion on her own (extremely intelligent) accord and is in no way being influenced by anything other than saying what she thinks is right. And I also believe that the characteristics and skills she displays—curiosity, willingness to change her mind and say she was wrong, research literacy and commitment to staying up to date on current research, clear communication—are the EXACT qualities that will keep us moving toward the best wellness solutions EVEN IF it happens that you don’t like what she’s saying right now. These qualities starkly contrast with what we usually see from wellness influencers…the ones who are so blindly committed to a concept or idea (and the money they make from it) that they’ll lead themselves and you into illness in order to stay the course. The opposite is happening here. And I love it. We hope you enjoy the episode as much as we liked speaking with Dr. Sarah.For more on the science behind her views on vegetable oils, please click here to listen to Dr. Sarah and Stacy Toth’s discussion on The Whole View, and click here for Dr. Sarah’s interview on The Unbiased Science podcast.Dr. Sarah Ballantyne’s bioDr. Sarah Ballantyne, PhD, is the founder of Nutrivore.com and the New York Times best-selling author of Nutrivore: The Radical New Science for Getting the Nutrients You Need from the Food You Eat. She creates educational resources to help people improve their day-to-day diet and lifestyle choices, empowered and informed by the most current evidence-based scientific research. With Nutrivore, Dr. Sarah has created a positive and inclusive approach to dietary guidance, based in science and devoid of dogma, using nutrient density and sufficiency as its basic principles: Nourishment, not judgment. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit influencedtodeath.substack.com/subscribe

In this episode, Hannah and Victoria explore the hyper-controversialized world of soy, one of the most studied yet misunderstood foods in our diet.History:Isoflavones first came to the attention of the scientific community in the 1940s because of fertility problems observed in sheep grazing on a type of isoflavone-rich clover. * The most economically important bean in the world* China 7000 BCE* Soybeans were introduced into the United States in 1804 and became particularly important in the South and Midwest in the mid-20th century - the majority of soybean crops are genetically modified for resistance to the herbicide glyphosate*. Brazil and Argentina are also major producers.Evidence:“Soy” = 23,500ish results in PubMed, Last 10 years, about 10K results.Phytoestrogens are a broad group of compounds that consist of isoflavones, lignans, and coumestans. Of these, isoflavones are heterocyclic phenols, the main constituents of which are genistein, daidzein, and glycitein. They have a similar structure to 17 beta-estradiol and have been shown to have biological activity exerting estrogen-like effects both in vitro and in vivo. Interesting note on isoflavones and cultural differences in consumption and genetic differences in metabolism, from M. Messina, Soy and Health Update https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5188409/ : “...mean isoflavone intake among adults ranges from about 30–50 mg/day in Japan but is less than 3 mg/day in the United States, Canada, and Europe [60,61,62,63,64,65,66,67]”Understanding soy intake by milligram:It is difficult for the average consumer to even understand the consumption of isoflavones. For example, according to United States Department of Agriculture data and an assumption of about a half-cup serving, most vegetables contain <1 mg, miso soup 1–2 mg, cooked edamame 15–20 mg, raw pistachios 1–3 mg, most soymilks 1–10 mg, and some higher soy content cereals 20–100 mg (5). “Meatless” meats contain anywhere from very little to high amounts of isoflavones depending on how they are produced. Much of the content of all soy products depends on processing, whether alcohol or water extracted, and the crop or variety. Needless to say, it is quite complicated. https://www.fertstert.org/article/S0015-0282(19)30621-1/fulltext Glyphosate residue potentially disrupting our microbiomes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8959108/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10561581/ https://www.sciencedirect.com/science/article/pii/S0169534722002294 Equol:“In regard to isoflavone metabolism, a striking difference among individuals is that only about 25% of non-Asians and 50% of Asians host the intestinal bacteria that convert daidzein into the isoflavonoid