1
00:00:01,360 --> 00:00:06,040
Speaker 1: Hi, Perry, Hi Emily, So I brought some props for

2
00:00:06,120 --> 00:00:07,280
Speaker 1: our episode today.

3
00:00:07,640 --> 00:00:10,799
Speaker 2: This will do great on an audio primarily podcast.

4
00:00:11,080 --> 00:00:15,120
Speaker 1: If people are watching on YouTube, you will see that

5
00:00:15,240 --> 00:00:16,680
Speaker 1: for our episode, I.

6
00:00:16,520 --> 00:00:18,079
Speaker 3: Brought creating dummies.

7
00:00:18,280 --> 00:00:24,439
Speaker 1: I have sour cherry, I have sour apple, and I

8
00:00:24,480 --> 00:00:26,560
Speaker 1: have watermelon.

9
00:00:27,040 --> 00:00:29,040
Speaker 2: Amazing. Are these your creating gummies?

10
00:00:29,120 --> 00:00:31,160
Speaker 1: Okay, I'll tell you how I got these creating gummies.

11
00:00:31,520 --> 00:00:36,600
Speaker 1: I mentioned Creatine on Instagram, and all of a sudden,

12
00:00:37,080 --> 00:00:40,479
Speaker 1: many people wanted to send me creatine, and so a

13
00:00:40,520 --> 00:00:43,839
Speaker 1: lot of Creatine has been arriving at my house because

14
00:00:43,880 --> 00:00:45,480
Speaker 1: I'm an Instagram influencer.

15
00:00:45,760 --> 00:00:52,080
Speaker 2: First in secret, Emily, can you mention an Nvidia RTX

16
00:00:52,240 --> 00:00:54,880
Speaker 2: fifty ninety graphics card on Instagram?

17
00:00:55,680 --> 00:00:57,760
Speaker 3: Everyone, Perry would love.

18
00:00:58,120 --> 00:01:02,400
Speaker 1: To talk about your Nvidia blah blah.

19
00:01:02,080 --> 00:01:05,080
Speaker 3: Graphics card on here. Thank you so much.

20
00:01:05,400 --> 00:01:08,600
Speaker 2: It's important for all of our wellness. That's me. I'm

21
00:01:08,640 --> 00:01:11,760
Speaker 2: excited to hear whether you are partaking in the creatine.

22
00:01:11,760 --> 00:01:14,080
Speaker 2: But I suppose we should look at the data first.

23
00:01:14,160 --> 00:01:14,960
Speaker 3: We're going to find out.

24
00:01:15,520 --> 00:01:16,040
Speaker 2: Let's do it.

25
00:01:18,840 --> 00:01:22,399
Speaker 1: I'm Emily Aster, I'm an economist and a data expert.

26
00:01:22,000 --> 00:01:24,039
Speaker 2: And I'm Perry Wilson. I'm a medical doctor.

27
00:01:24,520 --> 00:01:28,280
Speaker 1: It's Thursday, April second, twenty twenty six, and this is

28
00:01:28,319 --> 00:01:30,039
Speaker 1: wellness actually.

29
00:01:30,000 --> 00:01:33,480
Speaker 2: Because you're getting a staggering amount of health and wellness

30
00:01:33,520 --> 00:01:37,360
Speaker 2: information nowadays from every source imaginable, and some of it

31
00:01:37,400 --> 00:01:38,319
Speaker 2: is awesome.

32
00:01:38,240 --> 00:01:43,560
Speaker 1: And some of it is well actually both Fortunately we

33
00:01:43,600 --> 00:01:46,240
Speaker 1: are both people who know how to read studies, how

34
00:01:46,240 --> 00:01:48,640
Speaker 1: to parse the data, and can tell you what's worth

35
00:01:48,640 --> 00:01:51,200
Speaker 1: thinking about and what you can safely ignore.

36
00:01:51,520 --> 00:01:53,800
Speaker 2: But before we dig in, a note that this podcast

37
00:01:53,880 --> 00:01:56,440
Speaker 2: is for educational purposes and should not be construed as

38
00:01:56,480 --> 00:01:59,640
Speaker 2: medical advice. We don't know your unique situation, so talk

39
00:01:59,640 --> 00:02:01,800
Speaker 2: to your doctor for personal health decisions.

40
00:02:02,720 --> 00:02:06,680
Speaker 1: This week, we're asking what's the deal with creating Perry

41
00:02:06,680 --> 00:02:08,919
Speaker 1: and I will give the official smash or pass, and

42
00:02:09,000 --> 00:02:10,600
Speaker 1: then we'll get to your question of the week.

43
00:02:11,040 --> 00:02:14,480
Speaker 3: But first let's do the health news roundup. After the break.

44
00:02:26,720 --> 00:02:29,680
Speaker 2: And we're back with the health news of the week

45
00:02:30,240 --> 00:02:35,160
Speaker 2: coming up first, Emily, President Trump says quote, it's possible

46
00:02:35,320 --> 00:02:39,240
Speaker 2: he will withdraw the nomination of Casey Means for Surgeon

47
00:02:39,320 --> 00:02:42,040
Speaker 2: General given the lack of Republican support. You may remember

48
00:02:42,080 --> 00:02:47,400
Speaker 2: we discussed the nomination of doctor Means on this podcast,

49
00:02:47,480 --> 00:02:52,440
Speaker 2: and I think brought some much needed attention to the

50
00:02:52,440 --> 00:02:55,760
Speaker 2: fact that she doesn't actually practice medicine and is a

51
00:02:55,760 --> 00:03:00,200
Speaker 2: wellness influencer and had a confirmation hearing in which she

52
00:03:00,520 --> 00:03:06,600
Speaker 2: declined to advocate for vaccination for measles. Does wellness actually

53
00:03:06,760 --> 00:03:10,000
Speaker 2: have some real political clout now? That is my question?

54
00:03:10,080 --> 00:03:11,760
Speaker 2: Are we what's moving Washington, DC?

55
00:03:12,440 --> 00:03:17,920
Speaker 1: It is possible, but I would say unlikely. However, you

56
00:03:18,000 --> 00:03:22,280
Speaker 1: never know, And I think this is not very surprising

57
00:03:22,400 --> 00:03:28,040
Speaker 1: given where the conversation has landed over the past couple

58
00:03:28,080 --> 00:03:33,000
Speaker 1: of months. I think the appetite for moving away from

59
00:03:33,080 --> 00:03:36,600
Speaker 1: vaccines has somewhat waned. This is a little bit separate

60
00:03:36,640 --> 00:03:39,520
Speaker 1: from the Casey means confirmation hearing, But I do think

61
00:03:39,600 --> 00:03:43,240
Speaker 1: as we have seen more cases of measles, for example,

62
00:03:44,280 --> 00:03:49,560
Speaker 1: it's become less palatable to be like, who cares about vaccines?

63
00:03:49,600 --> 00:03:53,880
Speaker 1: It's like, well, actually children are dying, so maybe people

64
00:03:54,120 --> 00:03:56,839
Speaker 1: should care about them. And I think we've seen increasingly

65
00:03:56,880 --> 00:04:02,160
Speaker 1: inside the administration from Jay Baticharia from the Republican senators,

66
00:04:02,160 --> 00:04:04,400
Speaker 1: a feeling of like, okay, you know, enough is enough,

67
00:04:04,560 --> 00:04:08,120
Speaker 1: Like let's try to get back towards having more vaccines

68
00:04:08,160 --> 00:04:10,840
Speaker 1: and appointing someone as surgeon general who has refused in

69
00:04:10,880 --> 00:04:14,640
Speaker 1: the confirmation hearings to say that she supports vaccines is

70
00:04:14,720 --> 00:04:17,159
Speaker 1: kind of part of that. So I suspect that the

71
00:04:17,200 --> 00:04:19,680
Speaker 1: nomination will be withdrawn because I just don't think there's

72
00:04:19,720 --> 00:04:23,480
Speaker 1: Republican support. Bill Cassidy has had enough of this. Thanks

73
00:04:25,320 --> 00:04:28,360
Speaker 1: also in the camp of all the ways in which

74
00:04:28,360 --> 00:04:32,480
Speaker 1: we're positively influencing the world. I noticed after last week's

75
00:04:32,839 --> 00:04:38,000
Speaker 1: stem cell episode there was a BMJ article about stem

76
00:04:38,040 --> 00:04:40,000
Speaker 1: cells a heart attack that was retracted.

77
00:04:41,120 --> 00:04:43,680
Speaker 3: Tell me more, and what role did you specifically play

78
00:04:43,720 --> 00:04:43,960
Speaker 3: in this?

79
00:04:45,200 --> 00:04:48,680
Speaker 2: Yeah, I mean, once again the curse of wellness. Actually, like,

80
00:04:48,800 --> 00:04:51,680
Speaker 2: woe be unto you who is mentioned on this show,

81
00:04:51,839 --> 00:04:55,520
Speaker 2: because bad things will happen. The BMJ is the British

82
00:04:55,560 --> 00:04:57,760
Speaker 2: Medical Journal. Actually used to be called the British Medical Journal.

83
00:04:57,800 --> 00:05:01,560
Speaker 2: It is now officially just the BMJ, their hip but

84
00:05:02,279 --> 00:05:05,280
Speaker 2: very well respected journal. In twenty twenty five, there was

85
00:05:05,320 --> 00:05:08,560
Speaker 2: a report of in that journal of a randomized trial

86
00:05:08,839 --> 00:05:11,480
Speaker 2: of people who had heart attacks and were getting a

87
00:05:11,520 --> 00:05:14,760
Speaker 2: cardiac cathorization. So they you know, they put a little

88
00:05:14,839 --> 00:05:17,159
Speaker 2: wire into the heart to open up the blood vessel

89
00:05:17,480 --> 00:05:21,960
Speaker 2: that is blocked, and the intervention a placebo controlled intervention.

90
00:05:22,120 --> 00:05:25,200
Speaker 2: Was to inject some stem cells that were isolated from

91
00:05:25,360 --> 00:05:29,480
Speaker 2: Wharton's jelly, which is, for lack of a better word,

92
00:05:30,000 --> 00:05:33,800
Speaker 2: the goo that's inside the umbilical cord. Okay, it's like

93
00:05:33,920 --> 00:05:37,560
Speaker 2: a yeah, it does have a fair amount of mesenchymal

94
00:05:37,600 --> 00:05:40,320
Speaker 2: stem cells in it. Please go back to last week's

95
00:05:40,320 --> 00:05:42,480
Speaker 2: episode if you want to hear more details about that.

96
00:05:43,320 --> 00:05:46,039
Speaker 2: And what this study claimed to show was that the

97
00:05:46,120 --> 00:05:49,640
Speaker 2: rate of heart failure was significantly lower in the people

98
00:05:49,640 --> 00:05:51,960
Speaker 2: who got this special stem cell injection. So it was

99
00:05:52,000 --> 00:05:54,000
Speaker 2: sort of a thought like, oh, you're putting in these

100
00:05:54,160 --> 00:05:57,080
Speaker 2: these stem cells, They're going to differentiate into heart tissue

101
00:05:57,160 --> 00:06:00,799
Speaker 2: and become, you know, protect the heart in the long term.

102
00:06:01,480 --> 00:06:04,839
Speaker 2: This is biologically plausible, as we often say, and it was,

103
00:06:04,920 --> 00:06:08,520
Speaker 2: you know, by reports, a well done trial. Unfortunately, it

104
00:06:08,520 --> 00:06:12,680
Speaker 2: turns out that there were significant data regularities that were

105
00:06:12,839 --> 00:06:16,120
Speaker 2: subsequently revealed when the data was analyzed, and the full

106
00:06:16,240 --> 00:06:19,680
Speaker 2: article has now been retracted. The BMJ stopped short of

107
00:06:19,680 --> 00:06:23,520
Speaker 2: saying it was fraudulent, but it does just remind all

108
00:06:23,560 --> 00:06:26,560
Speaker 2: of us that no one study is ever definitive because

109
00:06:26,960 --> 00:06:29,120
Speaker 2: you never really know. You always need replication in this

110
00:06:29,200 --> 00:06:29,640
Speaker 2: kind of thing.

111
00:06:30,440 --> 00:06:32,800
Speaker 1: Yeah, and I should say that retraction of a study

112
00:06:32,800 --> 00:06:35,800
Speaker 1: in a paper is actually pretty unusual, so it's not

113
00:06:36,360 --> 00:06:39,440
Speaker 1: Certainly it can be retracted if it is fraudulent, but

114
00:06:39,560 --> 00:06:41,800
Speaker 1: generally this means it is fraudulent or it is wrong.

115
00:06:42,520 --> 00:06:45,040
Speaker 1: You know, papers are updated over time and sometimes you

116
00:06:45,080 --> 00:06:46,760
Speaker 1: will look back and say, well, we weren't quite right

117
00:06:46,760 --> 00:06:47,120
Speaker 1: about that.

118
00:06:47,160 --> 00:06:48,839
Speaker 3: But to actually retract a paper means you.

119
00:06:48,839 --> 00:06:51,960
Speaker 1: Know, the paper is not right, something was wrong, and

120
00:06:52,040 --> 00:06:54,680
Speaker 1: how this was done not We have learned more later,

121
00:06:54,760 --> 00:06:57,000
Speaker 1: but like the way this paper was done was not right.

122
00:06:57,080 --> 00:07:00,880
Speaker 1: So it's a more extreme change than just you know,

123
00:07:00,920 --> 00:07:02,080
Speaker 1: the literature has evolved.

124
00:07:02,520 --> 00:07:06,520
Speaker 2: Yeah, absolutely, so wellness, Actually skepticism around stem cells is

125
00:07:06,560 --> 00:07:11,440
Speaker 2: proven correct yet again. Our last news item is I

126
00:07:11,440 --> 00:07:14,200
Speaker 2: think a good one for to put your economist hat on, Emily.

