In this episode of "What's the Proof?" we uncover why exercise truly is the miracle treatment we've been searching for. Exercise can drastically reduce the risk of heart disease, diabetes, cancer, dementia, and it has significant mortality benefits. Despite its profound impact, many physicians don't emphasize it enough in their practices. Join hosts Bobby, Dawn, and Sandy as they delve into the studies revealing the incredible health benefits of exercise and discuss practical ways to incorporate it into daily routines. Whether you're a clinician looking to motivate your patients or someone seeking to improve your own health, this episode is packed with valuable insights and evidence-based advice.

Episode Highlights:

[00:00] Introduction:

• Welcome and episode introduction by Bobby, Dawn, and Sandy.
• Discussion on the underutilization of exercise in medical practice despite its proven benefits.

[08:04] Exercise and the Effect on Major Diseases:

• Review of a 2013 BMJ study by on the dose-response relationship between physical activity and major disease risks.
• Explanation of MET minutes and their significance in quantifying physical activity levels.
• Discussion on how even moderate levels of physical activity can substantially reduce the risk of chronic diseases.

[12:02] Cardiorespiratory Fitness (CRF) and Mortality Risk:

• Overview of a 2018 JAMA study on CRF and all-cause mortality.
• Findings showing a strong linear inverse relationship between CRF levels and mortality rates.
• The importance of maintaining high fitness levels for reducing mortality risk.
• Insights on the impact of fitness at different periods of life, including midlife and later

[17:05] Strength Training Benefits:

• Analysis of a 2022 meta-analysis on muscle-strengthening activities and health outcomes.
• Discussion on the critical role of muscle strength in longevity and overall health.
• Practical advice for incorporating muscle-strengthening activities into daily routines.

[22:17] Practical Tips and Closing Remarks:

Episode Links:

• BMJ Study on Physical Activity
• JAMA Study on Cardiorespiratory Fitness
• CRF in Early Adulthood and Midlife
• Long-Term Change in CRF and Mortality
• Midlife CRF and Cancer Outcomes
• CRF and Dementia Benefits
• Br J Sports Med Strength Meta-Analysis
• Muscle Strength & Mortality

If you enjoyed this episode, please share it with your colleagues, friends, and patients! Subscribe here to "What's the Proof?" on YouTube for video content, and stay updated with the latest episodes! Share your thoughts and questions with us on Twitter @theproofpodcast or email us at whatstheproofpodcast@gmail.com.

Credits:

• Hosts: Bobby Scott, MD, FAAFP, DABFM; Sandy Robertson, PharmD; Dawn Caviness, MD, BSN, DABFM
• Production & Cover Art: Bobby Scott, MD, FAAFP, DABFM
• Music: Twisterium, MondayHopes, Muzaproduction, and SergeQuadrado from Pixabay

In this episode of "What's the Proof?" we delve into non-hormonal therapies for menopausal vasomotor symptoms (VMS), commonly known as hot flashes and night sweats. Hormone replacement therapy (HRT) is the most effective treatment for VMS, but it isn't suitable for everyone. Join Bobby, Dawn, and Sandy as they explore alternative treatment options for women who cannot or choose not to use HRT. From lifestyle interventions and mind-body techniques to dietary supplements and prescription medications, we break down the latest evidence and provide practical advice for managing these disruptive symptoms. Whether you're a clinician seeking to expand your treatment toolkit or a patient looking for more information, this episode offers valuable insights into improving quality of life during menopause.

Episode Highlights:

[00:00] Introduction and Overview:

• Welcome and episode introduction by Bobby, Dawn, and Sandy.
• Discussion on the significance of VMS during menopause and the limitations of hormone replacement therapy.
  

[05:50] Lifestyle Interventions

• Discussion on general health benefits and specific interventions like cooling techniques, avoiding triggers, and yoga.
• Evidence review showing limited effectiveness of these methods for reducing VMS.

[10:42] Mind-Body Techniques

• Examination of Cognitive-Behavioral Therapy (CBT) and its promising results for VMS management.
• Insights into clinical hypnosis as a potential therapy.
• Brief discussion on mindfulness and paced breathing, highlighting the lack of substantial evidence for VMS relief.