equol* [80]. In 2002, Setchell et al. (2002) proposed that those individuals who host these bacteria are more likely to benefit from soyfood consumption [81]” Equol [7-hydroxy-3-(4′-hydroxyphenyl)-chroman], an isoflavan produced by intestinal bacteria in response to soy isoflavone intake in some but not all humans, exhibits a wide range of biological properties: https://pubmed.ncbi.nlm.nih.gov/20519411/ More on equol: https://gutpathogens.biomedcentral.com/articles/10.1186/s13099-024-00625-9 Big picture view of interactions with hormones: Specifically, soy isoflavones are the phytoestrogen focus of the study published in this issue from Salsano et al., because they are very chemically similar to 17β-estradiol (2). The two predominant soy isoflavones, genistein, and daidzein, bind primarily to estrogen receptor (ER) β but remain very weak estrogens compared with endogenous E2. There is data that they may act by both hormonal and nonhormonal pathways, which include arresting or altering cellular growth through kinases or even epigenetics (3). https://www.fertstert.org/article/S0015-0282(19)30621-1/fulltext A Brief Historical Overview of the Past Two Decades of Soy and Isoflavone ResearchMark Messina, 2010https://www.sciencedirect.com/science/article/pii/S0022316622132049#bib84Baby formula:https://pubmed.ncbi.nlm.nih.gov/9217716/ Comparative Study Lancet. 1997 Jul 5;350(9070):23-7. doi: 10.1016/S0140-6736(96)09480-9.Exposure of infants to phytoestrogens from soy-based infant formula “From the concentrations of isoflavones in these formulas (means 32-47 micrograms/mL), the typical daily volume of milk consumed, and average body weight, a 4-month-old infant fed soy formula would be exposed to 28-47 per day, or about 4.5-8.0 mg/kg body weight per day, of total isoflavones. Mean (SD) plasma concentrations of genistein and daidzein in the seven infants fed soy-based formulas were 684 (443) ng/mL and 295 (60) ng/mL, respectively, which was significantly greater (p < 0.05) than in the infants fed either cow-milk formulas (3.2 [0.7] and 2.1 [0.3] ng/mL), or human breast-milk (2.8 [0.7] and 1.4 [0.1] ng/mL), and an order of magnitude higher per bodyweight than typical plasma concentrations of adults consuming soy foods.”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2661347/#b7-pch14109 ​​ Concerns for the use of soy-based formulas in infant nutritionPaediatr Child Health. 2009 PMCID: PMC2661347However, they are present in relatively large amounts in soy-based formulas, such that the total isoflavone content is approximately 40 μg/mL in ready-to-use soy formulas. Infants who consume these products have isoflavone plasma concentrations of approximately 13,000 to 22,000 times greater than their estradiol plasma concentrations. In contrast, the plasma concentrations of isoflavones in infants who are fed cow’s milk formula or breast milk are only 50 to 200 times greater than their estradiol plasma concentrations (7). There is concern that these isoflavones may mimic the actions of estradiol or alter estradiol metabolism, and consequently modify the processes influenced by estradiol. Despite this theoretical possibility, practical experience has shown that the millions of infants who have consumed these products since the 1960s appear to have grown and matured normally.Fertility: * Inverse association between soy intake and sperm count in men (soy lowers sperm count): https://pubmed.ncbi.nlm.nih.gov/18650557/ …but, another study shows:* Dadizen (found in soy) good for sperm morphology, as well as red meat and whole milk https://onlinelibrary.wiley.com/doi/10.1111/andr.12858Breast cancer:Soy Isoflavones and Breast Cancer Risk: A Meta-analysis: https://pubmed.ncbi.nlm.nih.gov/35241506/ * 2022 meta of 8 studies and 477,832 women examined the AMOUNT of soy consumed and the connection to breast cancer - found the consumption of soy isoflavones can reduce the risk of breast cancer in pre-menopausal and post-menopausal women.Bone health:Soy Reduces Bone Turnover Markers in Women During Early Menopause: A Randomized Controlled Trial: https://pubmed.ncbi.nlm.nih.gov/27465911/ There was a significant increase in TSH and reduction in free thyroxine (p < 0.01) with SPI supplementation (200 white women given 15 g soy protein with 66 mg isoflavone (SPI) or 15 g soy protein alone (SP), daily for 6 months) though free tri-iodothyronine was unchanged. In conclusion, soy protein with isoflavones may confer a beneficial effect on bone health, analogous to the mode of action of antiresorptive agents, albeit to a less magnitude. There was a significant improvement