127
00:07:14,280 --> 00:07:16,000
Speaker 2: I know we don't get to use that as often

128
00:07:16,040 --> 00:07:18,800
Speaker 2: as we would like in the podcast, but a new

129
00:07:18,880 --> 00:07:23,720
Speaker 2: study came out looking at childhood sugar intake and the

130
00:07:23,800 --> 00:07:27,480
Speaker 2: genetic risk for obesity and how those things interact using

131
00:07:27,520 --> 00:07:30,960
Speaker 2: a really cool natural experiment. So can you walk me

132
00:07:31,000 --> 00:07:32,600
Speaker 2: through this new paper.

133
00:07:33,160 --> 00:07:37,640
Speaker 1: Yeah, so this paper uses a technique that economists call

134
00:07:37,920 --> 00:07:42,120
Speaker 1: natural experiments, where you want to think about this as

135
00:07:42,600 --> 00:07:43,480
Speaker 1: the world.

136
00:07:43,120 --> 00:07:44,480
Speaker 3: Has experimented for you.

137
00:07:44,640 --> 00:07:48,240
Speaker 1: And so in this particular case, they're using sugar restrictions

138
00:07:48,640 --> 00:07:51,960
Speaker 1: post World War two. So in the UK after World

139
00:07:52,000 --> 00:07:53,480
Speaker 1: War Two, there was a long period of time in

140
00:07:53,520 --> 00:07:56,440
Speaker 1: which there were restrictions on how much sugar you could

141
00:07:56,480 --> 00:08:00,440
Speaker 1: buy because of worries about not having enough, and then

142
00:08:00,480 --> 00:08:03,239
Speaker 1: at some point in the middle of nineteen fifty three

143
00:08:03,280 --> 00:08:05,640
Speaker 1: they relax those sugar restrictions and you were allowed to

144
00:08:05,680 --> 00:08:08,520
Speaker 1: buy more sugar. And the result of that was that

145
00:08:08,760 --> 00:08:11,360
Speaker 1: kids ate a lot more sugar, and pregnant people ate

146
00:08:11,400 --> 00:08:14,400
Speaker 1: a lot more sugar in like October nineteen fifty three

147
00:08:14,480 --> 00:08:17,800
Speaker 1: than in August nineteen fifty three. And so they're using

148
00:08:17,880 --> 00:08:21,000
Speaker 1: that sharp timing to look at whether being exposed to

149
00:08:21,080 --> 00:08:26,200
Speaker 1: higher levels of sugar, either in utero or in early childhood,

150
00:08:26,320 --> 00:08:30,480
Speaker 1: is associated with higher risks of metabolic disease later. This

151
00:08:30,560 --> 00:08:33,400
Speaker 1: paper actually follows on an earlier paper where they show

152
00:08:34,320 --> 00:08:37,760
Speaker 1: that kids who have higher sugar exposure in this period

153
00:08:37,760 --> 00:08:40,880
Speaker 1: have higher risks of diabetes later in life. And so

154
00:08:41,000 --> 00:08:47,840
Speaker 1: here they're showing higher risks of obesity and also that

155
00:08:47,840 --> 00:08:51,559
Speaker 1: that interacts with your genetic predisposition to obesity.

156
00:08:51,640 --> 00:08:53,680
Speaker 3: So it's really interesting paper.

157
00:08:53,720 --> 00:08:55,520
Speaker 1: I think it does give a little bit of caution

158
00:08:55,640 --> 00:08:59,559
Speaker 1: about very high levels of sugar exposure in early childhood.

159
00:08:59,880 --> 00:09:01,439
Speaker 1: I will say, you know, parents will come to me

160
00:09:01,480 --> 00:09:03,520
Speaker 1: and be like, oh my god, does this mean I

161
00:09:03,520 --> 00:09:05,280
Speaker 1: can't Like I one time I gave my child a

162
00:09:05,280 --> 00:09:07,240
Speaker 1: piece of cake, and like, have I ridden them forever? Like,

163
00:09:07,440 --> 00:09:11,400
Speaker 1: we're talking here about a lot of sugar exposure. Clearly

164
00:09:11,400 --> 00:09:14,400
Speaker 1: some is okay, but it is one of the dietary

165
00:09:14,440 --> 00:09:16,319
Speaker 1: things we probably want to be a little more cautious

166
00:09:16,320 --> 00:09:18,719
Speaker 1: about with kids than some others.

167
00:09:19,200 --> 00:09:21,800
Speaker 2: Yeah, I think this paper also does a nice job

168
00:09:21,840 --> 00:09:25,000
Speaker 2: reminding us that, like a lot of obesity is genetic,

169
00:09:25,679 --> 00:09:29,880
Speaker 2: and so you know, they can look at the because

170
00:09:29,920 --> 00:09:32,000
Speaker 2: this comes from the UK Biobank, which is this big

171
00:09:32,400 --> 00:09:35,160
Speaker 2: amazing genetic cohort study, they can look at the genetic

172
00:09:35,240 --> 00:09:37,720
Speaker 2: risk factors for obesity and they can see, you know,

173
00:09:37,760 --> 00:09:40,240
Speaker 2: it's very clear that certain genes and patterns of genes

174
00:09:40,240 --> 00:09:43,520
Speaker 2: increase the risk for obesity, but that lower sort of

175
00:09:43,559 --> 00:09:46,320
Speaker 2: intaken childhood can kind of modify that risk, not all

176
00:09:46,360 --> 00:09:49,480
Speaker 2: the way. So it wasn't even like these people who

177
00:09:49,480 --> 00:09:52,720
Speaker 2: are at high risk genetically for obesity didn't become obese

178
00:09:52,760 --> 00:09:55,920
Speaker 2: because they were born during the rationing period. You know,

179
00:09:56,000 --> 00:09:59,800
Speaker 2: many of them still did, but the disparity in BMI

180
00:09:59,880 --> 00:10:02,680
Speaker 2: was somewhat lower than would have been predicted by genetics alone.

181
00:10:02,760 --> 00:10:05,240
Speaker 1: So yeah, I mean it's a very The uk Biobank

182
00:10:05,360 --> 00:10:10,480
Speaker 1: is an extremely important data source because of the way

183
00:10:10,520 --> 00:10:12,440
Speaker 1: I think it will continue to help us understand over

184
00:10:12,480 --> 00:10:16,160
Speaker 1: time the intersection between genetics and behavior and you know,

185
00:10:16,200 --> 00:10:19,360
Speaker 1: how our behaviors turn on and off genes, which is

186
00:10:19,440 --> 00:10:20,640
Speaker 1: an exciting area.

187
00:10:20,360 --> 00:10:22,840
Speaker 3: Of research that hopefully we'll talk about more.

188
00:10:23,440 --> 00:10:26,560
Speaker 2: Absolutely, that's it for the health news of the week.

189
00:10:26,760 --> 00:10:35,320
Speaker 2: When we come back. What's the deal with creatine? Okay,

190
00:10:35,440 --> 00:10:39,920
Speaker 2: I want to start with an influencer telling us just

191
00:10:40,160 --> 00:10:42,600
Speaker 2: how important creatine is.

192
00:10:43,400 --> 00:10:47,600
Speaker 4: Creatine should be now mandatory in everybody's took it, just

193
00:10:47,640 --> 00:10:50,600
Speaker 4: like brushing your teeth or exercising. I think everybody should

194
00:10:50,640 --> 00:10:54,120
Speaker 4: be supplementing with creatine prior to being diagnosed with alzheim As.

195
00:10:54,120 --> 00:10:57,280
Speaker 4: You've got this thirty year period of all these stages,

196
00:10:57,559 --> 00:11:01,200
Speaker 4: and one of those stages is subjective cognitive impairment, which

197
00:11:01,240 --> 00:11:04,040
Speaker 4: is the first stages of Alzheimer's disease. Right, Sometimes your

198
00:11:04,120 --> 00:11:06,200
Speaker 4: thinking's not up to scratch, or you forgot where you

199
00:11:06,240 --> 00:11:09,040
Speaker 4: put your keys, or you're getting slower reaction times. These

200
00:11:09,080 --> 00:11:12,040
Speaker 4: are all cognitive functions. They start to decline, then you've

201
00:11:12,040 --> 00:11:14,959
Speaker 4: got mild cognitive impairment, which is a pre dementia state,

202
00:11:15,000 --> 00:11:17,960
Speaker 4: and that lasts around twenty years. So it's during these

203
00:11:18,000 --> 00:11:22,440
Speaker 4: states that you need as much brain energy as you can,

204
00:11:22,720 --> 00:11:24,280
Speaker 4: and we can get that from creatine.

205
00:11:24,600 --> 00:11:29,200
Speaker 3: Okay, so, Perry, I like this influencer quote because I

206
00:11:29,240 --> 00:11:32,720
Speaker 3: think that it illustrates what, for me is the core

207
00:11:32,800 --> 00:11:35,560
Speaker 3: point that we will get to with creating as we

208
00:11:35,559 --> 00:11:40,160
Speaker 3: move through this, which is this person starts with something

209
00:11:40,840 --> 00:11:44,200
Speaker 3: that I think is an overstatement but is true in

210
00:11:44,240 --> 00:11:45,840
Speaker 3: some sense, which is that there are some things where

211
00:11:45,840 --> 00:11:49,680
Speaker 3: we see benefits of creating, and then she kind of immediately.

212
00:11:49,000 --> 00:11:52,680
Speaker 1: Goes to like creatine prevents Alzheimer's, which is way on

213
00:11:52,760 --> 00:11:54,760
Speaker 1: the edge of what we think. So it's such a

214
00:11:54,760 --> 00:11:57,040
Speaker 1: good example of the kind of like let's take something

215
00:11:57,080 --> 00:12:00,800
Speaker 1: that's real and like make it matter for for everything.

216
00:12:00,960 --> 00:12:03,360
Speaker 3: So absolutely it's a good entry.

217
00:12:03,480 --> 00:12:06,800
Speaker 2: This is you know, we like to give people little

218
00:12:07,320 --> 00:12:09,960
Speaker 2: little hints that they are being influenced as opposed to

219
00:12:09,960 --> 00:12:12,199
Speaker 2: being provided with real data, and and one of those

220
00:12:12,280 --> 00:12:16,280
Speaker 2: hints is taking an extreme position. It's very engaging to

221
00:12:16,360 --> 00:12:21,640
Speaker 2: be like this supplement creatine like is necessary for literally

222
00:12:21,679 --> 00:12:24,360
Speaker 2: everyone and as important as brushing your teeth, and like

223
00:12:24,760 --> 00:12:27,880
Speaker 2: you're you're staking out a position so extreme that you

224
00:12:28,000 --> 00:12:30,840
Speaker 2: kind of have to pay attention to it. And we

225
00:12:30,920 --> 00:12:34,880
Speaker 2: just need to tell everyone that's never true. There's there's

226
00:12:34,920 --> 00:12:36,679
Speaker 2: literally even brushing is.

227
00:12:36,640 --> 00:12:40,040
Speaker 3: As important as brushing your teeth. You should brush your teeth.

228
00:12:40,080 --> 00:12:41,920
Speaker 1: But even if you don't do that, like it's rebably

229
00:12:41,960 --> 00:12:44,560
Speaker 1: okay occasionally, but still you should brush your teeth.

230
00:12:44,880 --> 00:12:48,880
Speaker 2: Yeah, so let's dig in. There's there's a lot here,

231
00:12:49,280 --> 00:12:52,280
Speaker 2: but let's start like just at the beginning, right, Like, so,

232
00:12:52,920 --> 00:12:54,320
Speaker 2: what is the what is creatine?

233
00:12:54,360 --> 00:12:54,400
Speaker 5: Like?

234
00:12:54,440 --> 00:12:56,480
Speaker 2: Why are people talking about creatine? I see it from

235
00:12:56,480 --> 00:12:59,920
Speaker 2: a lot of bodybuilders and stuff. What's your take on creatine?

236
00:13:00,160 --> 00:13:01,480
Speaker 1: I mean, I think the first thing to just tell

237
00:13:01,520 --> 00:13:04,920
Speaker 1: people like literally, creatine's an amino acid. It is an

238
00:13:04,920 --> 00:13:07,640
Speaker 1: amino acid that you consume in food.

239
00:13:08,120 --> 00:13:11,640
Speaker 2: It's a derivative of an amino acid. I only say

240
00:13:12,559 --> 00:13:13,880
Speaker 2: because we did that.

241
00:13:14,000 --> 00:13:17,200
Speaker 3: Right, I'll say, doctor, I'm a real die. I went

242
00:13:17,200 --> 00:13:19,920
Speaker 3: to medical school. Black blah black, Now go ahead.

243
00:13:19,679 --> 00:13:24,200
Speaker 2: Please, because we said there's twenty two amino acids that

244
00:13:24,320 --> 00:13:26,280
Speaker 2: you know people use in creatines. Not one of them.

245
00:13:26,320 --> 00:13:28,720
Speaker 2: It's a derivative of an amino acid. But yes, by

246
00:13:28,760 --> 00:13:31,400
Speaker 2: all means continue.

247
00:13:30,800 --> 00:13:36,439
Speaker 1: You consume creatine in food, primarily in meat and seafood,

248
00:13:36,960 --> 00:13:39,360
Speaker 1: and you store it in your muscles, and it is

249
00:13:39,400 --> 00:13:43,959
Speaker 1: helpful for making the muscles work, particularly in an anaerobic way.

250
00:13:44,400 --> 00:13:47,160
Speaker 1: I think the core thing that's relevant for this question

251
00:13:47,200 --> 00:13:50,480
Speaker 1: of supplementation is that your muscles can generally store more

252
00:13:50,600 --> 00:13:53,920
Speaker 1: creatine than most people can get indeed, and most people

253
00:13:53,960 --> 00:13:57,640
Speaker 1: can get through their food. So when people supplement with creatine,

254
00:13:57,880 --> 00:14:01,520
Speaker 1: it like ramps up the store of creatine and their muscles,

255
00:14:01,559 --> 00:14:05,880
Speaker 1: and in principle that can then help you when you

256
00:14:06,120 --> 00:14:10,840
Speaker 1: are exercising in particular ways at very high levels.