[17:05] Dietary Supplements

• Analysis of the mixed results for soy products and black cohosh.
• Summary of current recommendations against these supplements due to limited efficacy.
  

[19:52] Acupuncture

• Discussion on the effectiveness of acupuncture versus sham acupuncture.
• Conclusion that acupuncture is not recommended for VMS treatment based on current evidence.
  

[21:00] Prescription Medications

• Review of SSRIs, SNRIs, and gabapentin, discussing their varying degrees of effectiveness.
• Introduction to fezolinetant (Veozah), a new neurokinin B antagonist with promising results but higher costs.
• Practical advice on prescribing these medications and considerations for patient-specific factors.
  

[40:00] Practical Tips and Closing Remarks

Tune in to learn:

• The specific non-hormonal options available for VMS and their effectiveness based on recent studies.
• Practical tips for incorporating these alternatives into clinical practice.
• Personal insights from our hosts on managing VMS without hormones.

Episode Links:

• NAMS Position Statement
• MsFLASH Pooled Analysis

If you liked this episode, please share it with your colleagues, friends, and patients! Subscribe here to "What's the Proof?" on YouTube for video content, and stay updated with the latest episodes! Share your thoughts and questions with us on Twitter @theproofpodcast or email whatstheproofpodcast@gmail.com.

Credits:

• Hosts: Bobby Scott, MD, FAAFP, DABFM; Sandy Robertson, PharmD; Dawn Caviness, MD, BSN, DABFM
• Production & Cover Art: Bobby Scott, MD, FAAFP, DABFM
• Music: Twisterium, MondayHopes, Muzaproduction, and SergeQuadrado from Pixabay

The ASCVD Risk Estimator is OUT and PREVENT is IN! Join us on this episode of 'What's the Proof?' where hosts Bobby Scott and Sandy Robertson explore the American Heart Association's revolutionary PREVENT calculator. This new tool not only replaces outdated risk calculators but also introduces the comprehensive Cardiovascular-Kidney-Metabolic (CKM) Syndrome framework, aimed at transforming the approach to cardiovascular disease prevention. Delve into how this innovative calculator incorporates a broader range of health determinants to assess cardiovascular risk more accurately and inclusively. We'll break down how to use the PREVENT calculator, discuss its impact on clinical practice, and illustrate its application with a case example. This episode is essential for clinicians striving to enhance their understanding of cardiovascular risk assessment and eager to apply these insights into their everyday clinical decision-making.

Episode Highlights:

• Introduction to PREVENT: Discover how the American Heart Association's new PREVENT calculator is set to replace the Pooled Cohort Equations for assessing cardiovascular risk - 03:32
• History of Risk Assessment Tools: Dive into the evolution of cardiovascular disease risk assessment tools from the Framingham score to the latest PREVENT calculator - 04:25
• Understanding Cardiovascular-Kidney-Metabolic (CKM) Syndrome: Explore how the AHA's new disease framework integrates heart, kidney, and metabolic health into a unified risk assessment and management approach - 07:42
• Case Example Discussion: Follow a detailed walkthrough of a case illustrating how the PREVENT calculator and CKM staging can guide clinical decisions - 11:20
• Comprehensive Risk Assessment with PREVENT: Explore the features of the PREVENT calculator, which assesses cardiovascular, heart failure, and composite CVD risks using not just traditional health factors like blood pressure and cholesterol, but also innovative elements such as the urine albumin-creatinine ratio and the social deprivation index based on patient's zip code - 14:29
• Future Directions and Clinical Implementation: Discuss the potential changes in clinical guidelines and practices with the integration of the PREVENT tool in cardiovascular disease prevention strategies - 19:22

Episode Links:

• PREVENT Online Calculator
• AHA Scientific Statement
• Development/Validation Study

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Comments/Questions/Suggestions? Email us at whatstheproofpodcast@gmail.com or find us on X @theproofpodcast!

Credits:

• Hosts: Bobby Scott, MD, FAAFP, DABFM; Sandy Robertson, PharmD; Dawn Caviness, MD, BSN, DABFM
• Production & Cover Art: Bobby Scott, MD, FAAFP, DABFM
• Music: Twisterium, MondayHopes, Muzaproduction, and SergeQuadrado from Pixabay