of cardiovascular risk markers, but a significant increase in TSH and reduction in free thyroxine after SPI supplementation indicating a detrimental effect on thyroid function. © 2016 American Society for Bone and Mineral Research.Soy Food Consumption, Exercise, and Body Mass Index and Osteoporotic Fracture Risk Among Breast Cancer Survivors: The Shanghai Breast Cancer Survival Studyhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6527440/  High soy isoflavone intake was associated with reduced risk among pre-/perimenopausal patients (hazard ratio [HR] = 0.22, 95% confidence interval [CI] = 0.09 to 0.53, for soy isoflavone mg/d ≥56.06 vs <31.31; Ptrend < .001) but not among postmenopausal patients (Pinteraction < .01). https://pubmed.ncbi.nlm.nih.gov/19794985/ Marked individual variation in isoflavone metabolism after a soy challenge can modulate the skeletal effect of isoflavones in premenopausal women“Women in the soy group were divided into subgroups according to their ability to excrete more potent metabolites. Serum osteocalcin and urine deoxypyridinoline showed a tendency to increase after a challenge in equol high-excretors. Serum osteocalcin concentration in the genistein high-excretors increased significantly after a challenge (P=0.04) but did not increase in either the placebo or genistein low-excretors. An estrogenic antagonistic effect of isoflavones on bone turnover was observed in premenopausal women who are able to produce more potent metabolites.”CVD:https://pubmed.ncbi.nlm.nih.gov/29739677/ Same research group/ same participants as first bone turnover studyConclusions: Supplementation with soy protein with isoflavones for 6 months significantly improved CVR markers and calculated CVR at 6 months during early menopause compared to soy protein without isoflavones.Beneficial to CVD in early menopauseLikely beneficial for lupus:https://www.cambridge.org/core/journals/nutrition-research-reviews/article/an-update-on-diet-and-nutritional-factors-in-systemic-lupus-erythematosus-management/992C22937FC53A6B1D3D30BC97B331E9 Likely detrimental for people taking valproic acid: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3950581/ This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit influencedtodeath.substack.com/subscribe

In this episode, Hannah & Victoria check out what the research has to say about MM’s claims and do their best to provide a balanced takeaway. Check out the show notes for Episode #9: Medical Medium, Part 1 for references. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit influencedtodeath.substack.com/subscribe

In this episode, Hannah and Victoria do their best to keep their s**t together while discussing Medical Medium, a 55-year-old self-proclaimed medium who claims the Spirit of Compassion provides him with medical information years beyond what current science has uncovered.* HistoryFrom his website, Medicalmedium.com:“Medical Medium Anthony William, the chronic illness expert, originator of the global celery juice movement and Brain Shot Therapy, and host of the Medical Medium Podcast, is the #1 New York Times best-selling author of Brain Saver, Brain Saver Protocols, Cleanses & Recipes, Cleanse to Heal, Celery Juice, Liver Rescue, Thyroid Healing, Life-Changing Foods, and the revised and expanded Medical Medium. Anthony was born with the unique ability to converse with the Spirit of Compassion, who provides him with extraordinarily advanced healing medical information that’s far ahead of its time.Since age four, Anthony has been using his gift to see into people’s conditions and tell them and their doctors how to recover their health. Over decades of helping individuals find the answers they needed, Anthony found that he could only help so many as his waiting list continued to grow. Anthony now dedicates much of his time and energy to listening to Spirit of Compassion’s information and placing it into books so everybody can have an opportunity to heal.His unprecedented accuracy and success rate as the Medical Medium have earned him the trust and love of millions worldwide, among them movie stars, rock stars, billionaires, professional athletes, and countless other people from all walks of life who couldn’t find a way to heal until he provided them with insights from above. Over the decades, Anthony has also been an invaluable resource to doctors who need help solving their most difficult cases.”4.8 million followers on InstagramHe declines to give his age in interviews. From what we could find, he’s 55 years old.  