257
00:14:10,880 --> 00:14:11,880
Speaker 3: That's kind of the core thing.

258
00:14:11,960 --> 00:14:15,200
Speaker 1: So do you exercise to failure on a frequent basis?

259
00:14:15,240 --> 00:14:17,839
Speaker 2: Perry, No, but I've done it.

260
00:14:18,320 --> 00:14:20,520
Speaker 3: What does it mean to exercise to failure?

261
00:14:21,960 --> 00:14:22,840
Speaker 2: Have you ever exercised?

262
00:14:22,880 --> 00:14:22,960
Speaker 6: If?

263
00:14:23,000 --> 00:14:24,280
Speaker 2: Have you have ever done an exercise?

264
00:14:24,240 --> 00:14:26,360
Speaker 1: You feel like I exercise to failure every like the

265
00:14:26,440 --> 00:14:27,360
Speaker 1: three days, But I don't.

266
00:14:27,400 --> 00:14:29,360
Speaker 3: I'm not sure that I know what that means.

267
00:14:29,520 --> 00:14:35,000
Speaker 2: Okay, exercising to failure literally means that you're doing an exercise,

268
00:14:35,040 --> 00:14:38,040
Speaker 2: let's say push ups, and you just continue to do

269
00:14:38,080 --> 00:14:40,120
Speaker 2: push ups and do push ups and do push ups

270
00:14:40,200 --> 00:14:44,600
Speaker 2: until your muscles give out. They literally fail. And I

271
00:14:44,680 --> 00:14:47,800
Speaker 2: think it might be worthwhile to talk about physiologically, like

272
00:14:47,960 --> 00:14:50,720
Speaker 2: what is happening there, because that might be the best

273
00:14:50,720 --> 00:14:54,040
Speaker 2: way to understand how creatine works. So if you do

274
00:14:54,120 --> 00:14:56,400
Speaker 2: push ups and you keep going, and you don't do

275
00:14:56,480 --> 00:14:57,880
Speaker 2: like I'm going to do twenty, I'm going to do thirty,

276
00:14:58,360 --> 00:15:01,440
Speaker 2: you just keep going, going, going until your arms. What

277
00:15:01,520 --> 00:15:04,000
Speaker 2: will happen have a pillow under your face because your

278
00:15:04,080 --> 00:15:07,000
Speaker 2: arms will literally stop working and your face will smash

279
00:15:07,000 --> 00:15:09,040
Speaker 2: into the ground and there's nothing you can do about this.

280
00:15:09,040 --> 00:15:12,000
Speaker 2: This has happened to me, but bodybuilders will do these

281
00:15:12,040 --> 00:15:16,200
Speaker 2: types of exercises to failure. What's happening in the muscle

282
00:15:16,240 --> 00:15:19,480
Speaker 2: when your muscle is contracting is the muscles using energy,

283
00:15:19,760 --> 00:15:22,560
Speaker 2: and the energy currency of all the cells in your

284
00:15:22,560 --> 00:15:25,760
Speaker 2: body is ATP. Probably hard us mention that before, but

285
00:15:25,800 --> 00:15:28,200
Speaker 2: think of it as like cash spending cash in terms

286
00:15:28,240 --> 00:15:31,320
Speaker 2: of you know what cells can use for energy. There's

287
00:15:31,360 --> 00:15:34,960
Speaker 2: a problem, and that's that cells can't store very much ATP.

288
00:15:35,520 --> 00:15:39,360
Speaker 2: It's unstable. It's hard to keep it in its activated form.

289
00:15:39,920 --> 00:15:42,400
Speaker 2: So it's like they've got some cash in their pocket,

290
00:15:42,600 --> 00:15:45,200
Speaker 2: but it's not enough to you know, go on a

291
00:15:45,280 --> 00:15:47,960
Speaker 2: huge spending spree. That's sort of how I think about ATP.

292
00:15:49,280 --> 00:15:52,360
Speaker 2: For most cells, that's not a problem because they use

293
00:15:52,400 --> 00:15:55,080
Speaker 2: a little energy to like whatever they're doing. You know,

294
00:15:55,840 --> 00:15:57,840
Speaker 2: your gut sell and uses some energy to absorb some

295
00:15:57,880 --> 00:15:59,560
Speaker 2: glucose or whatever, and then it's done for a while

296
00:15:59,560 --> 00:16:02,400
Speaker 2: and it chills out and builds up more ATP no issues.

297
00:16:02,400 --> 00:16:04,560
Speaker 2: But there's some cells in your body that use energy

298
00:16:04,760 --> 00:16:08,200
Speaker 2: like a lot in over a period of time, and

299
00:16:08,760 --> 00:16:11,120
Speaker 2: muscle is definitely the biggest one, and that includes your

300
00:16:11,160 --> 00:16:13,680
Speaker 2: heart muscle, but you know your skeletal muscles as well.

301
00:16:14,200 --> 00:16:17,080
Speaker 2: If all they had to use for that energy was ATP,

302
00:16:17,880 --> 00:16:21,120
Speaker 2: then after about three seconds of muscle contraction, all the

303
00:16:21,160 --> 00:16:24,200
Speaker 2: ATP and a muscle cell is gone and the muscle fails,

304
00:16:24,480 --> 00:16:26,920
Speaker 2: and that means it just goes slack and your face

305
00:16:27,160 --> 00:16:30,080
Speaker 2: smashes forward into the pillow that you put under you

306
00:16:30,120 --> 00:16:35,520
Speaker 2: when you're doing pushups. That's not compatible with moving around

307
00:16:35,680 --> 00:16:37,960
Speaker 2: or lifting up anything. You can't have only two seconds

308
00:16:37,960 --> 00:16:42,960
Speaker 2: of muscle contraction, so what creatine is is a store

309
00:16:43,520 --> 00:16:47,760
Speaker 2: for phosphates that can regenerate ATP. So remember you can't

310
00:16:48,000 --> 00:16:49,480
Speaker 2: you can only have so much cash in your while

311
00:16:49,480 --> 00:16:51,040
Speaker 2: you can't have too much ATP in a cell, but

312
00:16:51,080 --> 00:16:53,240
Speaker 2: you can have lots of creatine. That's your bank account,

313
00:16:53,320 --> 00:16:56,160
Speaker 2: more or less. And so as your ATP is being

314
00:16:56,280 --> 00:16:59,920
Speaker 2: used up, creatine in the form of creatine phosphate is

315
00:17:00,120 --> 00:17:03,600
Speaker 2: regenerating ATP. So you're taking cash out of that.

316
00:17:03,800 --> 00:17:07,600
Speaker 1: But it's the ATM. It's your cells as an ATM

317
00:17:07,920 --> 00:17:09,160
Speaker 1: exactly exactly.

318
00:17:09,200 --> 00:17:11,800
Speaker 2: And as you pointed out, most of our muscle cells

319
00:17:11,800 --> 00:17:15,240
Speaker 2: based on a typical Western diet, actually can hold more

320
00:17:15,640 --> 00:17:21,000
Speaker 2: creatine than they have. And what that means is that

321
00:17:21,840 --> 00:17:23,959
Speaker 2: if you build up your store of creatine by creating

322
00:17:23,960 --> 00:17:29,040
Speaker 2: supplementation in theory, you have this extra amount in your

323
00:17:29,119 --> 00:17:33,000
Speaker 2: ATP bank account that you can extract upon. So it's

324
00:17:33,040 --> 00:17:36,280
Speaker 2: a little different. People often say creatine is like energy

325
00:17:36,320 --> 00:17:39,480
Speaker 2: for your muscle. It's more like the presence of creatine

326
00:17:39,520 --> 00:17:43,080
Speaker 2: allows your muscle to bank energy when it's not being

327
00:17:43,200 --> 00:17:45,560
Speaker 2: used so that it can pull it out again when

328
00:17:45,600 --> 00:17:47,800
Speaker 2: it is being used. It's almost acts more like a

329
00:17:47,840 --> 00:17:50,679
Speaker 2: battery or like a rechargeable battery, but you still have

330
00:17:50,720 --> 00:17:53,520
Speaker 2: to do the recharging. Creating does not have calories in it,

331
00:17:53,600 --> 00:17:56,760
Speaker 2: creating monohydrate right, like, so it's not energetic itself, but

332
00:17:57,040 --> 00:18:00,200
Speaker 2: it's a place to store energy in your muscles. There's

333
00:18:00,240 --> 00:18:03,240
Speaker 2: one other set of cells that do tend to be

334
00:18:03,440 --> 00:18:06,680
Speaker 2: active a lot and use a lot of ATP, which

335
00:18:06,720 --> 00:18:09,159
Speaker 2: is your brain, right, that's in your brain. Yeah, so

336
00:18:09,200 --> 00:18:10,880
Speaker 2: that's why you see a lot of muscle and brain

337
00:18:10,960 --> 00:18:11,840
Speaker 2: talk for creating.

338
00:18:11,960 --> 00:18:14,400
Speaker 1: Yeah, all right, so let's start with the muscle talk

339
00:18:14,760 --> 00:18:17,080
Speaker 1: and then move to the brain talk because the muscle

340
00:18:17,080 --> 00:18:21,560
Speaker 1: talk is in some ways a much easier conversation totally.

341
00:18:22,000 --> 00:18:27,000
Speaker 1: So the thing we know, I think with incredibly high certainty,

342
00:18:27,560 --> 00:18:31,720
Speaker 1: is that if you are doing a lot of bodybuilding

343
00:18:32,000 --> 00:18:38,160
Speaker 1: related exercise, creating supplementation can improve your performance. We have

344
00:18:38,760 --> 00:18:43,159
Speaker 1: hundreds and hundreds of randomized controlled trials of people doing

345
00:18:43,800 --> 00:18:49,600
Speaker 1: body building activities will show that creating supplementation on average

346
00:18:50,280 --> 00:18:52,800
Speaker 1: increases the time to failure, so allows you to do

347
00:18:52,840 --> 00:18:54,800
Speaker 1: more of those push ups before you smash your face

348
00:18:54,960 --> 00:18:56,919
Speaker 1: in the pillow.

349
00:18:56,960 --> 00:18:59,919
Speaker 3: And this is this has been used by bodybuilders for

350
00:19:00,040 --> 00:19:02,480
Speaker 3: are you know, decades?

351
00:19:02,520 --> 00:19:08,000
Speaker 1: I mean, this is like a very standard bodybuilder activity talk.

352
00:19:07,880 --> 00:19:09,879
Speaker 2: To me for a second, because this will come up again.

353
00:19:10,200 --> 00:19:14,200
Speaker 2: You said randomized control trials. Why in a study that's

354
00:19:14,240 --> 00:19:17,639
Speaker 2: looking at something like muscle strength, muscle performance, whatever your

355
00:19:18,119 --> 00:19:22,240
Speaker 2: metric is, why is a control randomization and control like

356
00:19:22,240 --> 00:19:25,359
Speaker 2: a placebo control so important Because there's plenty of studies

357
00:19:25,359 --> 00:19:27,560
Speaker 2: that aren't placebo controlled, particularly when we look at the brain.

358
00:19:27,640 --> 00:19:29,800
Speaker 2: So why does that matter when you're talking about things

359
00:19:29,840 --> 00:19:31,600
Speaker 2: like muscle strength and function?

360
00:19:32,119 --> 00:19:34,840
Speaker 1: Yeah, I mean, I think the core thing is that

361
00:19:34,920 --> 00:19:38,879
Speaker 1: actually a lot of your muscle strength and function is

362
00:19:38,920 --> 00:19:41,280
Speaker 1: what you think you can do, right, So if you

363
00:19:41,320 --> 00:19:44,199
Speaker 1: sort of engent, like, let's let's back up. In general,

364
00:19:44,200 --> 00:19:46,920
Speaker 1: we like randomized control trials because we have treat people

365
00:19:46,960 --> 00:19:49,280
Speaker 1: the same and the only thing that's different is what

366
00:19:49,400 --> 00:19:50,280
Speaker 1: thing we're giving them.

367
00:19:50,680 --> 00:19:53,040
Speaker 3: In this case, it's actually really.

368
00:19:52,800 --> 00:19:56,040
Speaker 1: Important that not only are we choosing at random who's

369
00:19:56,040 --> 00:19:59,520
Speaker 1: getting the creatine, but that we are also doing something

370
00:19:59,560 --> 00:20:02,480
Speaker 1: to the group that makes them think they're getting the

371
00:20:02,520 --> 00:20:05,480
Speaker 1: creatine or that they might be getting the creatine. Right,

372
00:20:05,520 --> 00:20:08,239
Speaker 1: Because if I tell you, hey, I gave you this

373
00:20:08,320 --> 00:20:11,200
Speaker 1: like amazing substance, it's going to make you be able

374
00:20:11,240 --> 00:20:13,320
Speaker 1: to do more push ups. You will be able to

375
00:20:13,359 --> 00:20:15,280
Speaker 1: do more push ups, even if what I have given

376
00:20:15,320 --> 00:20:16,720
Speaker 1: you is literally.

377
00:20:16,400 --> 00:20:18,639
Speaker 3: Like a like flower or something, or just like nothing.

378
00:20:18,640 --> 00:20:19,520
Speaker 3: I guess flower would help.

379
00:20:19,560 --> 00:20:21,159
Speaker 1: But like if I just give you nothing and I

380
00:20:21,200 --> 00:20:22,719
Speaker 1: tell you this helps you do push ups, you will

381
00:20:22,760 --> 00:20:23,560
Speaker 1: do more push ups.

382
00:20:23,760 --> 00:20:25,920
Speaker 3: Like that's how our brain is, which is cool.

383
00:20:26,000 --> 00:20:29,080
Speaker 2: Yeah, it's kind of amazing. It's it's like it's like

384
00:20:29,160 --> 00:20:31,679
Speaker 2: Dumbo with the feather. Remember he has the feather that

385
00:20:31,720 --> 00:20:33,760
Speaker 2: can make him fly, and then at the end he

386
00:20:33,840 --> 00:20:35,880
Speaker 2: loses the feather, but it turns out he could fly

387
00:20:35,960 --> 00:20:36,439
Speaker 2: all along.

388
00:20:36,920 --> 00:20:40,240
Speaker 1: Remember, right, I do remember it, I do remember, and

389
00:20:40,440 --> 00:20:42,400
Speaker 1: that movie makes me sad and so sorry, thank you

390
00:20:42,440 --> 00:20:45,720
Speaker 1: for please never bring it up again. And so yeah,

391
00:20:45,760 --> 00:20:47,840
Speaker 1: so the placebo effect is like one of our best

392
00:20:47,960 --> 00:20:49,320
Speaker 1: it's like one of our best effects.

393
00:20:49,400 --> 00:20:50,920
Speaker 3: It really works very well.

394
00:20:51,240 --> 00:20:53,600
Speaker 1: But if you want to evaluate the impact of creating

395
00:20:53,640 --> 00:20:55,440
Speaker 1: on any of these things, you need to like sort

396
00:20:55,480 --> 00:20:59,080
Speaker 1: of turn off the placebo effect by having a true

397
00:21:00,040 --> 00:21:04,320
Speaker 1: double blind, randomized placebo control trial in which you people

398
00:21:04,440 --> 00:21:07,280
Speaker 1: don't know what group they're in. And in the case

399
00:21:07,320 --> 00:21:08,720
Speaker 1: of these bodybuilders, we have that.

400
00:21:08,680 --> 00:21:09,960
Speaker 3: Because it's of course it's easy.

401
00:21:10,600 --> 00:21:12,600
Speaker 1: We can come back to this in other settings, but

402
00:21:12,640 --> 00:21:15,600
Speaker 1: it's really easy to experiment on athletes, Like, that's a

403
00:21:15,640 --> 00:21:19,680
Speaker 1: great population loves environmentation. They love to first of all,

404
00:21:19,680 --> 00:21:21,520
Speaker 1: they love to be in they love You tell some

405
00:21:21,920 --> 00:21:24,360
Speaker 1: athlete like I had a randomized control trial something which

406
00:21:24,440 --> 00:21:25,480
Speaker 1: might have proved your performance.

407
00:21:25,560 --> 00:21:27,000
Speaker 3: Is like where do I sign up?

408
00:21:28,440 --> 00:21:31,080
Speaker 1: And the second thing is often what you're looking at

409
00:21:31,119 --> 00:21:34,000
Speaker 1: in the outcomes is really easy to define and is

410
00:21:34,119 --> 00:21:36,520
Speaker 1: short term. Right, So you can run one of these

411
00:21:36,560 --> 00:21:38,679
Speaker 1: studies in like like a few days, you give some

412
00:21:38,720 --> 00:21:41,800
Speaker 1: people creating, You give them some people and some other powder.

413
00:21:42,200 --> 00:21:43,760
Speaker 1: You ask them to do a bunch of push ups

414
00:21:43,760 --> 00:21:45,720
Speaker 1: with a pillow under their face, and like then that's it.

415
00:21:45,760 --> 00:21:49,440
Speaker 1: That's your paper, And that's so much easier then like

416
00:21:49,600 --> 00:21:51,200
Speaker 1: I'm going to treat this and I'm going to see

417
00:21:51,200 --> 00:21:53,720
Speaker 1: whether you develop dementia like fifty years from now.

418
00:21:53,960 --> 00:21:56,159
Speaker 3: That's just a much harder thing to study.

419
00:21:56,359 --> 00:21:59,080
Speaker 2: And that's one of the reasons we have so many studies.

420
00:21:59,119 --> 00:22:01,399
Speaker 2: And you'll always hear almost every influencer I looked at

421
00:22:01,480 --> 00:22:04,960
Speaker 2: talking about creatine opened with like it's the most studied

422
00:22:05,160 --> 00:22:07,800
Speaker 2: supplement in the history of mankind, which I couldn't find

423
00:22:07,840 --> 00:22:10,840
Speaker 2: any reference for. Like I'm not entirely I think vitamin C,

424
00:22:11,160 --> 00:22:13,119
Speaker 2: and like, I think, I'm not sure if that's true,

425
00:22:13,240 --> 00:22:14,879
Speaker 2: but it has been studied a lot. I'll give them that.

426
00:22:14,960 --> 00:22:17,480
Speaker 1: As of two thousand and three, in some review there

427
00:22:17,480 --> 00:22:19,800
Speaker 1: are like five there's like a review with five hundred papers,

428
00:22:19,800 --> 00:22:21,840
Speaker 1: and that's like twenty five years ago. So I and

429
00:22:21,920 --> 00:22:23,560
Speaker 1: this has only become more pop So I think this

430
00:22:23,600 --> 00:22:25,480
Speaker 1: is a very highly studied I'm not sure.

431
00:22:25,480 --> 00:22:26,280
Speaker 3: We don't count papers.

432
00:22:26,320 --> 00:22:28,880
Speaker 1: It's not like the it's not a metric, official metric.

433
00:22:28,960 --> 00:22:32,040
Speaker 1: Comedy papers have been written on something. But anyway, yeah, no,

434
00:22:32,200 --> 00:22:33,480
Speaker 1: definitely not the best metric.

435
00:22:33,520 --> 00:22:36,040
Speaker 2: But let's put some let's put some numbers to it,

436
00:22:36,119 --> 00:22:38,440
Speaker 2: so you know, we could pick from a lot of papers.

437
00:22:38,640 --> 00:22:40,280
Speaker 2: Sometimes the best thing to do when there are a

438
00:22:40,280 --> 00:22:43,320
Speaker 2: lot of papers, and especially a lot of randomized controlled trials,

439
00:22:43,400 --> 00:22:46,560
Speaker 2: is to look a meta analysis, which is a single

440
00:22:46,560 --> 00:22:50,560
Speaker 2: paper that combines the results from multiple papers to kind

441
00:22:50,560 --> 00:22:52,960
Speaker 2: of give you an average. It's sort of the idea

442
00:22:53,160 --> 00:22:55,160
Speaker 2: that every paper is going to have little errors going

443
00:22:55,200 --> 00:22:57,320
Speaker 2: one way or another, and you kind of average them

444
00:22:57,359 --> 00:23:01,439
Speaker 2: out to get an estimate that's more more true. And

445
00:23:01,520 --> 00:23:05,960
Speaker 2: so one that caught my eye because probably it speaks

446
00:23:06,040 --> 00:23:09,399
Speaker 2: to my age is a recent meta analysis appearing in

447
00:23:09,400 --> 00:23:14,440
Speaker 2: the journal Nutrients, looking at creatine supplementation with resistance training

448
00:23:14,640 --> 00:23:18,800
Speaker 2: on muscle strength gains in adults under fifty years of age.

449
00:23:18,840 --> 00:23:21,439
Speaker 2: So there's quite a lot of research in older adults

450
00:23:21,480 --> 00:23:23,920
Speaker 2: for muscle function and falls and things like that, which

451
00:23:23,960 --> 00:23:27,000
Speaker 2: is interesting. But you know, I'm not quite there yet,

452
00:23:27,000 --> 00:23:31,520
Speaker 2: and I'm more interested, like for me personally, I want

453
00:23:31,640 --> 00:23:33,359
Speaker 2: to go to the gym and like look a little

454
00:23:33,400 --> 00:23:36,200
Speaker 2: better and feel a little stronger, and I'm otherwise healthy,

455
00:23:36,240 --> 00:23:38,040
Speaker 2: and so I was very curious to see, like, Okay,

456
00:23:38,040 --> 00:23:41,800
Speaker 2: what can I expect from creatine. So this study compared

457
00:23:41,960 --> 00:23:46,359
Speaker 2: creatine supplementation and resistance training to place EBO plus resistance training,

458
00:23:47,240 --> 00:23:50,480
Speaker 2: and they looked at upper and lower body strength and

459
00:23:51,200 --> 00:23:55,600
Speaker 2: basically they found that the people randomized to creatine could

460
00:23:56,200 --> 00:24:00,160
Speaker 2: lift an extra four point four kilograms on the bench

461
00:24:00,200 --> 00:24:01,800
Speaker 2: that's what, like about ten.

462
00:24:01,560 --> 00:24:03,520
Speaker 3: Extra pounds ten pounds, yeah.

463
00:24:03,400 --> 00:24:07,160
Speaker 2: Yeah, ten pounds on the bench press, and thirteen kilograms

464
00:24:07,280 --> 00:24:10,360
Speaker 2: on the leg press, so you know, maybe twenty five

465
00:24:10,400 --> 00:24:13,880
Speaker 2: thirty pounds on the leg press. That's not nothing. I mean,

466
00:24:14,280 --> 00:24:16,680
Speaker 2: you're own old all of a sudden, but that's real.

467
00:24:16,760 --> 00:24:17,320
Speaker 2: What do you think?

468
00:24:17,800 --> 00:24:19,800
Speaker 1: Yeah, I mean I think that seems real, and I

469
00:24:19,840 --> 00:24:22,359
Speaker 1: also wouldn't There's two things I would say about that.

470
00:24:22,400 --> 00:24:25,040
Speaker 1: So one is I would not dismiss the old people evidence.

471
00:24:25,080 --> 00:24:27,320
Speaker 1: I actually think that's the other piece of evidence here,

472
00:24:27,840 --> 00:24:30,480
Speaker 1: even though you know you're not, we're not yet older adults.

473
00:24:30,480 --> 00:24:32,760
Speaker 1: But actually the other really strong piece of evidence around

474
00:24:32,760 --> 00:24:36,639
Speaker 1: creatine is the benefits on falls and on mobility for

475
00:24:36,720 --> 00:24:40,840
Speaker 1: older for older adults. But in both those populations and

476
00:24:41,080 --> 00:24:43,560
Speaker 1: in the like the setting you're talking about, it's actually

477
00:24:43,640 --> 00:24:48,119
Speaker 1: very important to be combined with resistance training. So just

478
00:24:48,359 --> 00:24:51,800
Speaker 1: taking a bunch of creatine and doing nothing will not matter.

479
00:24:52,119 --> 00:24:54,679
Speaker 1: The thing that creatine is helping you do is helping

480
00:24:54,680 --> 00:24:58,320
Speaker 1: your muscles exercise closer to failure, which allows your muscles

481
00:24:58,359 --> 00:25:00,000
Speaker 1: to break down more and then allows them to build

482
00:25:00,160 --> 00:25:03,240
Speaker 1: back more. So we want to be like very clear

483
00:25:03,359 --> 00:25:07,879
Speaker 1: on this, even on the well established muscle stuff, that

484
00:25:08,000 --> 00:25:10,240
Speaker 1: it is not just taking the creatine. It is taking

485
00:25:10,240 --> 00:25:13,560
Speaker 1: the creatine and doing some strength training at the same time.

486
00:25:13,600 --> 00:25:19,320
Speaker 2: That is really important, and honestly not only doing whatever

487
00:25:19,359 --> 00:25:22,720
Speaker 2: strength training you normally do. The benefit derives from the

488
00:25:22,760 --> 00:25:25,359
Speaker 2: fact that you should be able to do slightly more.

489
00:25:25,480 --> 00:25:27,439
Speaker 2: We don't want to interhurt themselves. We want you to

490
00:25:27,560 --> 00:25:30,720
Speaker 2: ramp up slowly. And if you know you can afford

491
00:25:30,760 --> 00:25:32,960
Speaker 2: like a personal trainer to even work with you to

492
00:25:32,960 --> 00:25:36,159
Speaker 2: get there, that's amazing. I certainly can't. You do have

493
00:25:36,200 --> 00:25:40,480
Speaker 2: to be careful, but right, creating isn't magic. It allows

494
00:25:40,520 --> 00:25:42,720
Speaker 2: you to do a little more work, but you've got

495
00:25:42,720 --> 00:25:44,280
Speaker 2: to do the more work if you want to see

496
00:25:44,359 --> 00:25:44,960
Speaker 2: the improvement.

497
00:25:46,040 --> 00:25:47,880
Speaker 3: All right, So that's on muscles.

498
00:25:48,040 --> 00:25:52,280
Speaker 1: I want because it's my deep passion to say, very briefly,

499
00:25:52,600 --> 00:25:55,000
Speaker 1: if you are an endurance athlete, so this is like

500
00:25:55,080 --> 00:25:59,240
Speaker 1: there's also an active discussion around people who do sports

501
00:25:59,320 --> 00:26:03,040
Speaker 1: that are not like bodybuilding sports, and the evidence for

502
00:26:03,080 --> 00:26:09,960
Speaker 1: creating supplementation in like running and cycling is less compelling

503
00:26:10,640 --> 00:26:13,160
Speaker 1: for reasons that I think makes sense with the biology.

504
00:26:13,400 --> 00:26:16,000
Speaker 1: So you know, you asked about sort of exercising to failure.

505
00:26:16,640 --> 00:26:20,760
Speaker 1: It is rare, even in you know, pretty intense like

506
00:26:21,040 --> 00:26:23,439
Speaker 1: even in like long distance running, to exercise to the

507
00:26:23,520 --> 00:26:25,879
Speaker 1: kind of failure you have described, It does happen. You

508
00:26:25,920 --> 00:26:27,960
Speaker 1: will see people at the end of a marathon like

509
00:26:28,920 --> 00:26:32,440
Speaker 1: unable to like control your body and like just sort

510
00:26:32,480 --> 00:26:34,600
Speaker 1: of like crawling across the finish line.

511
00:26:35,040 --> 00:26:40,920
Speaker 3: Like but that's not common. That's not common, and so the.

512
00:26:40,800 --> 00:26:43,199
Speaker 1: Kind of thing that creating would help with is like

513
00:26:43,400 --> 00:26:45,399
Speaker 1: just it's less obvious, it will be helpful.