Anthony is a “trusted expert” on Goop, and his books have been on NYT bestseller lists. Note: Many of his supplement links go to a company called Vimergy. It’s owned by Phil McCulskey, who appears to be a close friend.  His work and claims are prolific. He may be best known for his hyperbolic claims about the curative properties of celery juice and about the Epstein-Barr Virus. He seems to flat-out make up his own definition and scientific explanation for his claims. He claims that celery juice can cure chronic disease, he details the mechanisms and processes that he says explain his claims but insists that the scientific community just hasn’t discovered them yet. He says he knows about them because the Spirit of Compassion tells him. This includes undiscovered viruses and mechanisms/physiology behind chronic diseases. All of this is woven into snippets of pretty solid holistic health advice - like eat more unprocessed foods, avoid alcohol, the body can heal, etc. He also claims that the worldwide scientific community uses his discoveries to further their understanding of human health and that many doctors successfully use his protocols to treat their patients with chronic diseases.Around 2000, he owned a health food store with his wife, Rachel Schutzman, in Machias, Maine, called Good Earth Organic Market.* Nutrition ClaimsHe claims that certain foods feed viruses in the body and recommends eliminating them. These include meat and eggs.From what I can tell, many of his protocols are strict vegan diets, consisting of mostly fruit and celery juice.He claims that any dietary fat accumulates in the liver. His idea of metabolism:“The idea that your body can switch to burning fat as fuel is also flawed. We don’t run on fat. We run on glucose, which is sugar. If it were true that our bodies could flip from burning glucose for energy to burning fat for energy, as the keto diet suggests, then it would be impossible for someone who was overweight or obese to starve. If the ketosis theory is correct, you could take away an overweight person’s food completely and they’d continue to live for a long period of time, using their fat as energy. But that’s not how it works. Fat does not convert to usable material for our bodies.”He also claims that the brain is a jellyfish-like organ is made of sugar:“There’s a highly popular belief today that the brain is made out of fat and you need to eat a lot of “healthy fats” to have good brain health and function. Sadly, this is more damaging misinformation. High-fat diets are disastrous for the brain. In truth, there is only a microscopic percentage of fat in the brain. Outside of these low traces of omegas, the brain is mostly a jellyfish-like organ made up of sugar.“Epstein Barr virus claims* Autoimmune diseases are caused by viruses, it is not possible for the body to form self-antigens. There is no genetic basis to AID. * Claims there are over 60 forms of EBV* “Doctors have no idea how the virus operates long-term”* “Medical communities are unaware that every case of mononucleosis is only Stage Two of EBV”* From his Epstein Barr podcast episode: “What the scientific community doesn’t know is that EBV causes more things than mono.” “The scientific community thinks that EBV can only be spread when someone has mono, but Medical Medium knows that it can be spread through saliva & bodily fluids by anyone who has it.” (Both of these claims are false - it is researched and documented that EBV can contribute to some cancer and other illnesses, and the CDC explains that EBV can be spread even when someone doesn’t have active mono.) For Breastfeeding moms: ”Just blend avocado, ripe banana, and water or coconut water to create a delicious drink to replace breastmilk or to supplement on top of it.” (THIS IS FALSE INFORMATION, DON’T DO THIS.)He no longer provides private consultations - it seems like he would do phone consults to “scan” peoples’ bodies. According to a Reddit thread, the cost was $500 for a 30-min phone consult.According to a Reddit thread: If someone disagrees with him in his telegram group he calls them a “fork tongue devil,” and bullying from the group follows https://www.reddit.com/r/medicalmediumskeptic/comments/1bux0jb/medical_medium_calls_anyone_who_disagrees_with/ * Controversy “In 2013, Kate Gallagher Leong, whose 5-year-old son, Gavin, was seriously ill, handed over $350 for an hour-long consultation. She was desperate, she admitted in a blog post. William, she said, told her that mercury poisoning caused Gavin’s disease, which she had passed to him in utero. William gave her a list of supplements to put him on. Forty-eight days later, Gavin died of a febrile seizure.Gallagher did not blame William for her son’s death but called him “a fraud” who took advantage of her anguish. She said she became a resource for others: “I feel glad when the people who don’t have $500 to lose write to me and I can keep them from handing over their rent money . . . grocery money . . . and their hopes to him.” William declined to comment on the case.” https://www.thetimes.com/business-money/article/gwyneth-paltrow-and-the-snake-oil-salesman-gmk8mcfgr This is Kate’s blog post about her experience from 2016“I explained to him my desperation to get answers about Gavin's mysterious, undiagnosed genetic syndrome. He spent the first ten minutes or so talking about supplements. The history, which brands he prefers, which supplements help with what. Then he told me that mercury was the cause of Gavin's issues - that I passed actual mercury on to him and a mercury sensitivity in utero, causing his physical, neurological and developmental issues and explaining his features. Basically, that he suffered mercury poisoning in my womb. He said that was the cause of all of my miscarriages as well (nine at that time). He also said I had the Epstein-Barr Virus in my system. Then... it was back to supplements again. He was a very nice person so I tried to remain patient. I thought he was just getting off track and would get back to helping me with our medical mystery. He didn't.I watched the clock tick and tock - and watched our money continue to fly out the window - as he spent 95% of our call discussing supplements and telling me to write down which brands of supplements to give Gavin and which I should take. I wondered, in frustration, if he got a kickback from supplement companies! You can read that original post here.”…After Gavin died, Anthony William's assistant called and said he requested that we call him. I suppose he either read that Gavin died on my blog or saw it on social media. I did NOT appreciate being summoned by him when it was my son that died, after all. I never called him - and he never called again.”There are claims that he’s asked his followers to leave positive reviews in exchange for prizes, essentially buying reviews.Accusations of silencing: https://www.reddit.com/r/medicalmediumskeptic/ Dan Adler’s article in Vanity Fair - The Medical Medium and the True Believer:https://www.vanityfair.com/style/2023/04/the-medical-medium-and-the-true-believer Medical Medium podcast - The Plotter Series - goes after Ashleigh Foster, a friend of the woman covered in the Vanity Fair article, and portrays her as a money grabber plotting against Medical Medium.* EvidenceCelery JuiceCelery cluster salts: used nutritionally, this term was coined by MM and appears to be completely fabricated and based on no evidence. Celery and fertility https://pubmed.ncbi.nlm.nih.gov/28985183/ Celery and MetSyn https://pubmed.ncbi.nlm.nih.gov/31464016/ Apiaceous veggies and detox https://pubmed.ncbi.nlm.nih.gov/10837004/ https://pubmed.ncbi.nlm.nih.gov/16762476/ Article from Dr. Sarah Ballantyn https://www.thepaleomom.com/celery-juice-fad-or-fabulous/ In some people, excessive amounts of raw celery might contribute to symptoms due to increased amounts of oxalates. According to the Oxalosis and Hyperoxaluria Foundation’s tracker, celery has a moderate amount of oxalates: https://ohf.org/vegetables-oxalate/  Epstein Barr Affects over 90% of the world’s population (some say 98% !) https://www.ncbi.nlm.nih.gov/books/NBK559285/#:~:text=Epstein%20Barr%20virus%20(EBV)%20is,from%20asymptomatic%20to%20infectious%20mononucleosis. Egg allergy and EBV https://www.researchgate.net/publication/234068531_Identification_of_EBV_infection_in_adults_with_egg_specific_food_allergy#:~:text=Conclusions%20The%20high%20expression%20of,involved%20in%20this%20allergy%20process. Epstein, M. A., & Achong, B. G. YM Bart. 1964. Virus particles in cultured lymphoblasts from Burkitt's lymphoma. Lancet, 702-703. - Article from 1964 when a virus (later found to be EBV) found in tumor cells began the hypothesis that viruses like EBV could contribute to some cancers. Nice write-up on Tony Epstein: https://www.nature.com/articles/d41586-024-00763-9 - Pathologist who found that viruses can trigger tumors in humans and transformed medical research in that area. * Takeaway:Joe Navarro on dangerous cult leaders: https://www.jnforensics.com/post/dangerous-cult-leaders“They all have or had an over-abundant belief that they were special, that they and they alone had the answers to problems, and that they had to be revered. They demanded perfect loyalty from followers, they overvalued themselves and devalued those around them, they were intolerant of criticism, and above all, they did not like being questioned or challenged.”A good breakdown of how MM likely operates: https://www.dradrianchavez.com/blog/GURUS  This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit influencedtodeath.substack.com/subscribe