514
00:26:45,440 --> 00:26:45,600
Speaker 2: There.

515
00:26:45,600 --> 00:26:47,880
Speaker 1: I will say a lot of endurance athletes do take

516
00:26:48,000 --> 00:26:50,159
Speaker 1: low levels of creating because like, why the hell not

517
00:26:51,160 --> 00:26:53,320
Speaker 1: just in case it might help because we're insane.

518
00:26:53,359 --> 00:26:55,840
Speaker 3: But the evidence isn't as it isn't as strong.

519
00:26:56,280 --> 00:26:58,240
Speaker 2: I'm so tempted to ask you if you take it.

520
00:26:58,200 --> 00:26:58,280
Speaker 1: But.

521
00:27:00,359 --> 00:27:02,160
Speaker 2: Oh you do, okay, I guess.

522
00:27:04,320 --> 00:27:06,720
Speaker 1: Because someone once said that it might make me faster.

523
00:27:06,800 --> 00:27:11,840
Speaker 1: Have we learned nothing about my psychology? Someone suggests all

524
00:27:12,000 --> 00:27:14,639
Speaker 1: you need to do is say you can run faster longer,

525
00:27:14,680 --> 00:27:16,680
Speaker 1: and Emily will do a little bit, a little bit

526
00:27:16,680 --> 00:27:20,760
Speaker 1: faster longer. I'll do it, absolutely, yes.

527
00:27:20,840 --> 00:27:23,360
Speaker 2: So let's while we're while we're sticking on effects, I mean,

528
00:27:23,400 --> 00:27:25,320
Speaker 2: we've got, of course, we have to talk about like

529
00:27:25,359 --> 00:27:28,480
Speaker 2: how you get creatine and stuff, but maybe let's go

530
00:27:28,640 --> 00:27:31,200
Speaker 2: on to the brain, because you know, I think the

531
00:27:31,520 --> 00:27:33,600
Speaker 2: data for muscle is great, but what I'm hearing from

532
00:27:33,600 --> 00:27:35,800
Speaker 2: a lot of people, and especially online, even that first

533
00:27:35,800 --> 00:27:40,400
Speaker 2: influencer is talking about creatine for Alzheimer's disease and things

534
00:27:40,520 --> 00:27:44,119
Speaker 2: like that. We'll get to general brain effects for a second.

535
00:27:44,160 --> 00:27:48,080
Speaker 2: But I'd like to play a quote from an influencer

536
00:27:48,160 --> 00:27:51,000
Speaker 2: for you. You're not going to be a surprise that this,

537
00:27:51,920 --> 00:27:53,159
Speaker 2: as I was.

538
00:27:53,720 --> 00:27:57,679
Speaker 5: There is a supplement that reversed memory loss in people

539
00:27:57,680 --> 00:28:01,640
Speaker 5: with Alzheimer's disease in a new double blind, Placibo controlled

540
00:28:01,640 --> 00:28:04,880
Speaker 5: trial right here in the United States, and very few

541
00:28:04,920 --> 00:28:06,479
Speaker 5: doctors are talking about it.

542
00:28:06,640 --> 00:28:08,840
Speaker 6: If you are news to my channel, Hi, my name

543
00:28:08,920 --> 00:28:09,520
Speaker 6: is Robert Love.

544
00:28:09,560 --> 00:28:12,000
Speaker 5: I'm a neuroscientist and I have a medical clinic in

545
00:28:12,080 --> 00:28:15,480
Speaker 5: Florida where we are reversing Alzheimer's in our patients. This

546
00:28:15,520 --> 00:28:18,960
Speaker 5: study was released June fourth or June fifth of twenty

547
00:28:19,040 --> 00:28:22,639
Speaker 5: twenty five. Kansas Medical School did a double blind, super

548
00:28:22,640 --> 00:28:26,760
Speaker 5: controlled trial in adults with Alzheimer's disease. Half the adults

549
00:28:26,760 --> 00:28:29,720
Speaker 5: got Creating, half the adults got at Placibo. Here's what

550
00:28:29,760 --> 00:28:33,080
Speaker 5: they found. The adults who took Creating actually improved their

551
00:28:33,359 --> 00:28:36,360
Speaker 5: memory in this study. Now, the thing is they give

552
00:28:36,400 --> 00:28:38,920
Speaker 5: them a very large dose of creating. The dose they

553
00:28:38,960 --> 00:28:41,920
Speaker 5: gave them was twenty grams a day. Most people are

554
00:28:41,960 --> 00:28:44,440
Speaker 5: taking three to five grams a day, maybe ten grams

555
00:28:44,480 --> 00:28:46,840
Speaker 5: a day. These people took twenty grams a day. There

556
00:28:46,840 --> 00:28:49,040
Speaker 5: were no serious side effects, in fact, really no side

557
00:28:49,040 --> 00:28:51,120
Speaker 5: effects at all of taking twenty grams a day, so

558
00:28:51,200 --> 00:28:52,720
Speaker 5: the people did not feel.

559
00:28:52,480 --> 00:28:54,840
Speaker 6: Bad and they improved their memory.

560
00:28:54,960 --> 00:28:58,320
Speaker 5: Now, creating is one of the most studied supplements on

561
00:28:58,960 --> 00:29:01,280
Speaker 5: the planets, lots of resource, specifically on.

562
00:29:01,280 --> 00:29:03,240
Speaker 6: Athletes for muscle health. Women.

563
00:29:03,280 --> 00:29:05,600
Speaker 5: This is especially important for you women, you make less

564
00:29:05,640 --> 00:29:09,960
Speaker 5: creatine than men do. Creatine is evolved in the process

565
00:29:09,960 --> 00:29:12,560
Speaker 5: of energy. Basically, it helps make ATP and so think

566
00:29:12,560 --> 00:29:15,640
Speaker 5: about it. When you make more ATP the creatine, some

567
00:29:15,720 --> 00:29:17,360
Speaker 5: of that can get into the brain and that can

568
00:29:17,400 --> 00:29:19,840
Speaker 5: help your brain make more energy, and that can improve

569
00:29:20,280 --> 00:29:20,959
Speaker 5: brain function.

570
00:29:21,680 --> 00:29:27,959
Speaker 2: So yeah, Emily, I was doing the research for this

571
00:29:27,960 --> 00:29:31,200
Speaker 2: this episode, and I was looking into the literature about

572
00:29:31,200 --> 00:29:34,640
Speaker 2: creatine in the brain, and I put together all my notes,

573
00:29:34,960 --> 00:29:36,720
Speaker 2: but then of course I went to the influencers. I

574
00:29:36,720 --> 00:29:39,040
Speaker 2: wanted to see what people were saying. And here's someone saying, like,

575
00:29:39,360 --> 00:29:44,440
Speaker 2: there's a you heard the words randomized placebo controlled trial

576
00:29:45,120 --> 00:29:51,400
Speaker 2: of creating for Alzheimer's disease, and it showed that it

577
00:29:51,760 --> 00:29:55,040
Speaker 2: fixed their memory problems. And I was like, huh, how

578
00:29:55,040 --> 00:29:57,520
Speaker 2: did I miss that? Like that's a big deal. How

579
00:29:57,520 --> 00:29:59,920
Speaker 2: did I miss that trial? And this is a this

580
00:30:00,160 --> 00:30:02,640
Speaker 2: influencers like a doctor. They have a clinic down in Florida,

581
00:30:02,760 --> 00:30:06,160
Speaker 2: Like it's always Florida, but you know whatever. So I

582
00:30:06,160 --> 00:30:07,840
Speaker 2: did a little bit of slew thing and I actually

583
00:30:07,840 --> 00:30:12,240
Speaker 2: found the study that this influencer was talking about. From

584
00:30:12,280 --> 00:30:15,160
Speaker 2: the context clues, the number of patients the university was

585
00:30:15,240 --> 00:30:18,360
Speaker 2: sent out of, et cetera. I found it. And it's

586
00:30:18,400 --> 00:30:21,000
Speaker 2: not a randomized trial. It's there's no randomization, it's not

587
00:30:21,000 --> 00:30:25,200
Speaker 2: placebo controlled. It's just twenty people with Alzheimer's who got

588
00:30:25,200 --> 00:30:28,280
Speaker 2: some memory testing and then went on creatine and then

589
00:30:28,320 --> 00:30:30,920
Speaker 2: got some more memory testing, and there was some modest

590
00:30:31,520 --> 00:30:34,840
Speaker 2: improvement in memory from before and after. But remember we've

591
00:30:34,840 --> 00:30:38,200
Speaker 2: already talked about like the importance of randomization of placebo controls.

592
00:30:38,680 --> 00:30:40,360
Speaker 2: So I know how you'll feel about this, But like,

593
00:30:40,840 --> 00:30:43,480
Speaker 2: I'm still having trouble with the influencer world, Like you

594
00:30:43,640 --> 00:30:46,960
Speaker 2: can just say anything like is there are there no rules?

595
00:30:48,480 --> 00:30:51,520
Speaker 1: What I think is interesting about this one? Yeah, of course, yes,

596
00:30:51,560 --> 00:30:53,040
Speaker 1: there are no there are no rules.

597
00:30:53,760 --> 00:30:56,200
Speaker 3: But what was interesting about this was it so specific.

598
00:30:56,440 --> 00:30:58,840
Speaker 1: Like often in these influencer things, you'll hear, you know,

599
00:30:58,880 --> 00:31:01,920
Speaker 1: there's a new exciting study that says that creating works

600
00:31:01,920 --> 00:31:05,000
Speaker 1: for Alzheimer's. But to be sort of specifically wrong is

601
00:31:05,040 --> 00:31:08,600
Speaker 1: actually quite dangerous because of course, like anybody who found

602
00:31:08,640 --> 00:31:10,840
Speaker 1: this study would be like, oh, well, it's actually not

603
00:31:10,920 --> 00:31:13,800
Speaker 1: a double blind, placy book controlled randomized trial. It's it's

604
00:31:13,840 --> 00:31:16,600
Speaker 1: not a randomized trial of any sort. It's just like

605
00:31:16,640 --> 00:31:18,760
Speaker 1: a study of some people. So I think it's dangerous

606
00:31:18,800 --> 00:31:20,600
Speaker 1: to be too specific with your lies.

607
00:31:20,440 --> 00:31:21,200
Speaker 3: In the internet.

608
00:31:21,720 --> 00:31:25,240
Speaker 1: But at any rate, there is not a double blind,

609
00:31:25,240 --> 00:31:27,720
Speaker 1: policy book controled randomized trial of patients with Alzheimer's that

610
00:31:27,760 --> 00:31:29,480
Speaker 1: shows effects of creatine full stop.

611
00:31:30,320 --> 00:31:30,760
Speaker 3: There is not.

612
00:31:31,440 --> 00:31:35,320
Speaker 2: There's not. And while we're on the subject of the

613
00:31:35,960 --> 00:31:40,160
Speaker 2: neurodegenerative diseases, you know, this is again a place for

614
00:31:40,480 --> 00:31:43,960
Speaker 2: the reasons we talked about. Because brain cells do use

615
00:31:44,120 --> 00:31:48,720
Speaker 2: atp at a rate that is faster than your typical cells,

616
00:31:48,840 --> 00:31:50,920
Speaker 2: it makes sense to test these things. I'm so glad

617
00:31:50,920 --> 00:31:54,880
Speaker 2: that people are evaluating, especially a relatively benign supplement like creatine,

618
00:31:55,360 --> 00:32:00,680
Speaker 2: for degenerative neurologic diseases. But to give you like the

619
00:32:00,760 --> 00:32:04,600
Speaker 2: data on this, there's a large randomized trial seventeen hundred

620
00:32:04,640 --> 00:32:08,160
Speaker 2: people with early Parkinson's disease. They're all within five years

621
00:32:08,200 --> 00:32:10,520
Speaker 2: of diagnosis. This is coming from the Journal of the

622
00:32:10,520 --> 00:32:14,560
Speaker 2: American Medical Association twenty fifteen. They were given creating monohydrate

623
00:32:15,000 --> 00:32:17,840
Speaker 2: ten grams a day for a minimum of five years.

624
00:32:18,160 --> 00:32:21,120
Speaker 2: This is a placeable controlled randomized trial. I mean, what

625
00:32:21,480 --> 00:32:24,320
Speaker 2: an amazing study, right, Yeah, and it is actually I.

626
00:32:24,320 --> 00:32:26,360
Speaker 1: Mean to actually to run a set of like that

627
00:32:26,440 --> 00:32:29,280
Speaker 1: is extraordinary, extraordinary, really really impressive.

628
00:32:29,560 --> 00:32:33,200
Speaker 2: Yeah, kudos to the authors. The study was stopped early

629
00:32:33,320 --> 00:32:37,680
Speaker 2: for futility. So when we run trials, especially trials that

630
00:32:37,720 --> 00:32:40,000
Speaker 2: are expensive like this one would have been, and that

631
00:32:40,040 --> 00:32:41,960
Speaker 2: go on for a long time, we'll have an independent

632
00:32:42,000 --> 00:32:45,480
Speaker 2: statistical board that looks at the data at some specified

633
00:32:45,480 --> 00:32:48,680
Speaker 2: time points and says, is it possible that if you

634
00:32:48,760 --> 00:32:51,800
Speaker 2: continue this study you'll see a signal of benefit or

635
00:32:51,880 --> 00:32:54,719
Speaker 2: at this point, based on the data we have, like,

636
00:32:55,640 --> 00:32:58,800
Speaker 2: unless every single person who gets creating does amazingly, well,

637
00:32:58,920 --> 00:33:01,080
Speaker 2: you're not showing benefit, so you might as well stop.