In this episode, Hannah & Victoria sit down with Jameson Simpson to explore the underbelly of high-class hippy-dom.There are no show notes—this episode is a mix of tales from Jameson’s chaotic and seriously adventurous life (his current address: Albania) and culminates in the story of a very famous raw food influencer who sold a very expensive product made in Jameson’s filthy (filthy) dirty garage.Names have been beeped out to protect the innocent keep us from getting sued. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit influencedtodeath.substack.com/subscribe

In this episode, Hannah and Victoria speak with Angie Alt about the use of continuous glucose monitors in non-diabetic populations.Angie Alt is a writer, community care activist, independent researcher, and former health coach and nutritional therapist. After a decade of helping clients manage chronic illness through nutrition and lifestyle and training practitioners to utilize the autoimmune protocol in their practices, she shifted her focus from teaching individuals about self-care concepts toward community care-centered work more well-suited to the cooperative and social nature of human well-being. Angie now writes at Notes from a Neighbor, a weekly newsletter on new ways to frame the pressing health and wellness challenges we face collectively and the small, slow, simple actions we can take to respond meaningfully. 2022 article Angie wrote that received some pushback from her audience: https://autoimmunewellness.com/are-wearable-health-trackers-helping-or-harming/Continuous Glucose Monitoring (CGM) refers to a medical device that measures glucose levels in dermal interstitial fluid. These levels correspond closely with blood glucose concentrations.History* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8120065/Continuous Glucose Monitoring Devices: Past, Present, and Future Focus on the History and Evolution of Technological Innovation>> Why CGMs were invented: Traditionally, the principal method of glucose monitoring for people with diabetes has been through self-monitoring of blood glucose (SMBG) without a clear consensus on sampling frequency that varied between four and ten times per day, for insulin-dependent patients with diabetes1999: First cgm system by Minimed: monitored along with calibration via finger stick every 6-12 hours to monitor over 3 days - info sent straight to healthcare provider Medtronic Guardian RT and the Dexcom STS—launched in 2005 and 2006 - patient could see results 2007: Dexcom first continuous monitor that recorded for 7 days2018: Abbott launched the FreeStyle Libre in the United States, the first flash glucose monitoring system Continuous monitoring allows the user to see trends vs. a finger stick which is just one measurement. 2019: Nutrisense2024: FDA approves first OTC CGM by Dexcom - intended for those 18 + who don’t require insulin Pop culture & Influencers:* https://www.instagram.com/jason.wittrock/ “Fit Dad” whose content is videos of him using his CGM to test isolated foods. * Nutrisense: CGM available without an rx, pretty popular on social media with wellness influencers https://www.instagram.com/nutrisenseio/ 2 weeks $1853 month membership $300 per monthEvidence* Review on continuous glucose monitor use in healthy populations: https://www.mdpi.com/1424-8220/22/5/2030Authors state that "CGM has a high potential for health benefits and self-optimization. More scientific studies are needed to improve the interpretation of CGM data. The interaction with other wearables and combined data collection and analysis in one single device would contribute to developing more precise recommendations for users."But one author is on the Abbott Advisory Board. Along with Ensure and Pedialyte, they also make...drumroll please...CGMs. https://www.abbott.com/consumer.html#diabetes-care* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10460390/Authors state that "The inter-day reproducibility of the CGM results was greater for subjects with diabetes (ICC 0.46 [CI 0.39–0.55]) than for normoglycaemic subjects (ICC 0.30 [CI 0.27–0.33]); the value for prediabetic subjects was intermediate (ICC 0.37 [CI 0.31–0.42]). For normoglycaemic subjects, inter-day reproducibility was poorer among the younger (ICC 0.26 [CI 0.21–0.30]) than the older subjects (ICC 0.39 [CI 0.32–0.45]).>> Inter-day reproducibility was poorest among normoglycaemic subjects, especially younger normoglycaemic subjects, suggesting the need to monitor some patient groups more often than others." <<* https://www.sciencedirect.com/science/article/pii/S0026049523002445 Continuous glucose monitoring in a healthy population: understanding the post-prandial glycemic response in individuals without diabetes mellitus“There has been a recent trend among individuals without diabetes using these devices as a means of monitoring their health. The increased visibility of glucose data has allowed users to study the effect lifestyle has upon post-prandial glucose levels. Although post-prandial hyperglycemia is well understood in the setting of diabetes, its impact in individuals without diabetes is less well defined. This article reviews the factors which contribute to post-prandial hyperglycemia in individuals without diabetes and how the data obtained from continuous glucose monitoring can be used to improve an individual's metabolic health.”PPHG is defined as a sharp rise in plasma glucose concentrations following food intake and is influenced by many factors including the timing, quantity and composition of a consumed meal [3].* CHO content, complex CHO, protein composition of meals* Glycemic index of CHO foods* Meal timing * Hypothalamus, circadian timing*In metabolically healthy individuals, the glucose curve tends to be biphasic, defined as a curve that shows a peak around 30–60 min after a meal, which then decreases but is followed by another elevation 90–120 min after the meal. A biphasic curve is metabolically preferable over a monophasic curve.* Gut microbiome * hormonal status* stress/cortisol levels* metabolic health* intercurrent illness* Exercise* Genetic variation * Age* BMI* Pre-peri-postmenopause in females* Sleep timing/quality/duration * AM dopamine action/sympathetic tone* Smoking* Rx meds: β-blockers, thiazide diuretics, corticosteroids, and statins* CaffeineOther pubs show:* Vitamin C* Various micronutrients “Based on the published evidence, we suggest most adults could potentially benefit from wearing a CGM, at least for a two-to-four-week period, to better understand their glucotype and recognise how different foods affect their own glycemic response.In addition to reducing the long-term risk of cardiovascular disease such as coronary artery disease and stroke, there is evidence to support controlling post-prandial glucose excursions for weight loss, optimized mental health, suppressed hunger, and improved sleep.”* A large number of people with prediabetes are undiagnosed - up to 40%?https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes/reduce-proportion-adults-who-dont-know-they-have-prediabetes-d-02 * Postprandial glucose ranges: https://diabetesjournals.org/care/article/24/4/775/23438/Postprandial-Blood-Glucose * Non-diabetic: 140 or < ~1 hour after the start of the meal, return to normal levels 2-3 hours after eating * Diabetic: Peak insulin is delayed, so 2 h after the start of a meal is practical, generally approximates the peak value in patients with diabetes, and provides a reasonable assessment of postprandial hyperglycemia. Specific clinical conditions, such as gestational diabetes or pregnancy complicated by diabetes, may benefit from testing 1 h after the meal“The host response to any respective glucose sensor will define sensor sensitivity, sensor performance, and ultimately sensor longevity. As such, one significant limitation of all implantable glucose monitoring devices is the foreign body response (FBR), which is an inflammatory reaction stimulated by the host’s immune system in response to a foreign substance. An FBR commences when macrophages, particularly pro-inflammatory M1 macrophages, are recruited to the sensor site through the skin’s vasculature. Recruitment of macrophages to the device location significantly affects the accuracy of the glucose sensor given that the metabolically active inflammatory cells consume interstitial glucose.27-29 This results in glucose gradient in which the glucose concentration adjacent to the sensor is vastly different from the true serum glucose concentration.28 Inflammatory cells are also responsible for the recruitment of fibroblasts, which are intimately associated with the FBR. Fibroblasts produce fibrous tissue that encapsulates the device in order to sequester it from the remainder of the body. Nevertheless, the lifespan of