638
00:33:01,080 --> 00:33:04,160
Speaker 2: Now it's no longer ethical to continue this trial. So

639
00:33:04,240 --> 00:33:08,920
Speaker 2: super impressive, no effect in Parkinson's disease. And then there's

640
00:33:08,960 --> 00:33:11,320
Speaker 2: another relatively large trial in this space five hundred and

641
00:33:11,320 --> 00:33:15,360
Speaker 2: fifty adults with Huntington disease. They were getting creatine amountohydrate

642
00:33:15,440 --> 00:33:18,440
Speaker 2: tight traded up to forty grams a day. We'll talk

643
00:33:18,480 --> 00:33:23,560
Speaker 2: about the dosing, but that is an incredibly high dose,

644
00:33:23,720 --> 00:33:28,680
Speaker 2: also placebo controlled, and also halted for futility.

645
00:33:28,800 --> 00:33:30,920
Speaker 3: So not a pantasy, I will say.

646
00:33:30,920 --> 00:33:34,200
Speaker 1: On the other side, there is a much smaller meta

647
00:33:34,240 --> 00:33:37,720
Speaker 1: analysis from twenty eighteen where they put together a number

648
00:33:37,760 --> 00:33:41,400
Speaker 1: of small trials. In the end totals like fewer than

649
00:33:41,400 --> 00:33:46,920
Speaker 1: three hundred people, but looking at just general cognitive performance,

650
00:33:48,120 --> 00:33:51,760
Speaker 1: and there, you know, maybe they get a little bit

651
00:33:51,800 --> 00:33:54,440
Speaker 1: of a signal on short term memory.

652
00:33:55,000 --> 00:33:59,640
Speaker 3: You know, this is not in a diagnosed population. The

653
00:33:59,680 --> 00:34:00,320
Speaker 3: result else.

654
00:34:00,760 --> 00:34:03,400
Speaker 1: Are pretty weak, and they only show up for a

655
00:34:03,400 --> 00:34:06,720
Speaker 1: small number of outcomes, and they mostly show up for vegetarians,

656
00:34:06,760 --> 00:34:10,439
Speaker 1: which you know, could be because they don't get enough meat,

657
00:34:10,600 --> 00:34:12,880
Speaker 1: or could be because you're cutting the data enough to

658
00:34:12,920 --> 00:34:16,080
Speaker 1: find a group where it matters for I don't really know.

659
00:34:16,200 --> 00:34:20,320
Speaker 1: So putting all of this together, I would say, certainly

660
00:34:20,600 --> 00:34:24,399
Speaker 1: the evidence for brain impacts is far, far, far, far

661
00:34:24,640 --> 00:34:28,400
Speaker 1: far weaker than the evidence for muscle impacts.

662
00:34:29,160 --> 00:34:32,320
Speaker 2: I agree. You know, in terms one of the issues

663
00:34:32,360 --> 00:34:35,800
Speaker 2: with the brain, it's like muscle's pretty easy to study.

664
00:34:36,080 --> 00:34:38,680
Speaker 2: You know, it's like how much can you bench? Like

665
00:34:38,719 --> 00:34:42,200
Speaker 2: that's a very reasonable metric, but like how well your

666
00:34:42,239 --> 00:34:45,360
Speaker 2: brain works is really hard. You know, we think about memory,

667
00:34:45,400 --> 00:34:48,560
Speaker 2: but if you look at detailed neurocognitive testing that happens

668
00:34:48,560 --> 00:34:51,640
Speaker 2: in a lot of these trials, it's it's memory, it's attention,

669
00:34:51,880 --> 00:34:55,680
Speaker 2: it's executive function. You know, there's all these sort of components,

670
00:34:55,960 --> 00:34:58,080
Speaker 2: many of which overlap with each other, some of which

671
00:34:58,120 --> 00:35:01,040
Speaker 2: we don't fully understand, all of to have scores on

672
00:35:01,200 --> 00:35:05,120
Speaker 2: scales that are impossible to explain to anyone, and it's

673
00:35:05,239 --> 00:35:08,480
Speaker 2: very hard to say like a global estimate of like

674
00:35:08,600 --> 00:35:11,239
Speaker 2: it makes your brain better. You're right. If there was

675
00:35:11,280 --> 00:35:13,719
Speaker 2: one thing that keeps kind of standing out in these

676
00:35:13,760 --> 00:35:18,320
Speaker 2: smaller trials of you know, older adults, it's probably memory.

677
00:35:18,360 --> 00:35:19,879
Speaker 2: I mean, did you did you find that as well?

678
00:35:19,920 --> 00:35:23,239
Speaker 1: Like if you're short term memory, it's kind of short

679
00:35:23,320 --> 00:35:26,719
Speaker 1: term memory issues, which which is something a lot of

680
00:35:26,719 --> 00:35:31,480
Speaker 1: older adults struggle with, and so that sort of comes

681
00:35:31,520 --> 00:35:34,760
Speaker 1: out most consistently in these trials. It's also a relatively

682
00:35:34,800 --> 00:35:37,920
Speaker 1: straightforward thing to measure, as opposed to you know, measuring

683
00:35:37,920 --> 00:35:40,960
Speaker 1: someone's executive function is much harder than measuring their short

684
00:35:41,040 --> 00:35:43,080
Speaker 1: term memory, which you more or less do by telling

685
00:35:43,080 --> 00:35:45,120
Speaker 1: them a bunch of words and then a little later

686
00:35:45,160 --> 00:35:46,480
Speaker 1: at the end of the study being like, do you

687
00:35:46,520 --> 00:35:49,160
Speaker 1: remember what those words were? So there's a series of

688
00:35:49,200 --> 00:35:52,239
Speaker 1: pretty standard tests for that. So I guess the other

689
00:35:52,280 --> 00:35:55,239
Speaker 1: thing I would say about this is like, there's an

690
00:35:55,280 --> 00:36:00,560
Speaker 1: interesting link with you know, mobility and exercise and not

691
00:36:00,719 --> 00:36:03,640
Speaker 1: falling down and the brain. Right, So one one thing

692
00:36:03,680 --> 00:36:05,600
Speaker 1: that could be true is like you take creatine and

693
00:36:05,640 --> 00:36:07,560
Speaker 1: you do some resistance training, and so then you don't

694
00:36:07,560 --> 00:36:10,799
Speaker 1: fall down, and then you you know, end up interacting

695
00:36:10,800 --> 00:36:11,439
Speaker 1: more in the world.

696
00:36:11,640 --> 00:36:13,240
Speaker 3: That's actually really good for your brain.

697
00:36:13,760 --> 00:36:16,960
Speaker 1: So there's a whole set of interacting things when we

698
00:36:16,960 --> 00:36:20,920
Speaker 1: talk about the elderly, where anything that improves your ability

699
00:36:20,960 --> 00:36:24,759
Speaker 1: to do the activities of daily life is likely to

700
00:36:24,800 --> 00:36:27,840
Speaker 1: improve your brain because your brain is benefiting from doing

701
00:36:27,840 --> 00:36:30,160
Speaker 1: the activities of daily life absolutely.

702
00:36:30,640 --> 00:36:34,760
Speaker 2: So let's talk a little bit about how people get creatine. Okay,

703
00:36:34,800 --> 00:36:37,799
Speaker 2: so let's say that people say this sounds pretty good,

704
00:36:37,920 --> 00:36:40,080
Speaker 2: I want to bench a little bit more. So all

705
00:36:40,080 --> 00:36:41,840
Speaker 2: you have to do if you want to get creatine

706
00:36:42,000 --> 00:36:46,080
Speaker 2: is post on Instagram and say, well, I like I

707
00:36:46,200 --> 00:36:48,279
Speaker 2: like creatine and apparently it shows up at your house.

708
00:36:48,320 --> 00:36:49,319
Speaker 2: Why doesn't this work for me?

709
00:36:49,880 --> 00:36:50,839
Speaker 3: I don't know.

710
00:36:50,960 --> 00:36:56,239
Speaker 2: We're going to combine people combined. Emily and I have

711
00:36:56,400 --> 00:36:59,640
Speaker 2: over five hundred thousand Instagram followers.

712
00:36:59,480 --> 00:37:02,120
Speaker 3: It's so so true.

713
00:37:02,640 --> 00:37:03,000
Speaker 1: All right.

714
00:37:04,400 --> 00:37:08,480
Speaker 2: So, creatine, as you pointed out, comes from meat. But

715
00:37:08,560 --> 00:37:11,399
Speaker 2: because meat is muscle, and animals are just like us

716
00:37:11,440 --> 00:37:15,000
Speaker 2: and they have they have creatine in their muscles as well,

717
00:37:15,719 --> 00:37:20,440
Speaker 2: Vegetarians are people who potentially aren't ingesting creatine in that

718
00:37:20,480 --> 00:37:22,720
Speaker 2: way as much, which is why some of the data

719
00:37:22,920 --> 00:37:26,399
Speaker 2: restricted to vegetarians looks a little bit better for creating supplementation.

720
00:37:27,400 --> 00:37:30,880
Speaker 2: I should say that creatine is not an essential nutrient.

721
00:37:31,600 --> 00:37:34,239
Speaker 2: So essential nutrients are things that you must ingest or

722
00:37:34,280 --> 00:37:36,560
Speaker 2: you die, right like vitamin C. If you don't, you

723
00:37:36,560 --> 00:37:39,680
Speaker 2: get scurvy, you die, et cetera. Creatine is synthesized by

724
00:37:39,680 --> 00:37:41,920
Speaker 2: your body. It's synthesized in the liver and the kidney,

725
00:37:42,120 --> 00:37:45,040
Speaker 2: but probably not as much to sort of saturate how

726
00:37:45,120 --> 00:37:47,640
Speaker 2: much your muscles can take. They really can take quite

727
00:37:47,640 --> 00:37:49,640
Speaker 2: a bit of creatine, and as you pointed out, even

728
00:37:49,640 --> 00:37:53,480
Speaker 2: meat eaters are probably not fully saturating their muscle with creating.

729
00:37:53,960 --> 00:37:56,960
Speaker 1: Yeah, so when people talk about taking a creatine supplement

730
00:37:57,040 --> 00:37:58,760
Speaker 1: just to like get to brass text.

731
00:37:58,800 --> 00:38:00,759
Speaker 3: It's kind of two approaches to this.

732
00:38:01,080 --> 00:38:05,600
Speaker 1: So for people who are doing who are taking this

733
00:38:05,719 --> 00:38:09,080
Speaker 1: for like bodybuilding, the approach tends to.

734
00:38:08,960 --> 00:38:12,160
Speaker 3: Be to take a lot for a short period of time.

735
00:38:12,239 --> 00:38:16,640
Speaker 1: Like, as you know, thirty forty grams of creating a

736
00:38:16,719 --> 00:38:19,239
Speaker 1: day for some period of time, and then return to

737
00:38:19,280 --> 00:38:22,759
Speaker 1: a maintenance dose. For most people who would take this

738
00:38:22,920 --> 00:38:27,560
Speaker 1: to kind of just generally improve their overall muscle functioning

739
00:38:27,640 --> 00:38:30,200
Speaker 1: and so on, the typical dosage would be something like

740
00:38:30,280 --> 00:38:34,040
Speaker 1: five grams a day, as like a regular just to

741
00:38:34,080 --> 00:38:35,719
Speaker 1: take five grams a day.

742
00:38:36,120 --> 00:38:39,320
Speaker 2: That's probably even a bit more than the average person needs.

743
00:38:39,600 --> 00:38:42,000
Speaker 2: What will happen is that you pee out the excess,

744
00:38:42,200 --> 00:38:45,279
Speaker 2: so you know you can think about whether it's worth

745
00:38:45,280 --> 00:38:47,200
Speaker 2: it to you. It's not going to be harmful to

746
00:38:47,239 --> 00:38:51,280
Speaker 2: take more those big, bulky loading doses. Be a little

747
00:38:51,280 --> 00:38:53,440
Speaker 2: careful with if you've never done this before. There are

748
00:38:53,480 --> 00:38:58,040
Speaker 2: some gi effects. You get some rumblies in your tumblies

749
00:38:58,400 --> 00:39:01,560
Speaker 2: with creating, even at the I do. So if you

750
00:39:01,600 --> 00:39:04,080
Speaker 2: have a sensitive stomach, be a little careful when you

751
00:39:04,120 --> 00:39:04,560
Speaker 2: start out.

752
00:39:05,239 --> 00:39:06,839
Speaker 1: And there's a lot of ways to get creatine. There's

753
00:39:07,200 --> 00:39:10,640
Speaker 1: creating in powder, there's creatine in water, there's creating in

754
00:39:10,680 --> 00:39:13,560
Speaker 1: gummy form. This creatine pills is like a lot of

755
00:39:13,560 --> 00:39:15,719
Speaker 1: different a lot of different options.

756
00:39:16,160 --> 00:39:19,080
Speaker 2: Most of what you'll see is creating monohydrate. All of

757
00:39:19,160 --> 00:39:22,400
Speaker 2: the data that we talked about today was creating monohydrate.

758
00:39:22,440 --> 00:39:25,239
Speaker 2: There is this other form of creatine out there called

759
00:39:25,280 --> 00:39:27,719
Speaker 2: creatine fylester or something like that that they argue like

760
00:39:27,840 --> 00:39:29,759
Speaker 2: is absorbed better. There's no data on it, and there

761
00:39:29,760 --> 00:39:31,640
Speaker 2: doesn't seem to be a reason to spend extra money

762
00:39:31,640 --> 00:39:31,880
Speaker 2: on that.

763
00:39:32,200 --> 00:39:36,439
Speaker 1: All right, So two downside questions people often have here.

764
00:39:36,840 --> 00:39:40,719
Speaker 1: One is does creatine make you retain water? So this

765
00:39:40,840 --> 00:39:43,680
Speaker 1: is like I take a bunch of creatine and then

766
00:39:43,840 --> 00:39:47,360
Speaker 1: I'm all of a sudden like a bloated water bag.

767
00:39:48,520 --> 00:39:49,720
Speaker 3: True or false?

768
00:39:49,960 --> 00:39:50,240
Speaker 2: True?

769
00:39:50,560 --> 00:39:50,799
Speaker 3: True?

770
00:39:50,840 --> 00:39:54,879
Speaker 2: Oh yeah, absolutely absolutely. So what creatine is getting taken

771
00:39:54,960 --> 00:40:01,360
Speaker 2: up by your muscles, and water will flow from parts

772
00:40:01,440 --> 00:40:05,360
Speaker 2: of your body that have less dissolved stuff in it

773
00:40:05,440 --> 00:40:07,920
Speaker 2: to parts of your body that have more dissolved stuff

774
00:40:07,960 --> 00:40:12,200
Speaker 2: in it. That's osmosis, and so water will move into

775
00:40:12,239 --> 00:40:15,040
Speaker 2: your muscle cells when you start taking creatine as the

776
00:40:15,080 --> 00:40:17,560
Speaker 2: creating concentration in your muscle cells, build up and that

777
00:40:17,600 --> 00:40:20,000
Speaker 2: actually swells your muscles a little bit, Like it's not

778
00:40:20,040 --> 00:40:22,480
Speaker 2: really you're not stronger, but it does kind of like

779
00:40:22,640 --> 00:40:27,120
Speaker 2: maybe add a little definition. The studies show you know,

780
00:40:27,160 --> 00:40:32,560
Speaker 2: you're talking about two kilograms, so four to five pounds

781
00:40:32,560 --> 00:40:36,279
Speaker 2: in the first week or two of creating supplementation of

782
00:40:36,360 --> 00:40:40,520
Speaker 2: water weight, so be aware of that. And it does

783
00:40:40,560 --> 00:40:43,120
Speaker 2: persist as long as you supplement creatine. So like if

784
00:40:43,160 --> 00:40:45,319
Speaker 2: you if you're just doing your five grams a day,

785
00:40:45,480 --> 00:40:47,880
Speaker 2: like you'll you'll get that initial weight and you'll just

786
00:40:47,920 --> 00:40:50,400
Speaker 2: sort of stay at that extra water weight. If you

787
00:40:50,440 --> 00:40:53,480
Speaker 2: stop the creatine, then you'll have what's called diarrhsis and

788
00:40:53,520 --> 00:40:55,759
Speaker 2: you'll you'll lose some of that water. So you know,

789
00:40:56,000 --> 00:40:58,160
Speaker 2: don't don't freak out. You're going to gain a couple

790
00:40:58,160 --> 00:40:59,839
Speaker 2: of pounds. And it's just.

791
00:41:01,560 --> 00:41:03,560
Speaker 1: Second question, is it bad for my kidneys? You're a

792
00:41:03,600 --> 00:41:04,200
Speaker 1: kidney doctor.

793
00:41:04,280 --> 00:41:07,120
Speaker 2: Oh, I love this question. Can I tell a story?

794
00:41:07,160 --> 00:41:08,440
Speaker 2: Can I tell the patient story?

795
00:41:08,520 --> 00:41:10,640
Speaker 3: Do you love the kidney? So yeah, please tell.

796
00:41:11,239 --> 00:41:16,399
Speaker 2: I am a fellow kidney fellow at the University of Pennsylvania,

797
00:41:16,760 --> 00:41:18,920
Speaker 2: and this woman comes in and consult She's like this

798
00:41:19,000 --> 00:41:24,160
Speaker 2: eighty five year old Russian grandma whatever you're picturing that

799
00:41:24,320 --> 00:41:27,600
Speaker 2: is correct. That is how she looked. Okay, and she

800
00:41:27,760 --> 00:41:34,520
Speaker 2: comes in and she is a creatinin value of ten. Now,

801
00:41:34,680 --> 00:41:37,040
Speaker 2: creatinin is a blood test that we use to assess

802
00:41:37,120 --> 00:41:42,440
Speaker 2: kidney function. Creatinin is a metabolite of creatine. So the

803
00:41:42,480 --> 00:41:46,160
Speaker 2: creatine that's in your muscle breaks down and forms creatinin

804
00:41:46,239 --> 00:41:48,600
Speaker 2: at sort of a steady rate. Because everything breaks down

805
00:41:48,680 --> 00:41:52,719
Speaker 2: and your kidneys excrete, the creatinin fine. As your kidney

806
00:41:52,760 --> 00:41:56,040
Speaker 2: function worsens because they can't excrete as much, the creatin

807
00:41:56,080 --> 00:41:58,280
Speaker 2: in your blood goes up. So the higher your creatin

808
00:41:58,440 --> 00:42:00,960
Speaker 2: is the worst. Normal creatin is around one. Just to

809
00:42:01,000 --> 00:42:04,439
Speaker 2: keep things simple, a level of crat int of ten

810
00:42:04,560 --> 00:42:07,400
Speaker 2: is like, your kidneys aren't functioning at all. You need

811
00:42:07,440 --> 00:42:11,920
Speaker 2: to be on dialysis, your dad, Yeah, you need a transplant.

812
00:42:11,960 --> 00:42:15,200
Speaker 2: This is terrible. So I'm waiting for her to come in.

813
00:42:15,280 --> 00:42:17,160
Speaker 2: I'm ready to like have a conversation with this eighty

814
00:42:17,160 --> 00:42:19,160
Speaker 2: five year old Russian grandmother. It's like, Okay, I need

815
00:42:19,160 --> 00:42:20,840
Speaker 2: to admit you to the hospital today. We're going to

816
00:42:20,880 --> 00:42:23,120
Speaker 2: start dialysis. We'll get you on that. She's probably too

817
00:42:23,120 --> 00:42:24,600
Speaker 2: old for transplant. Like it was going to be a

818
00:42:24,600 --> 00:42:28,160
Speaker 2: whole thing, and she walks in and she looks great.

819
00:42:28,280 --> 00:42:34,520
Speaker 2: She's just spunky, old small lady. And I'm looking at

820
00:42:34,560 --> 00:42:37,279
Speaker 2: her other laboratory parameters and like her potassium's fine, it's

821
00:42:37,400 --> 00:42:39,799
Speaker 2: very unusual for some of the advanced kidney disease. The

822
00:42:39,880 --> 00:42:43,000
Speaker 2: acid base balance in her blood is totally stone cold normal.

823
00:42:43,920 --> 00:42:46,400
Speaker 2: Like it didn't make sense. So I'm talking to her,

824
00:42:46,520 --> 00:42:49,479
Speaker 2: and it comes out eventually as I'm asking her about

825
00:42:49,480 --> 00:42:51,880
Speaker 2: her diet, that she has a trick to staying healthy

826
00:42:51,880 --> 00:42:55,239
Speaker 2: in life. And what she does is she takes a

827
00:42:55,320 --> 00:42:58,200
Speaker 2: giant pot roast essentially at the beginning of the week

828
00:42:58,600 --> 00:43:01,560
Speaker 2: and boils it and boils it and boils it and

829
00:43:01,560 --> 00:43:05,399
Speaker 2: boils it until there's basically nothing left. She takes out

830
00:43:05,400 --> 00:43:07,839
Speaker 2: all the like gristle and whatever is left, and then

831
00:43:07,840 --> 00:43:11,560
Speaker 2: she takes that boiled stuff and she boils it and

832
00:43:11,560 --> 00:43:14,520
Speaker 2: boils it and boils it until she has a thick

833
00:43:15,320 --> 00:43:24,160
Speaker 2: slurry of like meat juice. Okay, And she drinks like

834
00:43:24,239 --> 00:43:27,200
Speaker 2: a cup of this thick slurry of meat juice a

835
00:43:27,320 --> 00:43:32,760
Speaker 2: day to stay strong and virile. And what was happening

836
00:43:33,000 --> 00:43:39,640
Speaker 2: is she was ingesting just herculean amounts of probably creatine,

837
00:43:39,640 --> 00:43:42,279
Speaker 2: but also creatin in because the act of cooking is

838
00:43:42,320 --> 00:43:44,960
Speaker 2: going to break down the creatine from the meat into

839
00:43:45,080 --> 00:43:48,080
Speaker 2: creatin in as well, So she was ingesting this huge

840
00:43:48,120 --> 00:43:52,200
Speaker 2: amount of creatinin. Most people muscles produce about a gram

841
00:43:52,239 --> 00:43:55,040
Speaker 2: of creatin in a day. So if so you make

842
00:43:55,080 --> 00:43:56,520
Speaker 2: a gram of creatin and you pee out a gram

843
00:43:56,520 --> 00:43:58,920
Speaker 2: of creatin and you stay and balance, everything's honkey dory.

844
00:43:59,000 --> 00:44:02,320
Speaker 2: She was clear taking in about ten times that because

845
00:44:02,360 --> 00:44:05,480
Speaker 2: her certum cretity I used to she was totally fine.

846
00:44:05,680 --> 00:44:09,480
Speaker 2: She had no kidney dysfunction whatsoever. So no, there is

847
00:44:09,560 --> 00:44:12,279
Speaker 2: no risk of kidney dysfunction with creatine.

848
00:44:12,440 --> 00:44:16,840
Speaker 1: However, sorry, did you tell her to stop doing this

849
00:44:17,120 --> 00:44:18,399
Speaker 1: or this was like totally fine?

850
00:44:18,520 --> 00:44:21,359
Speaker 2: She seemed fine, but I did. I did tell her.

851
00:44:21,440 --> 00:44:24,399
Speaker 2: I was like, listen, every time you get your blood tested.

852
00:44:24,719 --> 00:44:26,720
Speaker 3: They're going to tell you that your kidneys are figuring.

853
00:44:28,160 --> 00:44:33,880
Speaker 2: So yes, creatine supplementation will increase your creatinin in your blood,

854
00:44:34,600 --> 00:44:37,080
Speaker 2: and that is our marker of kidney disease. So when

855
00:44:37,120 --> 00:44:39,520
Speaker 2: you get your blood tested, if you're supplementing creatine, it

856
00:44:39,560 --> 00:44:44,920
Speaker 2: will be higher. And certain doctors who are less informed

857
00:44:45,120 --> 00:44:48,880
Speaker 2: might worry about that. There's no evidence that harms your

858
00:44:48,960 --> 00:44:53,040
Speaker 2: kidneys directly. There is another blood test for kidney function

859
00:44:53,120 --> 00:44:56,560
Speaker 2: called cistate and C which won't routinely get run, but

860
00:44:56,600 --> 00:45:00,799
Speaker 2: you can ask for and that's independent of creatine and

861
00:45:00,840 --> 00:45:02,840
Speaker 2: creatin and whatever. So like, if you really want to

862
00:45:02,840 --> 00:45:05,000
Speaker 2: know for sure, if you're nervous and you're on creating,

863
00:45:05,120 --> 00:45:07,200
Speaker 2: just ask for a size staatency. It's an approved test

864
00:45:07,239 --> 00:45:09,760
Speaker 2: and you can get like a better estimate of kidney function.

865
00:45:11,120 --> 00:45:12,080
Speaker 3: That's a great story.

866
00:45:12,320 --> 00:45:16,880
Speaker 1: I Before we end, I want to end with the

867
00:45:16,920 --> 00:45:22,160
Speaker 1: bad news for you, which is that creating, although influencers

868
00:45:22,200 --> 00:45:24,560
Speaker 1: will tell you it does, creatine does actually not affect

869
00:45:24,640 --> 00:45:25,800
Speaker 1: your hair loss or my hair.

870
00:45:25,680 --> 00:45:27,960
Speaker 3: Growth or your hair growth.

871
00:45:28,400 --> 00:45:31,400
Speaker 1: There's some discussion of both hair loss and hair growth.

872
00:45:31,640 --> 00:45:33,680
Speaker 2: Talk to me about this. I mean, I'll take no

873
00:45:33,760 --> 00:45:36,919
Speaker 2: effect on hair any day, although I love hair growth

874
00:45:36,960 --> 00:45:37,920
Speaker 2: if you can give me some of that.

875
00:45:39,640 --> 00:45:42,839
Speaker 1: There is sort of one small study that suggests that

876
00:45:43,160 --> 00:45:47,520
Speaker 1: maybe creating would in testosterone and then lead to possible

877
00:45:47,640 --> 00:45:50,160
Speaker 1: hair loss. But then there's many other studies which show

878
00:45:50,160 --> 00:45:52,480
Speaker 1: there's no effect on any of these things and so

879
00:45:53,920 --> 00:45:55,680
Speaker 1: but also no effect in the other direction.

880
00:45:57,680 --> 00:46:00,640
Speaker 2: Yeah, there are some observational studies to which are interesting

881
00:46:01,560 --> 00:46:04,920
Speaker 2: that correlate creatine and hair loss, and we always love

882
00:46:04,960 --> 00:46:08,719
Speaker 2: to talk about confounders, which are like third variables that

883
00:46:08,840 --> 00:46:12,960
Speaker 2: explain and observed association. And there are a couple of

884
00:46:13,000 --> 00:46:15,960
Speaker 2: things here I can speak from personal experience. One is

885
00:46:16,000 --> 00:46:21,279
Speaker 2: that as men age and start to worry about their

886
00:46:21,400 --> 00:46:24,879
Speaker 2: like muscles and you know, have a little more time

887
00:46:24,920 --> 00:46:26,400
Speaker 2: maybe after the kids are older, to go to the

888
00:46:26,440 --> 00:46:28,719
Speaker 2: gym and start taking creating, is also the age in

889
00:46:28,760 --> 00:46:31,120
Speaker 2: their life when like, the hair is not as thick

890
00:46:31,160 --> 00:46:33,600
Speaker 2: as it used to be. And then in the slightly

891
00:46:33,600 --> 00:46:36,759
Speaker 2: more sinister side. You know, creatine is used extensively in

892
00:46:36,800 --> 00:46:39,759
Speaker 2: the bodybuilding community, and there are other substances that are

893
00:46:39,840 --> 00:46:43,840
Speaker 2: used rather extensively in the bodybuilding community that certainly do

894
00:46:44,000 --> 00:46:48,719
Speaker 2: result in hair loss, like the androgenic steroids. So that's

895
00:46:48,760 --> 00:46:52,799
Speaker 2: another thing that is often not disclosed when taking a

896
00:46:52,800 --> 00:46:55,360
Speaker 2: survey about your supplement use and your hair loss.