transdermal sensor devices has increased from 3 to 14 days over the past decade by addressing the FBR through advances in sensor chemistry, sensor coatings, and improved implantation techniques.30 Initial sensor biocompatibility studies first examined the toxicity of sensor materials followed by analyses of FBRs as in vivo lifespan increased from a few days to weeks.31”* Micronutrients affect glucose regulation https://pubmed.ncbi.nlm.nih.gov/38192249/ “Cumulative probability ranking showed that vitamin A + vitamin D + vitamin E ranked first in lowering fasting blood glucose (standardised mean difference (SMD) = 41.30, 95 % CI (2.07, 825.60)) and postprandial 2-h blood glucose (SMD = 15.19, 95 % CI (4.16, 55.53)). In terms of insulin resistance index, the first highest probability ranking is vitamin D “Some top food sources of these micronutrients:Vitamin A (preformed A or retinol): liver, cod liver oil, egg yolks, dairy, salmon, herringVitamin D: oily fish (trout, salmon, tuna, sardines, etc.), cod liver oil, mushrooms, dairy. Sunlight exposure is the best source of Vitamin D. Because D is hard to get through food, if you don’t get much sun, supplementation is often needed. Vitamin E: almonds, sunflower seeds, hazelnuts, mango, conch, wheat germ, peanut butter, spinach, kiwi, broccoli, tomato (raw) 500mg Vit C or more can cause a false increase in some CGM readings  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8861798/ This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit influencedtodeath.substack.com/subscribe

In this episode, Hannah and Victoria speak with two (hilarious and highly balanced) metabolic experts, Dr. Mike T Nelson & Dr. Tim Sharpe about the ketogenic diet.You’ll want to listen if you’ve been considering going keto to lose weight, boost your fitness, or fix your metabolism.* Sign up to get Dr. Mike’s fantastic newsletter here: www.miketnelson.com or learn if you should go keto at www.shouldyouketo.com* Read Dr. Tim’s newest publication here: https://pubmed.ncbi.nlm.nih.gov/38934469/ History * Fasting is the only therapeutic measure against epilepsy recorded in the Hippocratic collection, 500 BC* Five centuries later, fasting as a therapy for seizures was documented in Biblical times. In a quotation from the King James Version of The Bible, Mark relates the story of Jesus curing an epileptic boy (Huisjen, 2000).* The first modern use of starvation as a treatment for epilepsy was recorded by a pair of Parisian physicians, Gulep and Marie, in 1911 (Guelpa & Marie, 1911). They treated 20 children and adults with epilepsy and reported that seizures were less severe during treatment, but no specific details were given. * Ketogenic diet first appears at the Mayo Clnic, 1921: In 1921, two pivotal observations were made. Woodyatt noted that acetone and beta-hydroxybutyric acid appear in a normal subject by starvation or a diet containing too low a proportion of carbohydrates and too high a proportion of fat (Woodyatt, 1921). Concurrently, Dr. Wilder at the Mayo Clinic proposed that the benefits of fasting could be obtained if ketonemia was produced by other means (Wilder, 1921). Wilder proposed that a ketogenic diet (KD) be tried in a series of patients with epilepsy. He suggested that the diet should be as effective as fasting and could be maintained for a much longer period of time. Wilder subsequently reported on patients treated with the ketone-producing diet at the Mayo Clinic and coined the term “ketogenic diet.”  https://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2008.01821.x * Use decreased when epileptic drugs were discovered, but resurged again when Dateline NBC aired a story in the mid-90s on a 2-year-old named Charlie intractable generalized seizures were greatly helped at Johns Hopkins with KD.* https://charliefoundation.org/connie/ - Incredible accounts of how KD helps some kids * Keto & pop culture: Atkin’s Diet, Dr Atkin’s Diet Revolution published in 1972, 1997 - Atkin’s bars and shakes* Plans range from 20g net carbs (keto) to 100g net carb per day (lifestyle). * From Aktins website: “A low-carb lifestyle focuses on limiting carbohydrates to help the body burn fat instead of sugar for fuel. This contributes to more consistent energy levels throughout the day, providing the energy you need to enjoy the things you love.”* More on Robert Atkins: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1126011/ (He really mistrusted mainstream science and loved working as a clinician.) This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit influencedtodeath.substack.com/subscribe