897
00:46:55,680 --> 00:47:00,600
Speaker 1: Indeed, all right, I think that's it for creatine. Let's

898
00:47:00,640 --> 00:47:04,520
Speaker 1: do the smasher pass, Perry, smash your pass on the creatine.

899
00:47:04,680 --> 00:47:09,200
Speaker 2: So full disclosure, smash. I take my five grams of

900
00:47:09,520 --> 00:47:14,120
Speaker 2: creatine in gummy form a day, and I'm gonna just

901
00:47:14,440 --> 00:47:17,480
Speaker 2: whether it's placebo or not. I take it. I go

902
00:47:17,520 --> 00:47:20,279
Speaker 2: to the gym, and I'm doing it for muscle. And

903
00:47:20,400 --> 00:47:23,600
Speaker 2: if it helps my memory, that's great, but I'm not

904
00:47:23,600 --> 00:47:26,680
Speaker 2: sure that it does. Emily Smasher pass smash.

905
00:47:27,000 --> 00:47:29,120
Speaker 1: I also take my creatine every day. I even got

906
00:47:29,120 --> 00:47:31,640
Speaker 1: my husband to take it. It's the only weird supplement

907
00:47:31,640 --> 00:47:36,880
Speaker 1: thing I managed to encourage him to do. And yeah,

908
00:47:36,960 --> 00:47:40,720
Speaker 1: I tend to take it in powder form, five grams

909
00:47:40,719 --> 00:47:44,120
Speaker 1: a day. And I also am feeling I'm maybe relying

910
00:47:44,160 --> 00:47:45,080
Speaker 1: on the placebo effect.

911
00:47:45,080 --> 00:47:46,480
Speaker 3: But it's totally fine.

912
00:47:46,440 --> 00:47:49,359
Speaker 2: Okay, I try powder form. How do you what? Do

913
00:47:49,360 --> 00:47:52,440
Speaker 2: you put it in hot water? Just a cup of

914
00:47:52,440 --> 00:47:53,760
Speaker 2: hot water? Doesn't it taste gross?

915
00:47:53,880 --> 00:47:54,000
Speaker 6: No?

916
00:47:54,040 --> 00:47:56,480
Speaker 1: I don't think it tastes bad. The I understand some

917
00:47:56,520 --> 00:47:59,680
Speaker 1: people feel this way. I the creatine that I typically consume,

918
00:48:00,360 --> 00:48:02,560
Speaker 1: which is thorn creatine.

919
00:48:02,160 --> 00:48:04,560
Speaker 3: Does not taste bad. I don't think it tastes like anything.

920
00:48:04,840 --> 00:48:06,800
Speaker 2: To me. It tastes super bitter. I get the whatever

921
00:48:06,840 --> 00:48:10,239
Speaker 2: they sell at Costco because not an ad, by the way,

922
00:48:10,280 --> 00:48:14,560
Speaker 2: but Costco. If you're listening, I love you. I get

923
00:48:14,600 --> 00:48:17,000
Speaker 2: whatever they sell there, but it is very bitter. And

924
00:48:17,040 --> 00:48:18,680
Speaker 2: I used to put it in my coffee and then

925
00:48:19,200 --> 00:48:21,000
Speaker 2: I like missed the fact.

926
00:48:20,800 --> 00:48:22,640
Speaker 3: That I enjoyed it, and it makes your coffee sad.

927
00:48:23,120 --> 00:48:24,840
Speaker 2: Yeah. Yeah, And I don't like sad coffee. I like

928
00:48:24,840 --> 00:48:26,840
Speaker 2: happy coffee. So I'm on gummies.

929
00:48:27,440 --> 00:48:29,879
Speaker 1: I will say these Creatine, these Creatina gummies are actually

930
00:48:29,920 --> 00:48:32,960
Speaker 1: really delicious. Also not an ad, but they are they

931
00:48:33,000 --> 00:48:34,440
Speaker 1: are good. So if you don't like the way the

932
00:48:34,480 --> 00:48:36,080
Speaker 1: powder tastes, I recommend gummies.

933
00:48:36,400 --> 00:48:39,680
Speaker 2: All right, after the break, we will get to your

934
00:48:39,960 --> 00:48:40,680
Speaker 2: question of the week.

935
00:48:46,200 --> 00:48:47,840
Speaker 4: Hi, Emily and Perry.

936
00:48:47,880 --> 00:48:52,680
Speaker 7: This is Elizabeth from Boston. So as my elder millennial

937
00:48:52,719 --> 00:48:57,160
Speaker 7: heart is mourning, James Vanderbeek, I'm realizing that I should

938
00:48:57,160 --> 00:49:00,680
Speaker 7: be close to scheduling my first COLONOLS could be I'm

939
00:49:00,719 --> 00:49:02,919
Speaker 7: forty two. Is it time yet?

940
00:49:03,440 --> 00:49:03,840
Speaker 6: Thanks?

941
00:49:04,520 --> 00:49:07,920
Speaker 1: So, the recommendation is to start for somebody with sort

942
00:49:07,960 --> 00:49:10,799
Speaker 1: of typical risk factors is to have a first colonoscoby

943
00:49:10,920 --> 00:49:14,839
Speaker 1: or a first colon cancer screening at forty five. So

944
00:49:14,920 --> 00:49:18,000
Speaker 1: that is the standard age. So if you are forty five,

945
00:49:18,760 --> 00:49:21,720
Speaker 1: now is the time. If you are younger than forty

946
00:49:21,719 --> 00:49:24,120
Speaker 1: five and you have significant risk factors, that could be

947
00:49:24,280 --> 00:49:26,880
Speaker 1: the time, but you really do want to start this,

948
00:49:26,920 --> 00:49:29,960
Speaker 1: I mean colon cancer screening is not as bad as

949
00:49:30,000 --> 00:49:33,120
Speaker 1: you think. You can talk more about that if you want,

950
00:49:33,320 --> 00:49:34,120
Speaker 1: but it is.

951
00:49:34,200 --> 00:49:35,880
Speaker 2: It's great. I'm going to go. I'm going to go.

952
00:49:36,239 --> 00:49:38,560
Speaker 3: Really I also thought it was great. Okay, I actually

953
00:49:38,560 --> 00:49:41,360
Speaker 3: thought all is awe.

954
00:49:42,760 --> 00:49:45,480
Speaker 1: Just to be clear, when you have a colonoscopy, like

955
00:49:45,719 --> 00:49:47,359
Speaker 1: a lot of I think a lot of people find

956
00:49:47,360 --> 00:49:51,080
Speaker 1: this very scary. But the procedure, the worst part of

957
00:49:51,080 --> 00:49:53,960
Speaker 1: this is you drink some terrible tasting drink and then

958
00:49:54,040 --> 00:49:55,359
Speaker 1: you poop for a bunch of times.

959
00:49:55,400 --> 00:49:57,000
Speaker 3: You're actually totally fine.

960
00:49:57,320 --> 00:49:59,120
Speaker 1: You know, you can't eat that much for a day,

961
00:49:59,280 --> 00:50:02,440
Speaker 1: and then you go you take this amazing propofol like

962
00:50:02,640 --> 00:50:04,080
Speaker 1: nap and it's so.

963
00:50:04,200 --> 00:50:06,160
Speaker 3: Nice, and then they wake you up and you're done, and.

964
00:50:06,120 --> 00:50:08,200
Speaker 1: Then you go home and take another nap and eat

965
00:50:08,239 --> 00:50:10,440
Speaker 1: something and it's it's great.

966
00:50:10,880 --> 00:50:11,799
Speaker 3: Yeah, right, it's great.

967
00:50:12,480 --> 00:50:17,160
Speaker 2: Nothing to worry about. Forty five For people of average risk,

968
00:50:17,280 --> 00:50:19,040
Speaker 2: talk to your doctor. If you're at higher risk, if

969
00:50:19,040 --> 00:50:21,239
Speaker 2: you had a family member that colon cancer, you should

970
00:50:21,239 --> 00:50:25,440
Speaker 2: start screening ten years before the age that they were diagnosed,

971
00:50:25,520 --> 00:50:27,600
Speaker 2: or if you have other high risk factors. The recommendation

972
00:50:27,680 --> 00:50:32,400
Speaker 2: is age forty. Colon cancer is occurring with increasing incidents

973
00:50:32,400 --> 00:50:35,440
Speaker 2: in younger people. That is something we'll talk about in

974
00:50:35,520 --> 00:50:39,000
Speaker 2: some more detail in the future, but yeah, get it done.

975
00:50:39,360 --> 00:50:41,759
Speaker 1: And I will say that when you are forty five,

976
00:50:41,800 --> 00:50:45,440
Speaker 1: many people face a choice about getting a colonoscopy or

977
00:50:45,560 --> 00:50:48,600
Speaker 1: using coli Guard, which is a system where you poop

978
00:50:48,600 --> 00:50:49,880
Speaker 1: in a box and you send it off and it

979
00:50:50,000 --> 00:50:53,520
Speaker 1: tests for markers that could be associated with they could

980
00:50:53,560 --> 00:50:57,239
Speaker 1: predict colon cancer. Coli Guard is very good at detecting

981
00:50:57,560 --> 00:51:02,720
Speaker 1: colon cancer and advanced at Noma's kolonoscopy is better at

982
00:51:03,280 --> 00:51:06,120
Speaker 1: is much better at sort of earlier stage stuff, and

983
00:51:06,160 --> 00:51:08,240
Speaker 1: so it's a little bit of a trade off for people,

984
00:51:08,239 --> 00:51:11,160
Speaker 1: depending on your risk factors. One thing I think many

985
00:51:11,200 --> 00:51:13,040
Speaker 1: people are not aware of I will just say is

986
00:51:13,080 --> 00:51:15,840
Speaker 1: if you do the colon guard and you screen positive,

987
00:51:16,280 --> 00:51:20,759
Speaker 1: your insurance may actually not cover the colonoscopy afterwards.

988
00:51:20,760 --> 00:51:22,719
Speaker 3: And so that is something to find out before you

989
00:51:22,880 --> 00:51:23,160
Speaker 3: do this.

990
00:51:23,280 --> 00:51:26,400
Speaker 1: It's like a weird thing about diagnostic versus screening, and

991
00:51:26,480 --> 00:51:29,440
Speaker 1: so that is true for some insurances.

992
00:51:29,800 --> 00:51:32,560
Speaker 2: Oh interesting, and cold guard you have to do every year.

993
00:51:33,080 --> 00:51:35,480
Speaker 1: Color Guard you have to do every year, and colonoscopy

994
00:51:35,520 --> 00:51:38,040
Speaker 1: if everything is good in principle, you could go ten

995
00:51:38,120 --> 00:51:42,920
Speaker 1: years between them. All right, that's it for us today.

996
00:51:43,160 --> 00:51:45,200
Speaker 1: Stick with us next week when we will ask what's

997
00:51:45,239 --> 00:51:50,319
Speaker 1: the deal with protein? Wellness Actually is produced in association

998
00:51:50,400 --> 00:51:51,480
Speaker 1: with iHeartMedia.

999
00:51:51,920 --> 00:51:53,840
Speaker 3: Our senior producer is Tamar Avishai.

1000
00:51:54,280 --> 00:51:57,919
Speaker 1: Our executive producer at iHeart is Jennifer Bassett. Our theme

1001
00:51:57,960 --> 00:52:00,520
Speaker 1: music is by Eric Deutsch and our our content is

1002
00:52:00,560 --> 00:52:01,959
Speaker 1: for educational purposes only.

1003
00:52:02,640 --> 00:52:04,920
Speaker 2: If you like the show, help other people find us.

1004
00:52:05,239 --> 00:52:08,000
Speaker 2: Leave a rating and review on Apple Podcasts or your

1005
00:52:08,080 --> 00:52:10,839
Speaker 2: podcatcher of choice and help us spread the word about

1006
00:52:10,880 --> 00:52:13,920
Speaker 2: the show. You can follow us on Instagram at Wellness

1007
00:52:13,960 --> 00:52:17,120
Speaker 2: Actually pod and don't forget We want to hear from you.

1008
00:52:17,560 --> 00:52:20,080
Speaker 2: Head over to Wellness Actually dot fm and leave us

1009
00:52:20,080 --> 00:52:22,680
Speaker 2: a question for our mailbag or suggest a topic for

1010
00:52:22,719 --> 00:52:23,359
Speaker 2: a future show.

1011
00:52:24,160 --> 00:52:26,000
Speaker 3: We'll let the influencers have the last word.

1012
00:52:26,360 --> 00:52:28,640
Speaker 8: As gues, we know we have more than twenty flavors

1013
00:52:28,640 --> 00:52:30,640
Speaker 8: of creatin if we don't know what flavor to pick,

1014
00:52:30,680 --> 00:52:33,680
Speaker 8: here are the top five flavors from the last thirty days.

1015
00:52:33,719 --> 00:52:36,319
Speaker 8: At number one, as usual, we have ink Lemonade. At

1016
00:52:36,360 --> 00:52:39,520
Speaker 8: number two, we have puckin Blures. If you like sour flavors,

1017
00:52:39,560 --> 00:52:41,279
Speaker 8: you are good to love this one. At number three,

1018
00:52:41,320 --> 00:52:44,680
Speaker 8: we have pinat Pada at number four, we have Raspberry watermelone.

1019
00:52:44,680 --> 00:52:47,440
Speaker 8: At number five, we have Glacier Gummy. There's a new

1020
00:52:47,440 --> 00:52:50,279
Speaker 8: flavor on the way which mimics the White Monster Energy drink,

1021
00:52:50,280 --> 00:52:52,080
Speaker 8: and I cannot wait for that one to go live.